DSM-IV vs. DSM-V (Old vs New)

  • DSM-IV
    • Autistic Disorder
    • Asperger’s Disorder
    • Childhood Disintegrative Disorder  (CDD)
    • Rett’s Disorder
    • The catch-all diagnosis of Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS)
  • DSM-V (May 2013)
    • All Autism disorders were merged into one umbrella diagnosis of ASD- Autism Spectrum Disorder

What is Autism?

  • Neurodevelopmental Disorder

  • Autism Spectrum Disorder (ASD) and Autism are both general terms for a group of complex disorders of brain development.

  • Autism is characterized, in varying degrees, by difficulties in

    • Social interaction

    • Verbal and Nonverbal communication

    • Restricted, repetitive behaviors, interests, and/or activities (DSM-V)

Diagnostic Criteria

  • Individuals with Autism are most commonly diagnosed before the age of 5
  • CDC announced in April 2018 that 1 in 59 children in U.S. is diagnosed with Autism
  • Diagnostic Criteria:
    • Persistent deficits in social communication and social interaction
      • Deficits in social-emotional reciprocity
      • Deficits in non-verbal communicative behaviors used for social interaction
      • Deficits in developing, maintaining, and understanding relationships
    • Restricted, repetitive patterns of behavior
      • Stereotyped or repetitive motor movements, use of objects, or speech
      • Insistence on sameness, inflexible adherence to routines
      • Highly restricted, fixated interests
      • hyper- or hyporeactivity to sensory input DSM-V

How does Autism affect the body?

Examples:

  • Cognitive impairments
  • Sensory Integration Dysfunction
  • Poor eye contact
  • Lack of facial expression
  • Inability to speak or delayed speech
  • Seizure disorders
  • Self-stimulatory behavior: flapping, rocking, fidgeting with objects, making repetitive sounds, etc.
  • Health issues such as sleep and gastrointestinal disturbances
  • Problems with coordination or odd movement patterns, such as clumsiness or walking on toes, and odd, stiff or exaggerated body language

Risk Factors

  • “There is no one cause of autism, just as there is no one type of autism.” –Autism Speaks
  • Genetics:
    • “Autism is one of the most heritable mental disorders. If one identical twin has it, so will the other nearly 9 out of 10 cases. If one sibling has the disorder, the other siblings run a 35-fold greater-than-normal risk of having it.” –NIMH
  • Environment:
    • Advanced parental age
    • Perinatal factors: induced labor, short labor, 1-minute low Apgar score, fetal distress, elective or emergency C-Section, threatened miscarriage, oxytocin
  • Brain Biology:
    • These genetic and non-genetic risk factors give rise to Autism by affecting crucial aspects of early brain development.
  • “It is important to keep in mind that these factors, by themselves, do not cause autism. Rather, in combination with genetic risk factors, they appear to modestly increase risk.” –Autism Speaks

Prognosis

  • No cure
  • Therapies, behavioral interventions, medications, and other interventions can lead to great improvement in symptom severity.
  • Some people “recover” so much that the ASD diagnosis is withdrawn
  • For most, the symptoms become milder as a child grows older, but the core problem remains (such as difficulties with social interaction)
  • It all depends upon the degree of the disorder and the timing and level of treatment

Autism is a Spectrum Disorder

  • Presents differently in each individual
  • Severity levels:
    • Level 1: “Requiring very substantial support”
    • Level 2: “Requiring substantial support”
    • Level 3: “Requiring support” (DSM-V)

College Students on the Spectrum

  • Usually considered “high-functioning”
  • How students with Autism might be affected:
    • Sensory experience may be unusual
    • Learning style differences
    • Information processing affected (visual fields/ sounds distorted)
    • Experience of time may be unusual
    • Relationships/socialization may be exhausting and perplexing
    • Difficulty adjusting to change

College Students on the Spectrum Cont.

  • Possible student strengths: 
    • Above average, even brilliant academic performance in certain subjects
    • Dependable and responsible/good adherence to routines
    • Good at working independently
    • Excellent attention to detail and memory
    • Can maintain focus for long periods of time
    • Tend to have job longevity

How can we help people with Autism?

  • Accept their differences; respect their strengths
  • Find common interests
  • Invite them to participate in activities
  • Help them access useful resources
  • Use clear and direct communication
  • Remember they may have sensory sensitivities
  • Establish order and routine
  • Provide helpful feedback
  • Learn more about Autism
  • Ask them what you can do to help

Resources