Autism Spectrum Disorders
by Bradley T. Wajda, D.O.
Autistic Disorder is one of the five Pervasive Developmental Disorders usually referred to as Autism Spectrum Disorders (ASD). These include Autistic Disorder, Rett’s Disorder, Childhood Disintegrative Disorder, Asperger’s Disorder, and Pervasive Developmental Disorder Not Otherwise Specified (Including Atypical Autism). We will be discussing Autism; however, a very brief and oversimplified explanation of the other disorders on the spectrum are as follows:
- Rett’s is impaired head growth with the loss of purposeful hand movements in favor of stereotyped hand movements and poor coordination (along with the severely impaired speech and social interaction).
- Childhood Disintegrative Disorder is the development of symptoms from the spectrum after having developed normally for the first 2 years of life.
- Asperger’s is Autism without the impairment in language.
The diagnostic criteria for autistic disorder involve a triad of qualitative impairments including social interactions, communication, and restricted repetitive and stereotyped behaviors or interests. Delays or abnormal functioning must be evident in at least one of the areas before the age three.
Autism affects boys 3 - 4 times more often than girls. Some believe that the small amount of mercury (called thimerosal) that is a common preservative in multidose vaccines causes autism or ADHD. However, studies have NOT shown this risk to be true. In 1999 it was generally agreed to greatly reduce or eliminate thimerosal in vaccines as a precautionary measure only. The rapid rise in the prevalence of autism in the 1990s and the 2000s is attributable to the increased awareness in diagnostic practice. There are many other factors that appear to affect the development of autism including the age of the mother, preterm and very preterm delivery, low and very low birthweight, multiple births, cesarean delivery, breech presentation, and in vitro fertilization or other assisted reproductive technologies (ARTs).
Children with autism:
- Have difficulty with nonverbal communication.
- Have difficulty forming peer relationships.
- Have a lack of social or emotional reciprocity.
- Have a lack of sharing topics or objects of interest/enjoyment.
- Have a delay (or total absence) of spoken language.
- Have the inability to sustain a conversation.
- Display idiosyncratic or repetitive/stereotypic speech.
- Inflexibly adhere to nonfunctional routines.
- Have abnormally intense restricted areas of interest/focus (such as with parts of objects).
- Display stereotyped/repetitive motor mannerisms.
Not all cases of autism will manifest all of these difficulties and a health care provider experienced in diagnosing and treating autism is usually needed to make the actual diagnosis.