ERIC Identifier: ED436068
Publication Date: 1999-10-00
Author: Dunlap, Glen - Bunton-Pierce, Mary-Kay
ERIC Clearinghouse on Disabilities and Gifted Education Reston VA.
Autism and Autism Spectrum Disorder (ASD). ERIC Digest #E583.
Autism is a developmental disability that affects a person's ability to
communicate, understand language, play, and interact with others. Autism is a
behavioral syndrome, which means that its definition is based on patterns of
behaviors that a person exhibits. Autism is not an illness or a disease. It is
not contagious and, as far as we know, it is not acquired through contact with
the environment. Autism is a neurological disability that is presumed to be
present from birth and is always apparent before the age of three. Although
autism affects the functioning of the brain, the specific cause of autism is
unknown. In fact, it is widely assumed that there are most likely multiple
causes, each of which may be manifested in different forms, or subtypes, of
autism. Future research will help us understand the etiologies of autism.
Autism Spectrum Disorder (ASD) is an increasingly popular term that refers to
a broad definition of autism including the classical form of the disorder as
well as closely related disabilities that share many of the core
characteristics. ASD includes the following diagnoses and classifications: (1)
Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS), which refers
to a collection of features that resemble autism but may not be as severe or
extensive; (2) Rett's syndrome, which affects girls and is a genetic disorder
with hard neurological signs, including seizures, that become more apparent with
age; (3) Asperger syndrome, which refers to individuals with autistic
characteristics but relatively intact language abilities, and; (4) Childhood
Disintegrative Disorder, which refers to children whose development appears
normal for the first few years, but then regresses with the loss of speech and
other skills until the characteristics of autism are conspicuous. Although the
classical form of autism can be readily distinguished from other forms of ASD,
the terms autism and ASD are often used interchangeably.
Individuals with autism and ASD vary widely in ability and personality.
Individuals can exhibit severe mental retardation or be extremely gifted in
their intellectual and academic accomplishments. While many individuals prefer
isolation and tend to withdraw from social contact, others show high levels of
affection and enjoyment in social situations. Some people with autism appear
lethargic and slow to respond, but others are very active and seem to interact
constantly with preferred aspects of their environment.
Individuals with autism are
characterized primarily by developmental difficulties in verbal and nonverbal
communication, social relatedness, and leisure and play activities. All
individuals with autism experience substantial problems with social
interactions. In addition, people with autism often exhibit unusual, repetitive,
and perseverative movements (including stereotyped and self-stimulatory
behaviors), resistance to changes in routines and in other features of their
environments, apparent oversensitivity or undersensitivity to specific kinds of
stimulation, and extreme tantrums, aggression or other forms of acting out
behavior. It is also observed that individuals with autism have uneven patterns
of skill development. Some people display superior abilities in particular areas
(such as music, mechanics, and arithmetic calculations), while other areas show
DIAGNOSIS AND EVALUATION
The principal source for
diagnosing autism is the Diagnostic and Statistical Manual of the American
Psychiatric Association, Fourth Edition (DSM-IV,1994). Although children
affected by autism are being identified at earlier ages than was the case
previously, the diagnosis usually does not occur until sometime between two and
three years of age. Diagnosticians are often reluctant to issue a formal
diagnosis before the age at which complex language is expected to emerge.
However, early intervention services can still be provided on the basis of
developmental delay, even without a formal diagnosis of autism.
A diagnosis of autism is often provided by developmental pediatricians,
psychologists, child psychiatrists, or neurologists. At the time of (or prior
to) diagnosis, a comprehensive evaluation is typically arranged. Such an
evaluation usually includes a neurological examination, tests for biochemical
abnormalities, and other assessments designed to rule out physical and
diagnostic conditions. A battery of developmental and educational evaluations is
also conducted to help develop an appropriate early intervention plan. Family
involvement is integral to this entire process.
In 1997, the Centers for Disease Control and
Prevention (1999) estimated that a broad definition of autism may be present in
as many as one person out of every 500. This estimate suggests that there are
roughly 500,000 people in the United States who could be described as having
autism or autism spectrum disorder.
It is well established that autism occurs in four times as many boys as girls
(NICHCY, 1999) and that there are no known racial, social, economic, or cultural
distinctions. Although it is possible that there are some genetic linkages with
some forms of autism, there are no associations with particular familial or
cultural histories or practices. Earlier theories that implicated parents'
behavior in the occurrence of autism have been thoroughly discredited.
There have been occasional speculations about clusters of autism in some
areas of the country, and it has been suggested that such clusters may be
associated with environmental contaminants or regional medical practices. To
date, however, there have been no clear data that support these speculations.
APPROACHES TO INTERVENTION AND EDUCATIONAL SUPPORT
autism was first identified as a syndrome more than 50 years ago, a variety of
intervention strategies have been suggested. These interventions and treatments
have risen from a range of theoretical positions, but most have not proven to be
effective with large numbers of children. This pattern continues today, with a
large number of diverse treatment approaches being touted as uniquely effective
in resolving patterns of autistic behavior. For the most part, such claims have
not been substantiated in controlled research. The message for families,
teachers, and other consumers is to be cautious when considering new, grandiose
testimonials, and to be very thoughtful and selective when constructing plans
for intervention and support.
Even though autism has attracted an array of spurious treatments, a good deal
of real progress has occurred, and some very credible approaches have been
demonstrated repeatedly to be effective in improving the behaviors and
adaptability of people with autism. Interventions that are derived from an
educational and behavioral orientation have been shown to help children and
adults affected by autism, primarily by teaching new skills that enable the
person to function more successfully in the daily world of home, school, work,
and community interactions. Years of research and experience have produced some
relevant guidelines for providing instruction and intervention for individuals
with autism. For example, it is important that interventions be developed on an
individualized basis. The label of autism by itself is not prescriptive. It does
not indicate what intervention should be provided or how intervention should be
As a set of general rules, it is widely agreed that people with autism
respond better in a context where there is structure and clear guidelines
regarding expectations for appropriate and inappropriate behavior. It is also
recommended that the environment include systems or materials, such as written
or picture schedules, that can help the person to comprehend and predict the
flow and sequence of activities. The focus of intervention and instructional
efforts should be to develop functional skills that will be of immediate and
ongoing value in the context of daily living. This typically includes strategies
for enhancing a person's ability to communicate, to understand language, and to
get along socially in complex home, school, work, and community settings.
Another important guideline for intervention pertains to family involvement.
To the greatest extent possible, family members should be encouraged to
participate in all aspects of assessment, curriculum planning, instruction, and
monitoring. Parents and other family members very often have the most useful
information about an individual's history and learning characteristics, so
effective intervention and instruction should take advantage of this vital
resource. Furthermore, because families are so essential in the lives of people
with autism, family support that helps strengthen the family system is regarded
as a vital element in providing effective intervention for people with autism.
American Psychiatric Association. (1994).(4th
ed.). Diagnostic and statistical manual of mental disorders. Washington, DC:
Centers for Disease Control. (1999). Autism among children. (On-line).
Available: fact sheet at http:www.cdc.gov/nceh/programs/cddh/dautism.htm.
National Information Center for Children and Youth with Disabilities.( 1999).
Autism and pervasive developmental disorder. (Fact Sheet Number 1). Available
from NICHCY, PO Box 1492, Washington, DC 20013. 1-800-695-0285. Also available
online at http://www.nichcy.org/pubs/factshe/fs1txt.htm.%20
Readings and Resources on Autism, ERIC Minibibliography No. E13.
(information about Asperger Syndrome)
Program (Treatment and Education of Autistic and Related Communication
Handicapped Children) University of North Carolina, Chapel Hill.
Society of America, 7910 Woodmont Avenue, Suite 650, Bethesda, MD 20814-3015,
(301) 657-0881 http://www.autism-society.org
Research Institute, 4182 Adams Avenue, San Diego, CA 92116, (619) 281-7165
Autism Now (CAN), 5225 Wilshire Blvd., Suite 503 Los Angeles, CA 90036, (213)
549-0500 Email: CAN@primenet.com
Journal of Autism and Developmental Disorders, Plenum Publishing Corp., 227
W. 17th St., New York, NY 10011
Focus on Autism and Other Developmental Disabilities, PRO-ED, 8700 Shoal
Creek Blvd., Austin, TX 78757-6897
Journal of Positive Behavior Interventions, PRO-ED, 8700 Shoal Creek Blvd.,
Austin, TX 78757-6897