2. Definition
• Autism is a disorder of neural development characterized by impaired
social interaction and communication, and by restricted and repetitive
behavior.
• Autism affects information processing in the brain by altering how nerve
cells and their synapses connect and organize; how this occurs is not well
understood
• Parents usually notice signs in the first two years of their child's life.
The signs usually develop gradually, but some autistic children first
develop more normally and then regress
• The cause of autism is not known. Autism lasts throughout a
person's lifetime. There is no cure, but treatment can help.
Treatments include behavior and communication therapies and
medicines to control symptoms.
• Autism is just one of five different types of Autism disorders.
3. What is Autism?
Autism is classified by the American Psychiatric
Association as a Pervasive Developmental Disorder (APA,
1994). It is defined by symptoms appearing before the age
of three, which reflect delayed or abnormal development
in three areas:
• Language Development - doesn’t understand or say many words,
repeats things (“echoes”) or uses the third person.
• Social Skills - not interested in peers, no imitative play, poor eye
contact, doesn’t respond when spoken to, doesn’t show/point to
things.
• Behavioral Repertoire - repetitively plays with objects in a specific
way or insists that things be done the same way or engages in self
stimulatory actions such as hand flapping, staring at hands or
fingers or smelling things.
• Many children with autism are also mentally retarded, but the
presence and severity of specific symptoms and degree of mental
retardation is quite variable. Aside from sharing problems in the
above areas, children with autism are quite different from each
other. Some are affectionate, some do have pretend play, some
speak fairly well, and some do very little self-stimulating.
4. Types of Autism Disorders
There are in total five different types of autism disorders :
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• Classic autism : Develop language late, or not at all;profound lack
of affection or emotional contact with others; an intense wish for
sameness in routines, muteness or abnormality of speech; high
levels of Visio-spatial skills, but major learning difficulties in other
areas.
• Asperger’s syndrome : Deficiencies in social skill ; difficulties
with transitions or changes;cling to rituals and any changes in their
routine can upset them; difficulty reading body language and
determining proper body space; reduced sensitivity to pain ;
increased sensitivity to bright lights and loud noises ;have average
or above-average intelligence.
5. • Childhood Disintegrative Disorder : Severe regression in
communication skills, social behavior, and all developmental motor
skills;start to regress at between ages 2-4 years;stop socializing, lose
potty-training skills, stop playing, lose motor skills and stop making
friends
• Rett Syndrome :neurological and developmental disorder ;mostly
occurs in females ; marked by poor head growth; Loss of muscle ;
problems crawling or walking ; diminished eye contac;develop
stereotyped hand movements, ;The inability to perform motor
• Pervasive Developmental Disorder-Not Otherwise
Specified : This tends to describe people who have many or all of the
different types of Autism disorders. Children with PDDNOS either do
not fully meet the criteria of symptoms used to diagnose any of the four
specific types above, and/or do not have the degree of impairment
described in any of the above four specific types.
7. Social Development
• Lack the intuition about others that many people take for granted
• Do not understand social conversations / situations
• Infant stage : Autistic infants show less attention to social stimuli,
smile and look at others less often, and respond less to their own
name
• Toddler stage : Autistic toddlers differ more strikingly from social
norms; for example, they have less eye contact and turn taking, and
are more likely to communicate by manipulating another person's
hand
• Children stage : likely to exhibit social understanding, approach
others spontaneously, imitate and respond to emotions,
communicate nonverbally, and take turns with others.Form
attachments to their primary caregivers
• Older children / Adults : Perform worse on tests of face and emotion
recognition.
8. Communication
• About a third to a half of individuals with autism do not develop
enough natural speech to meet their daily communication needs
• 1st year : Differences in communication may be present from the
first year of life, and may include delayed onset of babbling, unusual
gestures, diminished responsiveness, and vocal patterns that are not
synchronized with the caregiver
• 2nd to 3rd year : Less frequent and less diverse babbling, consonants,
words, and word combinations; their gestures are less often
integrated with words
• Echolalia (repeating others’ words),
• Consistently fail to point at objects in order to comment on or share
an experience
• Perform poorly at complex language tasks such as figurative
language, comprehension and inference.
9. Repetitive Behaviour
Repetitive Behavior Scale-Revised (RBS-R)
• Stereotypy : repetitive movement, such as hand flapping, making
sounds, head rolling, or body rocking.
• Compulsive behavior : intended and appears to follow rules, such as
arranging objects in stacks or lines.
• Sameness : resistance to change; for example, insisting that the
furniture not be moved or refusing to be interrupted.
• Ritualistic behavior : involves an unvarying pattern of daily
activities, such as an unchanging menu or a dressing ritual. This is
closely associated with sameness and an independent validation has
suggested combining the two factors.
• Restricted behavior : limited in focus, interest, or activity, such as
preoccupation with a single television program, toy, or game.
• Self-injury : includes movements that injure or can injure the person,
such as eye poking, skin picking, hand biting, and head banging
10. Other S&S
• Some show superior skills in perception and attention
• splinter skills such as the memorization of trivia
• under-responsivity (e.g. walking into things)
14. Management of Autism
Early intervention often can reduce challenges associated
with the disorder, lessen disruptive behavior, and provide
some degree of independence.
• Occupational therapy helps improve independent function and
teaches basic skills (e.g., buttoning a shirt, bathing).
• Physical therapy involves using exercise and other physical
measures (e.g., massage, heat) to help patients control body
movements
• Communication Therapy : Communication therapy is used to
treat autistic patients who are unable to communicate verbally, or to
initiate language development in young children with the disorder.
• Picture exchange communication systems (PECS) enable
autistic patients to communicate using pictures that represent ideas,
activities, or items. The patient is able to convey requests, needs,
and desires to others by simply handing them a picture.
• Speech therapy may be used to help patients gain the ability to
speak
15. • Sensory integration therapy is a type of behavior modification
that focuses on helping autistic patients cope with sensory
stimulation. Treatment may include having the patient handle
materials with different textures or listen to different sounds
• Behavior modification often involves highly structured, skill-
oriented activities that are based on the patient's needs and
interests. It usually requires intense, one-on-one training with a
therapist and extensive caregiver involvement.
• Play therapy is a type of behavior modification that is used to
improve emotional development, which in turn, improves social
skills and learning. Play therapy involves adult-child interaction that
is controlled by the child.
• Dietary modifications is controversial. Studies have shown that
vitamin B, magnesium (improves the effects of vitamin B), and cod
liver oil supplements (which contain vitamins A and D) may
improve behavior, eye contact, attention span, and learning in
autistic patients. Vitamin C has been shown to improve depression
and lessen the severity of symptoms in patients with autism.
16. Prognosis of Autism
• No cure is known.
• Children recover occasionally.this occurs sometimes after intensive
treatment and sometimes not.
• It is not known how often recovery happens
• Most children with autism lack social support, meaningful
relationships, future employment opportunities or self-
determination.Although core difficulties tend to persist, symptoms
often become less severe with age
• Acquiring language before age six, having an IQ above 50, and
having a marketable skill all predict better outcomes.
• Independent living is unlikely with severe autistic patients.
• Patients with autism have normal life expectancies. With early
intervention and appropriate treatment, some autistic patients can
function productively and attain some degree of independence.
Most patients require lifelong assistance.