Spectrum of Confusion

Autistic Child
What Does it Mean when a Child is “On The Spectrum?”
What is Autism?

One in 50 schoolchildren has been diagnosed with autism, so chances are, you know someone (or someone who knows someone) with it. The confusing part is—what kind of autism do they have? Is Asperger’s a kind of autism? What’s the spectrum? Autism is a brain disorder where different areas of the brain fail to work together, often resulting in challenges in communicating with and relating to others. In May 2013, the official guide to mental disorders, the DSM-5, merged all autism disorders into one umbrella diagnosis of autism spectrum disorder (ASD). Previously, they were separated into types, and now they are not. The change to a spectrum is meant to recognize the variety of symptoms a person might have. The spectrum starts with “classic autism,” or lower-functioning autism, with people showing a clear disability in most of their interactions. The other end of the autism spectrum is people with high-functioning autism, characterized by above average language skills and high IQs, typical of Asperger’s syndrome.

Early Diagnosis

Lesley Henderson, Ed.S., a school psychologist for Williamsburg-James City County schools, often leads and participates in school screenings for autism. “There are more people professionally trained to identify autism spectrum disorders, and it’s looked for as early as preschool. But, some people with higher functioning autism may be harder to identify until they are older, particularly if they don’t have a language delay,” Henderson says. It can be caught early, with many pediatricians screening for it around 18 months old, but Henderson says it’s not uncommon for school staff to broach the subject because it may have been missed and is now impacting a student’s education. Dr. Christine Houlihan, a developmental pediatrician from Children’s Hospital of The King’s Daughters, says that early diagnosis, screening and services have improved outcomes for children with ASD. In order to benefit from an early diagnosis, Houlihan suggests that parents address any concerns with their pediatrician. Many early signs related to autism are isolating, such as not responding to people talking to them or avoiding eye contact. But they may also be obsessive or repetitive, such as repeating words or focusing intensely on certain things. But, with the spectrum, just some of those symptoms may lead to an ASD diagnosis.

Sarah Kenner’s Case

Sarah Kenner was relieved to get a diagnosis for her son Reed when he was
5 years old. Every visit to the pediatrician for her concerns resulted in the doctor saying “he’s fine.” But Kenner continued to feel uneasy and wondered if he was hyperactive, or if he had a hearing problem. “It wasn’t till years later that I learned he wasn’t really hyperactive; he was hyposensitive and needed near constant sensory input to tell where he was oriented in space and to feel ‘normal,’” Kenner says. The breakthrough came when Reed went to kindergarten. “At school, he was rolling back and forth in the back of the room during circle time, hiding in the coats, rocking his head back and forth, but he could answer all the questions the teacher posed and was keeping up with the curriculum,” Kenner says. Within a month, a psychologist and a neurologist gave Reed a diagnosis of autism. “Since then, we’ve had the help of a lot of solid professionals. The diagnosis was a huge relief,” she says. Today, Kenner also teaches in a program for kids with autism in Chesterfield County, and strongly suggests that parents use available resources like The Autism Center for Excellence at VCU. She also recommends finding other local parents, even using meetup.com, to help with insurance, services and educational plans. With a diagnosis and services, the spectrum doesn’t need to be confusing–many more resources exist and the variety of symptoms is now reflected in this new designation.

Misconceptions about Autism

Autism is Caused By Vaccines This incorrect and disproven theory continues to persist. The cause of autism is unknown, and it’s likely there is more than one cause, including a genetic component.

Autism Behaviors Can’t Be Changed Many kids with autism can learn appropriate social skills and improve communication with guidance.

All Kids With Autism Avoid Eye Contact Some do, but some kids with autism have normal eye contact.

Kids With Autism Can’t Make Friends They may need special help to make friends, including supervised and guided play or social interaction, until they learn some of those skills.

Kids With Autism Don’t Lie Although some kids with autism won’t communicate something they don’t believe to be true, many children with autism hit
this normal childhood milestone late.

That Kid Is Acting Weird-It Must Be Bad Parenting Kids with autism may not be aware of people in public observing them, and may continue their interest in small details, like the grocery cart wheels and how they roll, or wearing headphones to avoid getting overstimulated.

Autism Doesn’t Look Like that Autistic behaviors vary widely, and sometimes mimic other disorders, so it’s hard for anyone who is not a trained professional to judge it. As is often said, “One kid with autism is one kid with autism.”

About the author

Natalie Miller Moore

Natalie runs Moore than Words, a health communications consulting firm in Williamsburg. She loves to learn and write about health, particularly relating to patient experience and research.