| Autistic disorder is characterized by devastating | | | | images. In the psychoanalytic thought of |
| impairments in a young child's communication and | | | | Bettelheim, the disorder is caused by attachment |
| language skills, disinterest in social interaction, and | | | | trauma in infancy, the so-called refrigerator |
| preference for repetitive, stereotyped behaviors. | | | | parents who cannot respond nurturantly to their |
| Although it is usually present in infancy, no physical | | | | children. However, research suggests that parents |
| indicators or hard neurological signs facilitate an | | | | of autistic children are not significantly different |
| accurate neurological diagnosis before the age of | | | | from parents of any severely chronically ill child. |
| three. Early signs of autism include lack of eye | | | | Although the causal mechanisms have not been |
| contact, failure to cuddle with affection, and | | | | isolated, it is believed that the disorder originates |
| nonreciprocal smiling patterns. Children may not | | | | early in neonatal brain development. The |
| speak or may be unable to carry on a meaningful | | | | developing brain sustains some damage, perhaps |
| conversation, other than making requests to get | | | | mediated by maternal illness, chemical toxins, viral |
| their own needs fulfilled. Autistic children may | | | | agents, environmental pollutants, or genetic |
| engage in idiosyncratic verbalizations, especially | | | | susceptibility that affects its continued growth. As |
| echolalia or the repeating of recently heard or | | | | a consequence the central nervous system |
| preferred idiosyncratic phrases without prosody | | | | substrata necessary for processing complex |
| or communicative intent. When left to | | | | perceptual information, especially information |
| themselves, autistic children frequently become | | | | critical for establishing social reciprocity, does not |
| absorbed into stereotyped actions, especially | | | | mature through infancy. Self-stimulation through |
| spinning objects, body rocking, and flapping their | | | | kinesthetic actions seems to help the children |
| hands. They are repetitive specialists and can | | | | regulate their arousal and soothe their perceptual |
| sustain attention on their preferred activities for | | | | processing disturbance so that they can feel calm. |
| hours but will actively resist changes in their | | | | Children do not outgrow autism or the |
| routines or rituals. | | | | concomitant mental retardation. Better prognosis |
| Autistic disorder occurs at a rate of 2 to 5 cases | | | | is marked by the presence of language before |
| per 10,000 individuals and is more likely to be | | | | the age of five, ability to benefit from |
| present in males than in females at a ratio of 4 | | | | observational learning (imitation), absence of |
| to 1. At this time there is no definitive test for | | | | severe symptoms such as self-injury and |
| autism. Amniocentesis has not yet identified any | | | | aggression, and ability to demonstrate intelligence |
| chromosomal or chemical predictor of autism. | | | | with an intelligence quotient above 50. Most |
| Diagnosis occurs on the basis of symptom profiles | | | | autistic persons are unable to manage |
| and elimination of competing diagnoses such as | | | | rudimentary skills of daily living and require |
| deafness or expressive language disorders. | | | | substantial supervision and care through their adult |
| Neither is there full consensus in research and | | | | years. Treatment is more effective if it occurs as |
| theory about the causes of autistic disorder. | | | | early as possible with a focus on language, |
| Early infantile autism was first labeled by Kanner in | | | | functional communication, and motivational |
| 1943 from his clinical work with a sample of 11 | | | | assessment. Medication may be useful for |
| children. The term autism had first been used by | | | | management of behavioral outbursts and mood |
| Eugen Bleuler in 1919 to describe the withdrawal | | | | disturbances but does not resolve the core |
| from the outside world seen in adult | | | | symptoms of autistic disorder. The innovative |
| schizophrenics. Early theory focused on whether | | | | technique of facilitated communication teaches |
| autism should be viewed as a childhood version of | | | | autistic persons to use keyboards as language |
| schizophrenia. However, autism seems to follow a | | | | tools and has been useful for some autistic people. |
| more uniform course than the pattern of | | | | Intervention typically consists of efforts to teach |
| remission and relapse in schizophrenia and is | | | | adaptive skills, manage disruptive behavior, and |
| essentially marked by the absence of fantasy, | | | | communicate for self-advocacy purposes so that |
| play, and hallucinations, while schizophrenics | | | | persons with autistic disorder can care for |
| complain of excessive and confusing internal | | | | themselves in as independent a way as possible. |