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Autistic Disorder (Autism)

Autistic Disorder is a developmental disorder, which means that the symptoms become noticeable very early-on in life and reflect a problem with normal cognitive development. To be diagnosed with this condition, there must be evidence by age 3 of delays or abnormal functioning in at least one of the following areas:

  • social interaction
  • language as used in social communication
  • symbolic or imaginative play

A diagnosis of Autistic Disorder also requires that an individual have at least 6 of the symptoms described below, including at least 2 symptoms from category A, and at least one symptom from both categories B and C.

A - Impairments in social interactions:
  • Problems in using nonverbal forms of communication (ie. body language) that are a basic part of how people regulate social interactions.
    • This includes eye-to-eye gaze, facial expressions, body posture, and gestures.
  • A failure to develop age-appropriate peer relationships.
  • A lack of attempts to share enjoyment, interests and achievements with other people.
    • For example, the individual will seem to have little desire in wanting to show, bring, or point-out objects of interest to others.
  • A lack of social or emotional reciprocity.
    • For example, the individual will seem uninterested in joining activities with others and will tend to prefer solitary activities. When they do interact with other people, they may tend to relate to others more as objects than as people, seeing them as instrumental aids while being oblivious to their needs, feelings, or signs of distress.

B - Impairment in language and communication:

  • A delay in, or total lack of the development of spoken language, without any attempts to compensate with nonverbal forms of communication.
  • In individuals with adequate speech, there is an inability to initiate or sustain conversations with others.
  • Speaking in ways that are odd, stereotyped, and repetitive.
    • For example, the individual may repeat certain words or phrases out of context and regardless of the meaning (parroting), may speak with an odd intonation, use awkward grammar and sentence structure, or speak in ways that are only clearly understood by those who know the individual well. Speech may sound scripted. The individual may also have trouble understanding the subtleties of certain questions or jokes.
  • A lack of age-appropriate make-believe play or social imitative play.
    • These kinds of play are common among young children, and include pretending that certain objects are something else (eg. a block is a horse), inventing elaborate make-believe stories using dolls and action-figures, or acting-out different characters in role-playing games.
C - Restricted repetitive and stereotyped behaviors, interests and activities:
  • An encompassing preoccupation with stereotyped and restricted interests that is abnormal either in intensity or focus.
    • For example, this can include collecting certain kinds of odd objects (eg. rocks, wires), amassing facts on very particular topics (eg. astronomy, meteorology), mimicking the actions of a television character, or ordering and lining up objects repetitively.
  • An inflexible adherence to very particular and nonfunctional routines or rituals.
    • This can include such things as taking exactly the same route to school everyday, eating foods of a certain color only, or making sure different foods on a plate don't touch. Individuals can become very distressed when these routines are challenged or disrupted.
  • Stereotyped and repetitive gestures and mannerisms.
    • This can include flapping and twisting movements of one's hands or fingers, body rocking and swaying, and odd postures such as walking on tiptoe.
  • Persistent preoccupation with parts of objects.
    • The individual may seem very fascinated with certain objects that move or spin, may enjoy collecting and dissecting electronics and machines, and may become very attached to certain objects like a string or rubber band.

Autistic Disorder should not be diagnosed if the individual's condition can be better accounted for by Rett's Disorder or Childhood Disintegrative Disorder.

Associated Features of Autistic Disorder

About 70% of individuals with Autistic Disorder will have mental retardation ranging anywhere from mild to profound.

Although not necessary for making the diagnosis, individuals with Autistic Disorder will often have some of the following symptoms or behaviors:

  • Hyperactivity
  • Short attention span
  • Impulsivity (acting in potentially risky or dangerous ways without thinking much about the consequences)
  • Aggressiveness
  • Temper tantrums
  • Self-injurious behaviors, including head-banging and biting one's fingers, hands or wrists.
  • Poor motor skills, incoordination, clumsiness
  • Altered responses to sensory stimuli
    • a high threshold for pain
    • oversensitivity to sounds, textures, lights, odors, or being touched
  • Abnormal eating habits
    • accepting to eat only a limited number of foods
    • eating non-edible things such as dirt or rocks
    • these abnormal eating habits may be a feature of the symptoms described in category C above.
  • Sleep problems, including frequent awakenings at night with body-rocking behaviors
  • Abnormal moods or emotional expression
    • laughing or crying for no apparent reason
    • an absence of emotional reactions when they would be expected
    • a lack of fear in response to real dangers
    • fear towards harmless objects or situations
  • Special talents, such as excellent memorization of trivia

 

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