What is Autism?

Autism is a developmental disorder. It is neurobiological in nature, affecting the brain in areas of language/communication, social skills, sensory systems and behaviour. Autism impairs a person’s ability to communicate and relate to others. It is also associated with rigid routines and repetitive behaviours. Autism is a spectrum disorder, which means that characteristics can range from very mild to quite severe. Every individual with autism is one of a kind, so while they will have commonalities with others with autism, the way they are impacted will be unique to each individual.

Did you know?

  • 1 in 36 children have been identified with autism spectrum disorder (ASD) according to estimates from CDC’s Autism and Developmental Disabilities Monitoring (ADDM) Network
  • ASD is almost 4 times more common among boys than among girls.
  • ASD is reported to occur in all racial, ethnic, and socioeconomic groups.

Statistics from 2020 USA Centers for Disease Control and Prevention (CDC):  http://www.cdc.gov/ncbddd/autism/data.html

Statistic from 2018 Canadian Healthy survey on children and youth: https://www.canada.ca/en/public-health/services/publications/diseases-conditions/autism-spectrum-disorder-canadian-health-survey-children-youth-2019.html

How is Autism diagnosed?

Presently, there is no medical test for autism spectrum disorders. The diagnosis is based on observed behaviour, and educational and psychological testing. Therefore, there is no blood test, brain scan, or other high-tech test that can be used to diagnose it. The diagnosis relies on the judgment of an experienced doctor or team of specialists and is based on observation of the child’s behaviour, educational and psychological testing, and parent reporting. Usually the team members evaluate the child, assessing his or her strengths and weaknesses, and then explain the test results to parents.

The diagnostic criteria for ASD was recently revised in May 2013 in the Fifth Edition of the Diagnostic and Statistical Manual (DSM-V) produced by the American Psychiatric Association (APA).  The edition immediately preceding it, the DSM-IV, had ASD or Autistic Disorder as one of five disorders under the umbrella of Pervasive Developmental Disorders (PDD):  Autistic Disorder, Asperger’s Disorder, Childhood Disintegrative Disorder (CDD), Rett’s Disorder, and Pervasive Development Disorder-Not Otherwise Specified (PDD-NOS).  Each of these disorders had specific diagnostic criteria but shared the primary symptoms of deficits in social communication, social interaction and rigid, stereotypical behaviors.

When is Autism usually diagnosed?

Autism can be diagnosed at any age. If children are showing signs of autism, it usually becomes evident before age three. Some parents report that they noticed differences in their children from birth; others became concerned when their young child was not hitting their developmental milestones or walking and talking. In some other cases parents report that their child was developing normally and then began to lose skills they already had.

The child’s symptoms can be quite mild and only begin to struggle when the social demands of school increase. Sometimes children may be identified as having a developmental delay, such as a speech delay, before obtaining a diagnosis of autism or may have received a diagnosis of something else such as attention deficit disorder or non-verbal learning disability. These children are usually diagnosed with Asperger’s Syndrome and many are not diagnosed until after the age of seven or later.

What are the first signs of Autism?

Autism Speaks (www.autismspeaks.org/whatisit/learnsigns.php), a US-based non-profit organization, has developed the ASD Video Glossary (http://www.autismspeaks.org/what-autism/video-glossary), an innovative web-based tool designed to help parents, primary caregivers and professionals learn more about the early red flags and diagnostic features of autism spectrum disorders (ASD). This glossary contains over a hundred video clips and is available free of charge to anyone to help them see the subtle differences between typical and delayed development in young children and spot the early red flags for ASD. All of the children featured in the ASD Video Glossary as having red flags for ASD are, in fact, diagnosed with ASD.

In clinical terms, there are a few “absolute indicators,” often referred to as “red flags,” that indicate that a child should be evaluated. For a parent, these are the red flags that indicate their child should be screened to ensure that he/she is on the right developmental path.

  • No big smiles or other warm, joyful expressions by six months or thereafter.
  • No back-and-forth sharing of sounds, smiles, or other facial expressions by nine months or thereafter.
  • No babbling by 12 months.
  • No back-and-forth gestures, such as pointing, showing, reaching, or waving by 12 months.
  • No words by 16 months.
  • No two-word meaningful phrases (without imitating or repeating) by 24 months.
  • Any loss of speech or babbling or social skills at any age.

(Information from First Signs, Inc. For more information about recognizing the early signs of developmental and behavioural disorders, please visit www.firstsigns.org)

Who can diagnose Autism?

In Saskatchewan, diagnoses of autism spectrum disorders can be made by professionals registered with either the Saskatchewan College of Psychologists or the College of Physicians and Surgeons. The diagnoses may be made by a single professional such as a paediatrician, psychiatrist, or psychologist, or by a multidisciplinary team involving other professionals such as speech language therapists, occupational therapists, physiotherapists, and social workers.

What causes Autism?

Exactly what causes ASD is still unknown. Current research suggests that a predisposition to autism might be inherited. Researchers have not found a specific “autism gene” but instead a nonspecific factor, which may increase the likelihood of having cognitive impairments.  Over the last five years, scientists have identified a number of rare gene changes, or mutations, associated with autism.  Researchers have also found neurobiological differences in the brains of individuals with autism.  The current theory is that ASD is caused by a combination of “risk genes” and environmental factors in the early brain development period.

A small number of cases can be linked to genetic disorders, such as Fragile X, Tuberous Sclerosis, and Angelman’s Syndrome, as well as exposure to environmental agents such as infectious ones (maternal rubella or cytomegalovirus) or chemical ones (thalidomide or valproate) during pregnancy. While we don’t yet know what causes autism, we do know that it is not caused by bad parenting; rather, it is a neurobiological disorder.