The Autism Umbrella. Perhaps you’ve heard the term.

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), Autism Spectrum Disorder, or autism, is an umbrella term, defined by impairments in two specific categories: persistent deficits in social communication/interaction and restricted, repetitive patterns of behavior. The diagnosis of autism refers to an expansive spectrum, which is important to recognize.  A person on one end of the spectrum may look vastly different from a person on the other end of the spectrum, even though these two people carry the same diagnosis. 

If you haven’t been personally affected by autism, or if you have heard the term, but aren’t quite sure exactly what autism looks like, let me break it down for you. 

The first category of symptoms refers to how a person interacts with the world around them and can be broken down into three subcategories. 

1. Social-Emotional Reciprocity - this refers to the “back and forth” conversational skills we rely on to communicate effectively. Early skills, such as imitation, joint attention, eye contact, body language, and turn taking are all crucial to developing appropriate social-emotional reciprocity. For a child with autism, these foundational skills may not develop on time, may not develop at all, or may develop and then regress. 

2. Nonverbal Communication - this includes body language, facial expression, and gestures. A child with autism will have difficulty picking up on these subtle nuances in communication, thus making successful communication exchanges difficult. 

3. Developing, Maintaining and Understanding Relationships - this refers to the way in which we adjust our behavior to match specific situations, specific communication partners, and specific information. A good way to think about this is to imagine the way you may ask your boss about his day versus the way you may ask your spouse. You are displaying the same message to both people, but the way in which you do it will be very different. People with autism have difficulty adjusting their messages to fit different audiences. 

The second category of symptoms is exhibited by at least two of the following:

1. Stereotyped/repetitive motor movements, use of objects, or speech 

   1. Examples include, but are not limited to: lining up toys, repeating phrases, repeating other’s speech, flapping hands

2. Insistence on sameness, inflexible adherence to routines, or ritualized patterns or verbal nonverbal behavior

   1. Examples include, but are not limited to: difficulty with changes in routine, demanding to eat the same foods, lack of flexibility in thinking and/or play

3. Highly restricted, fixated interests that are abnormal in intensity or focus

   1. Examples include, but are not limited to: obsession with certain objects, attachment to unusual objects

4.  Hyperreactivity or hyporeactivity to sensory input or unusual interests in sensory aspects of the environment

   1. Examples include, but are not limited to: lights, sounds, smells, textures (especially food)

It is also important to keep in mind that in order to be diagnosed with autism spectrum disorder, these symptoms must be present in the early developmental period, although they may not be completely revealed until later. 

As always, if you suspect your child may present with any of these symptoms, your pediatrician is the first person you should call. Early intervention is crucial and talking with your pediatrician will help set you on the right path for your child! 

While the world of autism may seem daunting, it is important to keep in mind that your child is not defined by his/her diagnosis! Your attitude and perspective will play a huge role and I hope that this can be a place of encouragement and kindness for you and your family as you walk this difficult path.

...mg