Tag Archives: Social Interaction

Question?: Pdd Nos Symptoms

Thomas asks…

Could my little sister have a mild form of autism?Any advice or tips?

My little sister is 3 years old and screams alot for stupid little things that may happen.Some of her behavior makes me concerned that she may have a mild form of autism.She’s very smart for her age though.

admin answers:

Most children with autism are VERY smart for their age and have a HIGH physical abilities! My four year old son is autistic. I would like to also add after reading some of the other answers just now that there ARE different levels of autism. Some are higher functioning than others, and MR does NOT always go hand in hand with autism.

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Autism Spectrum Disorders

Autism Spectrum Disorders, or ASD, are a group of developmental disabilities characterized by abnormal or impaired development in social interaction and communication and the presence of repetitive behaviors or restricted interests. Some professionals may use the term Pervasive Developmental Disorders, or PDD, instead of ASD.

Incidence
ASD or PDD occurs 4 to 5 times more often in boys than in girls. Symptoms are present before the age of three, although diagnosis may occur later. ASD affects individuals from all racial, ethnic, and social backgrounds.

Cause
Nobody knows what causes ASD. Scientists believe that there are chemical and biological differences in how the brain functions, and there may be genetic factors involved. Parents do not cause autism spectrum disorders. No factors in a child’s experience or in parenting styles are responsible for ASD.

Prognosis
ASD is a lifelong disability, but with intensive and early intervention, individuals with ASD can and do make excellent progress and improve their quality of life. While there is no known cure for ASD, there are many intervention strategies designed to address the problems associated with ASD.

Characteristics
Although difficulties in social interaction, communication, and restricted or repetitive behavior are general characteristics of Autism Spectrum Disorders, the specific diagnoses are distinguished by the types, numbers, and severity of symptoms.
Communication
Some children develop speech, and then regress, or lose communication skills. Others echo or repeat what they hear. Many individuals with ASD do learn to talk, while others rely on technology, sign, or pictures to communicate. However, conversational skills, gestures, and non-verbal communication strategies remain difficult for most individuals with ASD.
Social Interaction
Persons with ASD often have difficulty interacting with others, learning to play with peers, and developing friendships, even though some may be very interested in having friends. They often have difficulty using and understanding eye contact, facial expressions, and social rules. They can be unaware of the interests and perspectives of other people, and may, therefore, become socially isolated and misunderstood.
Interests and Behavior
Some persons with autism may engage in repetitive behavior, like switching a light on and off, spinning, or rocking. Some may play with toys in an unusual manner, like lining toy cars up instead of pretending to drive them. They may insist on doing the same thing in the same way, and may have difficulty with changes to their surroundings or routines. Individuals with ASD also have difficulty processing information from their senses. For example, they may dislike the feel of certain fabrics or the texture of certain foods. Some individuals are very active and have difficulty with sleep. Some engage in challenging behavior, such as aggression, self-injury, or severe withdrawal.

Types
Neither ASD nor PDD are specific diagnoses. The specific ASD/PDD diagnoses are: Autism, Asperger Syndrome (AS), Rett’s Disorder, Childhood Disintegrative Disorder, and Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS). These specific diagnoses are considered “Spectrum disorders” because the severity of impairment varies from person to person and can change over time as a result of intervention. Because it is sometimes difficult to pinpoint the exact diagnosis, some professionals may refer to individuals as being “on the spectrum”. For example, one child with ASD may struggle to learn to use words to communicate while another may be capable of carrying on a long conversation, but will only care to talk about certain topics. Many show a strong aptitude in one area, while remaining weak in others.
Autism
Autism is the most well-known form of ASD. Often the most noteworthy piece of this diagnosis is a sever impairment in social skills, People with autism may prefer to play or work alone, and seek social interaction only as needed. Autism can occur with or without mental retardation or other health problems, such as seizure disorders. The first signs of autism usually are recognized during the second year of life, and may include odd, delayed, or absent speech development.
Asperger Syndrome
Asperger Syndrome (AS) is marked by significant difficulties in social interaction but in contrast to autism, there are no obvious delays in the development of speech. However, individuals often have more subtle problems with language and non-verbal communication. Persons with AS are likely to have average to above average intelligence, yet may have difficulty functioning in traditional school and work environments. A unique characteristic that many AS individuals show is an intense interest in one or two subjects to the exclusion of others. When speaking, these individuals tend to be formal, and they may not be skilled at conversational turn taking. Individuals with AS are typically diagnosed later than individuals with autism.
PDD-NOS
PDD-NOS is an abbreviation for Pervasive Developmental Disorder-Not Otherwise Specified. The diagnosis of PDD-NOS is usually given to an individual who does not meet the exact diagnostic criteria for any of the other diagnoses in ASD, yet clearly shows unusual development in social interaction, communication skills or interests, and behavior. Often, individuals with PDD-NOS diagnosis have better social or communication skills than individuals diagnosed with autism and may have fewer problems with repetitive behaviors or restricted interests.

Taken from CARD’s “A Map for Your Journey”

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“SPEAK UP LOUD FOR THOSE WHO CANNOT”
Today 80% of the Autism population is under 18.

In 2005, The Center For Disease Control announces that autism is the fastest growing serious developmental disability in the United States. In 2005 estimated that 1.77 million Americans are affected by autism. In real terms the estimated autistic population of 1 million plus cases in 2004 could reach 5 to 25 million by 2015. In 1994 the autism rate was rare and was estimated to be 1 in 10,000. In 2004 the autism epidemic revised rate was estimated to be 1 in 200. In 2005 the autism epidemic revised rate is now estimated to be 1 in 166 by the Center For Disease Control. In 2015 the statistics indicate the estimated rate could be as high as 1 in 7, if this 1994 to 2004 exponential growth rate continues at its present rate.

Therefore no matter who you are or where you live, Democrat or Republican, if these statistics of the past carry forward through the next decade; your family may be devastated by autism in the next decade… The current autism epidemic could become the most devastating epidemic in history, with 10-15% of the population afflicted in the next decade that need long term care. Many experts associate a genetic predisposition triggered be high levels of mercury in the environment together as the cause of Autism.

The latest study from the Centers for Disease Control and Prevention reports that 1 in 12 American women of childbearing age has mercury levels in her blood above the levels considered safe for the developing fetus. The U.S. Environmental Protection Agency experts have estimated that 630,000 infants are born every year with unsafe levels of mercury.

These higher mercury levels in the mothers body can be passed on during pregnancy. These 1 in 12 mothers could be unknowingly predisposing their unborn child to become autistic due to high levels of mercury passed on from the mother during pregnancy. It is now recommended that pregnant women not eat tuna fish, which is known to be high in mercury. Even small trace amounts of Mercury are known to be harmful to developing fetuses and never break down in the body. Mercury vapors can remain airborne for a year. These vapors can therefore travel around the world and we could be accumulating mercury in our bodies by inhaling them that over time.

According to a recent study of mercury emissions throughout the world. Coal fueled power plants in the U.S. Emit 48 tons of toxic mercury vapors into the air per year. China emits 1000 tons of toxic mercury vapors per year. The toxicity buildup of breathing these vapors along with mercury fillings over a period of decades within our bodies, may be the cause of the high levels mercury in women of childbearing age. Vaccines with mercury further spike an already high level of mercury passed on from the mother during pregnancy at a critical time in the infants development Vaccines with mercury may be the trigger that causes autism in children with a genetic predisposition for autism and an already high level of mercury passed on from the mother.

Acute mercury poisoning and Autism share many similar symptoms. Women who are pregnant or thinking about getting pregnant should now consider have their blood tested for elevated levels of mercury. We must ask the government to make Autism Awareness and prevention a national priority. Those who are saying that the numbers were under represented in the past are burying their heads in the sand.

“Houston, we have a problem”, we are going to have the next generation devastated by this disease if left unchecked at its present growth rate. This epidemic must quickly become the major health initiative of our time just as the search for the cure for aids has. Otherwise the effects on the next generation, families, businesses and the economy will be catastrophic. We can no longer wait for this “simmering modern day plague of the 21st century” to arrive at our doorstep in the form of a lost generation of innocent, helpless, unsuspecting children that through no fault of their own will need a lifetime of care.

Autism Awareness is Key

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Question?: Asperger Syndrome Symptoms

David asks…

is it possible borderline personality could exhibit similar symptoms to aspergers syndrome ?

or is aspergers syndrome a different disorder all together ?

would you be able to easily tell if you had aspergers ?

admin answers:

The symptoms for Asperger syndrome and any other autistic spectrum disorder are similar to borderline personality disorders but a professional clinical psychologist would be easily able to tell the difference. Asperger syndrome is a pervasive development disorder so you are born with it and will have it for the rest of your life. It is classified by the triad of impairments, difficulties with social interaction, imagination and communication. You would need a specialist or a psychologist to diagnose you with having Asperger syndrome.

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Question?: Autism Symptoms In Adults

Jenny asks…

Why should autistic people not work in business?

I was reading an article about jobs that are recommended for autistic adults and the article mentioned that business should be avoided. I can understand counselling or social work…but business too? Can someone explain this, is there a lot of social interaction involved?

admin answers:

Anyone who experiences some of the range of symptoms that people with autism frequently have is going to have greater challenges than most people would in almost any line of work; that’s just a given.

But the same could be said of anyone with a visual or hearing impairment, issues with fatigue, ADHD, limited use of their upper extremeties, you name it — yet most of us manage to work despite whatever physical or cognitive impairments we might have to contend with. ALS hasn’t stopped Stephen Hawking; blindness hasn’t stopped Stevie Wonder and – I forget the actor’s name – the guy who plays the coroner on CSI hasn’t let the fact that he’s a dual amputee keep him from being on a wildly successful TV show.

I help people with disabilities start their own small businesses. For me, concern #1 is whether the person I’m working with has the basic training and experience necessary to operate the type of business they want to start. Concern #2 is whether or not there’s a legitimate business opportunity to be exploited (if we build it, will they come?). Finally, concern #3 is if and how we can find reasonable accommodations to enable the person to do the job despite any impairments they may have.

Critical skills for business-related work:
1. Effective communication verbally and in writing
2. Planning skills
3. Problem-solving skills
4. Ability to handle bookkeeping, budgeting and record-keeping
5. Ability to be flexible, juggling multiple priorities

As you said, persons with autism may have difficulty with interpersonal interactions, multitasking or working in high-stimulus enviroments, for instance. I’d work with the entrepreneur to see how we could minimize those facets of the job and/or to find alternative means of handling those dimensions. Could more customer interaction be handled via email for instance? If so, would that help? Could the business support the wages of a second employee who could more effectively handle the personal selling aspects of the job if that was an issue? And so on.

Any person with Any disability should be open to considering Any job that interests them. However, that person and anyone who’s assisting them in making a career choice need to be creative, pragmatic and thorough in determining up front if and/or how they might be able to do the job in question given their impairments. There’s not always a “fix” to be done, but you’d be amazed how often there is a creative solution.

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Question?: What Is Autism Spectrum Disorder

Betty asks…

How will Asperger syndrome and PDD be Diagnosed in the future once the definition is Changed?

I heard that instead of 3 being diagnosed with High Functioning Autism (aspergers syndrome), PDD-NOS and Autistic disorder there will only be one type
but, what if the child have mild symptoms of Autism just like Aspergers, how will they be diagnosed? How will Aspergers syndrome and PDD-NOS be diagnosed differently under the dsm-5 if they have symptoms of an autism Spectrum disorder?

admin answers:

Actually there are currently 5 subtypes…also childhood disintegrative disorder and retts

instead of labeling by subtype–they will just use one label for all groups

Autism Spectrum Disorder

Must meet criteria A, B, C, and D:

A. Persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and manifest by all 3 of the following:

1. Deficits in social-emotional reciprocity; ranging from abnormal social approach and failure of normal back and forth conversation through reduced sharing of interests, emotions, and affect and response to total lack of initiation of social interaction,

2. Deficits in nonverbal communicative behaviors used for social interaction; ranging from poorly integrated- verbal and nonverbal communication, through abnormalities in eye contact and body-language, or deficits in understanding and use of nonverbal communication, to total lack of facial expression or gestures.

3. Deficits in developing and maintaining relationships, appropriate to developmental level (beyond those with caregivers); ranging from difficulties adjusting behavior to suit different social contexts through difficulties in sharing imaginative play and in making friends to an apparent absence of interest in people

B. Restricted, repetitive patterns of behavior, interests, or activities as manifested by at least two of the following:

1. Stereotyped or repetitive speech, motor movements, or use of objects; (such as simple motor stereotypies, echolalia, repetitive use of objects, or idiosyncratic phrases).

2. Excessive adherence to routines, ritualized patterns of verbal or nonverbal behavior, or excessive resistance to change; (such as motoric rituals, insistence on same route or food, repetitive questioning or extreme distress at small changes).

3. Highly restricted, fixated interests that are abnormal in intensity or focus; (such as strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests).

4. Hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment; (such as apparent indifference to pain/heat/cold, adverse response to specific sounds or textures, excessive smelling or touching of objects, fascination with lights or spinning objects).

C. Symptoms must be present in early childhood (but may not become fully manifest until social demands exceed limited capacities)

D. Symptoms together limit and impair everyday functioning.

Aspergers and PDDNOS CAN fit into this definition….instead of listing different types—there will just be one type…they won’t be diagnosed differently.

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Question?: Autism Signs In Adults

Maria asks…

What would autistic parents teach an autistic child?

Autism is a mutation in the brain, and mutations can be either helpful or harmful (mutations are what brought mankind to where it is today). Suppose for a moment that we all see autism as normal yet different from what is socially normal. How would autistic people live in a society where everyone is also autistic? How would they interact, and what would they teach each other? What would career environments be like? How would homes be built? What would be valued, and what wouldn’t be?

What would the autistic life be like?
This is what I am trying to ask.

I don’t believe autism should be seen as a “disorder” or a handicap but rather a different way of thinking and different behavior.
I read in Times magazine that autistic people have less “grey matter” and more “white matter” in their brains, and that’s why there has to be a mutation in their genes that makes it that way.
And to the person who says that it’s a disorder and that autistic people cannot compete with the rest of society, what I am stating is: what if they didn’t have to compete and had dominance in society?

admin answers:

Autism is NOT a mutation in the brain. When looking at fMRI scans and regular MRI scans, you will NOT find some defining anomoly characteristic of autism.

Autism is a complex developmental disability that typically appears during the first three years of life and is the result of a neurological disorder that affects the normal functioning of the brain, impacting development in the areas of social interaction and communication skills. Both children and adults with autism typically show difficulties in verbal and non-verbal communication, social interactions, and leisure or play activities. One should keep in mind however, that autism is a spectrum disorder and it affects each individual differently and at varying degrees – this is why early diagnosis is so crucial. By learning the signs, a child can begin benefiting from one of the many specialized intervention programs (see treatment and education).

And you are right, it should not be considered a disorder. It only is due to social standards created today. Austistic people are just different. They use their brain differently, and sometimes very uniquely. Like the Rain Man.

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Question?: Autism Symptoms Toddler Boys

John asks…

Could my 2 yr old son have autism?

I have a 2 yr old boy an he doesent talk yet, well nothing pastt mama baba. He throws servere tantrems sometimes I dont even know why he is so upset. he loves to run and seems completly absessed with cars but thats really all he plays with he shows little intrest in other toys. when he watches tv its like he gets sucked into it and cant take his gaze off. Most of the time when i speak to him he aks like he cant hear me and continues what he is doing and if i interupt him he starts screamng. I have never seen any other children his age throw tantrums as often and the way he does, he will throw hisself on the floor an sometimes he hurts hisself doing this. He had a really bad fibril sezure when he was one and has had 2 very small ones since. but i am really getting concerned because of his behavior and speech problems.
Yes my son has had his hearing tested. i also read that many autistic kids have servere allergies and bowel problems. my son is allerigic to milk products. and was also diagnosed with the childhood form of irritable bowel. as far as communication, well evey morning when we get up i have to pick him up so he can look to see what he wants then he either points or grabs what he wants. he turned two on june2 i dont plan on having him tested untill he is at least 3. i dont want to jump to conclushions. but alot of friends and family have sudgested i have him checked for autism

admin answers:

Characteristics

Autism is distinguished by a pattern of symptoms rather than one single symptom. The main characteristics are impairments in social interaction, impairments in communication, restricted interests and repetitive behavior. Other aspects, such as atypical eating, are also common but are not essential for diagnosis.[19]

[edit] Social development

Autistic people have social impairments and often lack the intuition about others that many people take for granted. Noted autistic Temple Grandin described her inability to understand the social communication of neurotypicals as leaving her feeling “like an anthropologist on Mars”.[20]

Social impairments become apparent early in childhood and continue through adulthood. Autistic infants show less attention to social stimuli, smile and look at others less often, and respond less to their own name. Autistic toddlers have more striking social deviance; for example, they have less eye contact and anticipatory postures and are less likely to use another person’s hand or body as a tool.[18] Three- to five-year-old autistic children are less likely to exhibit social understanding, approach others spontaneously, imitate and respond to emotions, communicate nonverbally, and take turns with others. However, they do form attachments to their primary caregivers.[21] They display moderately less attachment security than usual, although this feature disappears in children with higher mental development or less severe ASD.[22] Older children and adults with ASD perform worse on tests of face and emotion recognition.[23]

Contrary to common belief, autistic children do not prefer to be alone. Making and maintaining friendships often proves to be difficult for those with autism. For them, the quality of friendships, not the number of friends, predicts how lonely they are.[24]

There are many anecdotal reports, but few systematic studies, of aggression and violence in individuals with ASD. The limited data suggest that in children with mental retardation, autism is associated with aggression, destruction of property, and tantrums. Dominick et al. Interviewed the parents of 67 children with ASD and reported that about two-thirds of the children had periods of severe tantrums and about one third had a history of aggression, with tantrums significantly more common than in children with a history of language impairment.[25]

[edit] Communication

About a third to a half of individuals with autism do not develop enough natural speech to meet their daily communication needs.[26] Differences in communication may be present from the first year of life, and may include delayed onset of babbling, unusual gestures, diminished responsiveness, and the desynchronization of vocal patterns with the caregiver. In the second and third years, autistic children have less frequent and less diverse babbling, consonants, words, and word combinations; their gestures are less often integrated with words. Autistic children are less likely to make requests or share experiences, and are more likely to simply repeat others’ words (echolalia)[17][27] or reverse pronouns.[28] Autistic children may have difficulty with imaginative play and with developing symbols into language.[17][27] They are more likely to have problems understanding pointing; for example, they may look at a pointing hand instead of the pointed-at object.[18][27]

In a pair of studies, high-functioning autistic children aged 8–15 performed equally well, and adults better than individually matched controls at basic language tasks involving vocabulary and spelling. Both autistic groups performed worse than controls at complex language tasks such as figurative language, comprehension and inference. As people are often sized up initially from their basic language skills, these studies suggest that people speaking to autistic individuals are more likely to overestimate what their audience comprehends

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Question?: Pdd Nos Symptoms

Donald asks…

my 6 yr old was just dxd with pdd-nos we had her iep at school yesterday, but i need some advice?

need help understanding pddnos what is my child allowed to have in school? whats types of behavior are similar to other kids, need to talk to someone with a child with same issues

admin answers:

I taught a few students diagnosed with PDD-NOS and for the most part they had what is called SDD – Significant Developmental Delays. This means they may be behind in growth or hitting typical milestones in development. One of my students was very intelligent; however, he did not interact well among his peers socially. With each child, behavior varies. Here’s some more information below…

Hope this helps!

Pervasive Development Disorders (PDD)
Home > About Autism > What are Autism Spectrum Disorders? > Pervasive Development Disorders (PDD)

Defining AutismPervasive Developmental DisorderLearn the SignsRelated Disorders

Pervasive Development Disorders (PDD)
The term “PDD” is widely used by professionals to refer to children with autism and related disorders; however, there is a great deal of disagreement and confusion among professionals concerning the PDD label. Diagnosis of PDD, including autism or any other developmental disability, is based upon the Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition (DSM-IV), published by the American Psychiatric Association (Washington, DC, 1994), and is the main diagnostic reference of mental health professionals in the U.S.

According to the DSM-IV, the term “PDD” is not a specific diagnosis, but an umbrella term under which the specific diagnoses are defined.

Diagnostic labels are used to indicate commonalities among individuals. The key defining symptom of autism that differentiates it from other syndromes and/or conditions is substantial impairment in social interaction (Frith, 1989). The diagnosis of autism indicates that qualitative impairments in communication, social skills, and range of interests and activities exist. As no medical tests can be performed to indicate the presence of autism or any other PDD, the diagnosis is based upon the presence or absence of specific behaviors. For example, a child may be diagnosed as having PDD-NOS if he or she has some behaviors that are seen in autism, but does not meet the full criteria for having autism. Most importantly, whether a child is diagnosed with a PDD (like autism) or a PDD-NOS, his/her treatment will be similar.

Autism is a spectrum disorder, with symptoms ranging from mild to severe. As a spectrum disorder, the level of developmental delay is unique to each individual. If a diagnosis of PDD-NOS is made, rather than autism, the diagnosticians should clearly specify the behaviors present. Evaluation reports are more useful if they are specific and become more helpful for parents and professionals in later years when reevaluations are conducted.

Ideally, a multidisciplinary team of professionals should evaluate a child suspected of having autism. The team may include, but may not be limited to, a psychologist or psychiatrist, a speech pathologist and other medical professionals, including a developmental pediatrician and/or neurologist. Parents and teachers should also be included, as they have important information to share when determining a child’s diagnosis.

In the end, parents should be more concerned that their child find the appropriate educational treatment based on their needs, rather than spending too much effort to find the perfect diagnostic label. Most often, programs designed specifically for children with autism will produce greater benefits, while the use of the general PDD label can prevent children from obtaining services relative to their needs.

Behaviors:
The central features of Autistic Disorder are the presence of markedly abnormal or impaired development in social interaction and communication, and a markedly restricted repertoire of activity and interest. The manifestations of this disorder vary greatly depending on the developmental level and chronological age of the individual. Autistic Disorder is sometimes referred to as Early Infantile Autism, Childhood Autism, or Kanner’s Autism (page 66).

A. A total of six (or more) items from (1), (2), and (3), with at least two from (1), and one each from (2) and (3):

Qualitative impairment in social interaction, as manifested by at least two of the following:
Marked impairment in the use of multiple nonverbal behaviors such as eye to-eye gaze, facial expression, body postures, and gestures to regulate social interaction .
Failure to develop peer relationships appropriate to developmental level
A lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest)
Lack of social or emotional reciprocity
Qualitative impairments in communication as manifested by at least one of the following:
Delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gestures or mime)
In individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
Stereotyped and repetitive use of language or idiosyncratic language
Lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level
Restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following:
Encompassing preoccupation with one or more stereotyped patterns of interest that is abnormal either in intensity or focus
Apparently inflexible adherence to specific, nonfunctional routines or rituals
Stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)
Persistent preoccupation with parts of object
B. Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years:

Social interaction
Language as used in social communication
Symbolic or imaginative play
C. The disturbance is not better accounted for by Rett’s Disorder or Childhood Disintegrative Disorder.

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Question?: Rett Syndrome In Boys

Ken asks…

what are difference between autism, Asperger’s syndrome, and Rett syndrome.?

please list similarities and differences, thank you

admin answers:

I have been diangnosed with Asperger’s Syndrome.It’s a type of high functioning autisim.Here is some information I have found on all three conditions.

Autism
Autism is classified as a neurodevelopmental disorder that manifests itself in markedly abnormal social interaction, communication ability, patterns of interests, and patterns of behavior.
Although the specific etiology of autism is unknown, many researchers suspect that autism results from genetically mediated vulnerabilities to environmental triggers. And while there is disagreement about the magnitude, nature, and mechanisms for such environmental factors, researchers have found at least seven major genes prevalent among individuals diagnosed as autistic. Some estimate that autism occurs in as many as one United States child in 166, however the National Institute of Mental Health gives a more conservative estimate of one in 1000[1]. For families that already have one autistic child, the odds of a second autistic child may be as high as one in twenty. 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. Diagnosis is based on a list of psychiatric criteria, and a series of standardized clinical tests may also be used.
Autism may not be physiologically obvious. A complete physical and neurological evaluation will typically be part of diagnosing autism. Some now speculate that autism is not a single condition but a group of several distinct conditions that manifest in similar ways.
By definition, autism must manifest delays in “social interaction, language as used in social communication, or symbolic or imaginative play,” with “onset prior to age 3 years”, according to the Diagnostic and Statistical Manual of Mental Disorders. The ICD-10 also says that symptoms must “manifest before the age of three years.” There have been large increases in the reported incidence of autism, for reasons that are heavily debated by researchers in psychology and related fields within the scientific community.
Some children with autism have improved their social and other skills to the point where they can fully participate in mainstream education and social events, but there are lingering concerns that an absolute cure from autism is impossible with current technology. However, many autistic children and adults who are able to communicate (at least in writing) are opposed to attempts to cure their conditions, and see such conditions as part of who they are.
There is a great diversity in the skills and behaviors of individuals diagnosed as autistic, and physicians will often arrive at different conclusions about the appropriate diagnosis. Much of this is due to the sensory system of autistics, which is quite different from the sensory system of other people, since certain stimulations can affect an autist differently than a non-autist, and the degree to which the sensory system is affected varies wildly from one autistic person to another.
Nevertheless, professionals within pediatric care and development often look for early indicators of autism in order to initiate treatment as early as possible. However, some people do not believe in treatment for autism, either because they do not believe autism is a disorder or because they believe treatment can do more harm than good.
Social development
Typically, developing infants are social beings—early in life they do such things as gaze at people, turn toward voices, grasp a finger, and even smile. In contrast, most autistic children prefer objects to faces and seem to have tremendous difficulty learning to engage in the give-and-take of everyday human interaction. Even in the first few months of life, many seem indifferent to other people because they avoid eye contact and do not interact with them as often as non-autistic children.
Children with autism often appear to prefer being alone to the company of others and may passively accept such things as hugs and cuddling without reciprocating, or resist attention altogether. Later, they seldom seek comfort from others or respond to parents’ displays of anger or affection in a typical way. Research has suggested that although autistic children are attached to their parents, their expression of this attachment is unusual and difficult to interpret. Parents who looked forward to the joys of cuddling, teaching, and playing with their child may feel crushed by this lack of expected attachment behavior.
Children with autism often also appear to lack “theory of mind”, the ability to see things from another person’s perspective, a behavior cited as exclusive to human beings above the age of five and, possibly, other higher primates such as adult gorillas, chimpanzees and bonobos. Typical 5-year-olds can develop insights into other people’s different knowledge, feelings, and intentions, interpretations based upon social cues (e.g., gestures, facial expressions). An individual with autism seems to lack these interpretation skills, an inability that leaves them unable to predict or understand other people’s actions. The social alienation of autistic and Asperger’s people can be so intense from childhood that many of them have imaginary friends as companionship. However, having an imaginary friend is not necessarily a sign of autism and also occurs in non-autistic children.
Although not universal, it is common for autistic people to not be able to regulate their behavior. This can take the form of crying or verbal outbursts that may seem out of proportion to the situation or self-injurious behaviours. Individuals with autism generally prefer consistent routines and environments; they may react negatively to changes in them. It is not uncommon for these individuals to exhibit aggression, increased levels of self-stimulatory behavior, self-injury or extensive withdrawal in overwhelming situations.
Sensory system
A key indicator to clinicians making a proper assessment for autism would include looking for symptoms much like those found in sensory integration dysfunction. Children will exhibit problems coping with the normal sensory input. Indicators of this disorder include oversensitivity or underreactivity to touch, movement, sights, or sounds; physical clumsiness or carelessness; poor body awareness; a tendency to be easily distracted; impulsive physical or verbal behavior; an activity level that is unusually high or low; not unwinding or calming oneself; difficulty learning new movements; difficulty in making transitions from one situation to another; social and/or emotional problems; delays in speech, language or motor skills; specific learning difficulties/delays in academic achievement.
One common example is an individual with autism hearing. A person with autism may have trouble hearing certain people while other people are louder than usual. Or the person with autism may be unable to filter out sounds in certain situations, such as in a large crowd of people (see cocktail party effect). However, this is perhaps the part of the autism that tends to vary the most from person to person, so these examples may not apply to every autistic.
Communication difficulties
By age 3, typical children have passed predictable language learning milestones; one of the earliest is babbling. By the first birthday, a typical toddler says words, turns when he or she hears his or her name, points when he or she wants a toy, and when offered something distasteful, makes it clear that the answer is “no.” Speech development in people with autism takes different paths. Some remain mute throughout their lives with varying degrees of literacy; communication in other ways—images, visual clues, sign language, and typing may be far more natural to them. Some infants who later show signs of autism coo and babble during the first few months of life, but stop soon afterwards. Others may be delayed, developing language as late as the teenage years. Still, inability to speak does not mean that people with autism are unintelligent or unaware. Once given appropriate accommodations, many will happily converse for hours, and can often be found in online chat rooms, discussion boards or websites and even using communication devices at autism-community social events such as Autreat.
Those who do speak often use language in unusual ways, retaining features of earlier stages of language development for long periods or throughout their lives. Some speak only single words, while others repeat the same phrase over and over. Some repeat what they hear, a condition called echolalia. Sing-song repetitions in particular are a calming, joyous activity that many autistic adults engage in. Many people with autism have a strong tonal sense, and can often understand spoken language. Some children may exhibit only slight delays in language, or even seem to have precocious language and unusually large vocabularies, but have great difficulty in sustaining typical conversations. The “give and take” of non-autistic conversation is hard for them, although they often carry on a monologue on a favorite subject, giving no one else an opportunity to comment. When given the chance to converse with other autistics, they comfortably do so in “parallel monologue”—taking turns expressing views and information. Just as “neurotypicals” (people without autism) have trouble understanding autistic body languages, vocal tones, or phraseology, people with autism similarly have trouble with such things in people without autism. In particular, autistic language abilities tend to be highly literal; people without autism often inappropriately attribute hidden meaning to what people with autism say or expect the person with autism to sense such unstated meaning in their own words.
The body language of people with autism can be difficult for other people to understand. Facial expressions, movements, and gestures may be easily understood by some other people with autism, but do not match those used by other people. Also, their tone of voice has a much more subtle inflection in reflecting their feelings, and the auditory system of a person without autism often cannot sense the fluctuations. What seems to non-autistic people like a high-pitched, sing-song, or flat, robot-like voice is common in autistic children. Some autistic children with relatively good language skills speak like little adults, rather than communicating at their current age level, which is one of the things that can lead to problems.
Since non-autistic people are often unfamiliar with the autistic body language, and since autistic natural language may not tend towards speech, autistic people often struggle to let other people know what they need. As anybody might do in such a situation, they may scream in frustration or resort to grabbing what they want. While waiting for non-autistic people to learn to communicate with them, people with autism do whatever they can to get through to them. Communication difficulties may contribute to autistic people becoming socially anxious or depressed.
Repetitive behaviors
Although people with autism usually appear physically normal and have good muscle control, unusual repetitive motions, known as self-stimulation or “stimming,” may set them apart. These behaviors might be extreme and highly apparent or more subtle. Some children and older individuals spend a lot of time repeatedly flapping their arms or wiggling their toes, others suddenly freeze in position. As children, they might spend hours lining up their cars and trains in a certain way, not using them for pretend play. If someone accidentally moves one of these toys, the child may be tremendously upset. Autistic children often need, and demand, absolute consistency in their environment. A slight change in any routine—in mealtimes, dressing, taking a bath, or going to school at a certain time and by the same route—can be extremely disturbing. People with autism sometimes have a persistent, intense preoccupation. For example, the child might be obsessed with learning all about vacuum cleaners, train schedules or lighthouses. Often they show great interest in different languages, numbers, symbols or science topics. Repetitive behaviors can also extend into the spoken word as well. Perseveration of a single word or phrase, even for a specific number of times can also become a part of the child’s daily routine.
Effects in education
Children with autism are affected with these symptoms every day. These unusual characteristics set them apart from the everyday normal student. Because they have trouble understanding people’s thoughts and feelings, they have trouble understanding what their teacher may be telling them. They do not understand that facial expressions and vocal variations hold meanings and may misinterpret what emotion their instructor is displaying. This inability to fully decipher the world around them makes education stressful. Teachers need to be aware of a student’s disorder so that they are able to help the student get the best out of the lessons being taught.
Some students learn better with visual aids as they are better able to understand material presented this way. Because of this, many teachers create “visual schedules” for their autistic students. This allows the student to know what is going on throughout the day, so they know what to prepare for and what activity they will be doing next. Some autistic children have trouble going from one activity to the next, so this visual schedule can help to reduce stress.
Research has shown that working in pairs may be beneficial to autistic children. Autistic students have problems in schools not only with language and communication, but with socialization as well. They feel self-conscious about themselves and many feel that they will always be outcasts. By allowing them to work with peers they can make friends, which in turn can help them cope with the problems that arise. By doing so they can become more integrated into the mainstream environment of the classroom.
A teacher’s aide can also be useful to the student. The aide is able to give more elaborate directions that the teacher may not have time to explain to the autistic child. The aide can also facilitate the autistic child in such a way as to allow them to stay at a similar level to the rest of the class. This allows a partially one-on-one lesson structure so that the child is still able to stay in a normal classroom but be given the extra help that they need.
There are many different techniques that teachers can use to assist their students. A teacher needs to become familiar with the child’s disorder to know what will work best with that particular child. Every child is going to be different and teachers have to be able to adjust with every one of them.
Students with Autism Spectrum Disorders typically have high levels of anxiety and stress, particularly in social environments like school. If a student exhibits aggressive or explosive behavior, it is important for educational teams to recognize the impact of stress and anxiety. Preparing students for new situations by writing Social Stories can lower anxiety. Teaching social and emotional concepts using systematic teaching approaches such as The Incredible 5-Point Scale or other Cognitive Behavioral strategies can increase a student’s ability to control excessive behavioral reactions.
There is a great diversity in the skills and behaviors of individuals diagnosed as autistic, and physicians will often arrive at different conclusions about the appropriate diagnosis. Much of this is due to the sensory system of autistics, which is quite different from the sensory system of other people, since certain stimulations can affect an autist differently than a non-autist, and the degree to which the sensory system is affected varies wildly from one autistic person to another.
Nevertheless, professionals within pediatric care and development often look for early indicators of autism in order to initiate treatment as early as possible. However, some people do not believe in treatment for autism, either because they do not believe autism is a disorder or because they believe treatment can do more harm than good.
Social development
Typically, developing infants are social beings—early in life they do such things as gaze at people, turn toward voices, grasp a finger, and even smile. In contrast, most autistic children prefer objects to faces and seem to have tremendous difficulty learning to engage in the give-and-take of everyday human interaction. Even in the first few months of life, many seem indifferent to other people because they avoid eye contact and do not interact with them as often as non-autistic children.
Children with autism often appear to prefer being alone to the company of others and may passively accept such things as hugs and cuddling without reciprocating, or resist attention altogether. Later, they seldom seek comfort from others or respond to parents’ displays of anger or affection in a typical way. Research has suggested that although autistic children are attached to their parents, their expression of this attachment is unusual and difficult to interpret. Parents who looked forward to the joys of cuddling, teaching, and playing with their child may feel crushed by this lack of expected attachment behavior.
Children with autism often also appear to lack “theory of mind”, the ability to see things from another person’s perspective, a behavior cited as exclusive to human beings above the age of five and, possibly, other higher primates such as adult gorillas, chimpanzees and bonobos. Typical 5-year-olds can develop insights into other people’s different knowledge, feelings, and intentions, interpretations based upon social cues (e.g., gestures, facial expressions). An individual with autism seems to lack these interpretation skills, an inability that leaves them unable to predict or understand other people’s actions. The social alienation of autistic and Asperger’s people can be so intense from childhood that many of them have imaginary friends as companionship. However, having an imaginary friend is not necessarily a sign of autism and also occurs in non-autistic children.
Although not universal, it is common for autistic people to not be able to regulate their behavior. This can take the form of crying or verbal outbursts that may seem out of proportion to the situation or self-injurious behaviours. Individuals with autism generally prefer consistent routines and environments; they may react negatively to changes in them. It is not uncommon for these individuals to exhibit aggression, increased levels of self-stimulatory behavior, self-injury or extensive withdrawal in overwhelming situations.
Sensory system
A key indicator to clinicians making a proper assessment for autism would include looking for symptoms much like those found in sensory integration dysfunction. Children will exhibit problems coping with the normal sensory input. Indicators of this disorder include oversensitivity or underreactivity to touch, movement, sights, or sounds; physical clumsiness or carelessness; poor body awareness; a tendency to be easily distracted; impulsive physical or verbal behavior; an activity level that is unusually high or low; not unwinding or calming oneself; difficulty learning new movements; difficulty in making transitions from one situation to another; social and/or emotional problems; delays in speech, language or motor skills; specific learning difficulties/delays in academic achievement.
One common example is an individual with autism hearing. A person with autism may have trouble hearing certain people while other people are louder than usual. Or the person with autism may be unable to filter out sounds in certain situations, such as in a large crowd of people (see cocktail party effect). However, this is perhaps the part of the autism that tends to vary the most from person to person, so these examples may not apply to every autistic.
Communication difficulties
By age 3, typical children have passed predictable language learning milestones; one of the earliest is babbling. By the first birthday, a typical toddler says words, turns when he or she hears his or her name, points when he or she wants a toy, and when offered something distasteful, makes it clear that the answer is “no.” Speech development in people with autism takes different paths. Some remain mute throughout their lives with varying degrees of literacy; communication in other ways—images, visual clues, sign language, and typing may be far more natural to them. Some infants who later show signs of autism coo and babble during the first few months of life, but stop soon afterwards. Others may be delayed, developing language as late as the teenage years. Still, inability to speak does not mean that people with autism are unintelligent or unaware. Once given appropriate accommodations, many will happily converse for hours, and can often be found in online chat rooms, discussion boards or websites and even using communication devices at autism-community social events such as Autreat.
Those who do speak often use language in unusual ways, retaining features of earlier stages of language development for long periods or throughout their lives. Some speak only single words, while others repeat the same phrase over and over. Some repeat what they hear, a condition called echolalia. Sing-song repetitions in particular are a calming, joyous activity that many autistic adults engage in. Many people with autism have a strong tonal sense, and can often understand spoken language. Some children may exhibit only slight delays in language, or even seem to have precocious language and unusually large vocabularies, but have great difficulty in sustaining typical conversations. The “give and take” of non-autistic conversation is hard for them, although they often carry on a monologue on a favorite subject, giving no one else an opportunity to comment. When given the chance to converse with other autistics, they comfortably do so in “parallel monologue”—taking turns expressing views and information. Just as “neurotypicals” (people without autism) have trouble understanding autistic body languages, vocal tones, or phraseology, people with autism similarly have trouble with such things in people without autism. In particular, autistic language abilities tend to be highly literal; people without autism often inappropriately attribute hidden meaning to what people with autism say or expect the person with autism to sense such unstated meaning in their own words.
The body language of people with autism can be difficult for other people to understand. Facial expressions, movements, and gestures may be easily understood by some other people with autism, but do not match those used by other people. Also, their tone of voice has a much more subtle inflection in reflecting their feelings, and the auditory system of a person without autism often cannot sense the fluctuations. What seems to non-autistic people like a high-pitched, sing-song, or flat, robot-like voice is common in autistic children. Some autistic children with relatively good language skills speak like little adults, rather than communicating at their current age level, which is one of the things that can lead to problems.
Since non-autistic people are often unfamiliar with the autistic body language, and since autistic natural language may not tend towards speech, autistic people often struggle to let other people know what they need. As anybody might do in such a situation, they may scream in frustration or resort to grabbing what they want. While waiting for non-autistic people to learn to communicate with them, people with autism do whatever they can to get through to them. Communication difficulties may contribute to autistic people becoming socially anxious or depressed.
Repetitive behaviors
Although people with autism usually appear physically normal and have good muscle control, unusual repetitive motions, known as self-stimulation or “stimming,” may set them apart. These behaviors might be extreme and highly apparent or more subtle. Some children and older individuals spend a lot of time repeatedly flapping their arms or wiggling their toes, others suddenly freeze in position. As children, they might spend hours lining up their cars and trains in a certain way, not using them for pretend play. If someone accidentally moves one of these toys, the child may be tremendously upset. Autistic children often need, and demand, absolute consistency in their environment. A slight change in any routine—in mealtimes, dressing, taking a bath, or going to school at a certain time and by the same route—can be extremely disturbing. People with autism sometimes have a persistent, intense preoccupation. For example, the child might be obsessed with learning all about vacuum cleaners, train schedules or lighthouses. Often they show great interest in different languages, numbers, symbols or science topics. Repetitive behaviors can also extend into the spoken word as well. Perseveration of a single word or phrase, even for a specific number of times can also become a part of the child’s daily routine.
Effects in education
Children with autism are affected with these symptoms every day. These unusual characteristics set them apart from the everyday normal student. Because they have trouble understanding people’s thoughts and feelings, they have trouble understanding what their teacher may be telling them. They do not understand that facial expressions and vocal variations hold meanings and may misinterpret what emotion their instructor is displaying. This inability to fully decipher the world around them makes education stressful. Teachers need to be aware of a student’s disorder so that they are able to help the student get the best out of the lessons being taught.
Some students learn better with visual aids as they are better able to understand material presented this way. Because of this, many teachers create “visual schedules” for their autistic students. This allows the student to know what is going on throughout the day, so they know what to prepare for and what activity they will be doing next. Some autistic children have trouble going from one activity to the next, so this visual schedule can help to reduce stress.
Research has shown that working in pairs may be beneficial to autistic children. Autistic students have problems in schools not only with language and communication, but with socialization as well. They feel self-conscious about themselves and many feel that they will always be outcasts. By allowing them to work with peers they can make friends, which in turn can help them cope with the problems that arise. By doing so they can become more integrated into the mainstream environment of the classroom.
A teacher’s aide can also be useful to the student. The aide is able to give more elaborate directions that the teacher may not have time to explain to the autistic child. The aide can also facilitate the autistic child in such a way as to allow them to stay at a similar level to the rest of the class. This allows a partially one-on-one lesson structure so that the child is still able to stay in a normal classroom but be given the extra help that they need.
There are many different techniques that teachers can use to assist their students. A teacher needs to become familiar with the child’s disorder to know what will work best with that particular child. Every child is going to be different and teachers have to be able to adjust with every one of them.
Students with Autism Spectrum Disorders typically have high levels of anxiety and stress, particularly in social environments like school. If a student exhibits aggressive or explosive behavior, it is important for educational teams to recognize the impact of stress and anxiety. Preparing students for new situations by writing Social Stories can lower anxiety. Teaching social and emotional concepts using systematic teaching approaches such as The Incredible 5-Point Scale or other Cognitive Behavioral strategies can increase a student’s ability to control excessive behavioral reactions.
Asperger’s Syndrome
Asperger syndrome (sometimes called Asperger’s syndrome, AS, or the more common shorthand Asperger’s), is characterized as one of the five pervasive developmental disorders, and is commonly referred to as a form of high-functioning autism. In very broad terms, individuals with Asperger’s have normal or above average intellectual capacity, and atypical or poorly developed social skills, often with emotional/social development or integration happening later than usual as a result.
Like other conditions classified as autism spectrum disorders, Asperger syndrome appears to be more prevalent among males than females, with males making up approximately 75–80 percent of diagnoses. Many clinicians believe that this may not reflect the actual incidence among females; well-known Asperger syndrome expert Tony Attwood suggests that females learn to better compensate for their impairments because of differences in socialization (Attwood, pp 151–2). Some preliminary evidence for this is found in the Ehlers & Gillberg study, which found a 4:1 male to female ratio in the people they thought definitely had Asperger’s but a much less lopsided 2.3 to 1 ratio when merely suspected or otherwise borderline cases were included.
The overwhelming majority of available information on Asperger syndrome relates to children; there is currently more conjecture than hard evidence on how it affects adults. It is thought that most people with Asperger syndrome learn to cope with their social impairments later in life. However, there is no “cure” as such, and some people, including prominent clinicians such as Attwood and some of those diagnosed with Asperger’s, would strenuously argue that a cure is neither possible nor desirable (see “A gift and a curse” and “Culture” below), mainly pointing out that the syndrome is a hereditary trait and attempts to “cure” or eliminate it would be an example of eugenics. Organizations such as Cure Autism Now disagree; this remains a highly controversial area.
The most common and important characteristics of Asperger syndrome can be divided into several broad categories: social impairments, narrow but intense interests, and speech and language peculiarities. Other features are commonly associated with this syndrome but not always held to be necessary for diagnosis. This section reflects mainly Attwood, Gillberg, and Wing’s thinking on the most important characteristics of Asperger; the DSM-IV criteria (see below) represent a slightly different view.
Social impairments
Although there is no single feature that all people with Asperger syndrome share, difficulties with social behavior are nearly universal and are perhaps the most important criteria that define the condition. People with Asperger syndrome lack the natural ability to see the subtexts of social interaction (sometimes resulting in well-meaning remarks that may offend and so on, finding it hard to know what is “acceptable”) and also tend to lack the ability to broadcast their own emotional state.
Non-autistics, often colloquially called neurotypicals, are able to gather a host of information about other people’s cognitive and emotional states based on clues gleaned from the environment and the other person’s facial expression and body language, but people with Asperger syndrome have an impairment in this ability, sometimes called mind-blindness. To be mind-blind is to find it difficult or even impossible to figure out things a person implies but does not say directly (more colloquially, to “read between the lines”). This is not because they cannot imagine the answer but because they cannot choose between the possibilities; the mind-blind person cannot reliably gather enough information to do so or does not know how to interpret the information that they do gather.
Along with this difficulty in reading the nonverbal communication of others, most people with Asperger’s have difficulty expressing their own emotional state via body language, facial expression, and nuances as most people do. Some such people have emotional responses as strong as, or perhaps stronger than, those of most people, although what generates an emotional response might not always be the same; the difficulty is in expressing these feelings, although it sometimes comes across as lacking them. And some such people do truly lack, or have reduced levels of emotions. For example, many people with Asperger syndrome have difficulty with eye contact. Some make very little eye contact because they find it overwhelming, whereas others have unmodulated, staring eye contact that can cause discomfort to other people. Similarly, the use of gestures may be almost nonexistent or may seem exaggerated and differ from what would normally be considered appropriate for a situation.
It is worth noting that because it is classified as a spectrum disorder, some people with Asperger syndrome are nearly normal in their ability to read and use facial expressions and other subtle forms of communication. However, this ability does not come naturally to most people with Asperger syndrome. Such people must learn social skills intellectually, delaying social development.
Some people feel that much of the social difficulties in Asperger Syndrome are more accurately characterized as “mutual misunderstanding”, in that neither the “aspie” nor the neurotypical understands each other. Some autistics assert that they have a much easier time reading body language of other autistic people, and that neurotypicals have difficulties interpreting autistic body language. Comparing the nonverbal communication problems that often occur between people from different cultures is a common defense given for this theory.
Narrow, intense interests
Asperger syndrome can involve an intense and obsessive level of focus on things of interest. For example, one person might be obsessed with 1950s professional wrestling, another with national anthems of African dictatorships, or another with building models out of matchsticks. Particularly common interests are means of transport (such as trains), computers, maths (particularly specific aspects, such as pi), astronomy, geography, and dinosaurs. Note that all of these last items are normal interests in ordinary children; the difference in Asperger children is the unusual intensity of their interest.
Sometimes these interests are lifelong; in other cases, they change at unpredictable intervals. In either case, there are normally one or two at any given time. In pursuit of these interests, the person with Asperger’s often manifests extremely sophisticated reason, an almost obsessive focus, and great memory for apparently trivial facts (occasionally even eidetic memory). Hans Asperger called his young patients “little professors” because he thought his thirteen-year-old patients had as comprehensive and nuanced an understanding of their field of interest as university professors.
Some clinicians would not entirely agree with this description; for example, Wing and Gillberg both argue that there is often more rote memorization than real understanding of these areas of interest, despite occasional appearances to the contrary. However, such a limitation is not required for diagnosis, even under Gillberg’s criteria.
Children and adolescents with Asperger syndrome often have little patience for things outside these areas of interest. During the school years, many are perceived as highly intelligent underachievers or overachievers, clearly capable of outperforming their peers in their field of interest yet persistently unmotivated to do regular homework assignments (sometimes even in their areas of interest). Others, in contrast, may be hypermotivated to outperform peers in school. This adds to the difficulties of diagnosing the syndrome. In more serious cases, the combination of social problems and intense interests can lead to unusual behavior, such as greeting a stranger by launching into a lengthy monologue about a special interest rather than introducing oneself in the socially-accepted way. However, in many cases adults can outgrow this impatience and lack of motivation and develop more tolerance to new activities and meeting new people.
Speech and language peculiarities
People with Asperger syndrome often are noted for having a highly pedantic way of speaking, using language far more formal and structured than the situation normally would be thought to call for. A five-year-old child with this condition may regularly speak in language that could easily have come from a university textbook, especially on his or her special area of interest.
Literal interpretation is another common but not universal hallmark of this condition. Attwood gives the example of a girl with Asperger syndrome who answered the telephone one day and was asked “Is Paul there?”. Although the Paul in question was in the house, he was not in the room with her, so after looking around to ascertain this, she simply said “no” and hung up. The person on the other end had to call back and explain to her that he meant for her to find him and get him to pick up the telephone (Attwood 78).
Many people with Asperger syndrome also make idiosyncratic use of words, including new coinages and unusual juxtapositions. This can develop into a rare gift for humor (especially puns, wordplay, doggerel, satire) or writing. Another potential source of humor is the eventual realization that their literal interpretations can be used to amuse others. Some are so proficient with written language as to qualify as hyperlexic. Tony Attwood refers to a particular child’s skill at inventing expressions, e.g. “tidying down” (the opposite of tidying up) or “broken” (when referring to a baby brother who cannot walk or talk) (Attwood, 82).
Other characteristics
Those affected by Asperger’s may also manifest a range of other sensory, developmental, and physiological anomalies. Children with Asperger’s may evidence a delay in the development of fine motor skills. In some cases (although with many exceptions) people with AS may have an odd way of walking, or display compulsive finger, hand, or arm movements.
In general, orderly things appeal to people with Asperger’s. Some researchers mention the imposition of rigid routines (on self or others) as a criterion for diagnosing this condition. It appears that changes to their routines cause inordinate levels of anxiety for some people with this condition (Attwood 100).
Some people with Asperger’s experience varying degrees of sensory overload and are extremely sensitive to touch, smells, sounds, tastes, and sights. They may prefer soft clothing, familiar scents, or certain foods. Some may even be pathologically sensitive to loud noises or strong smells or dislike being touched; for example, certain children with Asperger’s exhibit a strong dislike of having their head touched or their hair disturbed. Sensory overload may exacerbate problems faced by such children at school, where levels of noise in the classroom can become intolerable for them. Some are also unable to block out certain repetitive stimuli, such as the constant ticking of a clock. Whereas most children stop registering this sound after a short time and can hear it only if they consciously listen for it, the child with Asperger’s can become distracted, agitated, or even (in rare cases) violent if the sound is not removed.
Additionally, people with Asperger’s exhibiting severe symptoms may frequently be diagnosed with clinical depression, Oppositional defiant disorder, ADHD, General anxiety disorder, Bipolar disorder, Obsessive compulsive disorder, or Obsessive-compulsive personality disorder. However, while elements from all of these conditions are associated with Asperger syndrome, the cause is usually Asperger’s itself and not a separate condition. While there may be a correlation between them, the disorders are in fact distinct from one another. There is research which indicates people with Asperger’s may in fact be far more likely to have the associated conditions, but for now the connection is largely one of resemblance.
Asperger syndrome usually leads to problems in social interaction with peers. These can be severe, especially in childhood and adolescence; children with Asperger syndrome often are the target of teasing and bullying at school because of their idiosyncratic behavior, language, interests, and their lowered or delayed ability to perceive and respond in socially expected ways to nonverbal cues, particularly in interpersonal conflict. A child or teen with Asperger syndrome often is puzzled as to the source of this mistreatment, unaware of what has been done “wrong.” Those who are aware of their condition may come to recognize such errors, but almost never immediately upon making them. The social alienation of children with Asperger syndrome can be so intense that they create imaginary friends for companionship (although this is certainly not specific to Asperger syndrome, since non-autistics may do the same). Even later in life, many people with Asperger’s report a feeling of being unwillingly detached from the world around them.
Bullying and other reasons were cited as a cause for William Freund’s rampage in October 2005.
One example of this sort of bullying: non-Autistic students will pretend to befriend those with Asperger’s syndrome by using sarcasm and intense use of “sexual phrases” which many children with Asperger’s syndrome may not recognize as such. The Asperger’s child is unaware he is being bullied and believes he has a true friend, while the “normal” child and his friends are laughing at him.
Children with Asperger syndrome often display advanced abilities for their age in language, reading, mathematics, spatial skills, and/or music, sometimes into the “gifted” range, but this may be counterbalanced by appreciable delays in other developmental areas. This combination of traits can create problems with teachers and other authority figures. (It may be relevant here that one of the social conventions many people with Asperger’s syndrome ignore is respect for authority. Attwood notes a tendency to feel that everyone should be treated much the same regardless of what social position they occupy; the student with Asperger’s syndrome may not give respect to an authority figure until he or she feels it has been earned, an attitude many teachers either do not understand or take strong exception to.) Like many other gifted children, a child with Asperger’s might be regarded by teachers as a “problem child” or a “poor performer.” The child’s extremely low tolerance for what they perceive to be mundane and mediocre tasks (such as typical homework assignments) can easily become frustrating; the teacher may well consider the child arrogant, spiteful, and insubordinate. Meanwhile, the child sits mutely, feeling frustrated and wronged and often having no idea how to express these feelings.
However, Asperger syndrome does not guarantee one will have a miserable life. The intense focus and tendency to work things out logically, a characteristic of Asperger syndrome, often grants people with the syndrome a high level of ability in their fields of interest. When these special interests coincide with a materially or socially useful task, the person with Asperger’s often can in fact lead a profitable life. The child obsessed with naval architecture may grow up to be an accomplished shipwright, for instance.
Although many people with Asperger’s are not considered socially successful by common standards – and there are many who remain alone their entire lives – it is certainly possible for them to find understanding people with whom they can have close relationships. Many autistics have children, in which case their children may or may not have an autism spectrum disorder. Also, many people with Asperger syndrome recognize that there is a problem and try to adapt to living among people without the syndrome, even if they are unaware of the term “Asperger syndrome” itself or believe it does not apply to them. It is possible with training and self-discipline for a child with Asperger’s to end up as an adult who, though still having Asperger’s, is able to interact well with others. However, because of their delayed social development, it is not unusual for people with Asperger’s to feel most comfortable with people much younger or older than they are.
However, not showing affection (or not doing so in conventional societally-acceptable ways) does not necessarily mean that he or she does not feel it. Understanding this can lead the significant other to feel less rejected and be more understanding. There are usually ways to work around the problems, such as being more explicit about one’s needs. For instance, when describing emotions, it can be helpful to be direct and to avoid vague terms such as “upset” when the emotion being described is anger (some individuals with Asperger’s would interpret “upset” as mere annoyance, or even nausea). It is often effective to lay out in clear language what the problem is and to ask the partner with Asperger’s to describe what emotions are being felt or ask why a certain emotion was being felt. It is very helpful if the family member or significant other reads as much as he or she can about Asperger’s syndrome and any comorbid disorders. In a minority of situations the opposite problem occurs; the person with Asperger’s is unusually affectionate to significant others and misses or misinterprets signals from the other partner, causing the partner to get annoyed and leave the person with Asperger syndrome feeling depressed and alone.
Experts generally agree that there is no single condition called autism. Rather, there is a spectrum of autistic conditions, with different forms of autism taking different positions on this spectrum. But in certain circles of the autism community, this concept of a spectrum is being questioned. If differences in development are purely a function of differences in skill acquisition, then attempting to distinguish between degrees of severity may be dangerously misleading. A person may be subjected to unrealistic expectations, or even denied life-saving services, based solely on very superficial observations made by others in the community.
In the 1940s, Leo Kanner and Hans Asperger, working independently in the United States and Austria, identified essentially the same population, although Asperger’s group was perhaps more “socially functional” than Kanner’s as a whole. Some of Kanner’s originally identified autistic children might today get an Asperger syndrome diagnosis, and vice versa. It is a mistake to say that a “Kanner autistic” is a child who sits and rocks and does not communicate. Kanner’s study subjects were all along the spectrum.
Traditionally, Kannerian autism is characterized by significant cognitive and communicative deficiencies, including delays in or lack of language. Often it is clear that these people do not function normally. On the other hand, a person with Asperger’s will not show delays in language. It is a more subtle condition, and affected people often appear only to be eccentric.
Researchers are grappling with the problem of how to divide the spectrum. There are many potential divisions, such as autistics who speak versus those who do not, autistics with seizures versus those without, autistics with more “stereotypical behaviors” versus those with fewer, and so forth. Some researchers are trying to identify genes associated with these traits as a way to make logical groupings. Eventually, one may hear autistics described as being with or without a specific gene, with or without changes to a certain chromosome, etc.
Leo Kanner identified another form of autism around the same time as Hans Asperger.
Some clinicians believe that communicative or cognitive deficiencies are so essential to the concept of autism that they prefer to consider Asperger’s a separate condition from autism. This opinion is a minority one. Uta Frith (an early researcher of Kannerian autism) has written that people with Asperger’s seem to have more than a touch of autism to them. Others, such as Lorna Wing and Tony Attwood, share in Frith’s assessment. Dr. Sally Ozonoff, of the University of California at Davis’s MIND institute, argues that there should be no dividing line between “high-functioning” autism and Asperger’s, and that the fact that some people do not start to produce speech until a later age is no reason to divide the two groups because they are identical in the way they need to be treated.
A gift and a curse
With the increase of Asperger syndrome diagnoses, its image continues to shift from that of a disease to a more complex view of a syndrome with both advantages and disadvantages because there are adults diagnosed with Asperger syndrome or autism who have become quite successful in their fields, possibly as a direct result of intellectual gifts and above-average focus and motivation associated with the syndrome. For example, some prominent Asperger-diagnosed people include Nobel Prize-winning economist Vernon Smith, comedian/actor Dan Aykroyd, industrial rocker Gary Numan, Craig Nicholls, frontman of the band The Vines, as well as Satoshi Tajiri, the creator of Pokémon. BitTorrent inventor Bram Cohen is widely cited as having Asperger syndrome, although he appears to have made this conclusion without consulting a medical professional. [1][2]
Speculation about recognized people who may have Asperger syndrome
It has been speculated that Albert Einstein had what is now considered Asperger syndrome.
Recently, some researchers such as Simon Baron-Cohen and Ioan James have speculated that well-known figures of the past, such as Albert Einstein and Isaac Newton, had Asperger syndrome because they showed some Asperger’s-related tendencies or behaviors, such as intense interest in one subject, or social problems. A chapter of the aforementioned Gillberg book is devoted to this subject, including a detailed case study of philosopher Ludwig Wittgenstein concluding that he met the criteria for the condition. However, such posthumous diagnoses remain controversial.
The specific arguments alleging that certain famous people might be on the autistic spectrum vary from person to person. Some claim that Albert Einstein (one of the more frequently cited figures of the past as possibly autistic) was a loner as a child, had violent temper tantrums, repeated under his breath sentences he uttered, and needed his wives to act as parents when he was an adult, factors that are stereotypical of autistic people. Isaac Newton stuttered and was epileptic. Many of these suspected historical Asperger cases might have been quite mild, but some skeptics believe these people may have had a few autistic traits but not enough for an autism spectrum diagnosis. Finally, many critics of historical diagnosis claim it is simply not possible to diagnose the dead, so nothing can be said definitively regarding the Asperger status of historical figures.
Such speculation may simply be an attempt to create role models for autistics to demonstrate that they can be exemplary contributors to society. Autistic rights activists often use such speculative diagnoses to argue that it would be a loss to society if autism were cured. However, others in the autistic rights movement dislike these arguments because they think autistics should be able to value their uniqueness without the desire for a cure, regardless of whether people such as Einstein were autistic.
Shift away from view as a disease
The speculated social contributions of autistic people have contributed to the shift in the perception of autism spectrum disorders as complex syndromes rather than diseases that must be cured. Proponents of this view reject the notion that there is an ‘ideal’ brain configuration and that any deviation from the norm must be considered pathological. They demand tolerance for what they call their neurodiversity in much the same way lesbian and gay people have demanded tolerance for theirs. Views such as these are the basis for the autistic rights and autistic pride movements.
A Wired magazine article called “The Geek Syndrome” suggested that Asperger syndrome is more common in the Silicon Valley, a haven for computer scientists and mathematicians. It created an enduring notion popularized in the media and self-help books that “Geek Syndrome” equals Asperger syndrome and caused an explosion of self-diagnoses in part because it was printed alongside Simon Baron-Cohen’s 50-question Autism Spectrum Quotient Test. Like some people with Asperger syndrome, geeks may exhibit an extreme professional or casual interest in computers, science, engineering, and related fields and may be introverted or prioritize work over other aspects of life. However, no determination has yet been made of whether the “Geek Syndrome” personality type has a direct relation to autism or is simply a “variant normal” type that is not part of the autistic spectrum.
Regardless, societal acceptance of Asperger or Asperger-like traits is still rare, as many people in the autistic spectrum will confirm.
Rett syndrome
Rett syndrome (Rett syndrome, Rett’s disorder) is a progressive neurological disorder. The symptoms of this disorder are easily confused with those of autism and cerebral palsy. The gene is recessive and can therefore lie dormant for generations. The clinical diagnosis specifies a small head and small hands and feet. Stereotypical repetitive hand movements such as mouthing or wringing are also included as diagnostic signs. Symptoms of the disease include learning disorders and a total inability to socialize. Girls with Rett syndrome are very prone to seizures and GI disorders. They typically have no verbal skills, and about 50% of females are ambulatory. Rett syndrome (symbolized RTT) is X-linked dominant, affecting almost exclusively girls. Development is normal until 1 year of age, when language and motor milestones regress and acquired microcephaly is seen. Hand wringing and sighing are characteristic, and they develop autistic behavior. Rett syndrome is usually caused by a mutation in the gene encoding methyl-CpG-binding protein-2 (MECP2). MECP2 is found on chromosome band Xq28, near the long end of the X chromosome. Rett syndrome can also be caused by a mutation to the gene encoding cyclin-dependent kinase-like 5 (CDKL5). Rett syndrome affects 1 in every 12,500 female live births. Most individuals with Rett syndrome are female. One explanation given for this was that the genetic defect that caused Rett syndrome in females caused embryonic lethality in males (that is, males with pathogenic MECP2 mutations died before they were born). While a plausible hypothesis, more recent research has contradicted this explanation. Most males with a pathogenic MECP2 mutation suffer from neonatal encephalopathy and die within a year or so of birth. Males who have two X chromosomes and a Y chromosome (often called Klinefelter’s syndrome), one with a mutated MECP2 gene, follow a similar development path to females with Rett syndrome. Males who have somatic mosaicism also have symptoms like females with Rett syndrome. Infants with Rett syndrome typically develop normally until they are 6-18 months old. Physioneurological development tends to plateau after this brief period of normal development, and is followed by deterioration of the high brain functions. Psychomotor and cognitive abilities rapidly decline between 1-2 years of age. Symptoms that develop are similar to those of autism, including mental retardation and poor growth. It is, hence, easy to mistakenly diagnose Rett syndrome for autism, or cerebral palsy.
Symptoms of Rett syndrome that are similar to autism:
•screaming fits
•panic attacks
•inconsolable crying
•avoiding looking into other people’s eyes
•lack of social/emotional reciprocity
•general lack of interest
•marked impaired use of nonverbal behaviors to regulate social interaction
•delay of linguistic development
oloss of speech

Symptoms of Rett syndrome that are also present in cerebral palsy:
•short stature
•severe dementia
•mild learning disability
•hypotonia
•Delayed or absent ability to walk
•gait/movement difficulties
•ataxia
•microencephalopathy – abnormally small head, lack of head growth
•some forms of spasticity
owringing of hands
oChorea – spasmodic movements of hand or facial muscles
odystonia
obruxism – grinding of teeth

Symptoms may stabilize for up to a few decades before complications set in, such as epilepsy or seizure and spastic paraparesis (spasticity or paralysis of the lower limbs).
Depending on the severity of psychomotoral and cognitive impairment, 2-15% of patients may achieve a nonretarded level of functioning through various rehabilitation methods. Marriage, success in achieving employment and independent living can be achieved during adulthood. Currently there is no cure for Rett syndrome.
Males with pathogenic MECP2 mutations usually die during infancy stage from severe encephalopathy, unless they have an extra X chromosome (often described as Klinefelter’s syndrome), or have somatic mosaicism.
Females can live up to 40 years or more. Abnormal lab data values on Rett disorder may show:
•EEG abnormalities from 2 years of age
•atypical glycolipids
•elevated levels of beta-endorphins and glutamate
•reduction of substance P
•decreased levels of nerve growth factors
Mortality rate among children with Rett disorder is approximately at 1.2% per year.
High proportion of deaths are abrupt; due to:
•heart conduction problem – abnormally prolonged QT interval on ECG
•spontaneous brainstem dysfunction
•respiratory arrest

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Question?: Pdd Symptoms

Linda asks…

Is it possible to have severe aspergers?

Autism has a scale and aspergers is on the high end. So I know it doesn’t make sense to say severe aspergers b/c that would be equivalent to pdd or classic autism. But I have extreme difficulties in social interaction, worse than most people with aspergers…yet in all other areas i’m high functioning.

admin answers:

You’re right, asperger’s syndrome is on the high-functioning end of the autism spectrum but to say that someone has severe asperger’s doesn’t mean they are the same as other autism spectrum sufferers.

Asperger’s is different in that the level of linguistic and cognitive development is close to normal. This means that while a person with asperger’s will struggle with social interactions and display repetitive behaviour they do not suffer from the low functioning language or cognitive skills of other diagnoses.

Severe asperger’s means simply that the symptoms displayed (difficulty with social interactions etc.) will be more pronounced.

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Question?: Autism Symptoms In 7 Year Old

John asks…

My nephew was just tested for autism?

My sister in law was so upset by the results the Dr. gave. I have 2 questions. The Dr. said my 21/2 year old nephew was only testing at a 7 month old level so she could not diagnose him with Autism, Why? Also what can I do for my sister in law to help ease her mind? They have been through so much already, I honestly think she would be happy to put a medical name to what her son has, but she still gets down and out sometimes. Thanks for your answers!

admin answers:

Well for me, its important that he is getting the treatment he needs regardless of the “official” dx. A lot of therapies used to treat autistic children and to treat children developmentally behind are similar. I agree to get a second opinion. For our son, one of the first indicators he had autism was him testing at a 9 month level in certain areas when he was 2 1/2. However it can take months or even years to get a dx. Try and educate yourself about what specific symptoms he has and work on those. But I completely understand about wanting a dx. It does help ease your mind in a way once you have a name to go with it.

As a side point, to the above poster who saw the 3 docs. The last one who said that autistic children won’t test differently— is completely wrong. In fact that should point more towards autism. Autism affects social interaction so taking language out and she is testing higher is a huge indicator that autism should be more looked into. My son who tested at a 9 month level when language was involved, could test at a school-age level when he was tested with pictures instead of questions. One of the main treatments for autism involves picture boards- because language is such a difficult thing for them. There are entire websites/books/therapies devoted to reaching autistic children with modified means of communication. That doctor needs educated himself.

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