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The autistic spectrum (sometimes referred to as the autism spectrum) is a developmental and behavioral syndrome that results from certain combinations of characteristically autistic traits. Although these traits may be normally distributed in the population, some individuals inherit or otherwise manifest more autistic traits. At the severe end of the spectrum is low-functioning autism which has profound impairments in many areas, to high-functioning autism and Asperger's syndrome, to Nonverbal learning disorder or Sluggish cognitive tempo on the high end of the spectrum (see below for the connection between attention deficit and autism spectrum disorders) and Schizophrenia.

In the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) and the International Statistical Classification of Diseases and Related Health Problems (ICD-10), autism spectrum disorders (ASD) are classified as pervasive developmental disorders (PDD), as opposed to specific developmental disorders like dyslexia, dysgraphia, dyscalculia, or Developmental Dyspraxia.

One review estimated a prevalence of at least 1.3 per 1,000 for autism and 6.0–6.5 per 1,000 for ASD; PDD-NOS was the vast majority of ASD, Asperger's was about 0.3 per 1,000 and the atypical forms childhood disintegrative disorder and Rett syndrome were much rarer.

Autistic spectrum and pervasive developmental disorders

In practice, autistic spectrum disorder and pervasive developmental disorder are synonymous, but making a distinction is valuable. PDD refers to those psychological and behavioral developmental disorders encompassing many areas of functioning: language and communication, self-help skills, motor coordination, executive function, and scholastic achievement. The nosological category of pervasive developmental disorders includes syndromes that may be etiologically unrelated to autism, with autistic-like behavior being only one part of the disorder: Rett's syndrome and childhood disintegrative disorder.

Autistic traits

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Behaviorally, certain characteristics identify the autism spectrum. The type, severity and/or number of autistic traits present determines the severity of autism in the individual. These autistic traits may be beneficial for some disciplines like science, mathematics, engineering and computer programming. Some autistic individuals might show a marked proficiency in rote memorization which may help learn the foundation of these subjects; however, the exceptionally good aptitude (in these subjects) of high functioning autistic spectrum persons may be due to their ability to readily identify patterns and apply them consistently to new situations outside of established knowledge or teaching. These savant skills, although popularly considered to be a major part of autistic disorders, are evident only in about 5% of autistic individuals (Klin and Volkmar, 1997).

Social difficulties

• Some lack an observed desire for friendship
• The vast majority have a poor ability to make friends
• Difficulties with interpreting facial expressions
• Inability to understand other people's feelings (alexithymia)
• Social awkwardness
• Indiscriminate (indifferent) social interaction
• Many lack natural eye contact
• Brief response to questions of un-interest
• Inability to interpret sayings and/or slang (Autistic individuals cannot understand the abstract- 'she was the apple of his eye' makes no sense literally)

Intense interests

• Individuals on the higher end of spectrum and some in the lower end display unusual interests in terms of intensity and/or focus
• Interests are often narrow (i.e. steam trains, a particular species of animal, etc.)
• Any given individual may have several interests or simply one; in addition, these interests may remain intense for very long, even lifetime periods, or may change at unpredictable intervals
• Interests may dominate thought at all times
• For some, these interests act as a general coping mechanism, whereas others are simply ‘driven’ by curiosity
• These interests can and have been used as the foundation to highly successful careers in adulthood

Difficulties confined to "Lower Functioning Autism (LFA)"

• In practice, Lower Functioning Autism refers to individuals on the spectrum with an IQ below 70. In recent times the term has been incorrectly used to describe individuals on the spectrum who are non-verbal, or mute; however, not all of these individuals are mentally retarded and some communicate through writing or facilitated communication.
• Many, but not all, people with LFA are mute.
• By definition people with LFA are also mentally challenged, however this has come under some scrutiny in recent years.

Marked differences in the comprehension and expression of language

• May have odd or monotonous prosody of speech
• Some exhibit above average or superior linguistic ability in the areas of vocabulary, syntax and sentence structure
• Some express themselves using highly formal and/or pedantic language
• Echolalia may be present in some individuals, especially during earlier stages in the development of language
• Pronoun reversal may be present in some individuals
• May use rote chunks of language
• Many experience late development of language (three or four years of age rather than one or two)
• May experience difficulty or inability to translate thoughts into words
• Poor use and understanding of nonverbal communication (i.e., facial expressions and body language)
• Literal interpretation of language, e.g. when told "Pull your socks up", individuals on spectrum may physically pull their socks up

Marked differences in imaginative activities and repetitive routines

• May have poor understanding of abstract thought, metaphors and symbolism
• May have preference for routine
• May become upset, enraged and/or throw a tantrum if routines disturbed
• May neatly place toys in lines or patterns as young child rather than play imaginative games

Marked differences in the perception of sensory stimuli

• Hyper- and/or hyposensitivity of the various senses
• May have peculiar clothing and/or food preferences, often due to sensory hyper- and hyposensitivity

Marked differences in overall motor coordination

• Deficiency in fine and/or gross motor coordination
• Some individuals may show no deficiency in coordination while participating in certain sports (see “Intense interests” above)

ADHD and autism

Some research has indicated a possible genetic and behavioral connection between ADHD and autism. As a result, some clinicians have suggested that ADHD be included under the category of autism-spectrum disorders.

Diagnoses of ADHD together with autism spectrum disorder are becoming increasingly common in children. In young children, the two conditions can appear similar. However, as children age, differences emerge between the two conditions. Children with typical autism become more withdrawn, while with a suitable environment hyperactivity reduces. In either event, problems with social skills can develop.

By contrast, children with ADHD rarely calm down with age but often develop social and communication skills to a normal level. Any issues with social skills experienced by children with ADHD may have other causes. Examples include low self-esteem or difficulty with quiet, constructive social interaction.

References

1. Fombonne E (2005). "Epidemiology of autistic disorder and other pervasive developmental disorders". J Clin Psychiatry. 66 (Suppl 10): 3–8. PMID 16401144.

• Attention deficit hyperactivity disorder and autism

External links

• Template:Dmoz
• CDC's "Learn the Signs. Act Early.” campaign - Information for parents on early childhood development and developmental disabilities such as autism
• Autism Spectrum Disorders (Pervasive Developmental Disorders)
• Autism Spectrum Disorders from ScienceDaily - Latest research news on autism spectrum disorders. Includes searchable archives.

• Articles lacking sources from March 2007
• Autism