by Rebecca Barcy, PhD, NCSP
April is National Autism Awareness month. People are more aware of this disorder today than just five years ago due to increased media coverage and personal experience. Many readers will know an individual with this diagnosis – perhaps in their own family, in their friendship circle, in their child’s classroom.
The most recent prevalence estimate of Autism Spectrum Disorder, referred to as ASD, released by the Centers for Disease Control and Prevention (CDC) show an incidence rate of about one in 88, with boys diagnosed four to five times more frequently than girls. While each individual diagnosis of ASD is unique, there are some commonalities that define this disorder and are required to make the diagnosis.
ASD reflects differences in the way children develop from very early on, from infancy, and usually continues to affect development into adulthood. There are different degrees of severity and combinations of symptoms which affect levels of success in school and later in the workplace.
The definitive cause or causes of ASD is not yet clear, but ongoing global research suggests multiple causes that may be interactive. One important outcome of the research conducted makes it clear that autism is a biological or medical disorder. It is not caused by bad parenting.
Individuals with ASD are diagnosed by difficulties in three developmental areas:
- Reciprocal social interaction – Fewer social responses, such as social smile and appropriate facial expression; and fewer social initiations, such as starting a game with another.
- Communication – Less verbal and nonverbal communication, such as gestures and head nodding, especially in an area termed “joint attention” which includes showing, pointing, and greetings.
- Repetition and insistence on sameness – Evident in play, limited pretend or make believe play; and preoccupation with narrow or restricted interests.
The American Academy of Pediatrics currently recommends that all children be screened for ASD at 18 and 24 months of age. Presently, there is not a definitive medical test for ASD.
A diagnosis is based on observed behavior. Often a comprehensive evaluation will include information from more than one professional discipline – such as a psychologist, a speech and language pathologist, a developmental pediatrician, a social worker and an occupational therapist. A comprehensive evaluation will often rule out problems of vision and hearing acuity as well as possible contributing medical conditions.
Early identification is important. It helps families: reduce anxiety and access concrete information to better understand and advocate for their children in order to obtain the most appropriate treatment and services to best meet their needs.