The Many Faces of Autism

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Chapter Excerpt from The Autism Sourcebook: Everything You Need to Know About

By Karen Siff Exkorn

His parents called Nathan their "gentle giant." At age six, he was big for his age but wouldn't hurt a fly. He appeared to be shy and fearful at all social activities—from playing with other kids to looking his mom and dad in the eye. Nathan's favorite activity was jumping on the trampoline all by himself in his backyard. He seemed to live in a world of his own and had never uttered a word in his life.

At age four, Michael could tell you everything about the life cycle and migratory patterns of the monarch butterfly. He'd even taught himself about photosynthesis. Although clearly intellectually gifted, Michael could not hold a two-way conversation. Instead, he preferred to lecture nonstop about a subject with which he was obsessed, such as butterflies or train schedules.

Blonde-haired, blue-eyed Samantha, age three, was a bundle of energy—always racing aimlessly around the house and flapping her hands. She had an uncanny habit of echoing people's language—using the exact same words and intonation—and could recite entire passages from a Disney video after having seen it only once.

At age two, Jake, who used to be messy and throw his toys around like most kids his age, was now lining up his trains in perfectly neat rows. He would often take a train, lie down on his belly, and push the train on an imaginary three-inch track, his eyes carefully following the wheels of the train. He could entertain himself in this manner for hours.

These children seem so different, yet they have one thing in common: They were all diagnosed with autism.

A Brief History of Autism

The word autism comes from the Greek word autos, which means self. Even though autism seems like a fairly new diagnosis, some of the earliest published descriptions of behaviors that resemble autism date back to the eighteenth century. It wasn't until 1911 that Swiss psychiatrist Eugen Bleuler coined the term autism in his work with schizophrenic patients. He observed that his patients were isolated from the outside world and extremely self-absorbed.

Dr. Leo Kanner and Dr. Hans Asperger are considered the pioneers in the field of autism as we know it today. In the early 1940s, unbeknownst to each other, both men conducted research in which they described children as autistic—not in reference to schizophrenics, but to what we now know as the more classic definition of the word. Kanner conducted his research on children in the United States, Asperger in Austria. It's a remarkable coincidence that these studies happened to occur at the same time in different parts of the world, and that both researchers used the word autistic to describe the children in their studies. Kanner's definition of autism was referred to as early infantile autism or childhood autism. Now we just use the word autism. Kanner's explanation is what we would consider to be the classic definition, where children display symptoms of impaired social interaction, lack of imaginative play, and verbal communication problems. Asperger described children with similar traits, except that his children seemed to have higher IQs and precocious language skills—they spoke like little adults. In the 1980s, Dr. Lorna Wing, psychiatric consultant for the National Autistic Society in the United Kingdom, coined the term Asperger's Syndrome to differentiate the condition from classic autism.

What Does Autism Mean Today?

The word autism is the catch-all term that many people use when referring to the spectrum of autistic disorders. The more current term for autism is ASDs, or Autism Spectrum Disorders, and includes the following five diagnoses: Autistic Disorder, Asperger's Disorder, Childhood Disintegrative Disorder CDD), Rett's Disorder, and PDD-NOS (Pervasive Developmental Disorder-Not Otherwise pecified).

Many people used to subscribe to the myth that everyone with an ASD behaved like the Dustin Hoffman character in the movie Rain Man, who had the uncanny ability to remember complex combinations of numbers but couldn't perform simple tasks like making toast. Or people subscribed to the myth that all children with ASDs were aloof and unresponsive, rejected hugs, and never showed affection. We now know that ASDs are much more complex, with a variety of symptoms and characteristics that can occur in different combinations and in varying degrees of severity. We also know that each individual with an ASD is unique, with a distinctive personality and individual character traits.

An ASD is not a disease, such as pneumonia or high blood pressure. (A disease is defined as an illness or sickness where typical physiological function is impaired). AnASD is a developmental disorder—a condition in which there is a disturbance of some stage in a child's typical physical and/or psychological development, often retarding development. An ASD shows up in the first few years of a child's life. It can affect a child's abilities to communicate, use his or her imagination, and connect with other people—even parents and siblings.

As the name implies, ASDs are spectrum disorders, ranging from mild to severe. A child on the severe end of the spectrum may be unable to speak and also have mental retardation. A child on the mild end of the spectrum may be able to function in a regular classroom and even reach the point where he or she no longer meets the criteria for autism. No two children with ASDs are alike, even if they have the same diagnosis. One child with an ASD may be nonverbal and have a low IQ. Another child with the exact same diagnosis may have an above-average IQ. A third child may be verbally and intellectually precocious. The terms high-functioning and low-functioning are sometimes used to describe where a child is on the autism spectrum.

You can't tell that a child has an ASD simply by looking at a picture of him or her. A two-year-old with an ASD can be the same height and weight and be just as adorable as a "typical" two-year-old....

The foregoing is excerpted from The Autism Sourcebook by Karen Siff Exkorn. Courtesy Harper Collins Canada Ltd