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Information
Section: Conditions
Condition:
PDD
Article: Overview of
Autism
Source: Leslie E. Packer, PhD
(2002, revised 2004)
File Last Updated: May
16, 2006
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Page 1 of
1
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OVERVIEW
OF AUTISM
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Autism, or Autistic
Disorder, is usually recognized by the time a child
is 30 months old and is almost always recognized by
three years of age. The child's development is
atypical in the sense that: (1) there has been
language delay or regression in language skills
("regression" means that the child's speech was
developing normally, and then the child started
"losing ground" or losing the speech skills they
had), (2) the child doesn't cuddle or interact
normally with family or others and (3) the child
generally appears unresponsive or nonresponsive to
the environment. The precise diagnostic criteria
are contained in the DSM-IV
and in the European alternative, ICD-10
(both pages open in windows).
The autistic child
may engage in unusual or ritualistic behaviors like
rocking, hand waving, or an obsessive need to
maintain order. Many children with autism do not
speak at all, and those who do speak may speak in
rhyme, exhibit echolalia (repeating a person’s
words like an echo), refer to themselves as a "he"
or "she," or use otherwise atypical language.
Imagination is also impaired and many autistic
children will have abnormal responses to sensory
events, being either under- or
over-reactive.
Although autism is
about 3 to 4 times more common in boys, girls with
the disorder tend to have more severe symptoms and
greater cognitive impairment.(Fombonne, 1998). A
study based on data collected in 1996 indicates
that the M:F ratio declines as the severity of
cognitive impairment increases, such that the male
to female ratio is 4.4 for children with mild
cognitive impairment and 1.3 for those with severe
cognitive impairment.
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HOW COMMON IS AUTISM?
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The estimates of
incidence in the general population have increased
significantly over the last decade from estimates
of 5 - 10 cases per 10,000 births up to about 60
cases per 10,000, while a more
recent study
yielded a somewhat more conservative rate of 3.4
cases per 1000. Wing and Potter (2002)
reviewed
the research and
note some of the clinical and methodological
reasons for the widely varying and increasing
estimates, but Fombonne's
editorial in
the January 2003 issues of JAMA is an excellent
analysis and commentary.
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WHERE ARE CHILDREN WITH AUTISM EDUCATED?
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Autism represents a
significant predictor for referral to special
education, although whether the special education
program is provided in a mainstream school or a
segregated special education school may be more of
a function of what country you are in.
In the U.S., for the
1998 - 1999 school year, over one half of all
children classified under I.D.E.A.'s "autism"
classification spent more than 60% of their school
day outside of a regular
classroom:
Percent
of Autistic Students x Educational Placement, 1998
- 1999*
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Placement
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Percentage
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Regular
classroom (outside of regular classroom
for less than 21% of the day)
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20.3
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Resource
room (outside of regular classroom more
than 21% of the day but less than 60% of
the day)
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13.1
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Separate
class (outside of the regular classroom
for more than 60% of the day)
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51.1
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Public
separate school facility
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7.8
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Private
separate school facility
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5.7
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Public
residential facility
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.2
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Private
residential facility
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1.2
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Homebound/hospital
placement
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0.4
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In the UK, data
collected on 5- to 11- year-old children by Fiona,
Baron-Cohen, Bolton, and Brayne (2002) during the
same time period indicated a prevalence rate of
.33% in mainstream schools in Cambridgeshire (33 in
10,000 cases) and a prevalence rate of 12.5% in
special education schools. These figures cannot be
directly compared to the U.S. data, however, as the
U.S. percentages are based on percent of children
with autism while the UK data are based on
percent of children in a particular school. A
subsequent study in a single health district in the
UK (Keen & Ward, 2004) on students
diagnosed with Autism Spectrum Disorder
compared placements in 1997 and
2001:
Educational Provision:
1997, 2001
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Placement
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Percentage
in 1997
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Percentage
in 2001
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Mainstream:
- with statement of special educational
needs
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54.2
87
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69.9
89
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Severe
learning difficulty:
- main school
- autistic unit
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3.1
15.6
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4.1
11.7
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Moderate
learning difficulty:
- main school
- autistic unit
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4.1
14.5
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6.1
6.1
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Language
unit, mainstream school
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--
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1.5
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Non-LEA
autistic school
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6.3
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1.5
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Specialist
residential placement
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1
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1
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Out of
school
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0
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.5
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EBD school
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--
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.5
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ARE OTHER CONDITIONS ASSOCIATED WITH AUTISM?
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Individuals with
autism often have symptoms of various co-occurring
mental disorders, including Attention Deficit
Hyperactivity Disorder (ADHD),
psychoses, depressive
disorders,
obsessive-compulsive
disorder, and
other anxiety
disorders
(Volkmar, Cook, Pomeroy, et al., 1999). About
one-third of children and adolescents with autism
develop seizures (Giovanardi, Posar, &
Parmeggiani, 2000). The relationship between autism
and ADHD has recently received greater attention,
as it appears that up to 60% of children with
autism may also meet diagnostic criteria for the
combined or inattentive subtypes of ADHD, and
recognizing and addressing any comorbid ADHD may be
an important piece of planning and
treatment.
As with other
conditions, autism is a spectrum disorder and the
severity of the symptoms and presence of other
conditions varies quite a bit. Some autistic
individuals are very bright and may do very well in
many domains but have significant social
impairment, while others may be profoundly retarded
and unable to live independently.
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MUST SEE!
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MAY 16, 2006:
If you are parenting or teaching a child
with autism, I strongly recommend that you see
"Autism
Every Day."
This 13-minute documentary is available for viewing
free online at AutismSpeaks.org and is a fabulous
resource for gaining awareness and empathy.
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NOTE
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SOURCE: U.S. Department of
Education, Office of Special Education and
Rehabilitative Services, Annual Report to Congress
on the Implementation of The Individuals with
Disabilities Education Act. Table
53, reproduced on the
NCES site.
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Information
Section: Conditions
Condition:
PDD
Article: Overview of
Autism
Source: Leslie E. Packer, PhD
(2002, revised 2004)
File Last Updated: May
16, 2006
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Page 1 of
1
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Tourette
Syndrome "Plus" © Copyright 1998 - 2006 Leslie
E. Packer, PhD. except as noted.
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This page last updated May 16, 2006.
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