Background of the study
Since the 1980's, we have gained a better understanding of the broad diagnostic category that includes autism and autism-like disorders. Autistic Disorder (autism) is now believed to represent only one part of a clinical spectrum or group of disorders collectively termed pervasive developmental disorders. What is Autism?
Autism is a neurobehavioral syndrome caused by a dysfunction of the central nervous system that leads to disordered development. According to the Diagnostic and Statistical Manual of Mental Disorders,4th edition (DSM-IV), published by the American Psychiatric Association (1994, pp. 70-71), the onset of symptoms in autism occurs within the first 3 years of life and includes three general categories of behavioral impairment common to all persons who have autism: •
qualitative impairments in social interaction
qualitative impairments in communication
restricted, repetitive, and stereotyped patterns of behavior, interest, and activities As defined in the DSM-IV, Autistic Disorder (Tables III-1 and III-2 ) is one of the clinical conditions classified within the spectrum of pervasive developmental disorders. Autistic Disorder is distinct from other pervasive developmental disorders such as Rett's disorder or childhood disintegrative disorder, two other distinctive clinical conditions classified within the spectrum of pervasive developmental disorders. What Are the Symptoms of Autism?
Children with autism demonstrate the three core symptoms as described in the DSM-IV. The symptoms vary according to the severity of the disorder. Qualitative impairments in social interaction
Much current research suggests that the lack of reciprocal social interaction is the primary symptom in autism. Sometimes this deficit in social relatedness is noticeable during the first months of life; parents may report that their child has poor eye contact, lacks interest in being held, or stiffens when held. Young children who have autism often do not initiate or sustain play with their peers and often do not take part in groups. They may lack the ability to judge appropriate reactions in social situations; they may not feel anxiety around strangers, or not be aware of how close to stand to someone. As they become adolescents and adults, some children with milder, higher functioning autism may demonstrate relatively normal social interactions, but they still "tend to show a lack of cooperative group play, failure to make close friendships, and inability to recognize feelings in others or to show deep affection" (Newson and Havanitz, 1997). Qualitative impairments in communication
Research suggests that a significant majority of children with autism are not using language for functional communication at the time of their initial diagnosis. Earlier studies suggested that about half of all children with autism remain "functionally mute" throughout their lives, although that may be an overestimate given the effectiveness of current interventions and the broader current definition of autism. Some children with autism initially develop some language and then show language loss or regression, usually during the second year. Others show significant generalized delays in all aspects of language and communication. When language is present in a young child with autism, it tends to be rote, repetitive, and lacking in apparent communicative intent. Certain unique features of language use are especially characteristic of autism. Children with autism frequently demonstrate echolalia (rote repetition of what has been heard), confusion of personal pronouns (such as referring to self in second or third person), verbal perseveration (repeating certain phrases over and over or dwelling on a single topic), and abnormalities of prosody (rate, rhythm, inflection, or volume of speech). Children who have autism, particularly when younger, often do not use gestures, such as pointing at objects to show shared interest, shaking...
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