WHAT CAUSES AUTISM?
Researchers from all over the world are searching for the answer to
this question. They are exploring different explanations for the
various forms of autism. Although a single specific cause of autism
is not known, current research links autism to biological or
neurological differences in the brain. In many families there
appears to be a pattern of autism or related disabilities- which
suggests there is a genetic basis to the disorder-although at this
time no gene has been directly linked to autism. The genetic basis
is believed by researchers to be highly complex, probably involving
several genes in combination.
Autism is not a mental illness. Children with autism are not kids
who mis-behave. Autism is not caused by bad parenting. There are no
known psychological factors in the development of the child that
have been shown to cause autism.
HOW IS AUTISM DIAGNOSED?
There are no medical tests for diagnosing autism. An accurate
diagnosis must be based on observation of the individual's
communication, behaviour, and developmental levels. Because many of
the behaviours associated with autism are shared by other disorders,
various medical tests may be ordered to rule out or identify other
possible causes of the symptoms.
The characteristics of a disorder vary so much, that a child should
be evaluated by a multidisciplinary team which may include a
neurologist, psychologist, developmental pediatrician,
speech/language therapist, learning consultant, or another
professionals knowledgeable about autism. Diagnosis is difficult for
a practitioner with limited training or exposure to autism. And is
sometimes misdiagnosed by well-meaning professionals. Difficulties
in the recognition and acknowledgment of autism often lead to a lack
of services to meet the complex needs of individuals with autism.
There is no 'template' for a quick diagnosis. To obtain a true
picture of an individual's abilities and behaviours parental (and
other caregivers') input and developmental history are very
important. Some persons with autism may appear to have mental
retardation, a behaviour disorder, problems with hearing, or even
odd and eccentric behaviour. While these conditions can co-occur
with autism, it is important to distinguish autism from other
conditions. An accurate diagnosis and early identification can
provide the basis for building an appropriate and effective
educational and treatment program.
Unfortunately, some professionals who are not knowledgeable about
the needs and opportunities for early intervention in autism do not
offer an autism diagnosis even if it is appropriate. Their
hesitation can lead to failure to obtain appropriate services for
the child.
WHAT ARE PEOPLE WITH AUTISM LIKE?
Children within the ASD often appear relatively normal in their
development until the age of 24-30 months, when parents may notice
delays in language, play or social interaction. Any of the following
delays, by themselves, would not result in a diagnosis of an ASD.
Autism is a combination of several developmental challenges.
The following areas are among those that may be affected by autism:
|
Communication: language
develops slowly or not at all; uses words without
attaching the usual meaning to them; communicates with
gestures instead of words; short attention span;
Social Interaction: spends time alone rather than
with others; shows little interest in making friends;
less responsive to social cues such as eye contact or
smiles;
Sensory Impairment: may have sensitivities in the
areas of sight, hearing, touch, smell, and taste to a
greater or lesser degree;
Play: lack of spontaneous or imaginative play;
may not imitate others' actions; may not initiate
pretend games;
Behaviours: may be overactive or very passive;
throws tantrums for no apparent reason; may show an
obsessive interest in a single item, idea, activity or
person; apparent lack of common sense; may show
aggression to others or self; often has difficulty with
changes in routine. |
Some individuals with autism may also have other disorders which
affect the functioning of the brain such as: Epilepsy, Mental
Retardation, Down Syndrome, or genetic disorders such as: Fragile X
Syndrome, Landau-Kleffner Syndrome, William's Syndrome or Tourette's
Syndrome. Many of those diagnosed with autism will test in the range
of mental retardation. Approximately 25-30 percent may develop a
seizure pattern at some period during life.
Every person with autism is an individual, and like all individuals,
has a unique personality and combination of characteristics. There
are great differences among people with autism. Some individuals
mildly affected may exhibit only slight delays in language and
greater challenges with social interactions.
The person may have difficulty initiating and/or maintaining a
conversation, or keeping a conversation going. Communication is
often described as talking at others (for example, monologue on a
favorite subject that continues despite attempts of others to
interject comments). People with autism process and respond to
information in unique ways.
Educators and other service providers must consider the unique
pattern of learning strengths and difficulties in the individual
with autism when assessing learning and behaviour to ensure
effective intervention. Individuals with autism can learn when
information about their unique styles of receiving and expressing
information is addressed and implemented in their programs. The
abilities of an individual with autism may fluctuate from day to day
due to difficulties in concentration, processing, or anxiety. The
child may show evidence of learning one day, but not the next.
Changes in external stimuli and anxiety can affect learning. They
may have average or above average verbal, memory or spatial skills
but find it difficult to be imaginative or join in activities with
others. Individuals with more severe challenges may require
intensive support to manage the basic tasks and needs of living day
to day.
Contrary to popular understanding, many children and adults with
autism may make eye contact, show affection, smile and laugh, and
demonstrate a variety of other emotions, although in varying
degrees. Like other children, they respond to their environment in
both positive and negative ways. Autism may affect their range of
responses and make it more difficult to control how their bodies and
minds react. Sometimes visual, motor, and/or processing problems
make it difficult to maintain eye contact with others.
Some individuals with autism use peripheral vision rather than
looking directly at others. Sometimes the touch or closeness of
others may be painful to a person with autism, resulting in
withdrawal even from family members. Anxiety, fear and confusion may
result from being unable to "make sense" of the world in a routine
way. With appropriate treatment, some behaviours associated with
autism may change or diminish over time. The communication and
social deficits continue in some form throughout life, but
difficulties in other areas may fade or change with age, education,
or level of stress. Often, the person begins to use skills in
natural situations and to participate in a broader range of
interests and activities. Many individuals with autism enjoy their
lives and contribute to their community in a meaningful way. People
with autism can learn to compensate for and cope with their
disability, often quite well.
While no one can predict the future, it is known that some adults
with autism live and work independently in the community (drive a
car, earn a college degree, get married); some may be fairly
independent in the community and only need some support for daily
pressures; while others depend on much support from family and
professionals. Adults with autism can benefit from vocational
training to provide them with the skills needed for obtaining jobs,
in addition to social and recreational programs. Adults with autism
may live in a variety of residential settings, ranging from an
independent home or apartment to group homes, supervised apartment
settings, living with other family members or more structured
residential care. An increasing number of support groups for adults
with autism are emerging around the country. Many self-advocates are
forming networks to share information, support each other, and speak
for themselves in the public arena. More frequently, people with
autism are attending and/or speaking at conferences and workshops on
autism. Individuals with autism are providing valuable insight into
the challenges of this disability by publishing articles and books
and appearing in television specials about themselves and their
disabilities.
WHAT ARE THE MOST EFFECTIVE APPROACHES?
Evidence shows that early intervention results in dramatically
positive outcomes for young children with autism. While various
pre-school models emphasize different program components, all share
an emphasis on early, appropriate, and intensive educational
interventions for young children.
Other common factors may be: some degree of inclusion, mostly
behaviourally-based interventions, programs which build on the
interests of the child, extensive use of visuals to accompany
instruction, highly structured schedule of activities, parent and
staff training, transition planning and follow-up.
Because of the spectrum nature of autism and the many behaviour
combinations which can occur, no one approach is effective in
alleviating symptoms of autism in all cases. Various types of
therapies are available, including (but not limited to) applied
behaviour analysis, auditory integration training, dietary
interventions, discrete trial teaching, medications, music therapy,
occupational therapy, PECS, physical therapy, sensory integration,
speech/language therapy, communication and social skills training
and TEACCH.
Studies show that individuals with autism respond well to a highly
structured, specialized education program, tailored to their
individual needs. A well designed intervention approach may include
some elements of communication therapy, social skill development,
sensory integration therapy and applied behaviour analysis,
delivered by trained professionals in a consistent, comprehensive
and coordinated manner. The more severe challenges of some children
with autism may be best addressed by a structured education and
behaviour program, which contains a one-on-one teacher to student
ratio or small group environment. However, many other children with
autism may be successful in a fully inclusive general education
environment with appropriate support.
In addition to appropriate educational supports in the area of
academics, students with autism should have training in functional
living skills at the earliest possible age. Learning to cross a
street safely, to make a simple purchase or to ask assistance when
needed are critical skills, and may be difficult, even for those
with average intelligence levels. Tasks that enhance the person's
independence and give more opportunity for personal choice and
freedom in the community are important.
To be effective, any approach should be flexible in nature, rely on
positive reinforcement, be re-evaluated on a regular basis and
provide a smooth transition from home to school to community
environments. A good program will also incorporate training and
support systems for parents and caregivers, with generalization of
skills to all settings. Rarely can a family, classroom teacher or
other caregiver provide effective habilitation for a person with
autism unless offered consultation or in-service training by an
experienced specialist who is knowledgeable about the disability.
A generation ago, the vast majority of the people with autism were
eventually placed in institutions. Professionals were much less
educated about autism than they are today; autism specific supports
and services were largely non-existent. Today the picture is
brighter. With appropriate services, training, and information, most
families are able to support their son or daughter at home. Group
homes, assisted apartment living arrangements, or residential
facilities offer more options for out of home support.
Autism-specific programs and services provide the opportunity for
individuals to be taught skills, which allow them to reach their
fullest potential.
Families of people with autism can experience high levels of stress.
Due to the challenging behaviours of their children, relationships
with service providers, attempting to secure appropriate services,
resulting financial hardships, or very busy schedules, families
often have difficulty participating in typical community activities.
This results in isolation and difficulty in developing needed
community supports.
IS THERE A CURE?
Understanding of autism has grown tremendously since it was first
described by Dr. Leo Kanner in 1943. To cure means "to restore to
health, soundness, or normality." In the medical sense, there is no
cure for the differences in the brain, which result in autism.
However, better understanding of the disorder has led to the
development of better coping mechanisms and strategies for the
various manifestations of the disability. Some of these symptoms may
lessen as the child ages; others may disappear altogether. With
appropriate intervention, many of the associated behaviours can be
positively changed, even to the point in some cases, that the child
or adult may appear to the untrained person to no longer have
autism. The majority of children and adults will, however, continue
to exhibit some manifestations of autism to some degree throughout
their entire lives.
Text from Autism Society of Ontario, Statistics from Autism Society
Canada
