Erie County Medical Society

March 28th, 2012

What Is Autism?

The incidence of diagnosed autism and autism spectrum disorders has substantially increased in recent years. It is unclear how much of this is from true disease increase and how much is from improved diagnosis.

Autism is a more specific term than autism spectrum disorder. Autism refers to (1) impaired social interaction, (2) impaired communication, and (3) restricted, repetitive behaviors. Autism spectrum disorder refers only to (1) impaired social interaction and (2) restricted, repetitive behaviors.

So what do these terms mean? (1) Impaired social interaction means that affected children may totally ignore the presence of a parent, sibling, or pediatrician. (2) Impaired communication means that these children may have delayed and limited use of language. (3) Restricted, repetitive behaviors means they may engage in repeated finger movements, postures, or utterances.

Of course, all behaviors must be taken in context. Further, there is no x-ray or laboratory test to detect autism. Only a well-trained, experienced clinician can make the diagnosis of autism or autism spectrum disorder. However, some elements do raise concerns and should be followed up with such a specialist.

First is the absence of protodeclarative pointing. Normally, when a small child is asked, “Where is (for example) the teddy bear?” the child will point with the index finger while looking at the questioner’s face. A child’s inability to do this should be investigated.

Second is the abence of normal gaze monitoring. Typically when an adult speaks a child’s name and points to an object across the room while saying, “Oh look, there’s a …,” the child looks at the object indicated. Again, regular failure at this gaze monitoring can be a cause for further examination.

Third is the absence of pretend play. The usual actions of a child presented with a toy object, such as a car, is to simulate the actions associated with the real object. A child may consistently fail to wheel the car across a surface, but instead seem fixated on the color or texture of the object or incessantly spin one of the car’s wheels. Consistent actions of this type warrant specialist consultation.

The prevailing professional opinion is that children with autism can be helped with behavioral therapy and special education programs. Speech and language therapy, social skills therapy, and occupational therapy are also deemed useful. While no medications exist to treat the core problem of autism, medications may help other problems often associated with autism.

Thomas Falasca DO