Autistic Spectrum Disorders
What Is Autism? by Jerry Lindquist, Ph.D., O.T.R.
Autism is a neurobiological disorder which affects brain function. Its cause or causes are currently unknown. Research is pointing to a multidetermined etiology which may eventually include genetics, immune function, the central nervous system and metabolic functions, to name a few.
Autism, or autistic disorder, is seen as a spectrum disorder which includes a range of related developmental disabilities that overlap, but are clinically distinct and can be separately diagnosed. Described in the Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM IV), these include:
• autistic disorder
• Asperger’s disorder
• pervasive developmental disorder
• childhood disintegrative disorder
• Rhett’s disorder
Generally, autism is a disorder which affects three areas of function - communication, social relatedness and behavior. Interests might be peculiar, inflexible, restricted or repetitive.
Behavioral symptoms of autism or a related disorder might include:
• abnormal responses to sensation
• abnormal ways of relating to people, objects or happenings
• speech and language skills which are absent or delayed, with specific thinking abilities present
• disturbances in the acquisition of motor, social and self care milestones
Children with autism may be at times unresponsive to caretakers, seeming to look right through them. Others cling to parents excessively and respond catastrophically to separation. Eye contact is not good, and they may use a peripheral gaze to look at objects or people. Unusual movements are common; these can include spinning, rocking, hand flapping or finger movements. These movements may occur with greater frequency when overexcited. Children with autism may be preoccupied with certain objects, parts of objects, or with certain routines. They can become quite upset when these are changed. Some are overactive while others seem under-responsive. Some are suspected of deafness while others are continually distracted by environmental sounds. Some respond with aversion and withdrawal to the touch of others while others seem unaware of light touch.
Occupational therapy using a sensory integration approach can address these abnormal responses to sensation. Guided into sensory and motor activity in a gym-like setting, the autistic child can seek the sensation necessary to normalize some of these sensory processing disturbances. Heavy work activity like climbing or jumping may be encouraged to calm and organize the nervous system. This, in turn, organizes behavior. Fast movement on various swings may be used to arouse the child’s nervous system; slow rocking on the same equipment may be needed for calmness and relaxation. Usually provided twice a week, such occupational therapy is an organizing influence. Improvements may be noted in eye contact, behavioral flexibility, coordination, social reciprocity, language and the ability to profit from a classroom experience.
Stanley I. Greenspan's Floortime approach is also a useful intervention.
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