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In the world of Autism, one size fits no one. As the popular phrase suggests, if you have met one person with Autism, you have met one person with Autism.  Autism is a neurobiological development disorder that manifests in children before the age of three. Autism is a set of neurological differences that is diagnosed behaviorally. Scientists believe that in all likelihood there are many different neurological disorders that make up Autism and that eventually subsets of Autism will be found. Some things that are considered Autism today may not be considered Autism in the future. This is congruent with the history of Autism in the United States. 

 

Currently Autism is defined in the Diagnostic and Statistical Manual 5th edition (DSM-V) of the American Psychological Association (APA). Today there is one diagnosis of Autism Spectrum Disorder which  is broken into three subsets: Autism level 1, Autism level 2, and Autism level 

A person is considered to have Autism Spectrum Disorder level 1 “Requiring support” if, 

 

Without supports in place, deficits in social communication cause noticeable impairments. Difficulty initiating social interactions, and clear examples of atypical or unsuccessful response to social overtures of others. May appear to have decreased interest in social interactions. For example, a person who is able to speak in full sentences and engages in communication but whose to- and-fro conversation with others fails, and whose attempts to make friends are odd and typically unsuccessful. 

 

Inflexibility of behavior causes significant interference with functioning in one or more contexts. Difficulty switching between activities. Problems of organization and planning hamper independence

 

A person is considered to have Autism Spectrum Disorder level 2 “Requiring substantial support” if:

Marked deficits in verbal and nonverbal social communication skills; social impairments apparent even with supports in place; limited initiation of social interactions; and reduced or  abnormal responses to social overtures from others. For example, a person who speaks simple sentences, whose interaction is limited to narrow special interests, and has markedly odd nonverbal communication.

 

Inflexibility of behavior, difficulty coping with change, or other restricted/repetitive behaviors appear frequently enough to be obvious to the casual observer and interfere with functioning in  a variety of contexts. Distress and/or difficulty changing focus or action.

 

A person is considered to have Autism Spectrum Disorder level 3 “Requiring very substantial support” if:

 

Severe deficits in verbal and nonverbal social communication skills cause severe impairments in functioning, very limited initiation of social interactions, and minimal response to social overtures from others. For example, a person with few words of intelligible speech who rarely initiates interaction and, when he or she does, makes unusual approaches to meet needs only and responds to only very direct social approaches. 

 

Inflexibility of behavior, extreme difficulty coping with change, or other restricted/repetitive behaviors markedly interfere with functioning in all spheres. Great distress/difficulty changing focus or action.

 

Many people with Autism also have other co-morbid conditions so it is usually specified as to whether the diagnosis is with or without intellectual impairment, language impairment, catatonia, and hyperactivity.

This is a lot of information to digest. In practical terms, let’s look at what Autism is and what being a spectrum means. 

As stated earlier everyone with Autism is different. Some children with Autism are very articulate and some are nonverbal. Some are extremely intellectually gifted and some children had profound learning challenges. Some children love numbers and letters. Some children enjoy spinning wheels on cars.  Some children are sensory seeking and love hugs. Some children are sensory avoiders and detest them. 

Here are what all children with Autism have in common.

All children with Autism have deficits in social skills, communications skill, and the presence of some form of stereotypy. All three of these things must be present for a person to receive a diagnosis of Autism. 

Examples of communication skills include but are not limited to:

  1. Language development
  2. Communicating with the use of gestures
  3. Communicating with eye contact 

Examples of social skills include but are not limited to:

  1. Smile at caregiver
  2. Looking where a caregiver points
  3. Pointing out objects to caregiving
  4. Imitating the actions of others

Examples of stereotypy include but are not limited to:

  1. Hand flapping
  2. Rocking back and forth
  3. Lining up objects
  4. Looking at objects from the corner of the eye
  5. Preoccupations with numbers and letters
  6. Repetitive vocalizations

References

Diagnostic and Statistical Manual of Mental Disorders: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA: American Psychiatric Association, 2013

 

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