What is Autism / Autistic Spectrum Disorder (ASD) / Aspergers syndrome / (AS) High Functioning Autism and Pervasive Developmental Disorder (PDD)?
There is much confusion around the terms used for the condition of Autism, you may be told that you, your child/young person or adult has Autism, Autistic spectrum disorder, Aspergers syndrome, High functioning Autism and PDD.
All these terms relate to the condition of Autism.
ASD, AS, High functioning Autism and PDD are all a group of disorders with similar features related to the condition of Autism.
Autism is a lifelong developmental disorder of the brain. This means that when the brain was maturing pre natal, it did not develop biologically, physiologically or emotionally as normal.
Autism is a consistent pattern of abilities, disabilities and behaviour that affects a personsí ability to understand the world around them as we know it.
What are the traits associated with Autism/ ASD?
Those with Autism are said to have difficulties in 3 areas of their lives which are called the TRIAD of IMPAIRMENTS these affect a persons
∑ Social interaction
Autism/ASD is a lifelong condition, there is no cure
How and to what extent each person will be affected by their Autism/ASD is individual to that person, NO two people with Autism/ASD are the same.
Life experiences can influence how much a person with the condition of Autism/ASD can overcome some of these traits/difficulties, but it can also exasperate their condition.
Communication difficulties associated with Autism/ASD.
Poor understanding of what is being said / Misunderstanding what is being said to them
They will express only their needs
They have a literal understanding of the spoken word
Talking at you, rather than to you
Talking incessantly on own subject regardless of the response of others.
Difficulty understanding others points of view
Asking repetitive questions
Inability to read between the lines of what people mean
Absence of the desire to communicate
Uninterested in the points of views of others
Echolalia (repeating what is said, mimicking speech or accents and or behaviours of others)
Difficulty generalising situations
Difficulty initiating conversations and sustaining conversations
Difficulty understanding sarcasm (but can use sarcasm on others)
Making factual comments irrelevant to the conversation
Difficulty understanding the differences between reality and pretend; also what is true and untrue, which can make those with Autism vulnerable to abuse from society.
Imagination difficulties associated with Autism/ASD
Limited ability to play with toys or items imaginatively e.g. preferring to play with the wheels of a toy car rather; than rolling them across a floor. Lining up cars, teddy bears, or watching the same DVD repeatedly.
Difficulty with understanding time; and or difficulty with time management.
Difficulty predicting what may happen at a social occasion, such as at a birthday party, Christmas, school day/ school holidays etc.
Difficulty comprehending how their behaviour; or their actions may affect others.
A preference for facts and figures
Difficulty talking or thinking on non specific subjects i.e. small talk.
Difficulty coping with change, need for order and routine any change from the normal routine can cause anxiety and panic as the person with autism cannot imagine what will happen when this stability is taken away.
Social interaction difficulties associated with Autism/ASD
Difficulty understanding how to interact appropriately with other people
Difficulty understanding facial expressions and gestures
Difficulty giving eye to eye contact
Difficulty understanding what is expected of them within a social situation
Difficulty understanding what is appropriate physical contact (the person with Autism may inappropriately touch others; but may not like any physical contact by others, or may like light touch or firm touch).
Inability to recognise personal space of others
Difficulty understanding the need to interact in different ways with family members, friends, people they are acquainted with and strangers.
Difficulty making and sustaining relationships
Difficulty with Empathy, this could relate to understanding another personís circumstances and or the feelings of others, and or the motives of others.
What is Autism disorder?
What they call (Classic) Autism is named after the psychiatrist Leo Kanner who first recognised Autistic disorder as a condition in children, and wrote books on this behaviour in the early 1930ís.
Kannerís Autism is nearly always accompanied by a severe learning disability, which is an academic I.Q. under 70.
Kanner wrote that those with Autism disorder have -
∑ An inability to relate to people and situations from birth
∑ An inability or preference not to use language to communicate
∑ A need for routines
∑ A fascination with objects, special interests.
What is Autistic Spectrum Disorder (ASD) Aspergers syndrome?
Autistic Spectrum Disorder is the term which is used to refer to a range of disorders on the Autistic spectrum called Aspergers Syndrome, pervasive developmental disorder and childhood disintegrative disorder.
Those with Autistic spectrum disorder (ASD) can have a range of intelligential ability ranging from a Mensa I.Q. well above the population average, right through the scale to severe learning disability.
Those with ASD would ask
What appears natural to us may mean the opposite to someone with ASD.
Signs of Autistic spectrum disorder
∑ Social impairment and extreme egocentricity
∑ Speech & Language peculiarities
∑ Repetitive routines
∑ Narrow interests/special interests
∑ Difficulties understanding NON verbal gestures
∑ Motor clumsiness
These identified behaviours can be considered as a signpost to the diagnoses of Autism/ASD.
We must also point out that some children with ASD can hide the above symptoms until they reach post primary school due to the fear of being different. However parents need not feel they have failed to pick up their childís difficulties because they are so subtle and complex; and many of us parents have been duped or thought their child was individual, or just a little eccentric.
Itís during the diagnostic process the psychologist will assess the childís or persons social and emotional abilities, their communication skills, the cognitive skills, special interests, and also their movement skills and sensory difficulties.
Social and emotional abilities
Individuals with ASD have difficulties in the following areas
∑ A need for routine and structure
∑ They are resistant to change
∑ They are inflexible and misunderstand social rules especially when they apply to themselves.
∑ They have a difficulty coping with social demands and situations (having little understanding of what is expected of them from family, friends and society).
∑ They have a literal understanding of language and can correct people on their misuse of language.
∑ They can lack tact
∑ They can be unable or are naive at finding the appropriate help and understanding
∑ They have repetitive and ritualistic activities/special interests.
∑ Suffer from severe anxiety, which can lead to self harm, depression, lack of self worth and lack of acceptance of their difficulties.
∑ They are very vulnerable to teasing, bullying, and are a target from people who would take advantage.
∑ They have a poor ability to manage their emotions and lack the ability to understand theirs and otherís emotions.
∑ They can suffer from frustration at their own difficulties or in explaining those difficulties to others.
∑ They have an inability to organise themselves; this can be related to cooking, cleaning, course work for school /college etc.
∑ They lack the ability to problem solve in true life situations.
∑ They can have poor sleeping routines, poor toileting routines, and poor diets.
This list is not exhaustive and the above is meant only as a guide
Those with ASD are gathers of facts and would only read books that are related to their special interests i.e. Star Trek, Dr. Who, dinosaurs etc.
They have exceptional long term memory but poor short term memory abilities.
They have obsessive special interests and will collect items related to that special interest, becoming encyclopaedias on that special interest.
They have difficulty coping with changes to their daily routine which can cause high anxiety.
They can develop routines that must be completed and adhered too or once again can suffer anxiety attacks i.e. washing of hands, wetting of hair, lining up books and or toys.
When walking or running they suffer from an odd gait and would often bump into door frames, radiators, chairs etc. and often have poor hand to eye co ordination i.e. problems with writing and eating.
People with Autism/ASD would have great difficulty with all of their senses.
They can hear every sound within a shopping mall i.e. talking, walking, music, escalators, tills, etc all at the same time causing complete sensory overload.
They have sensitivity to bright lights, colours, shadows and flashing colours. In some with the condition the above is fascinating and compulsive to watch, and in others it would cause frustration, anger and anxiety.
The taste and textures of certain foods can cause immediate retching and choking which means they often have a limited diet. Some are tube fed or will only eat baby food due to their inability to cope with certain types of food.
There are those with Autism/ ASD who cannot bear to be touched, others like firm touch and some like light touch. It is extremely important for those working with people with Autism/ASD to ascertain which touch is appropriate to that person, as mistakes can lead to violent reactions. They can be over or under sensitive to touch.
The most expensive perfumes can smell like cats urine, as they have an over sensitive sense of smell.
It is very important that we understand that although people with Autism/ASD experience similar difficulties related to their condition this does not mean that they are not as individual as you and I are; and can differ according to the support they get or have received.
What is high functioning Autism?
There is much confusion around this diagnosis as clinically there is very little difference between High functioning Autism and Aspergers syndrome. It is thought that those who are given a diagnosis of High functioning autism have had no difficulties with language delay and have average or above average intelligent /I.Q.ís. Otherwise those diagnosed with high functioning Autism show the triad of impairments/ difficulties with social interaction, communication and imagination, which is explained under the heading of Autistic Spectrum Disorder ASD.
What is PDD?
PDD stands for Pervasive Developmental Disorder and is the broader term sometimes used by health care professionals to describe Autism, Autistic spectrum disorder, Aspergers syndrome, high functioning autism.
What is PDD-NOS?
PDD-NOS standís for Pervasive Developmental Disorder Not Otherwise Specified.
This term was first used in the early 1980ís for children who show some of the behavioural characteristics of Autism /ASD but do not meet the full clinical criteria for a diagnosis of Autism/ASD.
A child/young person can be given a diagnosis of PDD-NOS but as the child/young person develops they can be re-diagnosed with Autism/ASD.
Conditions that may also be associated with Autism/ASD/ Aspergers syndrome.
According to research carried out by the National Autistic Society in 2011, 71% of those with autism also have a dual diagnosis. Conditions which are more commonly seen are
Obsessive compulsive disorder (OCD)
Oppositional defiance disorder (ODD)
Attention deficit disorder (ADD)
Hyper motility syndrome