|
At the same time,
an
Austrian scientist named Dr.
Hans Asperger made similar observations,
although his name has since become attached to a
different higher-functioning form of autism known as
Asperger syndrome. Widespread recognition of
Asperger's work was delayed by
World War II in
Germany, and by his seminal paper not being
translated into English for almost 50 years. The
majority of his work was not widely read until 1997.[20]
Autism and Asperger's
Syndrome are today listed in the
DSM-IV-TR as two of the five
pervasive developmental disorders
(PDD), which
also include
Childhood disintegrative disorder,[21][22]
Rett syndrome[23]
and
Pervasive Developmental Disorder Not Otherwise
Specified (or atypical autism). Health care
providers also refer to
autism spectrum disorders (ASD) which includes
only three of those listed in PDD: Autistic
disorder, Asperger syndrome, Pervasive Developmental
Disorder Not Otherwise Specified.[24]
All of these conditions are characterized by varying
degrees of deficiencies in
communication skills and social interactions,
along with restricted, repetitive, and stereotyped
patterns of
behavior.
Characteristics of Autism
On the surface,
individuals who have autism are physically
indistinguishable from those without. Some studies
show that autistic children tend to have larger head
circumferences[25][26]
but the significance in the disorder is unclear.
Sometimes autism co-occurs with other disorders, and
in those cases outward differences may be apparent.
Individuals
diagnosed with autism can vary greatly in skills and
behaviors, and their response to sensory input shows
marked differences in a number of ways from that of
other people. Certain
stimulations, such as sounds, lights, and touch,
will often affect someone with autism differently
than someone without, and the degree to which the
sensory system is affected can vary greatly from one
individual to another.[27]
Key
behaviors and Difficulties in Diagnosis
Autistic children may
display unusual behaviors or fail to display
expected behaviors. Normal behaviors may develop at
the appropriate age and then disappear or,
conversely, are delayed and develop quite some time
after normal occurrence. In assessing
developmental delays, different physicians may not
always arrive at the same conclusions. Much of this
difference between diagnosis is due to the disputed
criteria for autism.[28]
Deciding how a child should behave is also difficult
because diagnostic tests have to be objective, which
is not a simple thing to accomplish.
Because of this,
practitioners and researchers in
pediatrics,
child psychology,
behavior analysis, and
child development are always looking for early
indicators of autism.
|

A young boy
with autism, and the precise line of
toys he made. |
The diagnosis of autism
must meet specific criterion but there are also many
characteristics that are idiosyncratic. Thus, Autism
is not a "one size fits all" label. In other words
the
spectrum disorder encompasses a very wide range
of behaviors and symptoms.
Some behaviors
cited by the National Institute of Child Health and
Human Development (listed below) may simply mean a
normal delay in one or more areas of development,
while others are more typical of ASDs—Autistic
Spectrum Disorders.
The list below is
not all-inclusive, and generally applies to children
and not adults. Furthermore, while some of these
behaviors might be seen in a person with autism,
others may be absent.
|
Noted Behaviors in Autistic Children
-
Stares into open
areas, doesn't focus on anything specific.
-
Does not respond to
his/her name.
-
Cannot explain what
he/she wants.
-
Language skills are
slow to develop or speech is delayed.
-
Does not follow
directions.
-
Will fuss if didn't
get what wanted.
-
At times, the child
seems to be deaf.
-
Seems to hear
sometimes, but not other times.
-
Doesn't point or
wave "bye-bye."
-
Doesn't understand
the concept of pointing; will look at the hand
pointing rather than the object being pointed
at.
-
Used to say a few
words or babble, but now he/she doesn't.
-
Throws intense or
violent tantrums.
-
Has odd movement
patterns.
-
Likes to spin around
in a circle.
-
Likes being in a
place well known.
-
Hands on ears often.
-
Is overly active,
uncooperative, or resistant.
-
Doesn't know how to
play with toys.
-
Doesn't smile when
smiled at.
-
Has poor eye
contact.
-
Gets "stuck" doing
the same things over and over and can't move on
to other things.
-
Seems to prefer to
play alone.
-
Gets things for
him/herself only.
-
Is very independent
for his/her age.
-
Does things "early"
compared to other children.
-
Seems to be in
his/her "own world."
-
Seems to tune people
out.
-
Is not interested in
other children.
-
Dislikes playing
pretend.
-
Walks on his/her
toes.
-
Shows unusual
attachments to toys, objects, or schedules
(i.e., always holding a string or having to put
socks on before pants).
-
Spends a lot of time
stacking objects, lining things up or putting
things in a certain order.
-
Unconcerned about -
or completely oblivious to - dangers around
him/her (i.e., standing in the middle of the
street without worrying about getting hit by a
car).
Social development
Typically developing
infants respond socially and will look at faces or
orient towards voices. In contrast, most autistic
children show little interest in faces and must
learn to engage in social interaction. Even in the
first few months of life, many autistic children
seem indifferent to other people, lacking the eye
contact and interaction with others that
non-autistic children exhibit naturally.
Some infants with
autism may appear very calm and may cry less often
or fail to seek
parental attention.
Other children may
develop normally for the first two years of life,
but then regress unexpectedly and fail to pass
developmental milestones without intervention
[31].
Autistic children often
seem to prefer being alone and may passively accept
such things as hugs and cuddling without
reciprocating, or resist attention altogether.
Later, they seldom seek
comfort from others or respond to parents' displays
of
anger or
affection in a typical way.
Research has suggested
that, despite popular belief, many autistic children
have bonded with their parents - and anecdotal
evidence certainly supports this notion. However,
this bond may be difficult for others to recognize
because an autistic child's particular ways of
expressing this attachment may differ from the
patterns of expression used by their typical peers.
Though social deficits
are common, autistic children may vary significantly
in their levels of social attachment and
interaction.
According to
Simon Baron-Cohen et al (1985),[32]
many autistic children appear to lack a "theory
of mind". Theory of mind refers to representing
epistemic mental states such as knowing, believing,
deceiving or imagining, and tying them together
"into a coherent understanding of how mental states
and actions are related."[33]
This is a behavior cited as being exclusive to human
beings above the age of five and possibly, to a
lesser degree, to other higher
primates.[34]
Typical 5-year-olds can usually develop insights
into other people's knowledge, feelings, and
intentions based on social cues (e.g., gestures,
vocal tone and
facial expressions). An autistic individual may
lack these interpretation skills, leaving them
unable to predict or understand other people's
actions or intentions.
Many children with
autism experience
social alienation during their school-age years.
As a response to this, or perhaps because their
social surroundings simply do not "fit" them,
many
report inventing
imaginary friends, worlds, or scenarios.[35]
Making friends in real life and maintaining those
friendships often proves to be difficult for those
with autism.
Sensory System and Ability
Indicators of autism
include oversensitivity or under reactivity to
touch, movement, sights, or sounds; physical
clumsiness or carelessness; poor body awareness; a
tendency to be easily distracted; impulsive physical
or verbal behavior; an activity level that is
unusually high or low; not unwinding or calming
oneself; difficulty learning new movements;
difficulty in making transitions from one situation
to another; social and/or emotional problems; delays
in
speech,
language or
motor skills; specific learning
difficulties/delays in academic achievement.
However, it is important to remember that while most
people with autism have some degree of sensory
integration difficulty, not every person who has
sensory problems is autistic.
Autistic
individuals may sometimes also develop obsessions or
routines around foods, restricting what is eaten to
certain colors, textures or types of food;
alternatively they may obsessively avoid certain
foods with similar characteristics.[36]
One common example
is autistic
hearing. An autistic person may have trouble
hearing certain people while other people are
perceived as speaking at a higher volume. Or the
autistic person may be unable to filter out sounds
in certain situations, such as in a large crowd of
people. However, this is perhaps a part of autism
that tends to vary widely from person to person, so
these examples may not apply to every autistic
person. Note that such auditory difficulties fall
under auditory processing disorders, and like
sensory integration dysfunction, are not necessarily
experienced by all people with autism or indicative
of a diagnosis of autism.
Autism and Blindness
The
characteristics of a person with both an Autism
Spectrum Disorder (ASD) and a severe visual
impairment (VI) may vary from a person with just ASD
or just VI.[37]
Historically, many behaviors of blind children were
seen as "autistic-like" but were attributed to their
blindness rather than pursuing possibilities of
autism.[38]
Developmental
trajectories of children with ASD-VI are often very
similar as those followed by children with typical
autism, but the child with ASD-VI will have
particularly unusual responses to sensory
information. The person may be overly sensitive to
touch or sound, or be less responsive to pain.
Typically, touch, smell, and sound are affected the
most dramatically.[39]
Communication Difficulties Associated with Autism
Some people with
autism demonstrate advanced cognitive ability, but
lack communicative skills or are not inclined to
interact with others socially. An example of this is
the noted autistic
Temple Grandin, who holds a PhD and is a
successful developer of livestock handling
technologies. She describes her inability to
understand the social communication of neurotypicals
as leaving her feeling "like an anthropologist on
Mars." Grandin's case was described by neurologist
Oliver Sacks in his 1995 book titled
An Anthropologist on Mars: Seven Paradoxical Tales.
Another person with extreme autism is author Tito Mukhopadhyay, one of whose books is The Mind Tree.[40]
Perhaps due to
their difficulties communicating with other humans,
some autistics have gravitated toward working with
animals. Temple Grandin describes her observations
and theories about animals, taken from her work with
cattle.[41]
Dawn Prince-Hughes, diagnosed with Asperger's,
describes her observations of gorillas in Songs
of the Gorilla Nation.[42]
Some infants who later
show signs of autism coo and babble during the first
few months of life, but stop soon afterwards. Others
may be delayed, developing language as late as the
teenage years.
Still, inability to
speak does not mean that people with autism are
unintelligent or unaware. Once given appropriate
accommodations, some will happily converse for
hours, and can often be found in online
chat rooms, discussion boards or
websites and even using communication devices at
autism-community social events such as
Autreat.
Sometimes, the body
language of people with autism can be difficult for
other people to understand. Facial expressions,
movements, and gestures may be easily understood by
some other people with autism, but do not match
those used by other people. Also, their tone of
voice has a much more subtle inflection in
reflecting their feelings, and the
auditory system of a person without autism often
cannot sense the fluctuations. What seems to
non-autistic people like odd
prosody; things like a high-pitched, sing-song,
or flat,
robot-like voice may be common in autistic
children and some will have combinations of these
prosody issues. Some autistic children with
relatively good language skills speak like little
adults, rather than communicating at their current
age level, which is one of the things that can lead
to problems.
Since non-autistic
people are often unfamiliar with the autistic
body language, and since autistic natural
language may not tend towards speech, autistic
people often struggle to let other people know what
they need. As anybody might do in such a situation,
they may scream in frustration or resort to grabbing
what they want. While waiting for non-autistic
people to learn to communicate with them, people
with autism do whatever they can to get through to
them. Communication difficulties may contribute to
autistic people becoming socially anxious or
depressed or prone to self-injurious behaviors.
Recently, with the awareness that those with autism
can have more than one condition, a significant
percentage of people with autism are being diagnosed
with co-morbid mood, anxiety and compulsive
disorders which may also contribute to behavioral
and functioning challenges.
Repetitive Behaviors
Although people
with autism usually appear physically normal,
unusual repetitive motions, known as
self-stimulation or "stimming,"
may set them apart. These behaviors might be extreme
or subtle. Some children and older individuals spend
a lot of time repeatedly flapping their arms or
wiggling their toes, others suddenly freeze in
position. Some spend hours arranging objects in a
certain way rather than engaging in pretend play as
a typical child might, and becoming agitated if they
are re-arranged or moved.
Repetitive behaviors can
also extend into the spoken word;
perseveration of a single word or phrase can
also become a part of the child's daily routine.
Some may repeat words from
movies and watch certain bits over and over
again.[43][44]
Autistic children may demand consistency in their
environment. A slight change in the timing, format
or route of a routine or trip can be extremely
disturbing to them. Autistics sometimes
have persistent, intense preoccupations. For
example, the child might be obsessed with learning
all about
computers,
television programs,
lighthouses or virtually any other topic.[45]
Autism and
Education
Children with autism are
affected by their symptoms every day, which set them
apart from unaffected students. Because of problems
with
receptive language and
theory of mind, they can have difficulty
understanding some classroom directions and
instruction, along with subtle vocal and facial cues
of teachers. This inability to fully decipher the
world around them often makes education stressful.
Teachers need to be aware of a student's disorder,
and ideally should have specific training in autism
education, so that they are able to help the student
get the best out of his or her classroom
experiences.
Some students learn more
effectively with visual aids as they are better able
to understand material presented visually. Because
of this, many teachers create “visual schedules” for
their autistic students. This allows students to
concretely see what is going on throughout the day,
so they know what to prepare for and what activity
they will be doing next. Some autistic children have
trouble going from one activity to the next, so this
visual schedule can help to reduce stress.
Research has shown that
working in pairs may be beneficial to autistic
children.[46]
Autistic students have problems not only with
language and communication, but with socialization
as well. By facilitating peer interaction, teachers
can help their students with autism make friends,
which in turn can help them cope with problems or
understand the world around them. This can help them
to become more integrated into the mainstream
environment of the classroom.
A teacher's aide can
also be useful to the student. The aide is able to
give more elaborate directions that the teacher may
not have time to explain to the autistic child and
can help the child to stay at an equivalent level to
the rest of the class through the special one-on-one
instruction. However, some argue that students with
one-on-one aides may become overly dependent on the
help, thus leading to difficulty with independence
later on.
There are many different
techniques that teachers can use to assist their
students. A teacher needs to become familiar with
the child’s disorder to know what will work best
with that particular child. Every child is going to
be different and teachers have to be able to adjust
with every one of them.
DSM
Definition of Autism
Autism is defined in
section 299.00 of the
Diagnostic and Statistical Manual of Mental
Disorders (DSM-IV) as:
-
A total of six (or
more) items from (1), (2) and (3), with at least
two from (1), and one each from (2) and (3):
-
Qualitative
impairment in social interaction, as
manifested by at least two of the following:
-
marked
impairment in the use of multiple
nonverbal behaviors such as eye-to-eye
gaze, facial expression, body postures,
and gestures to regulate social
interaction
-
failure to
develop peer relationships appropriate
to developmental level
-
a lack of
spontaneous seeking to share enjoyment,
interests, or achievements with other
people (e.g., by a lack of showing,
bringing, or pointing out objects of
interest)
-
lack of
social or emotional reciprocity
-
Qualitative
impairments in communication as manifested
by at least one of the following:
-
delay in, or
total lack of, the development of spoken
language (not accompanied by an attempt
to compensate through alternative modes
of communication such as gesture or
mime)
-
in
individuals with adequate speech, marked
impairment in the ability to initiate or
sustain a conversation with others
-
stereotyped
and repetitive use of language or
idiosyncratic language
-
lack of
varied, spontaneous make-believe play or
social imitative play appropriate to
developmental level
-
Restricted
repetitive and stereotyped patterns of
behavior, interests, and activities, as
manifested by at least one of the following:
-
encompassing
preoccupation with one or more
stereotyped and restricted patterns of
interest that is abnormal either in
intensity or focus
-
apparently
inflexible adherence to specific,
nonfunctional routines or rituals
-
stereotyped
and repetitive motor mannerisms (e.g.,
hand or finger flapping or twisting, or
complex whole-body movements)
-
persistent
preoccupation with parts of objects
-
Delays or abnormal
functioning in at least one of the following
areas, with onset prior to age 3 years:
-
social
interaction
-
language as used
in social communication
-
symbolic or
imaginative play.
-
The disturbance is
not better accounted for by
Rett's Disorder or
Childhood Disintegrative Disorder.
These are rules of thumb
and may not necessarily apply to all diagnosed
autistics.
Types of Autism: Low Functioning versus High
Functioning
Autism presents in
a wide degree, from those who are nearly
dysfunctional and apparently
mentally disabled to those whose symptoms are
mild or remedied enough to appear unexceptional
("normal") to others. Although not used or accepted
by professionals or within the literature, autistic
individuals are often divided into those with an
IQ<80 referred to as having "low-functioning
autism" (LFA), while those with IQ>80 are referred
to as having "high-functioning autism" (HFA).[47]
Low and high functioning are more generally applied
to how well an individual can accomplish activities
of daily living, rather than to
IQ. The terms low and high functioning are
controversial and not all autistics accept these
labels. Additionally, a recent review questioned the
validity of IQ testing of autistic people.[48]
This discrepancy can
lead to confusion among service providers who equate
IQ with functioning and may refuse to serve high-IQ
autistic people who are severely compromised in
their ability to perform daily living tasks, or may
fail to recognize the intellectual potential of many
autistic people who are considered LFA. For example,
some professionals refuse to recognize autistics who
can speak or write as being autistic at all, because
they still think of autism as a communication
disorder so severe that no speech or writing is
possible.
Asperger's and Kanner's Syndromes
|
|
In the current
Diagnostic and Statistical Manual of Mental
Disorders (DSM-IV-TR), the most significant
difference between Autistic Disorder (also known as
Kanner's syndrome) and Asperger's syndrome is that a
diagnosis of the former includes the observation of
"delays or abnormal functioning in at least one of
the following areas, with onset prior to age 3
years: (1) social interaction, (2) language as used
in social communication, or (3) symbolic or
imaginative play",[49]
while a diagnosis of Asperger's syndrome observes
"no clinically significant delay" in the latter two
of these areas.[50]
While the DSM-IV does
not include level of intellectual functioning in the
diagnosis, the fact that those with Asperger's
syndrome tend to perform better than those with
Kanner's autism has produced a popular conception
that
Asperger's syndrome is synonymous with
"higher-functioning autism", or that it is a lesser
disorder than autism. Similarly, there is a
popular conception that autistic individuals with a
high level of intellectual functioning in fact have
Asperger's syndrome, or that both types are merely 'geeks'
with a medical label.
The popular depiction of
autism in the media has been of relatively severe
cases (for example, as seen in the films
Rain Man and
Mercury Rising), and in turn many close
friends and relatives of those who have been
diagnosed in the autistic spectrum choose to speak
of their loved ones as having Asperger's syndrome
rather than autism.
|
The extent to
which someone with higher functioning autism or
Asperger's syndrome may excel is theoretically quite
high. For example,
Henry Cavendish, one of history's foremost
scientists, may have been autistic.
George Wilson, a notable chemist and physician,
wrote a book about Cavendish entitled, "The Life
of the Honourable Henry Cavendish", published in
1851. From Wilson's detailed description it seems
that while Cavendish may have exhibited many classic
signs of autism, he nevertheless had an
extraordinary mind.[51]
Autism as a Spectrum Disorder
Another view of these
disorders is that they are on a continuum known as
autistic spectrum disorders. Autism spectrum
disorder is an increasingly popular term that refers
to a broad definition of autism including the
classic form of the disorder as well as closely
related conditions such as PDD-NOS and Asperger's
syndrome. Although the classic form of autism can be
easily distinguished from other forms of autism
spectrum disorder, the terms are often used
interchangeably.
A related continuum,
Sensory Integration Dysfunction, involves how
well humans integrate the information they receive
from their senses. Autism, Asperger's syndrome, and
Sensory Integration Dysfunction are all closely
related and overlap.
Some people believe that
there might be two manifestations of classical
autism,
regressive autism
and
early infantile autism.
Early infantile autism
is present at birth while regressive autism begins
before the age of 3 and often around 18 months.
Although this causes some controversy over when the
neurological differences involved in autism truly
begin, some speculate that an environmental
influence or toxin triggers the disorder. This
triggering could occur during gestation due to a
toxin that enters the mother's body and is
transferred to the fetus. The triggering could also
occur after birth during the crucial early nervous
system development of the child.
A paper published in
2006 concerning the behavioral, cognitive, and
genetic bases of autism argues that autism should
perhaps not be seen as a single disorder, but rather
as a set of distinct symptoms (social difficulties,
communicative difficulties and repetitive behaviors)
that have their own distinct causes.[52]
An implication of this would be that a search for a
"cure" for autism is unlikely to succeed if it is
not examined as separate, albeit overlapping and
commonly co-occurring, disorders.
Gender
Differences
There is not a
clear-cut ratio of incidence between males and
females. Studies have found much higher prevalence
in males at the high-functioning end of the
spectrum, while the ratios appear to be closer to
1:1 at the low-functioning end.[53]
In addition, a study published in 2006 suggested
that males over 40 are more likely than younger
males to parent a child with autism, and that the
ratio of autism incidence in males and females is
closer to 1:1 with older fathers.[54][55]
Reported
Increase In Number of Cases
There
was a worldwide increase in reported cases of autism
over the decade to 2006. There are several theories
about the apparent sudden increase.
Many
epidemiologists argue that the rise in the incidence
of autism in the United States is largely
attributable to a broadening of the diagnostic
concept, reclassifications, public
awareness, and the incentive to receive federally
mandated services.[56]
However, some authors indicate that the existence of
an as yet unidentified contributing environmental
risk factor cannot be ruled out.[57]
On
the other hand, a widely-cited pilot study conducted
in California by the UC Davis M.I.N.D. Institute (17
October
2002), reported that the increase in
autism in California
is real, even after accounting for changes to
diagnostic criteria.[58]
The question of
whether the rise in incidence is real or an artifact
of improved diagnosis and a broader concept of
autism remains controversial. Dr. Chris Johnson, a
professor of pediatrics at the University of Texas
Health Sciences Center at
San Antonio and co-chair of the
American Academy of Pediatrics Autism Expert
Panel, sums up the state of the issue by saying,
"There is a chance we're seeing a true rise, but
right now I do not think anybody can answer that
question for sure." (Newsweek
reference below).[59]
The answer to this
question has significant ramifications on the
direction of research, since a real increase would
focus more attention (and research funding) on the
search for environmental factors, while the
alternative would focus more attention to genetics.
On the other hand, it is conceivable that certain
environmental factors (such as chemicals,
infections, medicines,
vaccines, diet and societal changes) may have a
particular impact on people with a specific genetic
constitution.
The Geek Syndrome
One of the more popular
theories is that there is a connection between "geekdom"
and autism. This is hinted, for instance, by a
Wired Magazine article in 2001 entitled "The
Geek Syndrome", which is a point argued by many
in the autism rights movement.[60]
This article, many professionals assert, is just one
example of the media's application of mental disease
labels to what is actually variant normal
behavior—they argue that shyness, lack of athletic
ability or social skills, and intellectual
interests, even when they seem unusual to others,
are not in themselves signs of autism or Asperger's
syndrome. Others assert that children who in the
past would have simply been accepted as a little
different or even labeled 'gifted' are now being
labeled with mental disease diagnoses. See
clinomorphism for further discussion of this
issue.
Due to the recent
publicity surrounding autism and autistic spectrum
disorders, an increasing number of adults are
choosing to seek diagnoses of high-functioning
autism or Asperger's syndrome in light of symptoms
they currently experience or experienced during
childhood. Since the cause of autism is thought to
be at least partly genetic, a proportion of these
adults seek their own diagnosis specifically as
follow-up to their children's diagnoses. Because
autism falls into the
pervasive developmental disorder category, an
individual's symptoms must have been present before
age seven in order to make a strict
differential diagnosis.
The causes and
etiology of autism are areas of debate and
controversy; there is currently no consensus, and
researchers are studying a wide range of possible
genetic and environmental causes. Since autistic
individuals are all somewhat different from one
another, there are likely multiple "causes" that
interact with each other in subtle and complex ways,
and thus give slightly differing outcomes in each
individual. Two environmental theories include the
impact of vaccines on the immune system (of which a
statistically significant link has never been found
despite many attempts).
Research claims
also link autism with abnormal blood vessel
function, and
oxidative stress. This line of research may lead
to new medical therapies.[65]
Physiology and Neurology
Autism appears to
involve a greater amount of the brain than
previously thought.[66]
A study of 112 children (56 with autism and 56
without), published in the Journal of Child
Neuropsychology, found those with autism to have
more problems with complex tasks, such as tying
their shoelaces or writing, which suggests that many
areas of the brain are involved.[67]
Children with autism performed simple tasks as well
as or better than those without. In tests of visual
and spatial skills, autistic children did well at
finding small objects in complex pictures (e.g.,
finding the character Waldo in "Where's
Waldo" pictures). However, they found it
difficult to tell the difference between
similar-looking people. Children with autism tended
to do well in spelling and grammar, but found it
much more difficult to understand complex speech,
such as idioms or similes when the meaning of the
phrase is figurative. They would, for example, not
understand that "He kicked the bucket" meant someone
had died, or were likely to actually hop if told to
"hop to it".
The inference from
this research, according to researchers at the
Pittsburgh School of Medicine, is that "These
findings show that you cannot compartmentalize
autism. It's much more complex.”[67]
The research from this
perspective has a number of implications:
-
Autism is more than
likely a global disorder which affects how the
brain processes the information it receives,
while complex information tends to make this
more readily apparent.
-
Neurological
‘wiring’ in people with autism manifest
abnormalities in the areas of the brain that
communicate with each other.
-
Observed
abnormalities provide a reasonable explanation
for why children with autism have problems with
complex tasks which require multiple areas of
the brain to work together; autistic people tend
to do better in tasks that only require one
region of the brain.
-
The causes of autism
are possibly more pervasive than previously
believed; for example, more areas of the brain
are affected than just those involving social
interaction, communication, interests, and
imagination.
-
Autism may not be
primarily a disorder of social interaction;
research must now take into account non-social
aspects.
A possible explanation
for the characteristics of the syndrome is a
variation in the way the brain itself reacts to
sensory input and how parts of the brain then handle
the information. An electroencephalographic (EEG)
study of 36 adults (half of whom had autism) at
Washington University in St. Louis found that
adults with autism show differences in the manner in
which neural activity is coordinated. The
implication seems to be that there is poor internal
communication between different areas of the brain.
(Electroencephalographs,
or EEGs, measure the activity of brain cells.)
The study
indicated that there were abnormal patterns in the
way the brain cells were connected in the
temporal lobe of the brain. (The temporal lobe
deals with language.) These abnormal patterns would
seem to indicate inefficient and inconsistent
communication inside the brain of autistic people.[68]
Studies in
neuropathology[69]
indicate abnormalities in the
amygdala,
hippocampus,
septum,
mamillary bodies,
limbic system,and the
cerebellum.
-
Autistic brains are
slightly larger and heavier and a larger than
normal head circumference is commonly noted.
-
In the limbic
system, there is an excess of cells and they are
too small. The neurons themselves appear to be
underdeveloped. Dendritic trees which provide
the basis for connections between neurons are
truncated (i.e. shortened).
-
In the cerebellum,
purkinje cells are widely affected. The
anatomic differences correlate to the
curtailment of development earlier than 30 weeks
gestation. In other words, the development of
the cells appears to have stopped at some time
before the 30th week in utero
-
An enlarged
third ventricle of the brain appears to
accompany autism in those who are non-mentally
retarded, but the reasons for this and its
effects are still unknown.[70]
Research has not
yet established exactly what is specific to autism
and what may be seen in other disorders however.[71]
Individuals with
autism are also far more likely to develop
epilepsy than would otherwise be expected
(estimated 10-30% incidence).
[72]
Autistic Savants
The autistic savant
phenomenon is sometimes seen in autistic people.
Estimates of the prevalence of this phenomenon range
between 1% and 10%.[98]
The term is used to describe a person who is
autistic and has extreme talent in a certain area of
study. Although there is a common association
between savants and autism (an association made
especially popular by the 1988 film
Rain Man), most autistic people are not
savants and savantism is not unique to autistic
people, though there does seem to be some relation.[99]
Mental calculators and fast
computer programming skills are the most common
form. A well known example is
Daniel Tammet, the subject of the
documentary film
The Brain Man[100]
(Kim
Peek, one of the inspirations for
Dustin Hoffman's character in the film Rain
Man, is not autistic). Bright Splinters of
the Mind by Beate Hermelin is a book that
explores this issue further.
Notes
-
^
Diagnostic Criteria for Autistic Disorder
Indiana Resource Center for Autism, Indiana
Institute on Disability and Community,
Indiana University. Retrieved Feb. 27, 2007
-
^
[1] ICD version 2006, World Health
Organisation Codes for Pervasive
developmental disorders, F84.0-F84.9,
retrieved 20 January, 2007
-
^
more commonly known as the DSM-IV-TR, i.e.
the fourth edition with text revision.
Relevant DSM codes are: 307.9 Communication
Disorder Not Otherwise Specified, Pervasive
Developmental Disorders, 299.00 Autistic
Disorder, 299.80 Rett's Disorder, 299.10
Childhood Disintegrative Disorder, 299.80
Asperger's Disorder, 299.80 Pervasive
Developmental Disorder Not Otherwise
Specified (Including Atypical Autism),
Attention-Deficit and Disruptive Behavior
Disorders, Attention-Deficit/Hyperactivity
Disorder
-
^
American Psychiatric Association Diagnostic
and Statistical Manual of Mental Disorders
(American Psychiatric Association,
Washington, DC, 1994)
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Harmon, Amy. "How About not Curing Us?
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