April 2021 Autism Awareness Month Becomes Autism Acceptance Month
This year the Autism Society chose the “Celebrate Differences” campaign for the Autism Awareness month. They would like to offer a better awareness of the signs, symptoms and realities of autism. Their focus is to provide more information and resources to communities to help us become more aware of autism as well as promote acceptance and help become more inclusive in everyday life. Thus the decision to change to Autism Acceptance Month.
Autism is a very complex disability that impacts a person’s social skills, communication skills, self-regulation skills and relationship skills throughout their life. Because autism is complex it is a “spectrum condition” that affects people in different ways and in varying degrees.
According to the Autism Society, the prevalence of autism in the United States has risen from 1 in 125 children in 2010 to 1 in 54 in 2020. This increase has inspired the Autism Society to increase awareness about autism including the signs and symptoms of the disability to offering information and resources for the community.
Their goal is to inform and encourage communities to celebrate the differences in those with autism as well as teach the communities how to become more inclusive of individuals with autism.
There is no known cause of autism, early diagnosis can be beneficial in helping a person receive the total support and services they will need throughout their life. This can help them lead a more happy and productive life.
The DSM-V characterizes Autism as:
Persistent differences in communication, interpersonal relationships, and social interaction across different environments.
This can look like a person being nonverbal or having atypical speech patterns. The person may have trouble understanding nonverbal cues and communication. They may have difficulty making friendships and keeping friendships. They may have difficulty with typical back and forth small talk or conversations. They may also have a hard time making eye contact.
The person may also have restricted or repetitive behavior, certain patterns, specific activities and interests. This could look like repeating sounds or phrases. They could have repetitive movements, click a pen continuously. They may prefer the sameness and have a difficult time with transition or making changes in a routine. They are rigid or restricted and intense with their interests. They may have extreme sensitivity to various sensory stimuli.
To learn more about the diagnosis click this link: https://www.autism-society.org/what-is/diagnosis/
The CDC (Centers for Disease Control and Prevention) created and submitted their ADDM autism prevalence report in 2018. The numbers are astonishing. The report showed that the prevalence of autism rose to twice as much from the 2004 report. It is now reporting 1 in every 59 people are being diagnosed with autism and in 2004 it was 1 in 125.
Autism isn’t impacting just one race or ethnicity, it is affecting all of us. One of the reports did let the CDC know that more white children are being diagnosed than black or Hispanic children. What this could mean is that these children do not have access to healthcare services for a proper diagnosis and thus cannot receive the services they need to be their full potential.
What they have found is that boys are 4.5 times more likely to have an autism diagnosis than girls. However, they also discovered that girls are not showing the same symptoms as boys and it may go undiagnosed due to that variable.
All research has shown that the earlier the diagnosis, the better opportunity for an improved quality of life. The CDC has an amazing link to help you learn the signs and milestones on the developmental scale for your autistic child: https://www.cdc.gov/ncbddd/actearly/index.html
Here are some signs to keep in mind:
· Atypical nonverbal communication: avoiding eye contact, few facial expressions, monotone.
· Speaks later than typical or not at all (nonverbal)
· Repeats words or sounds. Flaps hands, nods head, repeats movements.
· Becomes distressed by changes in routines, foods, schedule or transition from one thing to another.
· Prefers solitary play rather than engaging in cooperative play with other children.
· Prefers predictable, structured play over any make-believe or spontaneous play.
· Strong interest in a specific topic, toy or item that they cannot part with.
To learn more about autism at every age click on this amazing link: https://www.autism-society.org/living-with-autism/autism-through-the-lifespan/
Researchers are not finding one single cause for autism spectrum disorder, but they have found that it is caused by abnormalities in the brain structure and functioning of the brain. After reviewing brain scans they can see the differences in the shape and structure of the brains in those with autism compared to neurotypical children (NT). The researchers theorize that there are links between heredity, genetics and medical problems.
Some research has shown a pattern of autism and related disabilities, making it seem that the genetic theory has a great connection. Researchers continue to search for irregular segments of genetic code that those with autism may have inherited. Some are also born with susceptibility to autism, but the researchers haven’t been able to identify what that “trigger” could be to cause autism to develop.
Another set of research has revolved around the possibility that under certain conditions a cluster of genes become unstable and may interfere with the brain’s development. This instability will result in an autism diagnosis. More researchers are looking at any factors during pregnancy, deliver or environmental factors like viral infections, dangerous chemical exposure or any metabolic imbalances or if harmful substances were ingested during pregnancy.
Research has also shown that there are more prevalent diagnosis from those also suffering from certain medical conditions: tuberous sclerosis, untreated phenylketonuria (PKU), fragile X syndrome and congenital rubella syndrome.
Sometimes there may be multiple diagnosis depending on other intellectual disabilities, sensory processing issues or problems with hearing and vision. Having the autism diagnosis as well as the other diagnosis will help provide the proper treatments for all areas the person will need support. Many with an autism diagnosis can also have a sensory processing disorder, oppositional defiant disorder, attention deficit disorder and/or attention deficit hyperactivity disorder.
A medical diagnosis is done by a psychologist based on the DSM-5 of the American Psychiatric Association. The manual will guide the physician in diagnosing autism spectrum disorder using the specific number of symptoms.
The levels are such:
ASD level 1
Level 1 is the mildest form of autism. Those with level 1 may have a heard time communicating properly with others. They may not be able to read social cues, say the right thing at the right time or read body language appropriately.
They can usually speak in full sentences and communicate, but may have a hard time with eye contact, going back and forth with a conversation. They may make some friends, but it is hard.
They may also be inflexible in some ways and have issues transitioning from one activity to another. They may have issues with planning and over organization that can prevent them from being independent.
ASD level 2
Those with level 2 will have more problems with verbal communication and social skills. They may find it more difficult to change focus and become quite upset when they have to change from one activity to another, for example, leaving home in the morning or leaving school at the end of the day or even shopping in one area of the store to the next.
Those with level 2 diagnosis tend to have repetitive behaviors and narrow interests which can make it difficult for them to perform in certain situations appropriately.
ASD level 3
Those with a level 3 diagnosis have the most severe form of autism. Those in this category will have many of the same behaviors as level 1 and level 2 but to a more extreme degree. They may have problems expressing themselves verbally and non-verbally. They will have difficulty interacting socially, have trouble functioning appropriately and will have an extremely hard time changing focus, location or task. Most with level 3 diagnosis will engage in repetitive behaviors and have a very limited ability to speak intelligibly and rarely interact initiate interactions. Interactions may be awkward and they will only respond to those who have direct approaches to them.
You may have heard the term Asperger’s syndrome or Asperger’s Disorder. Dr. Hans Asperger first observed autism-like behaviors and social difficulties in boys who had normal intelligence and language development in the 1940’s. Many believe that Asperger’s is a milder form of autism and used the term, “high-functioning autism” to describe these children. Asperger’s Disorder was added to the DSM-IV in 1994 as a separate disorder from autism. Many professionals and researchers believe that it is a less sever form of autism and that these individuals would be able to live a more normal life with a job, family and friendships. In 2013, the DSM-IV replaced Autistic Disorder, Asperger’s Disorder and other developmental disorders with a diagnosis of autism spectrum disorder (ASD).
Those with Asperger’s may have good language and vocabulary as well as cognitive skills and less severe symptoms of a typical autistic person. To the untrained observer, the person with Asperger’s may seem like a neurotypical person. Those with an Asperger’s diagnosis will not seem aloof or uninterested. Usually they want to fit in and have interactions with others, but are a bit awkward in doing so. They may not understand social cues or how to do small talk or even show empathy. They may have limited eye contact, not understand sarcasm, joking or seem unengaged in conversations or school projects when they have taken in all the information and could explain to you exactly what was described in a learning lesson even though it seemed they were not paying attention.
Asperger’s children will like to collect categories of things. My son loved dinosaurs and collected all the types. He currently has an amazing collection of stuffed animals of all types, one of each, like Noah’s Ark. They may research and know information on one specific topic and have good rote memory skills but can struggle with abstract concepts.
Asperger’s children do not have a language delay, in fact, they have an elevated vocabulary and excellent language skills. They may lack inflection or have a rhythmic nature. They may come off as too formal, too loud or too high pitched. Those with Asperger’s may not understand irony, humor, or understand the give-and-take of an ongoing conversation and could walk away in the middle of a conversation. They may be clumsy or have delays in learning motor skills and come off as awkward.
Another distinction between Asperger’s Disorder and autism lingers around cognitive ability. Someone with Asperger’s Disorder cannot have a “clinically significant” cognitive delay. Someone with autism can have this type of diagnosis along with the autism diagnosis. Most with Asperger’s Diagnosis have average to above-average intelligence.
In recent years there has been an increase of Asperger’s Disorder diagnosis. It is unclear as to why but it is clear that more professionals are detecting it. The first step in diagnosing Asperger’s is an assessment including a developmental history and observation. This should be done by a medical professional experienced with autism. The early diagnosis is best to help with support and services to create a timeline of growth and development. Being diagnosed early on will have an increased chance of being successful in school and being able to live independently as an adult.
To learn more about Asperger’s resources or support groups click this link: https://www.autism-society.org/about-the-autism-society/contact-us/
The ASD levels are useful for where one falls on the spectrum with regard to severity they can be very limited and subjective when it comes to the type of support that the person may need. Some need more help at school than at home. They may need more support at home but do very well at school. The person may also shift in levels through their lifetime. As they grow, mature (mind and body) and receive assistance with social skills they may see anxiety, depression and other issues decrease. The levels will help in determining the types of services they will need, but it will not predict for the nuances in personality and behavior changes that could take place. All services and support will become personalized and can change from year to year.
If you have concern or questions about your child and their developmental course, turn to your pediatrician and ask for a referral for a psychologist or another medical professional for support.
Autism CARES Act Reauthorization (2019) https://www.autism-society.org/public-policy/autism-cares-act-reauthorization-2019/