"The most striking thing about the traditional diagnostic criteria for autism is that they are all stated in the negative. Criteria include terms such as ‘impairment of…’, ‘lack of…’, ‘failure to…’ "
- Heather MacKenzie, Reaching and Teaching the Child with Autism
What is "autism"?
Autism spectrum disorder (ASD) is a lifelong developmental disorder that impacts a person's:
- communication (both verbal and non-verbal)
- social interaction (ability to form or understand relationships)
- perception, behavior and interests (sensory or emotional perception, repetitive or unusual behaviors, restricted or obsessive interests)
Autism is called a "spectrum" disorder because of the varying degree of severity and impact on a person's ability to function, and wide range of symptoms that may be present.
A person may have cognitive impairment or an intellectual disability- however, it's worth noting that nearly half of all children identified with ASD are of average or above-average intelligence.
Sensory issues are extremely common. People with ASD may be hyper- or hypo-sensitive to sights, sounds, smells, touch and/or taste. For example: loud noises, bright lights, scratchy clothes or certain textures can be excruciatingly uncomfortable. Or a person with autism might have an unusually high tolerance for pain (which can be extremely dangerous). There isn't always discomfort though- sometimes the information is simply processed differently. Researchers in the UK have also found higher rates of synaesthesia among those with ASD.
All of this affects how people with ASD learn, interact and behave in both positive and negative ways. For example:
- specialized interests can lead to outstanding achievements
- a different way of seeing the world can lead to highly original ideas
- challenges to learning through conventional methods can lead to unique approaches to problem-solving
In cases where a person doesn't receive a diagnosis until adulthood, unusual behaviors that weren't understood as they were growing up suddenly begin to make a lot more sense.
Many problems experienced by a person with autism may be compounded by their difficulty with communication or social abilities, which is one of the most heart-breaking features of this disorder.
Imagine a child who is sick but can't tell you where it hurts... or someone who wants to make friends, but doesn't understand the unwritten social rules of their peers.
What is "Asperger's"?
A diagnosis of autism spectrum disorder (ASD) now includes several conditions that used to be diagnosed separately: autistic disorder, pervasive developmental disorder not otherwise specified (PDD-NOS) and Asperger's syndrome (AS). Autism spectrum disorder is now used as a single term to include all these conditions, and illustrate the fact that they are part of the same "spectrum".
"Asperger's" is named after Hans Asperger, an Austrian pediatrician who released a paper in 1944 describing a group of children in his practice.
These children showed the classic signs of autism - trouble with social interaction, restricted/repetitive interests, difficulty reading non-verbal communication like body language or facial expressions - however, the children had fluent language ability. They were able to communicate verbally, but they had trouble with back-and-forth conversation, with the "social" part of interaction.
This is recognized as one of the reasons why some people don't receive a diagnosis until they are much older - sometimes not until they are adults - when differences between their abilities and that of their peers become much more noticeable. Because they are able to speak and adapt in social situations more easily than others on the spectrum, their condition may go unnoticed. Sometimes, indefinitely.
Even though it is now considered part of the overall autism spectrum, the term "Asperger's" is still used by many people, for several reasons:
- Until the DSM-V (the Diagnostic Standards Manual which is used by doctors to classify different disorders) was published in 2013, Asperger's syndrome (AS) had been considered a distinct diagnosis since the early 1990s.
- Many people who were originally diagnosed as having Asperger's syndrome still identify with the term and find it helpful for understanding or describing their condition
- The nickname "Aspie" (which originates from the word Asperger) has been adopted by people who accept, and embrace, their own particular form of autism
Autism Prevalence
1 in 66 Canadian children and youth aged five to 17 are on the autismspectrum, indicates a new report released by the Public Health Agency of Canada.
ASD occurs in all racial, ethnic and socioeconomic groups. Notably, ASD is almost five times more common among boys (1 in 42) than among girls (1 in 189). This ratio has remained approximately the same over the decades, even as overall rates have been rising.
While experts still disagree on the causes, improved monitoring and reporting has uncovered a steady increase in rates over the past few decades. Back in 1992, autism was identified in only one out of every 150 children.
DSM-IV and DSM-V
Even though the American Psychiatric Association released the new DSM-V in 2013, current statistics are still based on the definition of autism spectrum disorder as per the DSM-IV, which includes: autistic disorder, PDD-NOS (including atypical autism), and Asperger's syndrome.
Beginning in 2014, surveillance methods will incorporate the new definitions from the DSM-V. However, cases will still be evaluated to see if children meet the previous DSM-IV criteria, so that prevalence trends can be better understood.
What causes autism?
The exact cause of ASD is not known.
While both genetics and environment likely play a role, its exact cause remains unknown.
There is a lot of research being done worldwide to understand how genes and exposure to things in the environment can increase the risk that a child will have ASD. However it’s important to keep in mind that increased risk is not the same as cause. For example, some gene changes associated with ASD can also be found in people who don’t have the disorder.
It is important to know that vaccines do not cause autism. No links have been found connecting vaccines with a higher risk of developing ASD.
Immunize Canada states that, "the U.S. Institute of Medicine (IOM) has conducted evidence-based reviews and has rejected any causal associations between the measles-mumps-rubella (MMR) vaccine and autism spectrum disorders in children." Separate Danish and Canadian research have also confirmed these findings.
The idea of a link between autism and vaccines originated as a result of a now-discredited study which was conducted by Dr. Andrew Wakefield and published in the medical journal called The Lancet in 1998. The Lancet fully retracted the discredited paper in 2010. An investigation published by the British Medical Journal found the study to be fraudulent and that the medical histories in the study had been altered and misrepresented by Wakefield. (Wakefield was later stripped of his license to practice medicine.)
