Autism and Its Medical Definition

Autism as of 2010 is diagnosed in an average of 1 out of 110 children, according to the US Centers for Disease Control. Some have suggested there is an "autism epidemic"; but autism is not "catchable," and while there may be strong genetic components, environment may also play a strong role in whether a child develops autism. Children with autism grow into adults with autism, and providing services is becoming a serious problem for communities as well as the government.

Legal Definition

• According to the Individuals with Disabilities Education Act (IDEA), the law that provides services to children with disabilities, autism is "a developmental disability significantly affecting verbal and nonverbal communication and social interaction, generally evident before age 3, that adversely affects a child's educational performance." IDEA lists several other characteristics of autism, seen when the person exhibits repetitive and stereotyped behaviors, resists change, or responds to sensory experiences in unusual ways.

Characteristics

• Autism is highly variable; people with autism may have physical or mental disabilities or be highly athletic or intellectually gifted. "Meltdowns," self-stimulatory behavior and many behavior problems are caused by both physical and neurological reactions. At times the autistic brain "misfires," causing sensitivities or lack of sensitivity to lights, sound, texture and so on. The brain also has difficulty reading and understanding unspoken communication. Much of human communication is unspoken, and most people are able to understand it spontaneously through observation; but people with autism can not "see" this interaction and have to be taught it explicitly. Many are able to learn to communicate well enough that they show few signs of obvious difficulty.

American Psychiatric Association

• The fourth edition of the American Psychiatric Association's "Diagnostic and Statistical Manual of Mental Disorders" (DSM-IV) was published in 1994 and revised in 2000. The DSM is the standard used by therapists, psychologists, neurologists and other health professionals to diagnose any disorder that affects the brain, behavior or emotion. It offers standardized criteria that a person must meet to receive a diagnosis of autism and is also used by schools and insurance companies.

DSM Criteria for Autism

• The DSM uses three criteria to diagnose autism. One is impairment in social interaction and communication, along with repetitive and stereotyped behavior patterns; the second is delays or abnormal functioning in social interaction, language or play. To meet the third criterion, the disturbance must be one that cannot be better explained by two other specific disorders, called Rett's disorder and childhood disintegrative disorder.

Changing the Definition: DSM-V

• Two other disorders defined by the DSM-IV share commonalities with autism: pervasive developmental disorder (PDD) and Asperger disorder. As the next edition of the DSM (DSM-V) is being planned, the panel working on these disorders is recommending changes that would affect the diagnosis of autism. PDD would be replaced by the title "Autism Spectrum Disorders," which would encompass the disorders currently called autism, PDD-NOS and Asperger disorder. The thinking is all these disorders are better considered along a single spectrum -- they are the same disorder with varying expressions, not different disorders with similar traits. This change, if it occurs, will have multiple effects, including necessitating a new diagnosis of high functioning autism for those who are currently classified as having Asperger disorder if they are to continue to receive government aid.