Jeremy Tolmie

Living with Autism Spectrum Disorder


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      Dedication

      This book is dedicated to Dave Ray for without him I would not be where I am today.

      Preface

      Defining Autism

      Autism spectrum disorder (ASD) and autism are both general terms for a group of complex disorders of brain development. These disorders are characterized, in varying degrees, by difficulties in social interaction, verbal and nonverbal communication and repetitive behaviours.

      Autism appears to have its roots in very early brain development. However, the most obvious signs of autism and symptoms of autism tend to emerge between 2 and 3 years of age. Both children and adults with autism typically show difficulties in verbal and non-verbal communication, social interactions, and leisure or play activities.

      Autism Spectrum Disorder has specific diagnostic criteria outlined in the American Psychiatric Association's Diagnostic & Statistical Manual of Mental Disorders (DSM-IV-TR).

      Who is Affected?

      ASD occurs in all racial, ethnic, and socioeconomic groups, but are almost five times more common among boys than among girls. CDC estimates that about 1 in 68 children (2014 CDC) has been identified with an autism spectrum disorder (ASD).

      Types of ASD

      There are three different types of Autism Spectrum Disorders:

       Autistic Disorder ASD LEVEL 3 (ALSO CALLED "CLASSIC" AUTISM)This is what most people think of when hearing the word "autism." People with autistic disorder usually have significant language delays, social and communication challenges, and unusual behaviors and interests. Many people with autistic disorder also have intellectual disability.

       Asperger Syndrome ASD LEVEL 1People with Asperger syndrome usually have some milder symptoms of autistic disorder. They might have social challenges and unusual behaviors and interests. However, they typically do not have problems with language or intellectual disability.

       Pervasive Developmental Disorder – NOT OTHERWISE SPECIFIED (PDD-NOS; ALSO CALLED "ATYPICAL AUTISM") ASD LEVEL 2People who meet some of the criteria for autistic disorder or Asperger syndrome, but not all, may be diagnosed with PDD-NOS. People with PDD-NOS usually have fewer and milder symptoms than those with autistic disorder. The symptoms might cause only social and communication challenges.

      Signs and Symptoms

      ASDs begin before the age of 3 and last throughout a person's life, although symptoms may improve over time. Some children with an ASD show hints of future problems within the first few months of life. In others, symptoms might not show up until 24 months or later. Some children with an ASD seem to develop normally until around 18 to 24 months of age and then they stop gaining new skills, or they lose the skills they once had.

      A person with an ASD might:

       Not respond to their name by 12 months

       Not point at objects to show interest (point at an airplane flying over) by 14 months

       Not play "pretend" games (pretend to "feed" a doll) by 18 months

       Avoid eye contact and want to be alone

       Have trouble understanding other people's feelings or talking about their own feelings

       Have delayed speech and language skills

       Repeat words or phrases over and over (echolalia)

       Give unrelated answers to questions

       Get upset by minor changes

       Have obsessive interests

       Flap their hands, rock their body, or spin in circles

       Have unusual reactions to the way things sound, smell, taste, look, or feel

      Prevalence of Autism

      Autism statistics from the U.S. Centers for Disease Control and Prevention (CDC, April 2012) identify around 1in 68 American children as on the autism spectrum. Careful research shows that this increase is only partly explained by improved diagnosis and awareness. Studies also show that autism is five times more common among boys than girls. An estimated 1 out of 48 boys and 1 in 252 girls are diagnosed with autism in Canada.

      Causes and Risk Factors

      Scientist do not know all of the causes of ASDs. However, they have learned that there are likely many causes for multiple types of ASD. There may be many different factors that make a child more likely to have ASD, including environmental, biologic and genetic factors.

       Most scientists agree that genes are one of the risk factors that can make a person more likely to develop an ASD.

       Children who have a sibling or parent with an ASD are at a higher risk of also having an ASD.

       ASDs tend to occur more often in people who have certain other medical conditions. About 10% of children with an ASD have an identifiable genetic disorder, such as Fragile X syndrome, tuberous sclerosis, Down syndrome and other chromosomal disorders.

       Some harmful drugs taken during pregnancy have been linked with a higher risk of ASDs, for example, the prescription drugs thalidomide and valproic acid.

       We know that the once common belief that poor parenting practices cause ASDs is not true.

       There is some evidence that the critical period for developing ASDs occurs before birth.

       Social communication and interaction

      A child or adult with autism spectrum disorder may have problems with social interaction and communication skills, including any of these signs:

       Fails to respond to his or her name or appears not to hear you at times

       Resists cuddling and holding, and seems to prefer playing alone, retreating into his or her own world

       Has poor eye contact and lacks facial expression

       Doesn't speak or has delayed speech, or loses previous ability to say words or sentences

       Can't start a conversation or keep one going, or only starts one to make requests or label items

       Speaks with an abnormal tone or rhythm and may use a singsong voice or robot-like speech

       Repeats words or phrases verbatim, but doesn't understand how to use them

       Doesn't appear to understand simple questions or directions

       Doesn't express emotions or feelings and appears unaware of others' feelings

       Doesn't point at or bring objects to share interest

       Inappropriately approaches a social interaction by being passive, aggressive or disruptive

       Has difficulty recognizing nonverbal cues, such as interpreting other people's facial expressions, body postures or tone of voice

       Patterns of behaviour

      A child or adult with autism spectrum disorder may have limited, repetitive patterns of behaviour, interests or activities, including any of these signs:

       Performs repetitive movements, such as rocking, spinning or hand flapping

       Performs activities that could cause self-harm, such as biting or head-banging

       Develops specific