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Autism Program

What is Autism?

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Autism Spectrum Disorder (ASD) is a developmental disorder that affects a person’s social communication and sensory regulation. Individuals with ASD may also have restricted and/or repetitive behavior, interests and activities. The thinking and learning abilities of people with autism can vary dramatically from one individual to another and fall across a “spectrum”.

Each individual with autism is unique and many have average to above average intellectual abilities. It is not uncommon of those on the autism spectrum have exceptional abilities in visual skills, music and academic skills. Indeed, many persons on the spectrum take deserved pride in their distinctive abilities and “atypical” ways of viewing the world. Others with autism have significant disability and are unable to live independently. A number of individuals with ASD are nonverbal but can learn to communicate using other means such as augmentative speech devices.

What are some of the first signs of ASD?

Autism Spectrum Disorder typically begins before the age of three. While some attributes may appear in infancy, many parents first suspect a problem when their child does not reach developmental milestones, such as failing to turn when name is called, delay at speaking their first words, or failing to engage in simple social exchanges. A child may be able to complete a jigsaw puzzle with ease, but may not show interest in sharing his or her accomplishment with others. Some children may have no language delays and have sophisticated vocabularies, but have difficulty engaging in play or conversations with others.

How do I know if my child is developing typically?

While there are general trends in how children develop, all children grow and learn differently. Many factors affect a child’s progress toward developmental milestones, and it may be difficult for parents to determine whether their child is on track due to individual differences. If delays are present, early intervention can have a significant and lasting impact. Therefore, it is important to become familiar with child’s development and discuss any questions with your child’s healthcare providers.

There is no medical test to diagnose ASD. Instead, specially trained physicians and other health professionals administer autism-specific behavioral observations. Pediatricians are often the first contact when parents become concerned about their child’s development. Screening and the role of the pediatrician have become even more critical as we have recognized the stability of early diagnosis over time and the importance of early intervention. During office visits, the physician may ask questions about the child’s development, and parents often share their concerns at that time. Your child’s physician will utilize criteria from the DSM-5 and may refer your child to a neurologist.

Autism Spectrum Disorder according to the DSM-5:

  1. Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history (examples are illustrative, not exhaustive; see text):
  2. Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.
  3. Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication.
  4. Deficits in developing, maintaining, and understanding relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.

Severity is based on social communication impairments and restricted, repetitive patterns of behavior (see Table 1).

  1. Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at   least two of the following, currently or by history (examples are illustrative, not exhaustive; see text):
  2. Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypes, lining up toys or flipping objects, echolalia, idiosyncratic phrases).
  3. Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat same food every day).
  4. Highly restricted, fixated interests that are abnormal in intensity or focus (e.g., strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests).
  5. Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment (e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).

Severity is based on social communication impairments and restricted, repetitive patterns of behavior (see Table 1).

  1.  Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life).
  2. Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.
  3. These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay. Intellectual disability and autism spectrum disorder frequently co-occur; to make comorbid diagnoses of autism spectrum disorder and intellectual disability, social communication should be below that expected for general developmental level.

Information taken from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (Copyright © 2013)

Applied Behavior Analysis (ABA) is widely recognized as a safe and effective treatment for ASD by both the American Medical Association and the New Jersey Department of Education. Started in 1938, the science of ABA has been well documented to be an effective teaching method for children with ASD and is changing the face of education throughout the world.