What Is Autism?

What Is Autism?

Autism Spectrum Disorder is a complex brain-based difference that impacts a person’s communication, sensory processing, social interactions, and behavior.

The Centers for Disease Control and Preventions (CDC) estimates that Autism Spectrum Disorder (ASD) affects 1 in 68 US children. It affects males 5 times more than females; 1 in 42 boys and 1 in 189 girls. The overall rate in Maryland is 1 in 55 children, 1 in 34 boys, and 1 in 161 girls.

While the exact cause is unknown, the CDC suggests that it is a combination of genetics and environment. There is no cure, however, there are many therapies and treatments for some of ASD’s symptoms.

Diagnostic Classifications – Diagnostic and Statistical Manual of Mental Disorders (DSM)

Autism Spectrum Disorders
A DSM-5 diagnostic classification
Autism spectrum disorder (ASD) is a developmental disability that can cause significant social, communication, and behavioral challenges. There is often nothing about how people with ASD look that sets them apart from other people, but people with ASD may communicate, interact, behave, and learn in ways that are different from most other people. The learning, thinking, and problem-solving abilities of people with ASD can range from gifted to severely challenged. Some people with ASD need a lot of help in their daily lives; others need less.

A diagnosis of ASD now includes several conditions that used to be diagnosed separately: autistic disorder, pervasive developmental disorder not otherwise specified (PDD-NOS), and Asperger syndrome. These conditions are now all called autism spectrum disorder.

Source: http://www.cdc.gov/ncbddd/autism/facts.html

Social (pragmatic) Communication Disorder (SCD)
A DSM-5 diagnostic classification – not an ASD diagnosis
Diagnostic and Statistical Manual of Mental Disorders (DSM-5) will more accurately recognize individuals who have significant problems using verbal and nonverbal communication for social purposes, leading to impairments in their ability to effectively communicate, participate socially, maintain social relationships, or otherwise perform academically or occupationally. Previous editions of DSM did not provide an appropriate diagnosis for people with such symptoms, which led to inconsistent treatment across clinics and treatment centers. For these individuals, SCD brings their social and communication deficits out of the shadows of a “not otherwise specified” label to help them get the services and treatment they need.

While autism spectrum disorder (ASD) does encompass communication problems, it also includes restricted, repetitive patterns of behavior, interests or activities and gives equal weight to both communication issues and repetitive behaviors. ASD must be ruled out for SCD to be diagnosed. SCD is characterized by a persistent difficulty with verbal and nonverbal communication that cannot be explained by low cognitive ability. Symptoms include difficulty in the acquisition and use of spoken and written language as well as problems with inappropriate responses in conversation. The disorder limits effective communication, social relationships, academic achievement, or occupational performance. Symptoms must be present in early childhood even if they are not recognized until later when speech, language, or communication demands exceed abilities.

Source: http://www.dsm5.org/Documents/Social%20Communication%20Disorder%20Fact%20Sheet.pdf

Pervasive Developmental Disorder – Not Otherwise Specified, or PDD-NOS
A DSM-IV diagnostic classification – individuals relate to this diagnosis, so it is included here

PDD-NOS is a condition on the spectrum that has those with it exhibiting some, but not all, of the symptoms associated with classic autism. That can include difficulty socializing with others, repetitive behaviors, and heightened sensitivities to certain stimuli.

The term “PDD” is widely used by professionals to refer to children with autism and related disorders; however, there is a great deal of disagreement and confusion among professionals concerning the PDD label. Diagnosis of PDD, including autism or any other developmental disability, is based upon the Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition (DSM-IV), published by the American Psychiatric Association (Washington, DC, 1994), and is the main diagnostic reference of mental health professionals in the U.S. According to the DSM-IV, the term “PDD” is not a specific diagnosis, but an umbrella term under which the specific diagnoses are defined.

Asperger’s Disorder
A DSM-IV diagnostic classification – individuals relate to this diagnosis, so it is included here
What distinguishes Asperger’s Disorder from Autism Disorder is the severity of the symptoms and the absence of language delays. Children with Asperger’s Disorder may be only mildly affected and frequently have good language and cognitive skills. To the untrained observer, a child with Asperger’s Disorder may just seem like a normal child behaving differently.

Asperger Syndrome (AS) is a neurobiological disorder on the higher-functioning end of the autism spectrum. An individual’s symptoms can range from mild to severe. While sharing many of the same characteristics as other Autism Spectrum Disorders (ASD’s) including Pervasive Developmental Disorder – Not Otherwise Specified (PDD-NOS) and High-Functioning Autism (HFA), AS has been recognized as a distinct medical diagnosis in Europe for almost 60 years, but has only been included in the U.S. medical diagnostic manual since 1994 (“Asperger Disorder” in the DSM-IV).

Source: http://aspennj.org/what-is-asperger-syndrome

PFA Tips: Staying Ahead of the Game- The DSM-5 and Autism
In May 2013, the American Psychiatric Association released the 5th Edition of the DSM. In a nutshell, the diagnoses of Autistic Disorder, Pervasive Developmental Disorder – NOS, and Asperger’s Disorder has been replaced by a single category entitled Autism Spectrum Disorder. This is a basic information guide about the recent changes to the Diagnostic and Statistical Manual of Mental Disorders (DSM).

How do I explain my child’s experiences to people unfamiliar with autism?

How do I explain the diagnosis to my child?


Additional Autism Resources
Autism Spectrum Disorders from the Centers for Disease Control

101 Noteworthy Sites on Asperger’s and The Autism Spectrum

Could My Child Have Autism?

Why should a person get a diagnosis?

If your child had a physical illness, you would tell your child about the illness so that he or she could understand his or her body and learn to make the best choices under this medical circumstance. Having a diagnosis allows the family to move forward with appropriate treatments and make the best informed decisions for the child and the family

How is autism diagnosed?

There are no medical tests for diagnosing autism. In order to be diagnosed accurately, a person must be observed by professionals skilled in determining communication, behavioral and developmental levels. However, because many of the behaviors associated with autism are shared by other disorders, a doctor may complete various medical tests to rule out other possible causes.

Ideally, a person should be evaluated by a multi-disciplinary team which may include a neurologist, psychologist, internist, speech/language therapist, learning consultant or other professional knowledgeable about autism. A brief observation in a single setting cannot present a true picture of an individual’s abilities and behavior patterns. At first glance, the person with autism may appear to have an intellectual disability, a learning disability, or problems with hearing. However, it is important to distinguish autism from other conditions, since an accurate diagnosis can provide the basis of building an appropriate and effective treatment program.

What signs should I look for?

RED FLAGS – Early Signs of Autism Spectrum Disorders

Video Glossary from Autism Speaks
An innovative web-based tool designed to help parents and professionals learn more about the early red flags and diagnostic features of autism spectrum disorders (ASD).

Developmental Milestones Screening
Children develop skills, or “milestones,” at their own pace. How is your child doing? You only need 10-20 minutes to check with the Ages & Stages Questionnaires®, Third Edition. Your ASQ-3™ results will help you see if your child’s developmental progress is on time and alert you to concerns that you can talk over with your health care provider.

Early Signs of Autism Video Tutorial
To improve recognition of the early signs of ASD among pediatricians, parents, and early intervention providers, autism researcher Dr. Rebecca Landa of Kennedy Krieger Institute has developed this free 9-minute video tutorial on ASD behavioral signs in one-year-olds. The tutorial consists of six video clips comparing toddlers who show no signs of ASD to toddlers who show early signs of ASD. Each video is presented with voice-over explaining how the specific behaviors exhibited by the child, as they occur on screen, are either indicative of ASD or typical child development.

What are co-occurring conditions?

Co-occurring conditions (also known as co-morbid conditions) are those diagnoses that may be given in addition to an autism spectrum disorder. Comorbidity describes the effect that other diagnoses may have on a person other than the primary diagnosis. For instance, a person may have ASD and ADHD and/or bipolar disorder and/or anxiety, etc. Sometimes secondary diagnoses may be overlooked as they share the same or similar symptoms as the primary diagnosis. For example, a child may have poor impulse control. This may be a symptom of the person’s autism, or the person may have poor impulse control because he also has a co-occurring condition of ADHD. Often, co-occurring conditions need to be treated first, in order to facilitate the treatment and management of ASD.

Where do you go for diagnosis?

Assessments and services for your child and family are FREE of charge through Infants and Toddlers, and Child Find. You do not need health insurance and you do not need a referral from your doctor.

Maryland’s Infants and Toddlers Program (Age: Birth – 3)
Each county has an Infants and Toddlers program that will assess your child, provide ongoing services for your child and family (if eligible), and ensure that procedural safeguards are met to protect the rights of your child and family. Your child and family may be eligible for early intervention services if your child is under three years of age and: has a delay of 25 percent or more in development; or is developing in a way that is considered “atypical” for most children his or her age; or has a diagnosed condition such as a genetic disorder or severe vision impairment that is likely to affect development.

Child Find (Age: 3 – 21)
Parents with children ages 3 through 21-years old who suspect their child may have a disability can begin the process to determine if their child may require special education by writing a letter (and keeping a copy) to the school principal or by contacting the local school system Child Find office.

You can also request an assessment from a private provider. These services are not free of charge and may or may not be covered under your health insurance plan.

How do I explain the diagnosis to my child?

PFA Tips: “You have Autism.”

I am an adult and wonder if I may have ASD. Should I get a diagnosis?

Autism Diagnosis for Adults
Getting a diagnosis of autism, or an autism spectrum disorder (ASD), can be a really positive thing. A lot of people say their diagnosis has helped them to understand why they have difficulties with some things and why they are especially good at some things.

Diagnosis for Adults
Getting a diagnosis of autism in adulthood can be a mixed blessing and some people decide that they are happy with self-diagnosis.

What causes Autism?

While the exact cause of ASD is unknown, the CDC states that autism is caused by “environmental, biological, and genetic factors.”

Treatment for ASD

There is currently no known cure for ASD. Intervention strategies may include physical, occupational, speech, and/or behavioral therapy, medications, and biomedical and dietary treatments. For a detailed list, visit our therapies & treatments page.

Where Do I Begin?

We know how overwhelming everything seems right now. That feeling will come and go, and some days you will see giant leaps, and other days, setbacks. But it’s okay, and you will find your place in all of this.

Download our “Where do I begin?” Guide

Sign up for the Autism Waiver Registry
The Autism Waiver, through Medical Assistance, allows eligible children with Autism Spectrum Disorder to receive specific services to support them in their homes and communities. To be placed on the Autism Waiver Registry, contact 1-866-417-3480. For more information on the Autism Waiver, please call the Maryland State Department of Education at 410-767-1446 or the Department of Health and Mental Hygiene at 410-767-5220.

Explore our Autism By Age checklists
These checklists are a guide for the issues you need to address, and contacts you should make, not only for services, but for support as well.

Find a local support group
We encourage families to join a local support group or network, as we feel the best information you will ever get is from other parents.  In addition, there are several Facebook support groups for parents of children with Autism that provide responsive, caring, and supportive feedback.  For example, the Baltimore AUTISM Parents is a closed group and its members are actively sharing and offering feedback.  Similar groups exist in other counties, e.g., Frederick and Carroll.

Articles and Books
We have an article that describes the autism experience using everyday examples. This might be helpful to share with family members, friends, or anyone who works with your child. There are books written by professionals, parents, and self-advocates that offer tremendous insight into Autism, including “Ten Things Every Child with Autism Wishes You Knew” by Ellen Notbohms.

We also have additional articles on our website for newly diagnosed families. Our PFA Tips articles are helpful not only for parents, but other caregivers, family members, teachers, advocates, and individuals with Autism. Our PFA Tips: “You Have Autism.” will help guide you when you are ready to share this diagnosis with your child.

Autism Speaks offers their 100 Day Kit created specifically for newly diagnosed families. You can download it free of charge.

There are many therapies that are available. Typically, therapies are designed to address difficulties in communication, social skills, and sensory issues. In addition, therapies attempt to mitigate aggressive, self-injurious, or repetitive behaviors such as rocking and hand flapping. For a description of the different types of therapies, please visit our treatments & therapies page.

You have TIME, so please do not feel that you need to read everything right away. This is a journey, so just focus on your priorities that are relevant now, as those will change over time.

contact us today to get involved