Understanding Autism For Dummies
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Professionals diagnose autism based upon symptoms shown in the categories of social interaction, communication, and behavior. Early diagnosis and intervention, with characteristics present before the age of 3, are very important, because research shows that many features of autism respond better when you deal with them early.

Sadly, some children don’t receive an official diagnosis until years after their parents first suspect that something is wrong, which means they lose valuable time. Even some doctors don’t have the necessary facts to provide an accurate diagnosis. You know your child better than any doctor, so if you disagree with a doctor’s assessment, get a second opinion. Trust your instinct if you think your child isn’t developing normally.

Social development

People with autism — partly because of the problems they have with communication — have difficulty developing friendships and playing cooperatively with others. Often, kids with autism don’t imitate others’ behaviors, as children usually do, and they don’t share their thoughts and observations. They also don’t spontaneously try to connect with others, as other children will.

Despite the challenges children with autism face regarding social interaction, they still have the desire to interact. Children with autism may just need direct instruction to learn what others pick up by mere observation.

Even mildly autistic children who have normal language development (a diagnosis known as Asperger Syndrome) find it difficult to form peer relationships because of their problems in understanding social protocols and others’ motivations. This social awkwardness can happen even if a child’s IQ is off the charts. Children on this end of the autism spectrum display little understanding of appropriate behaviors, and they may be criticized for being “brutally honest,” but many people note that they commonly lack pretension, dishonesty, flattery, and guile. However, they can also be quite hurt by their inability to connect socially, although they may not be able to express these emotions. Most people on this part of the spectrum lack the emotional vocabulary.

Communication

Autistic individuals have trouble with language development, sometimes losing speech at 18-24 months (known as regressive autism), talking only late in development, or not talking at all. Children may repeat words and phrases like television commercials (a condition known as echolalia), having no apparent understanding of their meaning. The children may hear words but not be able to make sense of what they mean.

Non-verbal communication is also impaired in children with autism. Commonly, autistic individuals may not understand what gestures mean. They won’t point to objects. They may not make eye contact or smile when smiled at. Their responses or lack of responses can be isolating, resulting in communication barriers rising between them and other people.

Behavior (activities and interests)

Autistic children often have obsessions or preoccupations with objects or with fantasy worlds (they may have trouble distinguishing fantasy from reality) that go beyond the normal interests of a developing child. For example, an autistic child may play exclusively with string or believe she’s an animal. She may have trouble transitioning from one activity to the next and insist on sticking to a ritual or routine — even one that seems to have no meaning. Some children with autism display repeated mannerisms, such as hand flapping, rocking, or walking on one’s toes, which are often considered as self-stimulatory behavior or “stims."

Doctors are certain that autism affects the way the brain functions (and autopsies of autistic brains show abnormalities in different areas), causing a sometimes distinctive set of behavioral symptoms. Each behavioral symptom can range from mild to severe. To complicate things further, not all children diagnosed as autistic display all of the behavioral symptoms. The behavioral symptoms govern the diagnosis, making treatment problematic.

Coexisting issues

Other conditions often coexist with autism, further complicating the diagnostic and treatment processes (and researchers are still debating whether the conditions are causes of autism). Some of the more common coexisting conditions include the following:

  • Mental retardation

  • Hyperlexia

  • Obsessive compulsive disorder (OCD)

  • Attention Deficit/Hyperactivity Disorder (AD/HD)

  • Dyslexia

Conditions are considered comorbid if they occur at the same time as the autistic symptoms and are deemed to have roughly equal “weight” by the diagnostician. Other associative conditions, such as depression, are often secondary to the autism — in other words, a person’s difficulties in interacting with the environment and connecting with others result in a depressive disorder.

About This Article

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About the book authors:

Stephen M. Shore received a regressive autism diagnosis at age 18 months, became nonverbal, and was deemed “too sick” to be treated on an outpatient basis. Today, he’s finishing a doctoral degree focused on helping people with autism lead fulfilling and productive lives. When not teaching college-level courses in special education and teaching children with autism how to play musical instruments, he consults and presents on autism-related issues internationally. Some topics of particular interest to him include comparative approaches for helping people with autism, education, and disaster preparedness for people with disabilities. He also focuses on challenges faced by adults in terms of self-advocacy, disclosure, post-secondary education, employment, interdependent living, and relationships.
Stephen holds bachelor degrees in music and accounting and information systems from the University of Massachusetts at Amherst. He also holds a masters degree in music education and is on the cusp of finishing his doctorate in education from Boston University. Although he seems to spend most of his time traveling in airplanes (Boeing 747-400 preferred), he resides in Brookline, Massachusetts, with his wife on the rare occasions when he’s home.

Linda G. Rastelli is an award-winning journalist, instructional designer, and author with 20 years of experience in writing and designing instruction for health, education, and business topics. In her career, she has focused on making complex and technical information understandable to the layperson. Although she has covered subjects ranging from financial ratio analysis to educational reform, her most challenging inquiry to date — an undertaking that has made her other projects look like finger painting in comparison — has been autism.
Linda holds a bachelor of arts degree from the University of Delaware and a masters degree from Columbia University. She lives on the New Jersey coast with her husband and her cat, who have reached a blissful state of detente. She hopes to keep her day job.

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