Autism

1. Autism A Puzzling Developmental Disorder

2. DSM-IV vs. DSM-V (Old vs New) • DSM-IV • Autistic Disorder • Asperger’s Disorder • Childhood Disintegrative Disorder (CDD) • Rett’s Disorder • The catch-all diagnosis of Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) • DSM-V (May 2013) • All Autism disorders were merged into one umbrella diagnosis of ASD- Autism Spectrum Disorder

3. What is Autism? • Neurodevelopmental Disorder • Autism Spectrum Disorder (ASD) and Autism are both general terms for a group of complex disorders of brain development. • Autism is characterized, in varying degrees, by difficulties in • Social interaction • Verbal and Nonverbal communication • Restricted, repetitive behaviors, interests, and/or activities (DSM-V)

4. Diagnostic Criteria • Individuals with Autism are most commonly diagnosed before the age of 5 • CDC announced in April 2018 that 1 in 59 children in U.S. is diagnosed with Autism • Diagnostic Criteria: • Persistent deficits in social communication and social interaction • Deficits in social-emotional reciprocity • Deficits in non-verbal communicative behaviors used for social interaction • Deficits in developing, maintaining, and understanding relationships • Restricted, repetitive patterns of behavior • Stereotyped or repetitive motor movements, use of objects, or speech • Insistence on sameness, inflexible adherence to routines • Highly restricted, fixated interests • hyper- or hyporeactivity to sensory input DSM-V

5. How does Autism affect the body? Examples: • Cognitive impairments • Sensory Integration Dysfunction • Poor eye contact • Lack of facial expression • Inability to speak or delayed speech • Seizure disorders • Self-stimulatory behavior: flapping, rocking, fidgeting with objects, making repetitive sounds, etc. • Health issues such as sleep and gastrointestinal disturbances • Problems with coordination or odd movement patterns, such as clumsiness or walking on toes, and odd, stiff or exaggerated body language

6. Risk Factors • “There is no one cause of autism, just as there is no one type of autism.” –Autism Speaks • Genetics: • “Autism is one of the most heritable mental disorders. If one identical twin has it, so will the other nearly 9 out of 10 cases. If one sibling has the disorder, the other siblings run a 35-fold greater-than-normal risk of having it.” –NIMH • Environment: • Advanced parental age • Perinatal factors: induced labor, short labor, 1-minute low Apgar score, fetal distress, elective or emergency C-Section, threatened miscarriage, oxytocin • Brain Biology: • These genetic and non-genetic risk factors give rise to Autism by affecting crucial aspects of early brain development. • “It is important to keep in mind that these factors, by themselves, do not cause autism. Rather, in combination with genetic risk factors, they appear to modestly increase risk.” –Autism Speaks

7. Prognosis • No cure • Therapies, behavioral interventions, medications, and other interventions can lead to great improvement in symptom severity. • Some people “recover” so much that the ASD diagnosis is withdrawn • For most, the symptoms become milder as a child grows older, but the core problem remains (such as difficulties with social interaction) • It all depends upon the degree of the disorder and the timing and level of treatment

8. Autism is a Spectrum Disorder “If you’ve met one person with autism, you’ve met one person with autism.” -Dr. Stephen Shore • Presents differently in each individual • Severity levels: • Level 1: “Requiring very substantial support” • Level 2: “Requiring substantial support” • Level 3: “Requiring support” (DSM-V) High-Functioning Autism Severe Autism

9. College Students on the Spectrum • Usually considered “high-functioning” • How students with Autism might be affected: • Sensory experience may be unusual • Learning style differences • Information processing affected (visual fields/ sounds distorted) • Experience of time may be unusual • Relationships/socialization may be exhausting and perplexing • Difficulty adjusting to change

10. College Students on the Spectrum Cont. • Possible student strengths: • Above average, even brilliant academic performance in certain subjects • Dependable and responsible/good adherence to routines • Good at working independently • Excellent attention to detail and memory • Can maintain focus for long periods of time • Tend to have job longevity

11. How can we help people with Autism? • Accept their differences; respect their strengths • Find common interests • Invite them to participate in activities • Help them access useful resources • Use clear and direct communication • Remember they may have sensory sensitivities • Establish order and routine • Provide helpful feedback • Learn more about Autism • Ask them what you can do to help “Our duty in aut­ism is not to cure but to re­lieve suf­fer­ing and to max­im­ize each per­son’s po­ten­tial.” -John Elder Robison

12. Resources • Autism Empowerment http://www.autismempowerment.org/11-ways-you-can-help-be-a-good-friend-to-children-on-the-autism-spectrum/ • Autism Speaks https://www.autismspeaks.org/what-autism • Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-V) • Indiana Resource Center for Autism https://www.iidc.indiana.edu/pages/irca • Mayo Clinic https://www.mayoclinic.org/diseases-conditions/autism-spectrum-disorder/symptoms-causes/syc-20352928 • National Institute of Mental Health https://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd/index.shtml • National Institute of Neurological Disorders and Stroke (NINDS) https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Autism-Spectrum-Disorder-Fact-Sheet