Tag: ASD

Medical science is a constantly evolving branch of knowledge. There is always more to learn, more to understand, and, in terms of technologies and techniques, always more to try. It’s because of the continuing advances in medicine that things like insulin allow people with diabetes to live full lives, and that some forms of cancer are now treatable, while dangerous viruses like AIDS/HIV continue to be researched with a hope for an eventual cure.

However, treatment and advancement do not come without understanding. Diagnosis is a critical part of medical treatment, and in the case of Autism Spectrum Disorder, or ASD, it has often been one of the most challenging aspects. For decades, ASD was not even diagnosed as a distinct medical condition but was misdiagnosed as a type of schizophrenia. Even when medical experts began to suspect it was a unique condition, it was incorrectly thought to be an entirely behavioral issue, arising from poor parenting, specifically from mothers.

Today, ASD is understood to be a complex condition with many symptoms. But how is it diagnosed?

The Old Versus New

ASD diagnosis is still experiencing something of a transition as both people with ASD, and established medical experts continue to grapple with a new form of classification and diagnosis. In the 1980s, when ASD was first entered into official medical texts, like Diagnostic & Statistical Manual of Mental Disorders (DSM), it was broken down into four categories that tried, roughly, to divide ASD patients by severity, with people having Asperger’s Syndrome considered “high functioning” while those that were diagnosed with Childhood Disintegrative Disorder were considered “low functioning” and had the most severe symptoms.

In 2013, with DSM-V, the four categories were eliminated due to the difficulty in accurately categorizing and treating patients with ASD. Instead, as the name implies, Autism is now diagnosed across a spectrum of different, individual symptoms. People are no longer described as high or low functioning and classed according to a ranking of their ability. Now the specific symptoms are evaluated for individual severity, and treatments are more personalized to each individual depending on the spectrum and intensities of those symptoms.

Evaluating ASD

ASD can be noticed in children at a very early age. Even just several months after birth, before a baby is even a toddler, it is sometimes possible to see behavior that can lead to early suspicions of ASD. For any parent that is wondering whether a child’s behavior is an indication of ASD, don’t sit on that suspicion, bring the child in for an evaluation and get an experienced specialist to conduct a diagnosis.

Early intervention is one of the best ways to give ASD children a better start in life. The parents need to get an accurate assessment of a child’s behavior, and the details of the condition so that they have a better understanding of how to raise and interact with the child, without creating unnecessary barriers or limitations that could impact the quality of life.

The Criteria

Under the current DSM-V diagnoses, parents should be on the lookout for behaviors that fall into three general categories:

Social-Emotional Reciprocity

A child shows a deficit in providing normal emotional or social responses to interactions. Children that display little or no emotional reaction are one example. Or failing to respond to questions, or interact in conversation is another. An unwillingness to initiate or even engage in social interaction is another example.

Nonverbal Communication Skills

Besides speech, there are many nonverbal actions and “cues” that are considered a normal but subtle part of communication. Eye contact, for example, is something that is not usually explained to children, but is learned over the course of interaction. A child that is unwilling to look people in the eye when communicating shows a deficit in nonverbal communication that might require evaluation.

Social Interaction & Maintenance

A more general deficit is the ability to interact or maintain social connections with others successfully. Due to the difficulties in social-emotional reciprocity, and/or nonverbal communication, a child may either prefer to be alone or be unable to successfully interact with others despite a wish to do so, resulting in alienation from other children.

There are also specific behavioral elements that parents should keep an eye out for. If two of the following are present in a child’s behavior, that also merits a closer look by a medical professional:

Repetitive Movements: A child performs the same action, or says the same words repeatedly.

Adherence To Ritual: A child insists on a specific routine or order, and is extremely upset when disruption occurs.

Hyper Focus: An ability, or insistence on focusing on an activity or other preoccupation with abnormal intensity.

There may be other associated factors to consider as well, like intellectual impairment, or other mental disorders, such as schizophrenia. This is why it is critical to try not to self-diagnose, but use the guidelines above as signs to bring a child in for a proper, detailed evaluation.

To most of the general public, autism, more accurately referred to in clinical circles as Autism Spectrum Disorder, or ASD is viewed as a mysterious, even frightening disorder. Popular culture has portrayed the disorder as either a crippling condition that leaves people unable to function in everyday settings, or results in eccentric genius, with an inability to bond meaningfully with others.

The truth, as with most public misconceptions and media portrayals, lies somewhere in the middle. People with ASD are not either doomed to the margins or blessed with genius. As the word “spectrum” implies, those with ASD have a huge range of different symptoms at different intensities. Some with milder forms of ASD may not even know they have the condition, and live their lives simply thinking of themselves as “introverted with a few quirks.” Others may, if the symptoms are severe, require extensive treatment to cope with the world.

But a few people have achieved enormous amounts of success and fame sometimes despite, and sometimes because of, their ASD. Here are a few famous people that have been diagnosed with ASD.

Satoshi Tajiri

While the name itself may not be commonly known in households, the product of this Japanese game developer is globally recognized by the young and young at heart everywhere. Tajiri is most well known for creating Pokemon, the Japanese phenomenon that went worldwide. Pokemon started as a portable videogame for children on the Nintendo Gameboy in 1996 and went on to become a huge hit all over the planet.

Over 20 years later, Pokemon continues to be a massive phenomenon, both for a new generation of children and for adults that still enthusiastically embrace the idea of collecting cute creatures for fights and duels. Tajiri has publicly admitted his autism diagnosis but prefers not to talk about it in depth, preferring to let his work do the talking.

Temple Grandin

In some circles, Temple Grandin is widely regarded as both a respected female scholar and writer. She is a professor at Colorado State University for Animal Science but has also authored many books on topics such as handling livestock and dealing with ASD. She is a very prominent advocate for ASD, having been diagnosed early in her life with the condition.

She did not speak until she was four years old, and her ASD was severe enough that, at the time, in the 1950s, her parents were advised she should be institutionalized. Her family did not follow that advice and allowed her to grow and develop without the obstacles of 20^th century, pre-ASD treatment methods. Today she has made great strides both professionally and helping to educate the public about ASD.

Susan Boyle

She was once just another average Scottish woman until her stunning debut at the Britain’s Got Talent reality TV show. Susan Boyle’s average appearance belied an incredibly powerful singing voice that, until 2012, had gone completely undiscovered. After that debut, she went on to a professional career and, in less than ten years, has already sold over 14 million albums worldwide.

Susan Boyle, however, was also officially diagnosed during her life with Asperger’s Syndrome, one of the four old classes of autism until modern medical diagnoses did away with dividing ASD into different categories. As with many people with ASD, Boyle finds it occasionally difficult to cope with people and is happiest pursuing her interests, which in this case, include singing.

Sir Anthony Hopkins

One of the most revered “elder statesmen” of acting today, Anthony Hopkins is such a talented actor that he eventually received a knighthood in 1993 for his service to the arts. Hopkins is probably best known for his role as the cannibalistic psychiatrist Hannibal Lecter in a widely-acclaimed performance in the movie Silence of the Lambs.

Hopkins, however, is also another celebrity diagnosed with, at the time, what would have been classified as Asperger’s Syndrome. He was not diagnosed until much later in life and, as a result, had a difficult childhood. He was treated poorly by peers, had trouble keeping grades up, and his inability to understand social interactions led to frustration and even substance addiction to cope.

Greta Thunberg

Perhaps the most famous person with ASD in the world right now is also one of the youngest. Greta Thunberg, a teenager from Sweden, is only 17 years old but has already become a Time “Person of the Year,” traveled the world advocating for fighting climate change, and has given fiery, angry speeches to no less than the entire United Nations. She is one of the few 17-year-old girls that rich, powerful men fear and want to stop, because of her powerful messaging.

She was also diagnosed early in life with ASD, but she refers to it as her “superpower,” and claims that it is because of her ASD, and her inability to comply with conventional social expectations, telling people what they want to hear, that she can move ahead and tell people what they need to hear.

Autism, which today is clinically known as Autism Spectrum Disorder (ASD), is one of the more complex and largely still unknown conditions in medical science today. It is a disorder with so many symptoms, in a broad range of intensities, that for centuries, it was not even properly recognized as a distinct condition. In past years, some forms of ASD were misdiagnosed as schizophrenia, because of some behavioral similarities and the fact that some ASD patients did respond positively to some schizophrenic treatments like prescribing antipsychotic medication.

Today, ASD understanding has improved, but the knowledge we have of the disorder is far from complete. Over the decades, many iterations of our understanding of ASD have come and gone. This has left some people confused as to the exact state of an ASD diagnosis since many are now outdated and no longer medically classified in such a way. All ASD patients today, for example, are diagnosed on “the spectrum.” There is no longer any distinct classification such as one ASD patient having Asperger’s Syndrome, while another has Childhood Disintegration Disorder.

One of these classifications that are no longer used is Atypical Autism, and there are many good reasons for that.

The Early Classifications

There is one medical document that is often considered a central source for global medical references, and that is the Diagnostic & Statistical Manual of Mental Disorders. The DSM, as it is more conveniently referred to, has been a touchstone of American mental health knowledge and reference since 1952. It is a “living document” in the sense that it is periodically updated to reflect discoveries, treatments and developments in the mental health medical space. So, the first edition of the text used is now referred to as “DSM-I.”

It was only in the 1980s, with the introduction of DSM-III, that ASD was given a distinct classification. However, unlike the current system, which defines ASD as one condition with a spectrum of different symptoms at different intensities, the DSM-III text created four different classifications for ASD and then tried to fit ASD patients into each of these categories. Atypical Autism was one of these four categories.

What Was Atypical Autism?

Atypical Autism, under DSM-III was not clinically referred to with this term. The technical term for it was Pervasive Developmental Disorder-Not Otherwise Specified, or PDD-NOS. As the name indicates, PDD-NOS was a “miscellaneous” category where those diagnosed with autism who didn’t fall into the other three categories would go. Asperger’s Syndrome was the first category and considered the “mildest and high functioning.”

The other categories, “Classic Autism” and “Childhood Disintegration Disorder,” were considered more severe. This meant people with ASD symptoms more severe than Asperger’s, but milder than Classic or CDD went into the PDD-NOS category, which quickly showed how inadequate a four-class category system was as more and more people failed to fit into the other three categories neatly.

The symptoms of people formerly classed as having PDD-NOS included:

Anomalous/Unusual Social Interactions

This was difficult to categorize since so many potential symptoms could be included, but in general, if a child experienced difficulty smoothly socializing with other children, and it was due to specific behaviors, such as unprovoked hostility, or unwillingness to speak, these fell into the category.

Linguistic/Communication Issues

Those with PDD-NOS in the past were also characterized by having communication deficits that made it difficult for them to be understood by others. This may have manifested as delayed communication development, or other anomalies, such as speaking without inflection and sounding like a robot.

Repeating Actions

Like other former categories of autism, PDD-NOS also included symptoms of repetitive motions or behaviors. Repeating certain gestures, actions, or words would often be a soothing activity in times of stress. However, there was little discretion about when these repeating behaviors would occur, which could be interpreted as inappropriate given the timing and circumstance.

Atypical Sensory Experience

This can be difficult to diagnose properly since an objective measurement is difficult. Atypical sensory experience means people formerly diagnosed with PDD-NOS may have apprehended their senses in ways that differ from those without the condition. Colors, for example, may look different, smells may be stronger or weaker, the sensation of touch may feel different.

The New Classification

By the 21^st century, it was apparent that trying to fit the huge variance of autism symptoms into four categories wasn’t working as accurately as envisioned. In 2013, with DSM-IV, the four categories of autism were discarded. We now operate on a single system of Autism Spectrum Disorder, where individuals are diagnosed as being “on the spectrum.” From there, a more in-depth diagnosis is made to catalog and diagnose the specific symptoms and then treat each person in a customized, personalized manner that suits their needs, rather than classing them as Category 1 or Category 4 and using only treatments specific to that category. ASD is far more complex than that and requires a nuanced treatment strategy.