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Autism spectrum disorders

Autism spectrum disorders represent a distinct category of developmental disabilities that share many of the same characteristics. Autism spectrum disorders affect an individual’s ability to communicate, understand language, play and relate to others. It is also associated with rigid routines and repetitive behaviors, such as obsessively arranging objects or following very specific routines. We use the term “autism spectrum disorders” because the symptoms can occur in any combination and can range from very mild to quite severe.

Autism spectrum disorders include autism and related disorders. There are five diagnostic terms that fall under this heading. They include:

  • Autistic disorder
  • Asperger’s syndrome
  • Pervasive developmental disorder-not otherwise specified
  • Retts disorder
  • Childhood disintegrative disorder

Each of these categories impact three major areas of development:

  • Social interaction: The individual may display difficulties in relating to people, objects and events. Often individuals are unable to establish and maintain reciprocal relationships. The ability to use objects, including toys and games, in an age-appropriate or functional manner may be absent or delayed.
  • Communication: The individual may display problems affecting many aspects of communication development. Language, if present, may have limited function, content or structure. Characteristics may involve delay in both receptive and expressive language.
  • Patterns of behavior: The individual may display significant distress over changes in routines or the environment and demonstrate a persistent preoccupation with or attachment to a specified object. The individual may display a restricted range of interests and/or stereotyped body movements. There may be a lack of interest or an inability to engage in imaginative activities.

The most comprehensive definition of autism and the related disorders appears in the “Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-Text Revision” (DSM-IV-TR; American Psychiatric Association, 2000).

Diagnoses

Here are some major points that help distinguish the differences between the specific autism spectrum disorders:

  • Autistic disorder: Characterized by impairments in social interaction and communication with the presence of restricted or repetitive patterns of behavior
  • Asperger’s syndrome: Characterized by impairments in social interactions and the presence of restricted interests and activities, with no clinical significant general delay in language, and testing in the range of average to above-average intelligence
  • Pervasive developmental disorder-not otherwise specified: May be diagnosed when a child does not meet the criteria for a specified diagnosis of autistic disorder or Asperger’s syndrome, but there is a severe and pervasive impairment in social interaction, communication or the presence of restricted or repetitive patterns of behavior
  • Retts disorder: A progressive disorder which occurs only in girls that results in a period of normal development and then loss of previously acquired skills, loss of purposeful hand use, and onset of repetitive hand movements
  • Childhood disintegrative disorder: Characterized by normal development for at least the first two years, with sudden and significant loss of previously acquired skills
VCU Rehabilitation Research Training Center on Workplace Supports and Job Retention Virginia Commonwealth University