Autism Defined

Autism is the most common situation in a group of developmental disorders known as the autism spectrum disorders (ASDs). Autism is characterized by impaired social interaction, problems with verbal and nonverbal communications, and unusual repetitive or severely limited activities and interests. Other ASDs include Asperger syndrome, Rett syndrome, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified (usually referred to as PDD-NOS). It is estimated that 1 in 150 children have autism. Males are four times more likely to have autism than females.

There are three distinguishing behaviors that typify autism. Children with autism have difficulties with social interactions, problems with verbal and nonverbal communication, and repetitive behaviors or narrow, compulsive interests. These behaviors can range in impact from mild to disabling.

The characteristic trait of autism is impaired social interaction. Parents are usually the first to notice symptoms of autism in their child. As early as infancy, a baby with autism may be indifferent to people or focus fixedly on one item, to the exclusion of others, for long periods of time. A child with autism may appear to develop normally and then withdraw and become indifferent to social engagements.

Children with autism may fail to respond to their name and often avoid eye contact with other people. They have difficulty interpreting what others are thinking or feeling because they can’t understand social cues, such as tone of voice or facial expressions; they don’t watch other people’s faces for clues about appropriate behavior. They lack understanding attentiveness.

Many children with autism take on rhythmic and repetitive movements such as rocking and twirling, or are involved in self-abusive behavior such as biting and head-banging. They also tend to start speaking later then other children and may refer to themselves by name instead of “I” or “me.” Children with autism don’t know how to play or interact with other children. Some speak in a sing-song voice about a narrow range of favorite topics, with little regard for the interests of the person to whom they are speaking.

Many children with autism have a reduced sensitivity to pain, but are peculiarly sensitive to sound, touch, or other sensory stimulation. These unusual reactions may contribute to behavioral symptoms such as resistance to being cuddled or hugged.

Autism varies broadly in its severity and symptoms and may go unrecognized, especially in mildly affected children or when it is shrouded by more incapacitating handicaps. Doctors rely on a central group of behaviors to alert them to the possibility of a diagnosis of autism. These behaviors include:

  • impaired ability to make friends with peers
  • impaired ability to initiate or sustain a conversation with others
  • absence or impairment of imaginative and social play
  • stereotyped, repetitive, or unusual use of language
  • restricted patterns of interest that are abnormal in intensity or focus
  • preoccupation with certain objects or subjects
  • inflexible adherence to specific routines or rituals

Autism is a multifaceted disorder. A comprehensive evaluation requires a multidisciplinary team including a psychologist, neurologists, psychiatrist, speech therapist, and other professionals who diagnose children with ASDs. The team members conduct a thorough neurological assessment and in-depth cognitive and language testing. Because hearing problems can cause behaviors that are sometimes mistaken for autism, children with delayed speech development should also have their hearing tested. After a thorough evaluation, the team usually meets with parents to explain the results of the evaluation and present the diagnosis.

Children with some symptoms of autism, but not enough to be diagnosed with classical autism are often diagnosed with PDD-NOS. Children with autistic behaviors but well-developed language skills are often diagnosed with Asperger syndrome. Children who develop normally and then suddenly deteriorate between the ages of 3 to 10 years and show marked autistic behaviors may be diagnosed with childhood disintegrative disorder. Girls with autistic symptoms may be suffering from Rett syndrome, a sex-linked genetic disorder characterized by social withdrawal, regressed language skills, and hand wringing.

Scientists aren’t certain what causes autism, but it’s likely that both genetics and environment play a role. Researchers have identified a number of genes associated with the disorder. Studies of people with autism have found irregularities in several regions of the brain. Other studies suggest that people with autism have abnormal levels of serotonin and other neurotransmitters in the brain. These abnormalities suggest that autism could result from the disruption of normal brain development early in the fetal stage, caused by defects in genes that control brain growth and regulate how neutrons communicate with each other. While these findings are fascinating, they are preliminary and require further study. The theory that parental practices are responsible for autism has now been disproved.

Recent studies strongly suggest that some people have a genetic predilection to autism. In families with one autistic child, the risk of having a second child with the disorder is approximately 5 percent, or one in 20. This is greater than the risk for the general population. Researchers are looking for clues about which genes contribute to this increased vulnerability. In some cases, parents and other relatives of an autistic child show mild impairments in social and communicative skills or engage in repetitive behaviors. Evidence also suggests that some emotional disorders, such as manic depression, occur more frequently than average in the families of people with autism.

For many children, autism symptoms improve with treatment and with age. Some children with autism grow up to lead normal or near-normal lives. Children, whose language skills degenerate early in life, usually before the age of 3, appear to be at risk of developing other complications including epilepsy or seizure-like brain activity.

There is no cure for autism. Therapies and behavioral interventions are designed to remedy specific symptoms and can therefore, bring about substantial improvement. The ideal treatment plan coordinates therapies and interventions that target the core symptoms of autism: impaired social interaction, problems with verbal and nonverbal communication, and obsessive or repetitive routines and interests. Most professionals agree that the earlier that intervention occurs, the better the child’s chances for successful skill development.

Applied Behavior Analysis (ABA) is the underlying educational approach at Shema Kolainu – “Hear Our Voices” (SK-HOV), which entails the comprehensive use of the principles of human learning theory to enhance the development, abilities and self-direction skills of children and adults. Thanks to the field of ABA, children with autism have been able to make greater strides than anyone might have imagined just a few decades ago!

Each program in SK-HOV has been developed to address skill variations and multiple levels of functioning. In addition to the broad spectrum of services for children, we provide support to families in the techniques of ABA to help their child generalize the learning acquired in school or day programs. Teaching methods we use involve a variety of strategies and formats developed within the field of applied behavior analysis, such as discrete trials, verbal behaviors and incidental learning.

Behavior analysts supervise and observe all staff on a regular basis regarding the manner and implementation of interventions across all services. Shema Kolainu is committed to furthering the understanding and treatment of autism spectrum disorders by keeping abreast of recent research findings and developing evidence-based practices. It offers hope to children and their families where none existed, so that one day many of these children can have the opportunity to overcome autism.