What Does It Mean to be Autistic

Autism is a brain disorder that too often results in a lifetime of impaired thinking, feeling, and social functioning — our most uniquely human attributes. Autism typically affects a person’s ability to communicate, form relationships with others, and respond appropriately to the external world. The disorder becomes apparent in children generally by the age of 3.

Autism (sometimes referred to as “classical autism”) is the most common condition in a group of developmental disorders known as the autism spectrum disorders.

Other autism spectrum disorders include:

• Childhood disintegrative disorder
• Asperger syndrome
• Rett syndrome
• Pervasive developmental disorder not otherwise specified (usually called PDD-NOS).

Experts estimate that three to six children out of every 1,000 will become autistic. Males are four times more likely to be autistic than females. Autistic girls with tend to have more severe symptoms and greater cognitive impairment.

Common Autistic Behaviors

Autism is characterized by three distinctive behaviors. Autistic children:

• Display problems with verbal and nonverbal communication
• Have difficulties with social interaction
• Exhibit repetitive behaviors or narrow, obsessive interests.

Some autistic people can function at a relatively high level, with speech and intelligence intact. Others have serious cognitive impairments and language delays, and some never speak.

In addition, autistic individuals may seem closed off and shut down, or locked into repetitive behaviors and rigid patterns of thinking. An autistic infant may avoid eye contact, seem deaf, and abruptly stop developing language. The child may act as if unaware of the coming and going of others, or physically attack and injure others without provocation. Autistic infants often remain fixated on a single item or activity, rock or flap their hands, seem insensitive to burns and bruises, and may even mutilate themselves.

Misinformation about autism is very common. Claims of a cure for autism are constantly presented to families of autistic individuals. There are various treatment models found within both the educational and clinical settings. Yet, there is only one treatment approach that has prevailed over time and is effective for all persons, autistic or not. That treatment model is an educational program that is suitable to a student’s developmental level of performance. For adults, that treatment model refers to a vocational program that is suitable to the individual’s developmental level of functioning.

Under the Individuals with Disabilities Educational Act (IDEA) Act of 1990, students with a handicap are guaranteed an “appropriate education” in the Least Restrictive Environment (LRE), which is generally considered to be as normal an educational setting as possible. As a result of this legislation, autistic children have generally been placed in a mainstreamed classroom and pulled out for whatever supplementary services were needed. Depending on the child’s needs, he or she could be placed up to 100% of the school day in a mainstreamed or a special education setting or any combination of the two.

There is an increasing trend, however, among the advocates for autistic children, to segregate these children into small, highly structured and controlled academic settings that are almost free from auditory and visual stimulation. All instruction is broken down into manageable segments. Information is presented in tiny units and the child’s response is immediately sought. A classic stimulus-response approach is used to maximize learning. Each unit of information is mastered before another is presented. A fundamental behavior such as putting hands on the tabletop, for example, must be mastered before the child is required to perform any other tasks, or before more information is presented. The long-term effects of this type of treatment as well as the ability of the child to transfer this to a broader context continue to be evaluated.

Autistic individuals must be taught how to communicate and interact with others. This is not a simple task, and it involves the entire family as well as other professionals. Parents of an autistic child or adult must continually educate themselves about new treatments and keep an open mind. Some treatments may be appropriate for some individuals but not for others. Many treatments have yet to be scientifically proven. Treatment decisions should always be made individually after a thorough assessment and based on what is suitable for that child and his or her family.

It is important to remember, despite some recent denials, that autism is virtually a lifelong condition. Treatment will change as the individual develops. Families must beware of treatment programs that give false hope of a cure. Acceptance of the condition in a family member is a very critical, foundational component of any treatment program and is understandably quite difficult.

Several medications have been tried or are under current scrutiny for the treatment of autism. No medication has consistently proven to be of benefit in closely controlled clinical trials. In the past, a piece on a television news show prompted a great deal of interest in the hormone secretin as a treatment for autism. An autistic child with chronic gastrointestinal complaints showed dramatic improvement following some routine testing performed by a gastroenterologist during which a small dose of secretin was administered. The family and their physicians felt that the secretin may have resulted in the improvement in the symptoms of autism. Many physicians began prescribing secretin, which can be costly for their autistic patients. However, studies published appear to completely refute the claim that secretin treatment benefits autistic patients. This example underscores the importance of good clinical trials in determining whether a drug will help patients with autism.

Autism At A Glance

• Autism is characterized by impaired development in social interaction, communication, and behavior.
• The degree of autism varies from mild to severe.
• Severely afflicted patients can appear to have a profound intellectual disability.
• The cause of autism is unknown.
• The optimal treatment of autism involves an educational or vocational program that is suited to the developmental level of the child or adult, respectively.