If someone you care about has symptoms, don’t try to plug him into one of the main types of autism. People usually fall along a spectrum of autism symptoms.
Five years ago, the Diagnostic Statistical Manual, known as the DSM, which defines psychiatric disorders, dissolved the idea of types of autism into one label, autism spectrum disorder (ASD). People with this diagnosis may also get a severity score of 1, 2, or 3.
Not everybody agreed with the new system, and you’ll still sometimes hear adults who received a diagnosis of Asperger’s syndrome long ago call themselves “Aspies.”
Although we’ve been hearing much more about autism in the past 20 years, it’s not clear that the problem is becoming more common. We may simply see it and label it now. And there’s no reason at all to think that vaccines cause ASD.
The main point: individuals vary, and the categories are less important than how you function.
What is autism? People with ASD function differently, in part because of their brain wiring. Autistic behavior will show up in early childhood and runs in families. One in 59 eight-year-olds has the disorder, according to the Centers for Disease Control. It is four times more common in boys than in girls.
It occurs among all kinds of groups, rich or poor, and across races.
Although ASD can be reliably detected by age 2, the average age of diagnosis ranges from age 4 to 6, depending on the population. Early treatment can make a difference, so the American Academy of Pediatrics recommends screening for ASD at an 18- and 24-month well-child visit. This is especially important if an older sibling has ASD or you see danger signs.
An infant who isn’t interested in your face or isn’t saying any words by 16 months may be at risk. Look for gesturing and babbling by a year. In their second year of life, toddlers with ASD are less likely than other children to respond to their name and to enjoy focusing on something together with a parent.
Studies that tracked children diagnosed around two find that from 10 to 14 percent get much better by the age of six; most stay around the same.
As a child with ASD gets older, you might notice that he is easily overwhelmed by sounds and smells and hates hugs from visitors. He may speak like a robot and rarely laugh or even smile. Some children rock back and forth or flap their hands. He may prefer to be alone, compared to other children.
Over time, he might become a big talker, but show little interest in other people. Instead he zeroes in intensely on a single subject, whether anyone is listening. He also might be especially distressed at any changes in routine — insisting on the same breakfast, for example.
In the past, one of the types of autism was pervasive “development disorder, not otherwise specified”, or atypical autism. People in this category have delays in their development as children and only mild autism symptoms as adults.
People who were not slow to learn language or other skills as children but have certain kinds of social difficulties might have been labeled with Asperger’s syndrome.
They might love routine, be oversensitive to their environment, and struggle to read social cues and pick up on other people’s emotions. They may actually seek out other people, but have trouble making friends. Social situations can make them shut down.
The new DSM, DSM-5, also includes a new diagnosis — social pragmatic communication disorder. People in this category developed normally as children but have trouble talking and writing.
Autism treatment can come from many kinds of professionals. There isn’t any one medication, but your child might benefit from medication for depression or anxiety.
A therapist can coach your child to be more expressive, using a normal pattern rather than a flat tone of voice, and maintaining eye contact. Cognitive behavioral therapy can help him be less obsessive. Parents benefit from learning the techniques their children are trying to master.
June 14, 2018
Janet O’Dell, RN