Read the interview here
What is Autism from chapter 2 of my book.
The Diagnostic Statistical Manual (DSM-5 2013) describes autism spectrum disorder as a neurodevelopmental disorder with three severity levels. Level 1 represents the highest functioning end of the spectrum and presents similarly to the condition previously diagnosed as Asperger’s syndrome. Level 3 denotes the lowest functioning end of the spectrum and involves very severe communication impairments and extremely restricted behaviours.
The borders between these diagnosis levels can sometimes be hazy and it is beyond the scope of this book to go into classification of diagnosis. However it can be both useful and important to take the diagnosis into account so as to be clear as to possible treatment outcomes.
There may be intellectual impairment and autism together, increasing the likelihood of aggression, destruction of property and increased tantrums. Autism and intellectual impairment (previously called mental retardation) are not necessarily present in all cases but there may be a joint diagnosis.
There can also be a joint diagnosis of Attention Deficit and Hyperactivity Disorder (ADHD) or Attention Deficit Disorder (ADD), indeed many ASD children have been formally or mis-diagnosed with ADHD or ADD. As with any child or adult in the general population they may also have a range of other physical health problems.
In the United States it is estimated that between 1 in 50 or 1 in 88 children have ASD; 695,000 people in the United Kingdom. There is a problem in verifying exact numbers as figures are not collated in each country and there is debate as to whether the conditions are under or over diagnosed; however the increased prevalence of all diagnoses on the spectrum is surely, and sadly, without doubt. Many countries worldwide report a growing number of cases including India, where there are an estimated six million people with autism (Gupta, Saxena et al 2010 pp19) and Kenya; 2.64% of South Korean children aged 7-12 have ASD (Kim 2011 Abstract). Aspect (2013) the Australian autism service provider estimates that there are 230,000 Australians living with ASD. Autism is no respecter of borders or cultures and is a worldwide epidemic, although there are certain cultural groups where numbers are higher or lower. The Somali refugee population in the UK has particularly high rates of ASD, whilst the Amish community in the US has lower ASD rates than the larger population.
Children and adults diagnosed with ASD have delays or abnormal functioning in the following areas:
Social interaction / impaired social ability
• unusual non-verbal behaviour such as lack of eye contact, facial expression, gestures
• failure to develop peer relationships, difficulties sharing with others
• lack of social or emotional response
• difficulty in recognising and understanding another person’s feelings or perspective
Language and social communication:
• delayed or lack of development of spoken language
• difficulty in sustaining or initiating conversation
• repetitive use of language, words and phrases e.g. echolalia
• lack of varied or spontaneous play
• flat or high pitched speech
• narrow bands of passionate interests or obsessions
• difficulty in comprehension
• preference for activates that require little verbal interaction
Behaviours, sensory or motor functions:
• restricted, repetitive, ritualised and stereotyped patterns of behaviour and activity.
• awkwardness or delayed development of fine and gross motor skills
• hyper or hypo sensitivity to pain, light, sound, crowds and other external stimuli
• inflexible behaviour and difficulty in coping with change