The Centers for Disease Control and Prevention reports that 1.5 million people who have some form of autism live in the United States. Also, 1 in every 166 children is diagnosed with autism (CDC, 2007). Autism is the third most common developmental disability in the United States. The occurrence of autism in males is significantly higher than in females, currently at a 4:1 ratio, and for children with severe to profound intellectual disability, the ratio is 2:1 (Fombonne, 2002). In the most current edition of the Diagnostic and Statistical Manual-DSM IV TR (American Psychiatric Association, 2000), autism is the most common of the five Pervasive Developmental Disorders (PDD). PDD is a category of neurological disorders with severe and pervasive impairments affecting the development of social interactions and communication skills. The other four are Rett's Disorder, Child Disintegrative Disorder, Asperger's Disorder and Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS).
Autism is a spectrum of conditions of neurobiological origin unrelated to parental nurturance with no known cause. It appears to be genetically linked and is a lifelong disorder (Bailey et al., 1995; International Molecular Genetic Study of Autism Consortium, 2001). Development in three main areas is impaired: verbal and non-verbal communication skills, social skills with limited or no initiation or reciprocal interaction, and restricted range of play and interests, including repetitive behaviors. Impairments may range from mild to severe, and each area of development may be affected to a different degree in the same child, where one area of development may be mildly impaired, while another area may be severely impaired. No two children are alike (American Psychiatric Association, 2000).
Presently there are no medical or biological tests to diagnose autism. The diagnosis is based on history, diagnostic tools and observations. A diagnosis of autism requires a comprehensive evaluation by a multidisciplinary team that usually includes a developmental pediatrician, psychologist, psychiatrist, physical, occupational, speech, behavioral and developmental therapist, a social worker, and others.
Autism is generally evident by age 3. In 1990, the average age of diagnosis was 4-6 years and in 2000, the age was 30 months (Neurology, 2000). An early diagnosis is important for the attainment of services and improved outcomes. Early intervention of services has shown to be effective in improving the development of children with autism and the prevention of secondary conditions (Filipek, Accardo, et al., 1999). Parent involvement is crucial.
Associated conditions can include, but are not limited to:
- Cognitive impairment
Secondary conditions can include:
The three characteristics of autism — 1) communication, 2) social interactions, and 3) restrictive play and interest in addition to modification of the environment that is conducive to learning the skill or participating in the activity — are key areas to address and to be aware of when individuals with autism are involved in physical activity or recreation programs.