   #copyright

Autism

2007 Schools Wikipedia Selection. Related subjects: Health and medicine

   CAPTION: Autism
   Classifications and external resources

     ICD- 10   F 84.0
     ICD- 9    299.0
      OMIM     209850
   DiseasesDB  1142
   MedlinePlus 001526
    eMedicine  med/3202  ped/180

   Autism is classified as a neurodevelopmental disorder that manifests in
   delays of "social interaction, language as used in social
   communication, or symbolic or imaginative play," with "onset prior to
   age 3 years," according to the Diagnostic and Statistical Manual of
   Mental Disorders. The ICD-10 also requires symptoms to be "manifest
   before the age of three years." Autism is often not physiologically
   obvious, in that outward appearance may not indicate a disorder, and
   diagnosis typically comes from a complete physical and neurological
   evaluation.

   There have been large increases in diagnosed autism, for reasons that
   are heavily debated by researchers in psychology and related fields
   within the scientific community. Some believe this increase is largely
   due to changed diagnostic criteria and/or societal factors, while
   others think the reason is environmental. The United States Centers for
   Disease Control (CDC) estimate the prevalence of autism spectrum
   disorders to be between 2 and 6 per 1000 births (i.e., between 1 in 500
   and 1 in 166 births). The National Institute of Mental Health (NIMH)
   states the "best conservative estimate" as 1 in 1000.

   Although the specific causes of autism are unknown, there is a large
   database of links between autism and genetic loci that span every
   chromosome. Further, observations such as autistic children having
   generally larger head circumferences are intriguing, but their roles in
   the disorder are unclear. Research continues, however; researchers at
   the University of Pennsylvania School of Medicine, for example, claim
   to have found a link between autism, abnormal blood vessel function,
   and oxidative stress (the result of higher levels of free radicals).
   This suggests that doors may be opened to new medical therapies if
   researchers can find more evidence linking decreased blood flow to the
   brain and oxidative stress with the pathology of autism.

   With early intervention, intense therapies (most notably Applied
   Behavioural Analysis), practice, and schooling, some children diagnosed
   with autism may improve on their skills to the point of neurotypical
   children. Some autistic children and adults are opposed to attempts to
   cure autism, because they see autism as part of who they are.

History

   The word "autism" was first used in the English language by Swiss
   psychiatrist Eugene Bleuler in a 1912 issue of the American Journal of
   Insanity. It comes from the Greek word for "self," αυτος (autos).
   Bleuler used it to describe the schizophrenic's seeming difficulty in
   connecting with other people.

   However, the classification of autism did not occur until 1943 when
   psychiatrist Dr. Leo Kanner of the Johns Hopkins Hospital in Baltimore
   reported on 11 child patients with striking behavioural similarities
   and introduced the label "early infantile autism." He suggested the
   term "autism" to describe the fact that the children seemed to lack
   interest in other people. Kanner's first paper on the subject was
   published in a now defunct journal called The Nervous Child, and almost
   every characteristic he originally described is still regarded as
   typical of the autistic spectrum of disorders.

   At the same time, an Austrian scientist named Dr. Hans Asperger made
   similar observations, although his name has since become attached to a
   different higher-functioning form of autism known as Asperger's
   syndrome. Widespread recognition of Asperger's work was delayed by
   World War II in Germany, and by his seminal paper not being translated
   into English for almost 50 years. The majority of his work wasn't
   widely read until 1997.

   Autism and Asperger's Syndrome are today listed in the DSM-IV-TR as two
   of the five pervasive developmental disorders (PDD), which are also
   referred to as autism spectrum disorders (ASD). All of these conditions
   are characterized by varying degrees of deficiencies in communication
   skills and social interactions, along with restricted, repetitive, and
   stereotyped patterns of behaviour.

Characteristics

   Individuals diagnosed with autism can vary greatly in skills and
   behaviors, and their sensory system is quite different from that of
   other people. Certain stimulations, such as sounds, lights, and touch,
   will often affect someone with autism differently than someone without,
   and the degree to which the sensory system is affected can vary greatly
   from one individual to another. On the surface, individuals who have
   autism are physically indistinguishable from those without. Sometimes
   autism co-occurs with other disorders, and in those cases outward
   differences may be apparent. Enlarged brain size appears to accompany
   autism, but the effects of this are still unknown.

   In assessing developmental delays, different physicians may not always
   arrive at the same conclusions. Much of this is due to the somewhat
   vague diagnostic criteria for autism, paired with an absence of
   objective diagnostic tests. Nevertheless, professionals within
   pediatrics, child psychology, behaviour analysis, and child development
   are always looking for early indicators of autism in order to initiate
   treatment as early as possible for the greatest benefit.

Social development

   Typically-developing infants are social beings—early in life they gaze
   at people, turn toward voices, grasp at fingers, and smile. In
   contrast, most autistic children do not show special interest in faces
   and seem to have tremendous difficulty learning to engage in everyday
   human interaction. Even in the first few months of life, many autistic
   children seem indifferent to other people, lacking the eye contact and
   interaction with others that non-autistic children are expected to
   exhibit. Some infants with autism may appear very calm; they may cry
   less often because they do not seek parental attention or ministration.

   Autistic children often seem to prefer being alone and may passively
   accept such things as hugs and cuddling without reciprocating, or
   resist attention altogether. Later, they seldom seek comfort from
   others or respond to parents' displays of anger or affection in a
   typical way. Research has suggested that although autistic children are
   attached to their parents, their expression of this attachment may be
   unusual and difficult to interpret.

   According to Simon Baron-Cohen et al, many autistic children appear to
   lack a " theory of mind," which is the ability to see things from
   another person's perspective. This is a behaviour cited as being
   exclusive to human beings above the age of five and possibly, to a
   lesser degree, to other higher primates such as adult gorillas,
   chimpanzees and bonobos. Typical 5-year-olds can usually develop
   insights into other people's knowledge, feelings, and intentions based
   on social cues (e.g., gestures and facial expressions). An autistic
   individual may lack these interpretation skills, leaving them unable to
   predict or understand other people's actions or intentions.

   Children with autism often experience social alienation during their
   school-age years. As a response to this, or perhaps because their
   social surroundings simply do not "fit" them, many report inventing
   imaginary friends, worlds, or scenarios. Making friends in real life
   and maintaining those friendships often proves to be difficult for
   those with autism.

   Although not universal, it is common for autistics to have difficulty
   regulating their behavior, resulting in crying, verbal outbursts, or
   self-injurious behaviors that seem inappropriate or without cause.
   Those who have autism generally prefer consistent routines and
   environments, and they may react negatively to changes in their
   surroundings. It is not uncommon for these individuals to exhibit
   aggression, increased levels of self-stimulatory behaviour,
   self-injury, or extensive withdrawal in overwhelming situations.
   However, as the child matures and receives education/training, he or
   she can gradually learn to control such behaviors and cope with
   difficult changes in other ways.

Sensory system

   Clinicians making a proper assessment for autism would look for
   symptoms much like those found in Sensory Integration Dysfunction.
   Children will exhibit problems coping with normal sensory input.
   Indicators of autism include oversensitivity or underreactivity to
   touch, movement, sights, or sounds; physical clumsiness or
   carelessness; poor body awareness; a tendency to be easily distracted;
   impulsive physical or verbal behaviour; an activity level that is
   unusually high or low; not unwinding or calming oneself; difficulty
   learning new movements; difficulty in making transitions from one
   situation to another; social and/or emotional problems; delays in
   speech, language or motor skills; specific learning difficulties/delays
   in academic achievement. However, it is important to remember that
   while most people with autism have some degree of sensory integration
   difficulty, not every person who has sensory problems is autistic.

   One common example is autistic hearing. An autistic person may have
   trouble hearing certain people while other people are perceived as
   speaking at a higher volume. Or the autistic may be unable to filter
   out sounds in certain situations, such as in a large crowd of people
   (see cocktail party effect). However, this is perhaps a part of autism
   that tends to vary widely from person to person, so these examples may
   not apply to every autistic person. Note that such auditory
   difficulties fall under auditory processing disorders, and like sensory
   integration dysfunction, are not necessarily experienced by all people
   with autism or indicative of a diagnosis of autism.

Communication difficulties

   By age 3, typical children have passed predictable language learning
   milestones; one of the earliest is babbling. By the first birthday, a
   typical toddler says words, turns when he or she hears his or her name,
   points when he or she wants a toy, and when offered something
   distasteful, makes it clear that the answer is "no." It should be
   noted, however, that late language development does occur in a minority
   of neurotypical children.

   Speech development in people with autism takes different paths than the
   majority of neurotypical children. Some remain mute throughout their
   lives with varying degrees of literacy; communication in other
   ways—images, visual clues, sign language, and typing may be far more
   natural to them. Contrary to the prevailing traditional stereotype of
   mute people with Kanner-type autism, around one third of people
   diagnosed with this type of autism will develop what is often viewed as
   dysfunctional verbal language, relying on rote learned stored phrases,
   songs, jingles and advertisements. Those with the autism spectrum
   condition of Semantic Pragmatic Disorder fall into this group.

   Those who do speak sometimes use language in unusual ways, retaining
   features of earlier stages of language development for long periods or
   throughout their lives. Some speak only single words, while others
   repeat a mimicked phrase over and over. Some repeat what they hear, a
   condition called echolalia. Sing-song repetitions in particular are a
   calming, joyous activity that many autistic adults engage in. Many
   people with autism have a strong tonal sense, and can often understand
   at least some spoken language whilst others can understand language
   fluently.

   Some children may exhibit only slight delays in language, or even seem
   to have precocious language and unusually large vocabularies, but have
   great difficulty in sustaining typical conversations. The "give and
   take" of non-autistic conversation is hard for them, although they
   often carry on a monologue on a favorite subject, giving no one else an
   opportunity to comment. When given the chance to converse with other
   autistics, they comfortably do so in "parallel monologue"—taking turns
   expressing views and information. Just as " neurotypicals" (people
   without autism) have trouble understanding autistic body languages,
   vocal tones, or phraseology, people with autism similarly have trouble
   with such things in people without autism. In particular, autistic
   language abilities tend to be highly literal; people without autism
   often inappropriately attribute hidden meaning to what people with
   autism say or expect the person with autism to sense such unstated
   meaning in their own words.

   Some people with high-functioning Autism demonstrate advanced cognitive
   ability, but lack the skills or are not inclined to interact with
   others socially. An example of the this is the noted autistic Temple
   Grandin, who holds a PhD and is a successful developer of livestock
   handling technologies. She describes her inability to understand the
   social communication of neurotypicals as leaving her feeling "like an
   anthropologist on Mars." Temple's case was described by neurologist
   Oliver Sacks in his 1995 book titled " An Anthropologist on Mars: Seven
   Paradoxical Tales."

   Some infants who later show signs of autism coo and babble during the
   first few months of life, but stop soon afterwards. Others may be
   delayed, developing language as late as the teenage years. Still,
   inability to speak does not mean that people with autism are
   unintelligent or unaware. Once given appropriate accommodations, some
   will happily converse for hours, and can often be found in online chat
   rooms, discussion boards or websites and even using communication
   devices at autism-community social events such as Autreat.

   Sometimes, the body language of people with autism can be difficult for
   other people to understand. Facial expressions, movements, and gestures
   may be easily understood by some other people with autism, but do not
   match those used by other people. Also, their tone of voice has a much
   more subtle inflection in reflecting their feelings, and the auditory
   system of a person without autism often cannot sense the fluctuations.
   What seems to non-autistic people like odd prosody; things like a
   high-pitched, sing-song, or flat, robot-like voice may be common in
   autistic children and some will have combinations of these prosody
   issues. Some autistic children with relatively good language skills
   speak like little adults, rather than communicating at their current
   age level, which is one of the things that can lead to problems.

   Since non-autistic people are often unfamiliar with the autistic body
   language, and since autistic natural language may not tend towards
   speech, autistic people often struggle to let other people know what
   they need. As anybody might do in such a situation, they may scream in
   frustration or resort to grabbing what they want. While waiting for
   non-autistic people to learn to communicate with them, people with
   autism do whatever they can to get through to them. Communication
   difficulties may contribute to autistic people becoming socially
   anxious or depressed or prone to self-injurious behaviours. Recently,
   with the awareness that those with autism can have more than one
   condition, a significant percentage of people with autism are being
   diagnosed with co-morbid mood, anxiety and compulsive disorders which
   may also contribute to behavioural and functioning challenges.

Repetitive behaviors

   Although people with autism usually appear physically normal and have
   good muscle control, unusual repetitive motions, known as
   self-stimulation or " stimming," may set them apart. These behaviors
   might be extreme and highly apparent or more subtle. Some children and
   older individuals spend a lot of time repeatedly flapping their arms or
   wiggling their toes, others suddenly freeze in position. As children,
   they might spend hours lining up their cars and trains in a certain
   way, not using them for the type of pretend play expected of a
   non-autistic child. If someone accidentally moves one of these toys,
   the child may be tremendously upset. Autistic children often need, and
   demand, absolute consistency in their environment. A slight change in
   any routine—in mealtimes, dressing, taking a bath, or going to school
   at a certain time and by the same route—can be extremely disturbing to
   them. Autistics sometimes have persistent, intense preoccupations. For
   example, the child might be obsessed with learning all about computers,
   TV programs and movie schedules or lighthouses. Often they show great
   interest in different languages, numbers, symbols or science topics.
   Repetitive behaviors can also extend into the spoken word as well.
   Perseveration of a single word or phrase, even for a specific number of
   times can also become a part of the child's daily routine.

Effects in education

   Children with autism are affected by their symptoms every day, which
   set them apart from unaffected students. Because of problems with
   receptive language and theory of mind, they can have difficulty
   understanding some classroom directions and instruction, along with
   subtle vocal and facial cues of teachers. This inability to fully
   decipher the world around them often makes education stressful.
   Teachers need to be aware of a student's disorder, and ideally should
   have specific training in autism education, so that they are able to
   help the student get the best out of his or her classroom experiences.

   Some students learn more effectively with visual aids as they are
   better able to understand material presented visually. Because of this,
   many teachers create “visual schedules” for their autistic students.
   This allows students to concretely see what is going on throughout the
   day, so they know what to prepare for and what activity they will be
   doing next. Some autistic children have trouble going from one activity
   to the next, so this visual schedule can help to reduce stress.

   Research has shown that working in pairs may be beneficial to autistic
   children. Autistic students have problems not only with language and
   communication, but with socialization as well. By facilitating peer
   interaction, teachers can help their students with autism make friends,
   which in turn can help them cope with problems. This can help them to
   become more integrated into the mainstream environment of the
   classroom.

   A teacher's aide can also be useful to the student. The aide is able to
   give more elaborate directions that the teacher may not have time to
   explain to the autistic child and can help the child to stay at a
   equivalent level to the rest of the class through the special
   one-on-one instruction. However, some argue that students with
   one-on-one aides may become overly dependent on the help, thus leading
   to difficulty with independence later on.

   There are many different techniques that teachers can use to assist
   their students. A teacher needs to become familiar with the child’s
   disorder to know what will work best with that particular child. Every
   child is going to be different and teachers have to be able to adjust
   with every one of them.

   Students with autism spectrum disorders sometimes have high levels of
   anxiety and stress, particularly in social environments like school. If
   a student exhibits aggressive or explosive behaviour, it is important
   for educational teams to recognize the impact of stress and anxiety.
   Preparing students for new situations, such as through writing social
   stories, can lower anxiety. Teaching social and emotional concepts
   using systematic teaching approaches such as The Incredible 5-Point
   Scale or other cognitive behavioral strategies can increase a student's
   ability to control excessive behavioural reactions.

DSM definition

   Autism is defined in section 299.00 of the Diagnostic and Statistical
   Manual of Mental Disorders (DSM-IV) as:
    1. A total of six (or more) items from (1), (2) and (3), with at least
       two from (1), and one each from (2) and (3):
         1. qualitative impairment in social interaction, as manifested by
            at least two of the following:
              1. marked impairment in the use of multiple nonverbal
                 behaviors such as eye-to-eye gaze, facial expression,
                 body postures, and gestures to regulate social
                 interaction
              2. failure to develop peer relationships appropriate to
                 developmental level
              3. a lack of spontaneous seeking to share enjoyment,
                 interests, or achievements with other people (e.g., by a
                 lack of showing, bringing, or pointing out objects of
                 interest)
              4. lack of social or emotional reciprocity
         2. qualitative impairments in communication as manifested by at
            least one of the following:
              1. delay in, or total lack of, the development of spoken
                 language (not accompanied by an attempt to compensate
                 through alternative modes of communication such as
                 gesture or mime)
              2. in individuals with adequate speech, marked impairment in
                 the ability to initiate or sustain a conversation with
                 others
              3. stereotyped and repetitive use of language or
                 idiosyncratic language
              4. lack of varied, spontaneous make-believe play or social
                 imitative play appropriate to developmental level
         3. restricted repetitive and stereotyped patterns of behaviour,
            interests, and activities, as manifested by at least one of
            the following:
              1. encompassing preoccupation with one or more stereotyped
                 and restricted patterns of interest that is abnormal
                 either in intensity or focus
              2. apparently inflexible adherence to specific,
                 nonfunctional routines or rituals
              3. stereotyped and repetitive motor mannerisms (e.g., hand
                 or finger flapping or twisting, or complex whole-body
                 movements)
              4. persistent preoccupation with parts of objects
    2. Delays or abnormal functioning in at least one of the following
       areas, with onset prior to age 3 years:
         1. social interaction
         2. language as used in social communication
         3. symbolic or imaginative play.
    3. The disturbance is not better accounted for by Rett's Disorder or
       Childhood Disintegrative Disorder.

   These are rules of thumb and may not necessarily apply to all diagnosed
   autistics.

Types of autism

   Autism presents in a wide degree, from those who are nearly
   dysfunctional and apparently mentally disabled to those whose symptoms
   are mild or remedied enough to appear unexceptional ("normal") to
   others. Although not used or accepted by professionals or within the
   literature, autistic individuals are often divided into those with an
   IQ<80 referred to as having "low-functioning autism" (LFA), while those
   with IQ>80 are referred to as having "high-functioning autism" (HFA).
   Low and high functioning are more generally applied to how well an
   individual can accomplish activities of daily living, rather than to
   IQ. The terms low and high functioning are controversial and not all
   autistics accept these labels.

   This discrepancy can lead to confusion among service providers who
   equate IQ with functioning and may refuse to serve high-IQ autistic
   people who are severely compromised in their ability to perform daily
   living tasks, or may fail to recognize the intellectual potential of
   many autistic people who are considered LFA. For example, some
   professionals refuse to recognize autistics who can speak or write as
   being autistic at all, because they still think of autism as a
   communication disorder so severe that no speech or writing is possible.

   As a consequence, many "high-functioning" autistic persons, and
   autistic people with a relatively high IQ, are under diagnosed, thus
   making the claim that "autism implies retardation" self-fulfilling. The
   number of people diagnosed with LFA is not rising quite as sharply as
   HFA, indicating that at least part of the explanation for the apparent
   rise is probably better diagnostics. Many also think that ASD's are
   being over diagnosed: (1) because the growth in the number and
   complexity of symptoms associated with autism has increased the chances
   professionals will erroneously diagnose autism and (2) because the
   growth in services and therapies for autism has increased the number
   who falsely qualify for those often free services and therapies.

Asperger's and Kanner's syndrome

   In the current Diagnostic and Statistical Manual of Mental Disorders
   (DSM-IV-TR), the most significant difference between Autistic Disorder
   (Kanner's) and Asperger's syndrome is that a diagnosis of the former
   includes the observation of "delays or abnormal functioning in at least
   one of the following areas, with onset prior to age 3 years: (1) social
   interaction, (2) language as used in social communication, or (3)
   symbolic or imaginative play", while a diagnosis of Asperger's syndrome
   observes "no clinically significant delay" in the latter two of these
   areas.

   Whilst the DSM-IV does not include level of intellectual functioning in
   the diagnosis, the fact that those with Asperger's syndrome tend to
   perform better than those with Kanner's autism has produced a popular
   conception that Asperger's syndrome is synonymous with
   "higher-functioning autism", or that it is a lesser disorder than
   autism. Similarly, there is a popular conception that autistic
   individuals with a high level of intellectual functioning in fact have
   Asperger's syndrome, or that both types are merely ' geeks' with a
   medical label attached. The popular depiction of autism in the media
   has been of relatively severe cases, for example, as seen in the films
   Rain Man (autistic adult) and Mercury Rising (autistic child), and in
   turn many relatives of those who have been diagnosed in the autistic
   spectrum choose to speak of their loved ones as having Asperger's
   syndrome rather than autism.

Autism as a spectrum disorder

   Another view of these disorders is that they are on a continuum known
   as autistic spectrum disorders. Autism spectrum disorder is an
   increasingly popular term that refers to a broad definition of autism
   including the classic form of the disorder as well as closely related
   conditions such as PDD-NOS and Asperger's syndrome. Although the
   classic form of autism can be easily distinguished from other forms of
   autism spectrum disorder, the terms are often used interchangeably.

   A related continuum, Sensory Integration Dysfunction, involves how well
   humans integrate the information they receive from their senses.
   Autism, Asperger's syndrome, and Sensory Integration Dysfunction are
   all closely related and overlap.

   Some people believe that there might be two manifestations of classical
   autism, regressive autism and early infantile autism. Early infantile
   autism is present at birth while regressive autism begins before the
   age of 3 and often around 18 months. Although this causes some
   controversy over when the neurological differences involved in autism
   truly begin, some speculate that an environmental influence or toxin
   triggers the disorder. This triggering could occur during gestation due
   to a toxin that enters the mother's body and is transferred to the
   fetus. The triggering could also occur after birth during the crucial
   early nervous system development of the child.

   A paper published in 2006 concerning the behavioural, cognitive, and
   genetic bases of autism argues that autism should perhaps not be seen
   as a single disorder, but rather as a set of distinct symptoms (social
   difficulties, communicative difficulties and repetitive behaviors) that
   have their own distinct causes. An implication of this would be that a
   search for a "cure" for autism is unlikely to succeed if it is not
   examined as separate, albeit overlapping and commonly co-occurring,
   disorders.

Epidemiology

          Further information: Frequency of autism and Autism (incidence).

   Sex differences

   There is not a clear-cut ratio of incidence between boys and girls.
   Studies have found much higher prevalence in boys at the
   high-functioning end of the spectrum, while the ratios appear to be
   closer to 1:1 at the low-functioning end. In addition, a study
   published in 2006 suggested that men over 40 are more likely than
   younger men to father a child with autism, and that the ratio of autism
   incidence in boys and girls is closer to 1:1 with older fathers.

   Reported increase with time

   The number of reported cases of autism increased dramatically over a
   decade. Statistics in graph from the National Center for Health
   Statistics.
   Enlarge
   The number of reported cases of autism increased dramatically over a
   decade. Statistics in graph from the National Centre for Health
   Statistics.

   There was a worldwide increase in reported cases of autism over the
   decade to 2006, which may echo the pattern following the description of
   schizophrenia in the twentieth century. There are several theories
   about the apparent sudden increase.

   Many epidemiologists argue that the rise in the incidence of autism in
   the United States is largely attributable to a broadening of the
   diagnostic concept, reclassifications, public awareness, and the
   incentive to receive federally mandated services (for example,)
   However, some authors indicate that the existence of an as yet
   unidentified contributing environmental risk factor cannot be ruled
   out. On the other hand, a widely-cited pilot study conducted in
   California by the UC Davis M.I.N.D. Institute ( 17 October 2002),
   reported that the increase in autism is real, even after accounting for
   changes to diagnostic criteria.

   The question of whether the rise in incidence is real or an artifact of
   improved diagnosis and a broader concept of autism remains
   controversial. Dr. Chris Johnson, a professor of pediatrics at the
   University of Texas Health Sciences Centre at San Antonio and co-chair
   of the American Academy of Pediatrics Autism Expert Panel, sums up the
   state of the issue by saying, "There is a chance we're seeing a true
   rise, but right now I don't think anybody can answer that question for
   sure." ( Newsweek reference below).

   The answer to this question has significant ramifications on the
   direction of research, since a real increase would focus more attention
   (and research funding) on the search for environmental factors, while
   the alternative would focus more attention to genetics. On the other
   hand, it is conceivable that certain environmental factors (such as
   chemicals, infections, medicines, vaccines, diet and societal changes)
   may have a particular impact on people with a specific genetic
   constitution.

   One of the more popular theories is that there is a connection between
   "geekdom" and autism. This is hinted, for instance, by a Wired Magazine
   article in 2001 entitled "The Geek Syndrome", which is a point argued
   by many in the autism rights movement. This article, many professionals
   assert, is just one example of the media's application of mental
   disease labels to what is actually variant normal behaviour—they argue
   that shyness, lack of athletic ability or social skills, and
   intellectual interests, even when they seem unusual to others, are not
   in themselves signs of autism or Asperger's syndrome. Others assert
   that children who in the past would have simply been accepted as a
   little different or even labeled 'gifted' are now being labeled with
   mental disease diagnoses. See clinomorphism for further discussion of
   this issue.

   Due to the recent publicity surrounding autism and autistic spectrum
   disorders, an increasing number of adults are choosing to seek
   diagnoses of high-functioning autism or Asperger's syndrome in light of
   symptoms they currently experience or experienced during childhood.
   Since the cause of autism is thought to be at least partly genetic, a
   proportion of these adults seek their own diagnosis specifically as
   follow-up to their children's diagnoses. Because autism falls into the
   pervasive developmental disorder category, an individual's symptoms
   must have been present before age seven in order to make a strict
   differential diagnosis.

Treatment

   There is a broad array of autism therapies, but the efficacy of each
   varies dramatically from person to person. Progress toward development
   of medical and behaviour modification remedies, for the more
   debilitating affects of autism, has been hindered significantly by
   widespread disagreements over such things as the nature and causes of
   autistic spectrum disorders, and by a relative paucity of efficacious
   therapies thus far recognized by medical authorities.

Causes

   The causes and etiology of autism are areas of debate and controversy;
   there is currently no consensus, and researchers are studying a wide
   range of possible genetic and environmental causes. Since autistic
   individuals are all somewhat different from one another, there are
   likely multiple "causes" that interact with each other in subtle and
   complex ways, and thus give slightly differing outcomes in each
   individual. Two theories environmental theories include the impact of
   vaccines on the immune system (of which a statistically significant
   link has never been found despite many attempts; see the vaccine theory
   sub-heading in the Causes of autism page for a more extensive
   treatment) and a more recent theory relating autism to high levels of
   television viewing while young.

   There is also a large genetic component to autism. Originally hinting
   toward this was the observation that there is about a 60% concordance
   rate for autism in monozygotic (identical) twins, while dizygotic
   (non-identical) twins and other siblings only exhibit about 4%
   concordance rates. A theory featuring mirror neurons states that autism
   may involve a dysfunction of specialized neurons in the brain that
   should activate when observing other people. In typically-developing
   people, these mirror neurons are thought to perhaps play a major part
   in social learning and general comprehension of the actions of others.

Sociology

   Due to the complexity of autism, there are many facets of sociology
   that need to be considered when discussing it, such as the culture
   which has evolved from autistic persons connecting and communicating
   with one another. In addition, there are several subgroups forming
   within the autistic community, sometimes in strong opposition to one
   another.

   Autistic students generally have difficulties fitting into the
   education system because of their (sometimes deliberate) eccentricities
   and their will to be accepted and considered equal to their
   non-autistic peers in disregard of these eccentricities.

Community and politics

   Curing autism is a very highly controversial and politicized issue.
   What some call the "autistic community" has splintered into several
   strands. Some seek a cure for autism - sometimes dubbed by pro-cure.
   Others do not desire a "cure", because they point out that autism is a
   way of life rather than a "disease", and as such resist it. They are
   sometimes dubbed anti-cure. Many more may have views between these two.
   Recently, with scientists learning more about autism and possibly
   coming closer to effective remedies, some members of the "anti-cure"
   movement sent a letter to the United Nations demanding to be treated as
   a minority group rather than a group with a mental disability or
   disease. Web sites such as autistics.org present the view of the
   anti-cure group.

   There are many resources available for autistic people. Because many
   autistics find it easier to communicate online than in person, a large
   number of these resources are online. In addition, successful autistic
   adults in a local community will sometimes help children with autism,
   using their own experience in developing coping strategies and/or
   interacting with society.

   The year 2002 was declared Autism Awareness Year in the United
   Kingdom—this idea was initiated by Ivan and Charika Corea, parents of
   an autistic child, Charin. Autism Awareness Year was led by the British
   Institute of Brain Injured Children, Disabilities Trust, National
   Autistic Society, Autism London and 800 organizations in the United
   Kingdom. It had the personal backing of British Prime Minister Tony
   Blair and parliamentarians of all parties in the Palace of Westminster.

Culture

   With the recent increases in autism recognition and new approaches to
   educating and socializing autistics, an autistic culture has begun to
   develop. Similar to deaf culture, autistic culture is based on a more
   accepting belief that autism is a unique way of being and not a
   disorder to be cured. There are some commonalities which are specific
   to autism in general as a culture, not just "autistic culture".

   It is a common misperception that autistic people do not marry; many do
   seek out close relationships and marry. Often, they marry another
   autistic, although this is not always the case. Autistic people are
   often attracted to other autistic people due to shared interests or
   obsessions, but more often than not the attraction is due to simple
   compatibility with personality types, the same as for non-autistics.
   Autistics who communicate have explained that companionship is as
   important to autistics as it is to anyone else. Multigenerational
   autistic families have also recently become a bit more noticeable.

   It is also a common misperception that autistic people live away from
   other people, such as in a rural area rather than an urban area; many
   autistics do happily live in a suburb or large city. However, a
   metropolitan area can provide more opportunities for cultural and
   personal conflicts, requiring greater needs for adjustment.

   Parents and relatives of autistic adults strongly fear their loved ones
   would be unsuspected victims of crime and fraud, and autistic adults
   are said to end up a target for hate crimes. In the U.S. it is a
   federal felony for one to purposely attack an individual for their
   disability.

   In schools it is commonplace for autistics to be singled out by
   teachers and students as "unruly," though an autistic student may not
   understand why his or her actions are considered inappropriate,
   especially when the student has a logical explanation for his or her
   behaviour.

   The interests of autistic people and so-called " geeks" or " nerds" can
   often overlap as autistic people can sometimes become preoccupied with
   certain subjects, much like the variant normal behavior geeks
   experience. However, in practice many autistic people have difficulty
   with working in groups, which impairs them even in the most 'geeky' of
   situations. The connection of autism with so-called geek or nerd
   behaviour has received attention in the popular press, but is still
   controversial within these groups.

   Speculation arises over famous people and celebrities are now
   suspected, but unconfirmed, of having autism and Asperger's syndrome.
   They are rumored to have most symptoms of autism or autistic-spectrum
   disorder. Biographers, personal physicians and media journalists
   continually investigate these rumors, but some say that the claims are
   actually libellous of their character as public figures, being singled
   out as "odd" or "nerdy" people.

Autistic adults

   Communication and social problems often cause difficulties in many
   areas of the autistic's life. Far fewer adult autistics marry or have
   children than the general population. Even when they do marry it is
   more likely to end in divorce than the norm. Furthermore, far fewer
   autistic adults live in metropolitan areas than the general population,
   and even if they live near metro areas they are more likely going to
   experience bullying and poverty than the norm. Nevertheless, as more
   social groups form, progressively more diagnosed adults are forming
   relationships with others on the spectrum.

   A small proportion of autistic adults, usually those with
   high-functioning autism or Asperger's syndrome, are able to work
   successfully in mainstream jobs, although frequently far below their
   actual level of skills and qualification. Some have managed
   self-employment; many of those are listed on self-employment sites such
   as Auties.org.

   Others are employed in sheltered workshops under the supervision of
   managers trained in working with persons with disabilities. A nurturing
   environment at home, at school, and later in job training and at work,
   helps autistic people continue to learn and to develop throughout their
   lives.

   It is often said that the Internet, since it is almost devoid of the
   non-verbal cues that autistics find so hard to interact with, has given
   some autistic individuals an environment in which they can, and do,
   communicate and form online communities. The internet has also provided
   the option of occupations such as, teleworking and independent
   consulting, which, in general, do not require much human interaction
   offline.

   Under the public law, in the United States, the public schools'
   responsibility for providing services ends when the autistic person is
   21 years of age. The autistic person and their family are then faced
   with the challenge of finding living arrangements and employment to
   match their particular needs, as well as the programs and facilities
   that can provide support services to achieve these goals.

   However autism can be a poverty trap for adult and young autistics,
   many of whom are engaged in unskilled jobs for which they are
   overqualified, or on welfare benefits. Many parents of autistic
   children also face financial difficulties as they must often pay for
   essential support and therapeutic services. Furthermore, autistics who
   might qualify for financial assistance in one country are not eligible
   in another, because some nations do not recognize autism as a
   disability.

Terminology

   When referring to someone who is diagnosed with autism, the term
   "autistic" is often used. Alternatively, many prefer to use the
   person-first terminology "person with autism" or "person who
   experiences autism." However, the autistic community generally prefers
   "autistic" for reasons that are fairly controversial. This article uses
   both terminologies.

Autism and blindness

   The characteristics of a person with both an Autism Spectrum Disorder
   (ASD) and a severe visual impairment (VI) may vary from a person with
   just ASD or just VI, and there have been observations of relatively
   high co-occurrence of the two.

   Developmental trajectories of children with ASD-VI are often very
   similar as those followed by children with typical autism, but the
   child with ASD-VI will have particularly unusual responses to sensory
   information. He or she may be overly sensitive to touch or sound, or be
   under responsive to pain. Typically, touch, smell, and sound are
   affected the most dramatically. Unusual posture or hands movements are
   common, and very difficult to redirect. These are so common because of
   the sensory input issues in addition to the lack of visual modeling.

Autistic savants

   The autistic savant phenomenon is sometimes seen in autistic people.
   Estimates of the prevalence of this phenomenon range between 1% and
   10%. The term is used to describe a person who is autistic and has
   extreme talent in a certain area of study. Although there is a common
   association between savants and autism (an association made especially
   popular by the 1988 film Rain Man), most autistic people are not
   savants and savantism is not unique to autistic people, though there
   does seem to be some relation. Mental calculators and fast computer
   programming skills are the most common form. A well known example is
   Daniel Tammet, the subject of the documentary film The Brain Man ( Kim
   Peek, one of the inspirations for Dustin Hoffman's character in the
   film Rain Man, is not autistic). "Bright Splinters of the Mind" is a
   book that explores this issue further.

Other pervasive developmental disorders

   Autism and Asperger's syndrome are just two of the five pervasive
   developmental disorders (PDDs). The three other pervasive developmental
   disorders are Rett syndrome, Childhood disintegrative disorder, and
   Pervasive developmental disorder not otherwise specified. Some of these
   are related to autism, while some of them are entirely separate
   conditions.

   Retrieved from " http://en.wikipedia.org/wiki/Autism"
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