What is autistic disorder?
Autistic disorder (also called autism; more recently described as “mindblindedness”) is a neurological and developmental disorder that usually appears during the first three years of life. A child with autism appears to live in their own world, showing little interest in others and a lack of social awareness. The focus of an autistic child is a consistent routine and includes an interest in repeating odd and peculiar behaviors. Autistic children often have problems in communication, avoid eye contact and show limited attachment to others.
Autism can prevent a child from forming relationships with others (in part, due to an inability to interpret facial expressions or emotions). A child with autism may resist cuddling, play alone, be resistant to change and have delayed speech development. Persons with autism tend to exhibit repeated body movements (such as flapping hands or rocking) and have unusual attachments to objects. However, many persons with autism excel consistently on certain mental tasks (i.e., counting, measuring, art, music, memory).
What causes autism?
The cause of autism is not known. Research suggests that autism is a genetic condition. It is believed that several genes are involved in the development of autism. Research studies in autism have found a variety of abnormalities in the brain structure and chemicals in the brain; however, there have been no consistent findings. One theory is the possibility that autistic disorder is a behavioral syndrome that includes several distinct conditions. However, parenting behaviors are not the cause or a contributing factor to the cause or causes of autism.
What are the guidelines?
The standardized guidelines developed for the diagnosis of autism actually involve two levels of screening for autism. Level one screening, which should be performed for all children coming to a physician for well-child check-ups during their first two years of life, should check for the following developmental deficits:
- No babbling, pointing or gesturing by age 12 months.
- No single words spoken by age 18 months.
- No two-word spontaneous (non-echolalia, or not merely repeating the sounds of others) expressions by age 24 months.
- Loss of any language or social skills at any age.
Other key behaviors that are useful in diagnosing autism in preschoolers include:
- Lack of joint attention
- Joint attention occurs when a person “shares” an experience with another. For example, a child points to a bird and turns to his parent while saying the word “bird”. Or a child also may “perform” for a parent, expecting the parent to watch and react to what he is doing.
- Lack of affective reciprocity
- Affective reciprocity occurs when a child “shares a moment” with a parent. Playing peek-a-boo while laughing and requesting more is one example. Another is when a child shows concern about another child who may be crying, however, true empathy may not develop until a child is 4 or 5 years old.
- Limited imitation
- Imitation occurs very early in children, usually by 15 months of age. A child may attempt to imitate her parent vacuuming or sweeping.
- Little evidence of pretend play
- Pretend play develops over the preschool years. Early examples include things like feeding a baby doll or making car noises while pushing them around the floor.