There is no known cure for autism – that’s the bad news. There is good news however… it is possible that a person with autism can reach a point (usually after ongoing and intensive intervention targeted to the challenges of the specific individual) where they no longer meet the diagnostic criteria for the disorder that is described above (e.g. Google the name ‘Temple Grandin’). This is one of the biggest misconceptions about the disability and this is why: autism is a spectrum disorder which means, in part, that some cases are less severe than others (also see above). For example, a person may meet the criteria for autism or a related spectrum disorder however, they may only have very obvious difficulties when it comes to social interactions. Then consider that this individual (who may be called ‘high-functioning’) has early, intensive, and ongoing exposure to the best, evidence based assessment and treatment that money can buy. In some instances it might also be the case that this child’s parent (or someone else that is intimately involved in the process) is an expert in autism and guides the course of treatment every step of the way. In these such ‘best case scenarios’, it is very often the case that the person can exceed all expectations and eventually no longer meet the diagnosis for autism. What makes autism all that more mysterious (and gives hope to all you incredibly dedicated parents) is that in some cases, it requires only ONE of these conditions for a child to thrive. In general, educating yourself as a parent about best practices in autism treatment can have a huge impact on your child’s progress.
One crucial piece of information is that there is no biological marker of autism. This means that a doctor cannot do a blood test as one might with diabetes, for example, or ‘see’ the disability on a chromosome like one can with Down’s Syndrome. The nature of the diagnosis of autism is different in that it comes down to a trained professional’s best judgment in conjunction with the DSM criteria (see #1) and other standardized questionnaires or tests. This trained professional is sometimes a licensed clinical psychologist or a pediatrician however it is good to ask what the person’s training consists of in regard to autism.
If you are suspicious about whether your son or daughter may have an autism spectrum disorder, the best thing to do is to watch for signs consistent with those three indicators described above: regression of language ability, repetitive or ritualistic behavior, and seemingly odd social interactions. Observe your child closely under a number of different contexts, conditions, and environments. Also note how your child compares with his or her peers. At the same time, it is important to focus on these three areas only and also to consider them as a whole. For example, although individuals with autism sometimes engage in challenging behavior such as tantrums, it does not mean that tantrums (even those that appear to be on the severe side for a 2-3 year old) should cause you to think that your child may have autism; especially if they do not present with any of the three defining characteristics. The bottom line is that if you suspect your child is not developing in these areas as a child their age should be, it is best to seek out a trained professional in order to complete a formal assessment.
According to the CDC (Center for Disease Control and Prevention), the prevalence rate of autism is approximately 1 in 88, which represents a 600% increase in prevalence over the last 20 years – yes, it is pretty clear that most people would view these numbers as an ‘explosion’. At the same time, there is debate about the cause for such as increase in prevalence; one possibility being that the criteria for diagnosis has been largely expanded in recent years to create the illusion of such an exponential increase. While passionate arguments persist on both sides of this issue, what it boils down to is that the exact cause for such an explosion of cases is unknown.
Autism is a developmental disability categorized under the umbrella of pervasive developmental disabilities by the Diagnostic and Statistical Manual for Mental Disorders (DSM IV-TR) (APA, 2000). What this means is that it is lifelong (currently there is no ‘cure’) and it can affect all areas of normal development and functioning, as well as the functioning of the family unit as a whole, as I am sure many parents of children who have autism can attest to. There are three major areas affected by autism:
- regression in regard to language/communication skills that have developed by age 2-3
- ongoing repetitive, ritualistic, or stereotypical behavior or interest in toys or other items in a child’s environment (some examples include hand flapping, toe walking, a vocal tic, rewinding/fast forwarding a movie over and over, etc.)
- general disinterest in social interaction with peers or family members (for example, avoidance of eye contact, affectionate behavior like hugging, etc.).
On the ‘Rain Man’ reference, it’s important to remember that autism is a spectrum disorder meaning you can have two children both diagnosed with autism that have starkly different strengths and challenges. In my practice, families of kids who have the more severe cases of autism generally feel a little left out of the mass media portrayal of what autism actually is. As a rule, I strive to make sure the voice of those children and families is heard as well… so no, kids with autism do not always have savant ‘Rain Man’ abilities – are they still interesting and amazing in their own way? Unequivocally… YES!