What is Autism Spectrum Disorder (ASD)?
For diagnostic purposes in North America, this category of disorders is currently identified as Pervasive Developmental Disorders or PDD (1994, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, American Psychiatric Association). More currently, PDD has been placed under the term Autism Spectrum Disorder or ASD. Thus, when professionals or parents are referring to different types of autism, often they are distinguishing autism from one of the other spectrum disorders that includes PDD.
There is no standard “type” or “typical” person with ASD. Parents may hear different terms used to describe children within this spectrum, such as: autistic-like, autistic tendencies, autism spectrum, and high-functioning or low-functioning autism. However, individuals who fall under the Autism Spectrum Disorder exhibit commonalties in communication, social, and sensory deficits yet differ in terms of severity, number of symptoms, or age of onset.
The umbrella term ASD includes the following diagnoses:
- Autism – impairments in communication, social interaction, imaginative play, and stereotyped behaviours, interests, and activities, prior to age 3 years.
- Pervasive Developmental Disorder (PDD)
- commonly referred to as atypical autism, a diagnosis of PDD may be made when a child does not meet the criteria for a specific diagnosis but there is a severe impairment in specified behaviours.
- Asperger’s Syndrome – impairments in social interactions and the presence of restricted interests and activities, with no clinically significant general delay in language, and testing in the range of average to above average intelligence.
- Childhood Disintegrative Disorder – characterized by normal development for at least the first 2 years, followed by a significant loss of previously- acquired skills.
Although a single specific cause of autism is not known, current research links autism to biological or neurological differences in the brain. In many families there appears to be a pattern of autism or related disabilities. This suggests there is a genetic basis to the disorder, although at this time no gene has been directly linked to autism. The genetic basis is believed by researchers to be highly complex and probably involves several genes in combination.
How is it manifested?
Autism is the result of a neurological disorder that affects the functioning of the brain. Autism is a spectrum disorder. In other words, the symptoms and characteristics of autism can present themselves in a wide variety of combinations, from mild to severe. Two children, both with the same diagnosis, can act very differently from one another and have varying skills.
Children within the ASD often appear relatively typical in their development until the age of 24-30 months. At that time parents may notice delays in language, play, or social interaction. Any of the following delays, by themselves, would not result in a diagnosis of an ASD. Autism is a combination of several developmental challenges.
There are a few common traits associated with all ASD’s.
- impaired communication e.g., language develops slowly or not at all; words are used without attaching the usual meaning to them; gestures are used in place of words; echolalia (repeating spoken language) is present; non-functional language or repetitive “scripted” language is present
- problems with social relationships and play skills e.g., time is spent alone rather than with others; little interest is shown in making friends; less responsive to social cues such as eye contact or smiles; little or no eye contact is exhibited; physical social contact (hugs, holding hands, etc.) is craved or avoided; there is a lack of spontaneous or imaginative play; poor motor- imitation skills; short attention span
- engagement in stereotypical/repetitive behaviours e.g., lining up toys; spinning/rocking the body; hand-flapping/flicking; performing repetitive gross motor sequences; overactive or very passive; tantrumming for no apparent reason; showing obsessive interest in a single item, idea, activity or person; showing difficulty with changes in routine
- sensory impairment e.g., may have sensitivities in the areas of sight, hearing, touch, smell, and taste to a greater or lesser degree
Contrary to popular understanding, many children with ASD may make eye contact, show affection, smile and laugh, and demonstrate a variety of other emotions, although in varying degrees. Like other children, they respond to their environment in both positive and negative ways. ASD may affect their range of responses and make it more difficult to control how their bodies and minds react. Sometimes visual, motor, and/or processing problems make it difficult to maintain eye contact with others (some individuals with ASD use peripheral vision rather than looking directly at others). Sometimes the touch or closeness of others may be painful to a person with ASD, resulting in withdrawal even from family members. Anxiety, fear, and confusion may result from being unable to “make sense” of the world in a routine way.
Every person with ASD is an individual, and like all individuals, has a unique personality and combination of characteristics. There are great differences among people with ASD. Some mildly affected individuals may exhibit only slight delays in language and experience greater challenges with social interactions. The individual may have difficulty initiating and/or sustaining a conversation. Communication is often described as talking at others (for example, monologue on a favorite subject that continues despite attempts of others to interject comments). People with ASD process and respond to external and internal information in unique ways.
Who is affected?
ASD is four times more prevalent in boys than in girls.
ASD and its associated behaviours have been estimated to occur in as many as 1 in 500 individuals.
How is ASD diagnosed or detected?
There are no medical tests for diagnosing autism. An accurate diagnosis must be based on observation of the individual’s communication, behaviour, and developmental levels. Because many of the behaviours associated with autism are shared by other disorders, various medical tests may be ordered to rule out or identify other possible causes of the symptoms.
The characteristics of the disorder vary so much that a child should be evaluated by a multidisciplinary team which may include a neurologist, psychologist, developmental pediatrician, speech language pathologist, learning consultant, or other professionals knowledgeable about ASD. Diagnosis is difficult for a practitioner with limited training or exposure and is sometimes missed by well-meaning professionals. Difficulties in the recognition and acknowledgment of ASD often lead to a lack of services to meet the complex needs of individuals with these disorders.
There is no “template” for a quick diagnosis. To obtain a true picture of an individual’s abilities and behaviours, parental and/or caregivers input and developmental history are very important. Some persons with ASD may appear to have a cognitive impairment, a behaviour disorder, problems with hearing, or even odd and eccentric behaviour.
An accurate diagnosis and early identification can provide the basis for building an appropriate and effective educational and intervention program.
Community Resource Directory for Children and Adolescents with Autism Spectrum Disorders (ASD) and their families in Toronto
The Community Resource Directory is a comprehensive listing of agencies in Toronto that provide a variety of services to children and adolescents with autism and their families. http://www.surreyplace.on.ca/resources-publications?id=121
Community Resource Directory for Adults with Autism Spectrum Disorders (ASD) and their Families in Toronto
The Community Resource Directory is a comprehensive listing of agencies in Toronto that provide a variety of services to adults with autism and their families http://www.surreyplace.on.ca/resources-publications?id=121
Geneva Centre for Autism
Geneva Centre for Autism is a multi-service agency providing direct clinical services to families living in the Greater Toronto Area (including Peel, Halton, Simcoe and York Regions). They also provide information, resources, consultation, and training services to individuals with Autism Spectrum Disorders (ASD), parents, service providers, educators and other professionals across Ontario, Canada and internationally.
Autism Society Ontario (ASO)
ASO is dedicated to increasing public awareness about autism and the day-to-day issues faced by individuals with autism, their families, and the professionals with whom they interact.
Special Needs Opportunity Windows
The Special Needs Opportunity Windows or SNOW Project is a provider of online resources and professional development opportunities for educators and parents of students with special needs.
Online Asperger Syndrome Information and Support
Information and links about Asperger Syndrome are available at this site.
A web site providing activities to promote independence in children and adults with special learning needs.
Parentbooks offers the most comprehensive selection of resources available anywhere – from planning a family, to everyday parenting issues, to special needs of all kinds. It also has a selection of resources for caregivers, counsellors, therapists, educators, and clinicians.
The content contained in this document is for general information purposes. It is not the intention to diagnose or treat a child.