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What Are the Autism Spectrum Disorders?

Updated on December 28, 2012
Autism Awareness Ribbon
Autism Awareness Ribbon | Source

The broad term autism is often used to refer to more than a single developmental disability. Under the umbrella, there are multiple disorders that are included, including autism, Asperger’s,and Pervasive Development Disorder (Not Otherwise Specified) (often called PDD-NOS). Other developmental disabilities that fall under the spectrum include Rett’s Syndrome, and Childhood Disintegrative Disorder. The term autism spectrum disorders is used because most of these disorders share some general diagnosable criteria. In addition, while one diagnosis may originally be made, as the child grows and changes, the diagnosis may change based on new information presented or developmental milestones that are hit. It is also important to note that even within each division, there are still different levels based on functionality.

PDD-NOS

PDD-NOS is sometimes referred to as “atypical autism.” PDD-NOS may be a “placeholder” diagnosis, one that is used in younger children when diagnosing autism or Asperger’s may not be possible. PDD-NOS generally is the diagnosis for those who have mild symptoms or do not meet all the criteria of other forms of autism spectrum disorders. Children often have only social or communication issues and still qualify as having PDD-NOS.

What Is Autism? (CDC)

Autism

Autism is considered the classic form of autistic spectrum disorders. With autism, the child has social and communication challenges (sometimes avoiding eye contact or being completely uninterested in physical contact), significant language delays (including being non-verbal), and unusual behaviors or interests. In some cases, the children may be fascinated with a single subject or may play with toys in “incorrect” ways, such as spinning wheels on cars or lining up their toys instead of playing with them. In addition, some autistic children will also have intellectual disabilities or may be diagnosed as having intellectual disabilities because they are unable to take the traditional IQ tests.

Asperger’s

Asperger’s is often considered a mild form of autism. Children with Asperger’s generally have problems with social issues and behavior, but they do not normally have language delays or any intellectual disabilities. In fact, many children who are diagnosed with Asperger’s may have genius level IQs or may have savant abilities.

Kim Peek - the real "Rain Man" (Video 1 of 5)

Rett’s Syndrome

Rett’s is a very rare form of an autism spectrum disorder. It includes a regression in development, as opposed to a lack of development. Rett’s occurs in girls, and only 1 in 10,000 to 22,000 girls will have Rett’s. Children who have Rett’s will appear to be developing normally until they are somewhere between six and eighteen months, and then autism-like symptoms will appear. In addition, girls with Rett’s often have problems with coordination, movement, and speech, in addition to the autistic symptoms. Children with Rett’s can benefit from speech, occupational, and physical therapy, but there is no other known treatment.

Childhood Disintegrative Disorder

Childhood Disintegrative Disorder (CDD) is an extremely rare form of an autism spectrum disorder. It includes a regression in development, and only 1 or 2 of 100,000 children with an autism spectrum disorder will have CDD. Because CDD is so rare, there is not much known about it. However, in most cases, CDD appears between the ages of two and four, during which time the child will regress from having age-appropriate social skills and communication to having a dramatic shift, often becoming far less functional than those with classic autism. In addition, children with CDD may also have problems with their bowel and bladder.

Major brain structures implicated in autism.
Major brain structures implicated in autism. | Source
Chart showing the increase in autism diagnosis, with statistics based on data from the National Center for Health Statistics.
Chart showing the increase in autism diagnosis, with statistics based on data from the National Center for Health Statistics. | Source

Controversy about the DSM-V

The DSM-V is the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. It is published by the American Psychiatric Association (APA), and it includes diagnosing criteria for mental disorders, developmental disorders, and other conditions that fall under the mien of the APA.

In this newest edition, due out in May 2013, autistic disorder, Asperger’s disorder, childhood disintegrative disorder, and PDD-NOS are all being subsumed under the heading “autism spectrum disorder.” The argument behind the change is that these conditions all have extremely similar symptoms and diagnosing criteria, and thus combining them is logical.

The controversy arises because many parents of children who have been diagnosed and many individuals who themselves have been diagnosed are concerned that the new criteria is harder to meet for those who were on the fringe of the diagnosis, and now those people will be refused services that they need as they will no longer fit the criteria and will lose their diagnosis.

In the DSM-IV, there were three groups of behaviors, and a person needed to only fit six of the twelve potential characteristics. In the DSM-V, however, there are only two groups, and this may leave some of the previously diagnosed people out of luck when it comes to insurance coverage for treatment.

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