Autism is primarily a pervasive developmental disorder that was formerly considered as a disorder separately classified from similar disorders such as Asperger Syndrome, Rett Syndrome and Childhood Disintegrative Disorder. Currently, the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision (DSM-IV-TR) reclassifies autism as part of a larger group comprised of the aforementioned disorders, Autism Spectrum Disorder (ASD) (National Institute of Mental Health [NIMH], 2004).
The hallmarks of this disorder have many presentations, but generally follow a pattern of slow attainment of developmental milestones; a normal pace followed by a gradual slowing and ...view middle of the document...
Their rare interaction with others consists of severe tantrums when their routines or activities are interrupted; extremes of exhibited language use (from limited to large vocabularies) with unusual intonations or inflections that are seemingly disassociated from any nonverbal cues in higher-functioning individuals (NIMH, 2004). Other associated problems with autism are the inability of the brains of autistic individuals to perceive different stimuli normally (roughly akin to an untunable radio transceiver), mental retardation, seizure disorder, Fragile X Syndrome and tuberous sclerosis (NIMH, 2004).
The estimated prevalence rate of autism according to several studies ranges from 2 to 6 per 1,000 children (CDC, 2006). However, this number may be underestimated due to the fact that nearly half of these cases are left undiagnosed (NIMH, 2004).
Diagnostic criteria according to DSM-IV-TR are as follows: â€œGroup 1, qualitative impairment in social interactionâ€¦Group 2, qualitative impairments in communication [and] Group 3, restricted repetitive and stereotyped patterns of behavior, interests, and activitiesâ€ (qtd. in Hilt, Metz & Dagg, 2006). Some of the more common symptoms in these groups were mentioned previously. There must be at least 6 symptoms altogether, with at least one from each group; In addition, at least two should come from Group 1 and any of the symptoms must be present by age 3 (Hilt, Metz & Dagg, 2006).
Surveillance (Level I) in the form of well-child visits is often the first to detect early signs of autism. Parents alert to the following may help in detecting autism early by noting failure to reach the following milestones in a timely manner (American Academy of Neurology & Child Neurology Society, 2003):
Â· babbling by 12 months;
Â· gesturing (e.g., pointing, waving bye-bye) by 12 months;
Â· single words by 16 months;
Â· two-word spontaneous (not just echolalic) phrases by 24 months [or]
Â· loss of any language or social skills at any age (p. 6).
Any of these red flags signal a need for further testing using any one of the autism screening tools available such as the Checklist for Autism in Toddlers (CHAT) or the Autism Screening Questionnaire (American Academy of Neurology & Child Neurology Society, 2003). Developmental tests administered routinely to document milestones such as the Denver Development Screening Test II may pick up signs of delay in one or more domains but have a low sensitivity and specificity for autism and similar disorders and are not recommended (American Academy of Neurology & Child Neurology Society, 2003). It is also prudent to rule out concomitant conditions such as congenital or acquired deafness and lead poisoning through the standard tests used to detect these diseases (American Academy of Neurology & Child Neurology Society, 2003).
Diagnosis and evaluation (Level II) takes an in-depth, multidisciplinary approach to arriving at the final diagnosis. Among these tests include...