Autism: Description and Early Childhood Diagnosis

Dr. Jack E. Amos and Sonja Flournoy

Abstract

The author looks at autism, exploring both its definition and the difficulties encountered in correct diagnosis. The author notes that early diagnosis of infants and children with autism represent a unique constellation of strengths and difficulties that impact the developmental period, affecting future cognitive and developmental functioning. Although the last few years have witnessed many advances in understanding of this mood disorder, the cause and cure have thus far avoided detection. However, constant research is helping define autism and provide for early diagnosis. 

Autism: Description and Early Childhood Diagnosis

        The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM IV): establishes the scientific criteria for diagnosing 299.00 Autistic disorders. In brief, autism is brain development disorder that is suspected when direct observation, interaction, and interviews assessments reveal impairment in social interaction and communication. Autism begins early in childhood and persists throughout adulthood affecting areas of communication, social skills, and creativity

         Autism is usually diagnosed in the developmental stage. It is reasonable to assume that parents want autism to be diagnosed as early as possible in hopes that and early intervention may improve long term outcomes. Autism is a behaviorally defined disorder, characterized by qualitative impairments in social communication, social interaction, and social imagination, with a restricted range of interests and often stereotyped repetitive behaviors and mannerisms.  Sensory hypo sensitivities or hypersensitivities to the environment are common features. Criteria for the diagnosis of autism are set out in the ICD-10 (international classification of diseases, 10th revision) and the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV).

Ghaziuddin (2005) points out that the diagnosis of autism is not

always uncomplicated. For example, Asperger Syndrome is often diagnosed as mild variation of autism even though is a distinct disorder in the DSM-IV.  Woodbury-Smith, M, Kiln, A., & Volkmar, F.  (2005) refer to Asperger, himself as having argued that the condition was genetic in nature. Correct diagnosis will separate autism and asperger syndrome. Autistic children often display difficulties in their adaptive and cognitive behaviors. At present, no medical test exists that defines autism. The current predominant means of autism diagnosis focuses on observation of the child’s developmental skills over time, examining early childhood development as well as current symptoms. Tomanik, Pearson, Loveland, Lane,& Shaw (2006) supposed It is important to consider cognitive function in the diagnosis process.

Symptoms displayed by the autistic child differ broadly in severity and manifestations. Autistic children that share the same diagnosis may display relatively different patterns of behavior and have marked differences in skill levels. Symptoms develop early on but are most often detected when the effected child is between 3 and 5 years old. Autism and related disabilities, such as PDD-NOS (Pervasive Developmental Disorder - Not Otherwise Specified), and Asperser’s Syndrome are difficult to diagnose, especially in young children where speech and reasoning skills are still developing.

            An article by Mooney, Gray, & Tonge (2006) references the American Psychiatric Association (1994), response to the marked increase in autism, estimated that 75% of children with autism function within a range associated with mental retardation.  This prompted recent studies  that suggested changes in diagnostic criteria for autism. Current thought infers that many clients formerly diagnosed with would currently be diagnosed as autistic. A feasible pathway to the increase in autism diagnosis in the late twentieth century is universally associated with vaccines protecting against measles, mumps and rubella. One theory suggests that these vaccines trigger an immune response that attacks the nervous system, whereas an alternative theory held by the majority of American research scientists, points to residual mercury in the same vaccines as the blame. It is now pretty well established that vaccination does not create autism.

            An equally important study by suggests that naturally occurring and synthetic chemicals in the environment, such as lead, mercury and polychlorinated biphenyls (PCBs), have been shown to have neurotoxic effects. Exposure to neurotoxicants during critical moments of fetal and childhood development can lead to neurodevelopmental disorders. Individuals may also carry genes which can increase their susceptibility to the effects of toxic compounds such as pesticides.

The rate of diagnosis has risen from 50 per 100,000 in 1990 to 400 per 100,000 today. Bishop seems to have confirmed the cause of the recent rise of autism as being a change in the diagnostic criteria. Of mutual agreement is the fact that autism is a brain development disorder. Areas of diagnosis may include problems with social interactions and relationships. Often there are significant problems developing nonverbal communication skills, such as eye-to-eye gazing, facial expressions, and body posture, failure to establish friendships with children the same age. There may be a lack of interest in sharing enjoyment, interests, or achievements with other people and/or a lack of empathy. People with autism may have difficulty understanding another person's feelings, such as pain or sorrow.

In conclusion; Autism is a lifelong, developmental disability. The characteristics of the disability; little or lack of speech development, avoiding social contact or awareness and routines of behaviors are not experienced in the same degree for everyone living with autism. The lack of a single identified cause for autism leaves much to be discovered in the field. Theoretical causes, such as neurological and genetic, may prove to be a link to the true cause of the disability. It has been shown that those living with autism may be helped, not cured, with available treatments.