Understanding the “Autism Spectrum”
Autism is a scary word. When most people think of autism, they think of “classic autism” as often portrayed in old movies and descriptions of children who often developed little language and had tremendous difficulty interacting with others and learning a wide range of skills.
The definition of autism has changed considerably and includes a much broader group of individuals, including individuals with language, and average to above-average intelligence. In the diagnostic manual used by doctors and psychologists in the United States, the Diagnostic and Statistical Manual of Mental Disorders–5(DSM-5); previous autism subtypes (Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS), Asperger’s Disorder, and Autistic Disorder, are all called Autism Spectrum Disorder.
Why Do Different Professionals Give My Child Different Labels?
It is common for parents to take their child to different professionals and get different diagnoses. One doctor may say, “He doesn’t have autism. He has PDD-NOS”. Another professional may say it’s not autism or PDD-NOS, but rather – Asperger’s Disorder. Currently, diagnosticians will diagnose these individuals as Autism Spectrum Disorder. Then, they will use other descriptors such as with or without language impairment, or with or without cognitive impairment.
I Don’t Want Him to be Labeled!
Undoubtedly, receiving a diagnosis is very upsetting. However, learning that your child has ASD can be very helpful to you, your family, and your child. Many parents who have been searching for a long time to understand their child’s struggles, are relieved to finally have a diagnosis that makes sense. Learning about ASD is the first step in helping you learn about your child in a more holistic fashion and give you the necessary tools to serve as “conductor of his orchestra”.
After all, it is parents who will work together with professionals to determine:
- What skills are most important for my child to work on?
- What is the best use of our family’s financial resources to help our child?
It is a good idea for parents to keep all diagnostic records and then decide what records would be useful in securing services for their child.
Areas of Impairment in ASDs
In the United States, medical doctors and psychologists use the Diagnostic and Statistical Manual of Mental Disorders to classify developmental and psychiatric disorders. In DSM-5, individuals with ASD are described as having impairments in two primary areas:
- Social communication
- Restricted range of interests, patterns, and behavior.
Most children with ASD have difficulty in the areas of attention:
- Executive functioning
- Adaptive skills
- Emotional regulation
- Motivation
Many children with ASD have intact or enhanced skills in certain areas, such as long-term rote memory and attention to details. Many also have specific weaknesses in areas of learning. This might be in specific academic areas or other areas of brain functioning, such as how quickly (or slowly) they process information. Learning how your child functions across all of these areas can be very helpful in prioritizing goals and helping your child improve his skills.
“The Doctor Said My Child is High-Functioning”
There is not a universally agreed-upon definition of HF-ASD. In all likelihood, what the diagnostician is saying is that your child has a significant amount of language and your child does not also have mental retardation, along with the ASD. An IQ of 70 or above is considered to be above the cut-off for mental retardation.
Having a higher IQ probably means that your child has the potential to learn more skills than a child with ASD who has a lower IQ, so it is a good prognostic indicator. A child who has developed considerable language skills, is able to communicate his wants and needs more effectively than a child with less language. In all likelihood, the child with more language is also better able to understand what others are trying to communicate. This is also very important.
If My Child is High-Functioning, Does This Mean that His Problem is Mild?
Unfortunately, having ASD is not a mild problem. By definition, to be diagnosed with ASD the child has to have significant impairment in functioning.
What are some of the First Steps I can take to Help My Child?
- Take care of yourself & your relationships. By addressing your own emotional well-being and nurturing the important relationships in your life, you will assist your family in becoming more resilient.
- Seek professional help, whether it is through face-to-face support groups, on-line support groups, or seeing a counselor or therapist.
- Learn about ASD. There’s a tremendous amount of information available. It is difficult to determine what information is most reputable. Seek out professionals you can trust to provide you with information as objectively as possible.
Dr. Diane Adreon is an internationally recognized autism expert, award-winning author, and public speaker. For more information on her consulting services, contact her at 929.249.1960.