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Autism (In Children and Adults)

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Medical Author:

Roxanne Dryden-Edwards, MD

Roxanne Dryden-Edwards, MD

Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Autism facts

• Autism is characterized by impaired development in social interaction, communication, and behavior.
  
  
• The degree of autism varies from mild to severe.
  
  
• Severely afflicted patients can appear to have a profound intellectual disability. Research tends to continue to refute the idea that immunizations cause autism.
  
  
• The cause of autism is unknown.
  
  
• The optimal treatment of autism involves an educational or vocational program that is suited to the developmental level of the child or adult, respectively.
  
  
• It is important for the unique medical and mental-health needs of people with autism to be addressed in order to optimized both their life expectancy and quality of life.

What is autism?

Autism is a developmental disorder that is characterized by impaired development in communication, social interaction, and behavior. Autism afflicts one out of every 100 to 166 children and it affects the lives of many children and their families. It tends to affect about five boys to every one girl. Autism is classified as a pervasive developmental disorder (PDD), a category of disorders that is often described interchangeably with the broad spectrum of developmental disorders affecting young children and adults called the autistic spectrum disorders (ASD). The range of these disorders varies from severely impaired individuals with autism to other individuals who have abnormalities of social interaction but normal intelligence--Asperger's syndrome. The ways in which autism is exhibited can differ greatly. Additionally, autism can be found in association with other disorders such as mental retardation and certain medical conditions. The degree of autism can range from mild to severe. Mildly affected individuals may appear very close to normal. Severely afflicted individuals may have an extreme intellectual disability and unable to function in almost any setting.

In the past, autism has been confused with childhood schizophrenia or childhood psychosis, and may have been misunderstood as schizotypal personality disorder in some adults. As additional research information about autism becomes available, the scope and definition of the condition continues to become more refined. Some of the past confusion about the disorder has been resolved.

What are the symptoms and signs of autism?

The current Diagnosis and Statistical Manual of Mental Disorders-Fourth Edition, Treatment Revision (DSM-IV-TR) identifies three features that are associated with autism:

• impairment in social interaction,
  
  
• communication, and
  
  
• behavior.

Impairment in social interaction

Individuals with autism fail to develop normal personal interactions in virtually every setting. This means that affected persons fail to form the normal social contacts that are such an important part of human development. This impairment may be so severe that it even affects the bonding between a mother and an infant. It is important to note that, contrary to popular belief, many, if not most, persons with this disorder are capable of showing affection, demonstrating affection bonding with their mothers or other caregivers. However, the ways in which individuals with autism demonstrate affection and bonding may differ greatly from the ways in which others do so. Their limited socialization may erroneously lead parents and pediatricians away from considering the diagnosis of autism.

As the child develops, interaction with others continues to be abnormal. Affected behaviors can include eye contact, facial expressions, and body postures. There is usually an inability to develop normal peer and sibling relationships and the child often seems isolated. There may be little or no joy or interest in normal age-appropriate activities. Affected children or adults do not seek out peers for play or other social interactions. In severe cases, they may not even be aware of the presence of other individuals.