Autism: Back to Basics

A high school student recently called to interview me for a research project on Autism. Our conversation led me to reflect on how beneficial it can be to take a step back and look at the basics of what we know about autism. Those of us in the field of special education for some time can, at times, forget that there are individuals who may not be familiar with autism. Autism can become such an integral part of our lives that it can be helpful to take a step back and look at the basics of what we know with a fresh perspective.

What is Autism?

The definition changes as we learn more through research and diagnosis models are debated and published. In the United States, and in other parts of the world, the Diagnostic and Statistical Manual, Fifth Edition (DSM-5) is the guidebook for diagnosis. The International Classification of Diseases (ICD-10) is used for insurance codes and is the primary diagnosis guide internationally, particularly in Europe. The basic criteria to receive a diagnosis of an Autism Spectrum Disorder, according to the DSM-5, is that an individual must demonstrate both:

– Deficits in social communication and social interaction, and

– Restricted and repetitive patterns of behavior, interests, or activities

The full text of DSM-5 diagnostic criteria can be found here. This new diagnosis groups together several diagnoses that were previously separated in the DSM-IV, Autistic Disorder, Asperger’s Disorder, Childhood Disintegrative Disorder, and Pervasive Development Disorder. Recent reports from the U.S. Centers for Disease Control and Prevention (CDC) state that 1 in 68 children have an Autism Spectrum Disorder. The rate is higher in boys, with 1 out of 42 receiving a diagnosis.

What Causes Autism?

This is the million dollar question that I am often asked in public when I tell people what I do. In fact, millions of dollars are spent trying to find the answer to this question. What we do know is that there is a difference in the brain of individuals with autism. Research has, also, found that there are many different types of autism and how it is manifested. Autism, truly, is a spectrum of disorders. Most professionals agree that there is a genetic component with autism that may be brought out or worsened by environmental influences. Possible influences may be pesticide use and air pollution. Many researchers believe that individuals with autism may be more sensitive to toxic influences. Research has not supported the theory that vaccines cause autism. Additional research is ongoing into possible causes of autism.

How do we treat Autism?

There is no known cure for autism, however, there are numerous treatment strategies that have shown a positive effect. It is important to remember that there are, not only, many types of autism, there are a number of treatments that may be effective. Parents and professionals need to find the most effective treatments for the particular individual. One thing is for certain. Early intervention is a critical factor to improved outcomes. One does not need to wait for a diagnosis to begin addressing the needs of the child.  Treatment may include speech and language therapy, therapy to address sensory needs, occupational and/or physical therapy, and behavioral therapy among others. The Autism Society of America discusses treatment options on their site.  Additional information regarding treatment can be found with Autism Speaks and WebMD.

Important points to remember

Many individuals with autism have difficulty with anxiety and processing sensory information. What may come across as unusual behavior, or even a complete melt down, may actually be a self-coping strategy to handle the situation. Approximately half of individuals with autism are known to wander. At times, the wandering may be due to the anxiety or sensory overload. Helping the individual learn to recognize the beginning stages of anxiety and sensory needs, developing coping strategies, as well as creating a supportive environment are all recommended interventions.

There are numerous medical concerns that are more prevalent in autism. Approximately half of children with autism have some type of GI disorder. Seizure disorders are more common and sleep disturbances are quite prevalent.

Most importantly, in my opinion, do not underestimate the potential of any individual with a disability. I am not suggesting that we push our students to the point of frustration and breakdown, but we do need to have high expectations. As stated previously, there is a wide spectrum of individuals with autism. Some will become high achieving adults who will share their gifts with the world. Others may be dependent on the care of others throughout their lives. Never underestimate what the individual will be capable of achieving. If possible, assist them in finding a way to channel their interests and strengths into a future profession. Teach them to be independent and to self-advocate appropriately for their needs. Show them examples of successful individuals with autism such as Dr. Temple Grandin and Dr. Stephen Shore as positive role models.  Celebrate their strengths and teach methods to help mitigate their weaknesses.

Written by: Michelle Killian, Director of IBCCES.  The International Board of Credentialing and Continuing Education Standards (IBCCES) was established to meet the credentialing needs of professionals who work with individuals with special needs. In 2001, IBCCES first established the industry standards for a Certified Autism Specialist. Each year these standards are reviewed and updated by our board of industry professionals, including BCBAs, researchers from leading universities, state level Special Education Directors, and industry leaders, as well as clinicians in the fields of mental health, Speech and Language Pathology, School Psychology, and Occupational Therapy. Parents of children with special needs are also represented on our board. Our Certified Autism Specialist standards are now used by organizations all over the world to ensure the highest quality of care and training for professionals in the field of Autism.

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