Autism

 Autism Spectrum Disorder

Today, I'd like to talk a little bit about autism spectrum disorder or autism. You'll notice that I used the term autism spectrum disorder because it is, in fact, a "spectrum." It isn't a single disorder; in fact, individuals fall on the spectrum in different ways, having different skills, abilities, and characteristics, but they all share certain things in common. We'll talk about those common features and characteristics in a moment.

Furthermore, when we talk about autism, we also often talk about pervasive developmental disorder PDD, also referred to as PDD-NOS. We talk about Asperger's syndrome, sometimes referred to as high-functioning autism, and we talk about childhood disintegrative disability or disorder, so what are some of the characteristic features predominant features of autism. 

Well, individuals who fall within this autism spectrum disorder 

1. They have difficulties in social interaction 
2. They have difficulties in communication 
3. They have difficulties in the area of behavior 

so let's look at each of those: 

Difficulties in Social Interaction 

• individuals with autism have great difficulty maintaining and establishing eye contact 
• they have difficulty reading facial expressions and their facial expressions at times are also somewhat flat and not particularly expressive 
• they have difficulties with body posture, knowing how to move their body, or moving their body in ways that end earthen socially with their peers 
• they have difficulty with emotional signals knowing when emotions are triggering certain kinds of responses, or being aware of their emotional status 
• they have difficulty in the area of reciprocity that's the give-and-take 
• those who have autism also seem not to have a shared interest in or enjoyment with others, so their experience is a very personal reflective solo kind of enjoyment that they take in the kinds of ways that they behave socially 
• they are not at all tuned in to or have difficulty tuning into the achievements of others 
• they have difficulty understanding other people's feelings, and especially when you think about young children, one of the hallmarks, early signs of autism is that they don't do that social fun, interactive kind of stuff so 

For example, playing peekaboo, you know young children went off will break off and break out into laughter because it's fun and there's a smile attached to it, and they giggle. Young children with autism tend not to do that, and they're often not comforted by touch, which can be very problematic, certainly too young families two parents and two siblings. 

Difficulty in Communication 

We talk about people with autism having difficulties both in verbal and nonverbal domains: 

• We often see a delay or lack of talk; young children with autism will sometimes begin to develop language, and then it'll properly stop. In many cases, that language never develops. 
• they have difficulties in the communication domain with taking turns, so if they say something and when they say something, it's often not in a reciprocal kind of give-and-take way 
• They often have difficulty remaining engaged in conversations; what we hear and see in the communication domain is stereotyped communication. 
• So they'll often repeat a phrase or repeat a sound or repeat a word, and they may also be echolalic. They may repeat something that someone else says. They echo the actual words that someone else has said again in the communication domain. 
• individuals with autism have difficulty taking the listener perspective 
• they have difficulty understanding and responding to humor 
• innuendo is very difficult for them
• In the social interaction area, they tend to be concrete and focus on their self needs instead of the needs of others around them.

Difficulty in Behavior 

• Focus on parts or pieces of things and not the whole; they may focus on a button on a shirt, or they may focus on the wheels of a truck but not necessarily on how that truck works so that a button is part of a piece of clothing that has a particular function. 
• they often have preoccupation so that they may be preoccupied with toothbrushes, or they may be preoccupied with certain kinds of toys or certain kinds of objects around the house 
• they have a very high need for sameness routines are very frustrating for them, and transitions tend to be very, very difficult classic kinds of autism 
• often are evidenced in some rocking behavior, so there's rocking back and forth of the whole body; there may be some flapping behavior which could be arms or legs or both, and what I call twiddling, which is taking something and shaking it in your hand or moving it back and forth you know banging it around tapping with it 
• very often, individuals with autism spectrum disorder have hypersensitivities to certain things, so for example, the texture of clothing or the texture of food, or they may show a lack of awareness of those kinds of things a great interest is that when you think about autism spectrum disorder, those individuals could be of 
• low IQ they could have pretty significant cognitive and intellectual challenges 
• They are gifted and are features of ADHD that we see in many individuals on the autism spectrum. 
• Anxiety and depression are often complicating factors in this set of disorders. 

We all know of movies like Rain Man what we talk where we see someone who is extraordinarily highly developed and sophisticated abilities individuals with autism. Some individuals with autism present with savant-like skills. They're incredibly capable of remembering things, lists or maps, or dates or even have certain gifts in the area of music. 

• They have some unusual sensory issues, so for example, individuals with autism may react differently to touch; they may find touch very aversive. 
• Moreover, they may have difficulties managing touch and not realize that they may be touching someone too hard or tap someone when they mean to touch them. 
• Harder, it appears that some individuals with a spur with autism spectrum disorder may have difficulties with modulation of pain and again. 

Plus, they have difficulties with certain textures. Plus, difficulties with sleep and activities for daily living are almost always interrupted. 

• The ability to care for yourself, 
• The ability to dress and eat and feed  
• Do certain activities for daily living, which may include some higher functioning. 
• Individuals can travel from one place to another, manage money, and do those activities for daily living.