Autism

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Autism
Autism is one of a group of disorders known as Pervasive Developmental Disorders or PDD.
Pervasive Developmental Disorders involve problems with speech, communication and social
interaction, as well as repetitive and compulsive behaviours. Autism can involve all of these
problems to varying degrees, or just a few. Autism is thus a ‘spectrum disorder’. At one end of the
spectrum are people with very few noticeable autistic problems; in the middle of the spectrum,
people may be diagnosed with high-functioning autism or Asperger’s syndrome; the other end is
called classic autism, and people with this degree of disability may take many years to communicate
with other people or may never learn to do so. Every person with autism is an individual and each
individual’s personality has a big impact on the degree of autism manifestation. When talking about
the behaviours associated with autism, we are talking in general terms. The way one person
responds to autistic problems is different from the way another responds.
*It seems that for every four boys with an autistic disorder there is only one girl.
All people with an autistic spectrum disorder have similar problems with three specific areas: social
relationships, verbal and non-verbal communication, and imagination. These are often known as the
triad of impairment.
Social relationships: Some people describe autism as being born without a social ‘sixth sense’. They
do not naturally pick up and learn social rules. People with autism may appear indifferent to other
people. They find it hard to understand other people’s thoughts and feelings.
Verbal and non-verbal communication: Speech development can be severely impaired in autistic
children. Some never learn to speak at all, and some learn to speak and then just stop and become
mute. Some children can sing or hum, or accurately mimicking machine or animal noises, but cannot
speak. Some children with autism learn to speak fairly normally but have other problems with
language. People with autism find it difficult to understand figures of speech; they tend to take
words literally. They also find it difficult to interpret body language and they tend not to produce
facial expressions.
Imagination: People with autism lack empathy—they do not automatically imagine how other
people feel. Children with autism play very differently from normal children. Normal children usually
play pretend games. Pretend games help children learn to think about how other people might feel
in different situations. Learning to imagine other people’s viewpoints is called developing a theory of
mind. The development of a theory of mind depends upon brain function and development. If the
necessary brain structures do not develop properly, then imaginative play will not occur. Some
children with autism do seem to act imaginary play situations but these are often based on things
they have seen on TV or real life. Many children with autism become obsessed with a particular
show or video and watch it repeatedly. Although they may be able to quote the whole show
perfectly with the right accent, they often do not understand the story.
People with autism usually have routines and interests, which are repetitive (rocking, spinning
around, staring at the washing in the washing machine). Repetitive routines vary upon the
individual. Interrupting these routines in any way can result in tantrums and distress. For people
with high-functioning autism or Asperger’s Syndrome these routines can appear as an obsession or
fascination with a particular subject: train-spotting, space missions, Lego, etc.
Asperger’s Syndrome
Asperger’s Syndrome and high-functioning autism are the names given to conditions that affect a
distinct group of people on the autistic spectrum. They tend to be clever, with an average or above-
average intelligence level, but still show the triad of impairment.
Social relationships: Unlike most people with autism, people with Asperger’s syndrome actually want
to make friends. They often feel lonely and want to make social contact.
Verbal and non-verbal communication: People with Asperger’s often speak fluently, using complex
words, but often in the wrong syntax. For example: an 8-year-old girl with Asperger’s may refer to a
classmate as ‘that nice young man’.
Imagination: People with Asperger’s tend to want things to be real, preferring data, science and
maths. When they are children, they may well play in what appears a normal imaginative way, but a
closer look often reveals that they are actually re-enacting situations they have seen on television or
in life and they will often go over the same situation again and again. People with high-functioning
autism dislike change.
Asperger’s syndrome differs from classic autism in the age at which they are diagnosed. Classic
autism is usually diagnosed at a young age, when it is noticed that a child is not developing normally.
However, speech develops normally in children with high-functioning autism and so these autistic
conditions often do not become noticeable until when the child is around 7 years old. It is often the
lack of social interaction that leads to the diagnosis in Asperger’s.
Between 50 and 90% of people with Asperger’s have problems coordinating their movements. They
can find it hard to ride a bike or catch a ball, and such un-coordination becomes worse when the
individual is anxious. However, one advantage of Asperger’s syndrome is that they can concentrate
for hours at a time on a task they are interested in. Therefore they often practise until they become
highly skilled at an activity.
People with high-functioning autism and Asperger’s syndrome may not do well in intelligence tests,
even though they are very able. This is because most intelligence tests look at a person’s ability
across a large number of areas, whereas people with Asperger’s tend to be exceptionally good in
some areas and not so good in others. Another feature of people with Asperger’s syndrome and
high-functioning autism is that they often think in pictures (visual thinking). They find it hard to
remember things related to speech, such as messages, but they tend to have superb long-term visual
memories. They also often display rigid thinking.
One of the main features of high-functioning autism is their variability. On a good day the conditions
hardly affect a person at all, on a bad day, they will suppress their fear and anxiety in school, and
then explode with tension at home.


Conditions that may look like autism
- Fragile X syndrome: Rare, found mostly in males, caused by an abnormality on the X
chromosome which results in long face shape, large ears, learning difficulties, over-
sensitivity to sound and touch, repetitive movements and routines, hyperactivity and
abnormal speech. This condition is different from autism in that people with Fragile X
syndrome tend to avoid other people because of anxiety and dislike of bodily contact,
whereas people with autism tend to be indifferent to other people.
- Retts syndrome: rare, found mainly in girls, caused by a gene mutation. Children with Retts
syndrome develop normally up to 18 months but then gradually lose the ability to
coordinate their hands. Their head growth slows, walking is difficult and the child may
develop a curvature of the spine. Children with Retts often become very anxious and
withdrawn, with learning difficulties and poor language skills. Few live to adulthood.
- Attention deficit disorder: Have difficulty concentrating; no problems social-wise
- Tourette’s syndrome: Known as the ‘swearing syndrome’, where sufferers have an
uncontrollable urge to shout swear words in public. In fact, only a small number of
Tourette’s sufferers have such a severe version of the syndrome. Most experience an
uncontrollable urge to make noises and tics or twitches. These are repetitive and not under
the control of the individual. Can occur with autistic spectrum disorders.

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