Autism Spectrum Disorder is a lifelong neurodevelopmental disorder. People living with an autism spectrum disorder will experience challenges with communication and social interactions and will display restrictive and repetitive behaviour. There are many degrees of autism, making each individual very unique. All people living with autism respond to effective intervention.
People living with autism have difficulty with communication. Some individuals may not communicate verbally. Children who do have language can be speech delayed, or may use speech inappropriately. Many are "echolalic", which means they echo, or repeat words, phrases or questions that are spoken to them. Some people with autism can use speech very well, and others have greater difficulty. This has no direct relation to their cognitive or social abilities. According to Temple Grandin, many autistics are visual thinkers, or "think in pictures". Written or spoken words can be very difficult, abstract concepts to these people. From a communication standpoint, many people with autism can have difficulty using language to make their needs known. Sometimes, people with autism use American Sign Language or PECS (a system that relies on pictures to communicate ideas) as their way of communication.
People living with autism show social differences at an early age. They may have odd or limited eye contact, they may not engage well with others, they may have trouble turn taking or understanding how others are feeling. People living with autism often have difficulty reading facial expressions and body language, consequently they may not fully understand the non-verbal messages others are sending. Temple Grandin has likened her bewilderment and lack of understanding of the social communication used by neurotypical people as if she was an ‘anthropologist on Mars’. As a result of challenges in reading and understanding verbal and non-verbal information, people living with autism may not make appropriate social interactions. They may appear socially aloof and disinterested in the world around them.
Many people with autism have a need for stability, for routine, for sameness. Making the transition between one activity and another, or changes in routines can be very difficult. The tolerance for change varies from individual to individual, with some having fewer problems to those whose rigidity can be very severe. This can be exhibited in ritualistic behaviours, like eating the same thing for lunch every day in the same order, or arranging toys and furniture for hours until it is in a desired location. Some autistic people will also develop an obsession for a particular object, or an area of knowledge. This can be everything from amassing an encyclopedic knowledge about refrigerator motors or hockey statistics, to only eating crunchy foods. There is a genuine sense of fear and anxiety when routines are upset, which can make our hectic, fast paced world a very trying place to live. Autistic people can learn to overcome some of the issues around rigidity with intervention, practice and understanding.
People with autism also interact with objects differently that those who do not have autism. Children with autism do not generally engage in the same sort of 'pretend play' with their toys that normally developing children do. For example, for a normally developing child, a large cardboard box might present a host of possibilities for play - a house, a spaceship, a car - and in the process imprint his life experiences onto that play. For a child with autism, play might involve playing with the flaps on the edge of the box, or tearing the box into strips - an activity that might provide a sensory reward.
Sensory Integration Difficulties
Sensory Integration Difficulties are often related to autistic spectrum disorders. You don't have to have autism to have sensory problems but many people with autism do have some kind of sensory issue.
What does that mean? Imagine you are sleeping. In a moment, someone turns a spotlight on your eyes, blasts a stereo in your ears, and pelts your skin with ice water. This would be frightening, painful and overwhelming. For a person with autism, this might occur when walking into a sunny room, when the phone rings or when someone shakes their hand.
Sensory issues are very individual. When an autistic child is taking what looks like a temper tantrum, it may be that they are reacting to the pain caused by bright lights of a store display, or the noise from air conditioning. For people with extreme touch sensitivities, the very act of wearing clothes can be painful. (Imagine putting a scratchy wool sweater over sun burnt skin!) To block out some of the sensory overload they experience, some people with autism 'stim'. That is, they engage in a repetitive behaviour, like rocking, tapping or hand flapping to help them calm down and feel safe in a world that can be very stressful to cope with.
About 1 in 68 children has been identified with autism spectrum disorder (ASD) according to estimates from CDC's Autism and Developmental Disabilities Monitoring (ADDM) Network (CDC website). Diagnostic criteria have been more clearly defined and broadened in recent years, and this does account for some increase in diagnosis. The apparent rise of cases is one of the many controversies surrounding autism.
The one thing scientists do know is that autism is NOT caused by bad parenting, emotional stress or "refrigerator mothers". The most recent studies suggest there is genetic component to Autistic Spectrum Disorders. However, scientists do not know if genetics is the sole factor, or if there are environmental triggers.
There is a lot of controversy about what causes Autistic Spectrum Disorders. The most controversial theory concerns vaccinations, or more specifically the addition of thimerosal, a mercury based preservative in some vaccines, including the MMR. Thimerosal has not been an additive in vaccines in Canada since 1997, and was removed from vaccines in Nova Scotia and other provinces much earlier. Several large epidemiological studies have reported no evidence to suggest a link between vaccines and ASD. Research is ongoing.
Other theories include the influence of environmental toxins or pollution. There is some speculation that individuals living with autism are more sensitive to gluten and casein, which are found in wheat and milk based products. By removing these items from the diet it is hoped there will be improvement in the autism symptoms evident in the individual. Recent studies have suggested that extraordinary brain growth in early infancy could be an indicator of autism.
Research into causation and into therapies is ongoing, and much of this work is being done in Canada.
Appropriate interventions and therapies are as individual as each person with autism. Early intervention is one of the keys to helping people with ASD manage their condition and operate more fully in society. There are a variety of interventions available to help a person living with autism, including behavioral therapies, speech therapy, communication strategies, medication, dietary changes and measures for coping with sensory issues. There is no miracle cure and no "one size fits all" approach to autism.
There are many adults with autism who feel they do not need to be "cured". They have many unique talents and abilities that can benefit others and these talents should be celebrated.