What is Autism?

What is Autism?

According to the Diagnostic and Statistics Manual of Mental Disorders ( DSM-IV),  Autism ( Autism Spectrum Disorder) is a term used to describe a variety of disorders known as Pervasive Developmental Disorders.  These are disorders which manifest in developmental delays  in multiple areas of basic functioning skills, usually socialization and communication.  The reason it is called a "spectrum disorder" is because no 2 children are alike in their symptoms.  It is often said that if you know one child with Autism, you know ONE child with Autism.  These delays can range from mild to severe and the symptoms themselves can vary from child to child.  For example, some children are high functioning and are communicative but lack the understanding of social cues and interactions.  This is often the case with Aspergers.  Other children may be non-verbal and low-functioning, as is sometimes the case with Classic Autism.

New DSM-5

Recently a new Diagnostic and Statistics Manual of Mental Disorders ( DSM-5) was released. It altered the description and diagnostic criteria for Autism Spectrum Disorder. Now, There are no subcategories within the Autism spectrum diagnosis (for example Asperger's was removed from the DSM-5).  The necessary criterion to diagnose Autism also changed.  In the DSM-IV, there were 3 categories from which symptoms must be present. These categories focused on problems with social interaction, problems with communication, and restricted repetitive and stereotyped patterns of behavior, interests and activities.  With the new diagnostic criteria have been rearranged into two areas: 1) social communication/interaction, and 2) restricted and repetitive behaviors.

(From DSM-5)
All of the following symptoms describing persistent deficits in social communication/interaction across contexts, not accounted for by general developmental delays, must be met:

• Problems reciprocating social or emotional interaction, including difficulty establishing or maintaining back-and-forth conversations and interactions, inability to initiate an interaction, and problems with shared attention or sharing of emotions and interests with others.
• Severe problems maintaining relationships — ranges from lack of interest in other people to difficulties in pretend play and engaging in age-appropriate social activities, and problems adjusting to different social expectations.
• Nonverbal communication problems such as abnormal eye contact, posture, facial expressions, tone of voice and gestures, as well as an inability to understand these.

Two of the four symptoms related to restricted and repetitive behavior need to be present:

• Stereotyped or repetitive speech, motor movements or use of objects.
• Excessive adherence to routines, ritualized patters of verbal or nonverbal behavior, or excessive resistance to change.
• Highly restricted interests that are abnormal in intensity or focus.
• Hyper or hypo reactivity to sensory input or unusual interest in sensory aspects of the environment.

Symptoms must be present in early childhood but may not become fully manifest until social demands exceed capacities. Symptoms need to be functionally impairing and not better described by another DSM-5 diagnosis.

Symptom severity for each of the two areas of diagnostic criteria is now defined. It is based on the level of support required for those symptoms and reflects the impact of co-occurring specifiers such as intellectual disabilities, language impairment, medical diagnoses and other behavioral health diagnoses.

Another man difference is the introduction of severity levels. Previously, terms like high-functioning or low functioning were used to describe the severity of symptoms. But these can be misleading because someone who is low functioning on a communication scale may be very high functioning cognitively. The new levels will enable the medical community to describe the level of supports needed based the level severity of symptoms.
Level 1: "Requiring Support"
Level 2: "Requiring Substantial Support"
Level 3: "Requiring Very Substantial Support"

No matter what the criterion or severity levels... The important thing to remember is that no 2 children are the same. Every Autistic Child's Autism is as different as every non-Autistic child's neurotypicalism. No 2 children are alike... Period.