What is Autism Spectrum Disorder (ASD)?

“Honor your child’s unique sensory profile which contributes to his/her unique individuality. There is no one else like him on the planet, so enjoy!” 

 

  • Ball-Pit-with-Earth-BallThe diagnosis and classification of Autism Spectrum Disorder is constantly in flux, as defined by the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM).
  • After a 14 year process, the new DSM-5th revision was released in 2013.
  • The new DSM-5 diagnostic criteria for Autism Spectrum Disorder (ASD) has changed in 5 ways:
    1. Previous subcategories on the Autism Spectrum were eliminated, including Asperger Syndrome (AS), Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS), Autistic Disorder, and Childhood Integrative Disorder. All those subcategories are now folded into one broad term of Autism Spectrum Disorder (ASD).
    2. The 2 new categories of autism symptoms are: social communication impairment (must exhibit 3 deficits in this area) and restricted interests/behaviors (must exhibit at least 2 symptoms in this area). With the second category, sensory hyper-reactivity or sensory hypo-reactivity is a new symptom.
    3. Symptoms can be present currently or reported in past history.
    4. In addition to the diagnosis, each person evaluated will also be described in terms of any medical conditions (seizures, gastrointestinal problems, etc), the presence of language and/or intellectual disability, and any existing genetic causes (Fragile X Syndrome, Rett Syndrome, etc.)
    5. The new DSM-5 also added a separate disability called Social (Pragmatic) Communication Disorder (SCD) allowing for a diagnosis of social communication difficulties without the presence of repetitive/restricted behaviors.
  • The DSM-5 states that “Individuals with a well-established DSM-4 diagnosis of Asperger’s Syndrome (AS) or Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) should now be given the diagnosis of Autism Spectrum Disorder (ASD) with re-evaluation not necessary.”
  • However, it is reported to be acceptable for individuals to retain a previous diagnosis as a label if it reflects a peer group with whom they identify. Most probably clinicians will document both the DSM-5 diagnosis of ASD as well as the previous DSM-4 diagnosis, such as Asperger Syndrome (AS).
  • Individuals fitting the past diagnostic criteria of Asperger Syndrome reportedly had a ‘dash of autism’, but with a very different cognitive profile. While individuals with autism display strength in performance abilities and weakness in verbal tasks, individuals previously diagnosed with Asperger Syndrome demonstrated the exact opposite pattern, having verbal strengths and relative weakness in performance abilities.
  • The variety of autism spectrum profiles reflect a neurobiological disorder of skills and deficits presenting on a continuum or spectrum of symptomotology, with varied amounts and degrees of difficulty in 1. social communication 2. restricted interests/behaviors, and 3. sensory processing.
  • The greatest shortcoming of autism spectrum diagnostic criteria is that sensory processing difficulties are not listed as a primary descriptive feature, when in fact sensory issues are present in more than 75% of individuals diagnosed with ASD.
  • Processing of social information is dependent upon the ability to effectively organize and integrate information from all of the senses. The ability to process complex, verbal, nonverbal, visual cues and social subtleties are all impacted by sensory processing difficulties.
  • Processing of emotional information is a more sophisticated form of sensory processing, with information received through the senses and taken to a more abstract level.
  • Theory of Mind (T.O.M.) is difficult for children with Autism Spectrum Disorder. Theory of mind relates to understanding that others can have thoughts that are different from one’s own, which allows for perspective-taking. This makes it difficult for the child to figure out what another person knows and feels when it is not the same as theirs.
  • Attentional difficulties are frequently present in children with autism spectrum disorder, inter related with underlying sensory processing difficulties.
  • Motor development and coordination is frequently compromised in children with autism spectrum disorder, related to poor sensory processing and feed back from the tactile, vestibular, and proprioceptive sensory systems.
  • Each sensational individual presenting with a profile somewhere on the autism spectrum, has individual differences in their sensory processing abilities, and this unique sensory profile is inter related with varying degrees of communication abilities, behavioral control, attentional abilities, and social-emotional development.
  • Children and teenagers with autism spectrum disorder (ASD) spend longer on screen-based media like television and video games than their neurotypical siblings, according to a recent study, and are more likely to develop video game addiction (Siddique, 2013).
  • Regular Exercise and being outside helps those individuals with ASD decrease anxiety, obsessive behaviors, and self stimulating behaviors.  Aerobic exercise and sunshine for vitamin D is essential.
  • Diet and nutrition has a significant impact on gastrointestinal/digestive functioning in individuals with ASD, whom very frequently struggle with immune system sensitivities in this area.

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