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Autism spectrum disorder (ASD) and autism are
both general terms for a group of complex disorders
of brain development. These disorders are charac-
terized, in varying degrees, by diffculties in social
interaction, verbal and nonverbal communication and
repetitive behaviors. With the May 2013 publication
of the ffth edition of the American Psychiatric
Association’s Diagnostic and Statistical Manual
of Mental Disorders (commonly referred to as the
DSM-5), all autism disorders were merged into
one umbrella diagnosis of ASD. Previously, they
were recognized as distinct subtypes, including
autistic disorder, childhood disintegrative
disorder, pervasive developmental disorder-not
otherwise specifed (PDD-NOS) and Asperger
Syndrome. The DSM is the main diagnostic
reference used by mental health professionals and
insurance providers in the United States.
You may also hear the terms Classic Autism or
Kanner’s Autism (named after the frst psychiatrist to
describe autism) used to describe the most severe
form of the disorder. Under the current DSM-5, the
diagnosis of autism requires that at least six develop-
mental and behavioral characteristics are observed,
that problems are present before the age of three and
that there is no evidence of certain other conditions
that are similar.
- What is Common is Autism?
Autism statistics from the U.S. Centers for Disease
Control and Prevention (CDC) released in March
2014 identify around 1 in 68 American children as on
the autism spectrum – a ten-fold increase in preva-
lence in 40 years. Careful research shows that this
increase is only partly explained by improved diag-
nosis and awareness. Studies also show that autism
is four to fve times more common among boys than
girls. An estimated 1 out of 42 boys and 1 in 189 girls
are diagnosed with autism in the United States.
ASD affects over 2 million individuals in the U.S.
and tens of millions worldwide. Moreover, govern-
ment autism statistics suggest that prevalence rates
have increased 10% to 17% annually in recent
years. There is no established explanation for this
continuing increase, although improved diagnosis
and environmental infuences are two reasons
often considered.
- Behaviour
Children with autism often engage in a restricted range of behaviours, interests and activities
in a repetitive and stereotypic way. For example, they may concentrate intensively on an activ-
ity such as spinning the wheels on a toy car or lining up toys time and time again, but much
more seldom engage in spontaneous and varying games of pretend and role playing. Fixations
on different objects are common, as well as fxations on very complicated habits and routines
that must be repeated in exactly the same way each time. A departure from such a routine or
ritual can cause an outburst of despair or rage. Any sort of change, such as something being in
a different place or something being done in a different order than usual, can also be hard to
tolerate for a person with autism. Slightly older, more well-gifted children may especially have
periods of one-sided and narrow interests such as time tables, others’ birth dates, the popula-
tion of all Swedish towns, etc. It is also common for children with autism to continuously wave
their hands, rock back and forth and walk on tiptoe.
In addition to the diagnosed-based behaviours in the three areas named above, other symp-
toms are also common with autism: over-sensitivity or under-sensitivity for certain sounds,
touches, odours etc; periods of hyperactivity; sleeping and eating disorders, etc. None of these
are required for a diagnosis of autism.
- What can be done?
Autism is a life-long disability. There is currently no known cure for autism. On the other hand,
many children with autism can develop signifcantly with early, well-planned and individu-
ally tailored educational efforts in specially adapted settings. One of the primary objectives is
to help the child develop functional communication. The educational approaches must focus
on knowledge about the unique ways that children with autism learn. Various ABA strategies
(Applied behaviour analysis) as well as the structured teaching method in the TEACCH-model
(Treatment and Education of Autistic and related Communication Handicapped Children) are
examples of such specially-tailored educational strategies for persons with autism.
Early identifcation, assessment and diagnosis are the frst step. The next step is to provide ac-
curate information for, and education of, parents and other concerned persons as soon as pos-
sible. These, together with promptly applied supportive measures that are both well-planned
and individually tailored, are the long-term basis for being able to help the child to develop. A
specially adapted nursery school and subsequent schooling are important prerequisites for the
child; similarly an adapted home environment and daily activities are equally important for the
adults. Adolescents and adults may need continued access to educational measures to further
develop skills that aim to increase independence and participation, even if these measures had been introduced early. High-functioning persons may require different types of assistance in
organizing their studies and access to various forms of tailored daily activities.
As adults, and for the rest of their lives, most persons with autism are in need of extensive as-
sistance and support. However, some persons may become relatively independent.
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