What is autism

Autism what is it now? How can you recognize it, and we answer many questions below.

Children with an autism spectrum disorder (ASD) think in a different way and that affects their ability to understand what another person thinks and feels, how things will go and how they communicate with others. Children with autism can also process the stimuli that come in through their senses, such as sounds or temperature, differently. As a result, they are extra sensitive to some stimuli and they hardly notice other stimuli.

Everything that children with autism see, hear, smell, taste or feel is processed in the brain in a different way. Children with autism can differ greatly from each other. Every child has a different mix of strengths and weaknesses. For example, some have a good eye for detail, are honest and straightforward. But at the same time, the same children can have difficulty with social contacts, keeping an overview and have remarkably few different interests. Autism can be associated with intellectual disability, but is also common in children with average to high intelligence.

Characteristics in autism

You can recognize a child with autism by a number of signals and characteristics. These could be:

  • Clumsy and anxious behavior in social situations
  • Poor understanding and use of eye contact, facial expressions and posture
  • Little or no learning from social experiences
  • Lack of reciprocity in contact
  • Fear of changes
  • Fanatical sticking to certain routines
  • Stubbornness and drive (caused by fear)
  • A one-sided interest
  • Hypersensitivity or undersensitivity to stimuli such as sound, temperature or touch
  • Sometimes slow language development
  • Peculiar old language
  • Take language literally
  • A clumsy, stiff motor skills
  • Eating problems
  • Stereotyped behavior (e.g., fluttering, twisting the hand or fingers, or complex whole-body movements)
  • Absence of varied spontaneous pretend play

DSM

The term autism spectrum disorder (ASD) originates from the DSM (Diagnostic and Statistical Manual of Mental Disorders), one of the most widely used international mental health classification systems. The disorders in the DSM are described on the basis of observable behavior.

Previously, different forms of autism were distinguished in the DSM:

  • Autistic Disorder (also called Classic Autism)
  • Aspergers
  • Rett’s syndrome
  • Disintegrative Disorder
  • And a residual group ‘Not Otherwise Specified’ (also called PDD-NOS)

In the Netherlands, the subgroup Multiple complex Developmental Disorder (McDD) is also distinguished. This category does not appear in the DSM, but has been used regularly by child and adolescent psychiatrists. In children with McDD, it is not the contact problems that are in the foreground, but problems in regulating emotions and thoughts (read more at What is McDD?).

Since the arrival of the DSM-5 in 2013, there has only been one diagnosis: Autism Spectrum Disorder (ASD). Autism is a spectrum. This means that autism can come in different forms and degrees. Autism spectrum disorder (ASD) is the collective name for the different forms of autism.

The most important change in the DSM-5 is that there are now two domains instead of three.

The three domains were:

  1. Limitations in social interaction
  2. Limitations in communication
  3. Stereotypical patterns of behavior

The two domains are now:

  1. Limitations in social communication and interaction
  2. Repetitive behavior and specific interests

Causes

In autism, a person’s brain is designed ‘differently’. This seems to be due to heredity. There are several factors that contribute to the presumption of heredity:

  • Autism is four times more common in men than in women
  • There is a greater chance of autism if there is already a brother or sister with autism in the family
  • If one half of a twin has autism, the other half usually has it too

There is no direct evidence of heredity. No genes have been found that cause autism. Other causes can also be of influence, for example the age of the parents.

Additional problems and comorbidities

Autism is a developmental disorder that affects various areas throughout life. This has consequences for social interaction, communication and empathy.

For example, children with autism find it difficult to make friends. It is often a one-way street. A child with autism does not ask another how things are going or continues to tell about a subject that interests him, without realizing that the other person does not care.

Young people with autism find changes difficult and are strongly attached to fixed routines and rituals. This is because they have trouble keeping an overview and therefore need structure.

Comorbidities with other disorders also occur:

ADHD

Children with autism do not like change. They can be very busy at times, like some children with ADHD. There is therefore an overlap between these two disorders. This often causes confusion when making a diagnosis.

Anxiety Disorders

When things change or go differently than usual, children with autism can become anxious. This can manifest itself in anger and tantrums.

LANGUAGE AND SPEECH PROBLEMS

Children with autism with normal general development often learn to speak well. However, they often talk monotonously, use old-fashioned words and take language literally. They have difficulty understanding imagery and proverbs which can make them anxious.

MOTOR PROBLEMS

Children with autism often move woodenly and have clumsy and stiff motor skills.

In addition to problems with motor skills, a nervous system that is not optimally developed can also have consequences in other areas of development. For example, DCD is relatively common in combination with an autistic spectrum disorder (ASD).

Read more at What is DCD?

COGNITIVE PROBLEMS

Children with autism have an increased risk of learning disabilities such as dyslexia or dyscalculia.

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