Although autism may become obvious at infancy with impaired
attachment, it is most often identified in toddlers, mostly boys, from 18 to 30
months of age. Parents or pediatricians notice an absence or delay of speech
development and a lack of normal interest in others or a regression of early
speech and sociability.
These autistic traits persist into
adulthood but vary from little speech and poor daily living skills throughout
life to graduating with a college degree and independent functioning. Adults
with autism may be perceived in society as being merely or reclusive or they may
be given a diagnosis of obsessive-compulsive disorder, schizoid personality,
simple schizophrenia, affective disorder, mental retardation, or brain damage (Mesibov
2000).
Autism does tend to improve over time, in some cases as children
start to acquire language and learn to use it to communicate needs and to
influence other people. Behavioral deterioration in adolescence may suggest
hormonal changes, the difficulty of meeting greater behavioral demands in an
increasingly complex social milieu, or depression (Rapin
1997). Although most
autistic patients remain dependent to a certain degree in adulthood, those with
enough social skills could find a way to become self-supporting. Rarely do
social skills improve enough to permit successful marriage.
The main symptoms of autism are deficits in sociability, and verbal communications. Contrary to the popular views, children with autism can be affectionate, but on their terms and without the expected joy and reciprocity. Parents of autistic toddlers may describe them as independent rather than aloof. Parents may be proud of their child’s self-sufficiency. However, anger or depression in adolescence may replace their excessive shyness, fearfulness, anxiety, or lability (rapid changing) of mood of the child with autism. If not dealt with early, unprovoked aggressiveness may become a major problem and lead to a need for heavy medication or institutionalization (Rapin1997).
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Young children with autism have language disorders as well. At least with
young autistic children, comprehension and the communicative use of speech and
gestures are typically deficient. The lack of ability to decode rapid sounds
that characterize speech results in verbal auditory agnosia or word deafness.
Children with this disorder understand little or no language and therefore fail
to acquire speech and remain nonverbal (Rapin1997).
Children that are less severely affected by autism may acquire a mixed
receptive-aggressive disorder and have better comprehension than expression.
Their speech may be described as impoverished, poorly articulated, agrammatical,
and sparse. Other children with autism that speak late may progress rapidly from
silence or jargon to fluent, clear, and well-formed sentences. However, their
speech may still be literal, repetitive, and noncommunicative. It is often
marked by striking echolalia (involuntary parrot-like repetition of a word or
sentence just spoken by another person) or “overlearned scripts” (Rapin1997). In other words, they may say the appropriate things but autistic children
say it more out of habit rather than actually understanding or planning the
appropriateness of what they say. Some autistic children speak nonstop in a
high-pitched, singsong, or poorly modulated voice to no one in particular and
overly focus on specific favorite topics.
Young children do not know how to play and may manipulate or line up their toys without understand what the toys actually represent (for example, the idea that dolls represent people), and they do not engage in pretend play which typically starts in other children by the age of two. Pretend play is an important part in building a child’s social skills by allowing them to act out and practice situations before they happen.
Some with autism have particularly long attention spans while doing a repetitive activity alone. However, they are incapable of focusing on an activity involving working with another person. They tend to have temper tantrums if someone tries to make them stop a repetitive activity. Their inability to concentrate along with other symptoms such as hand flapping may prevent children from working well with others. A decreased need for sleep and waking up often during the night also separate the children from those of the general population (Rapin1997).
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It has been estimated that about 75 percent of persons with autism are mentally retarded. The results of neuropsychological testing typically reveal an uneven cognitive profile with nonverbal skills generally superior to verbal skills. Throughout life, autistic people tend to have poor insight into what people are thinking as well limited creativity. However, a small portion of autistic children excel in music, math, or visual-spatial abilities, despite their other deficits (Rapin1997). If these abilities are astounding, autistic children may be known as savants.
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Children with autism may sometimes be hypersensitive or overly aware of new stimuli and at other times completely oblivious to certain stimuli, such as sounds, tactile stimuli, or pain. Children may sniff their food and have a great aversion to certain tastes or textures. Their visual perception is usually superior to their auditory perception. Children with this symptom may behave unusually at times by covering their ears and staring at some visual display. They may have an amazing rote visual or auditory memory (Rapin 1997). In other words, they may have an increased ability to remember order and to perform repetitive, mindless tasks.
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Seizures are a more common occurrence amongst those with autism than the general population. By adulthood, about a third of autistic people have had at least two unprovoked epileptic seizures. The probability of epilepsy increases throughout childhood with a peak in adolescence and is linked to motor deficits and mental retardation (Rapin1997).
Back to TopAbout a third of parents with autistic children report a regression of their child’s language, social, and play skills before the age of two. This is followed by a plateau and eventual improvement of skills but not full recovery (Rapin1997).
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Previously, autism was thought to be rare. Although there are no reliable figures on the prevalence of autism among adults, it has been suggested that in the United States, there is anywhere from 58,000-115,000 children with autism among the 57.6 million children 1 to 15 years of age. It has been reported that autism occurs in 4 or 5 out of every 10,000 children. The DSM-IV’s explicit behavioral criteria have allowed for the identification of more mild cases of child and adult autistic patients (Rapin1997).