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Definition of Autism
Facts for Families: What you should know about Autism
Autism is a developmental disorder-not a mental illness
By Alonzo Andrews, M.A. and Jeffery S. Long, Ph.D.
Autism is a disorder that perplexes parents and experts, and if not treated effectively, can be devastating to families and to the individuals themselves. Autistic-like behavior has been noted for centuries. One of the first case studies of autism occurred over two hundred years ago when a boy named Victor was found in the woods of south central France. Jean Itard, a physician who treated Victor (later labeled the Wild Boy of Aveyron) noted that the boy swayed back and forth ceaselessly bit and scratched showed no sort of affection and was indifferent to everything and attentive to nothing. In early folklore, such children were thought to have had their spirits stolen or were believed to have been abducted by fairies and replaced with unresponsive, wide-eyed duplicates.
Child psychiatrist Leo Kanner in 1943 first coined the term autism to describe eleven children who seemed socially unresponsive and uncommunicative. As research on autism has progressed, theories have shifted from early psychoanalytic belief that autism was the result of unloving and destructive parents to a more current (and less blaming) explanation of autism as a neurobiological condition that first manifests in early childhood.
The current diagnostic criteria for Autistic Disorder include a number of key symptoms and behaviors. Persons with autism show severe impairments in their ability to interact and relate to other people. They may seem severely unresponsive to others, almost as if locked in their own world. Deficits in communication are often noted. In fact, approximately one-half of autistic children have no speech. Individuals with autism also have limited interests and repetitive behaviors, such as becoming preoccupied with a particular objects or toy or engaging in odd mannerisms such as flapping their hands or spinning objects. Usually, these deficits are noted before age 3. Autism affects 4 to 5 times more males than females. Recent estimates suggest that 1 in 500 children display some sort of autism.
Autism is a heterogeneous disorder, and individuals with autism can differ widely in terms of their deficits and their skills. Approximately 85% of people with autism function at a mentally retarded level, based on intellectual estimates and daily living skills. However, because of the nature of autism, it is difficult to obtain accurate estimates of and autistic individual’s true intellectual abilities. Further, people with autism often display splinter skills, which represent remarkable abilities that are incongruous with their overall functioning. About 10% of those with autism present themselves as autistic savants, possessing extraordinary skills in the areas of music, art, mathematics, and memory. Invariably, autistic individuals have difficulty engaging in social interactions, usually seeming oblivious and disinterested in building relationships with others. Uta Frith, a leading researcher in autism, has suggested the concept of mind blindness to explain how autistic individuals display an extremely limited understanding that other people have thoughts, feelings, and intentions that are separate from them.
Current treatment of autism incorporates and integrates many factors and modalities. Traditional treatments include education and behavior management techniques. Applied behavior therapy focuses on using one-on-one interactions to build communication and social skills. Maladaptive behaviors such as self-injury and aggression are addressed by interrupting the behavior and replacing it with a more adaptive (and rewarding) behavior.
Temple Grandin, an expert who is diagnosed with autism, notes that many autism, notes that many autistic individuals think in pictures rather than words. As such, autistic individuals often respond to visual prompts, pictures, and photographs instead of verbal directions.
Autism often involves hypersensitivity or under-sensitivity to sensory information. In other words, autistic individuals may find certain sounds or light to be excruciatingly painful, whereas they may seem indifferent to experiences that would be painful for the average person. Sensory integration therapy is a type of treatment that helps autistic individuals manage and respond to sensory information in the environments more successfully.
Medication often is used to treat specific symptoms, such as compulsive behavior and aggression. The most effective treatment is to develop an understanding and supportive environment that views the autistic person as a unique, though complicated, individual, rather than merely as a disorder.
Andrews is Director of the Autistic Treatment Center in San Antonio, Texas.
Long is Director of Psychological Consultations Services at Southwest Mental Health Center in San Antonio, Texas.
From Mental Health Update, Fall 2002, published by Southwest Mental Health Center.
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