AUTISM AND BEHAVIOUR

Autism and Behaviour

Table of Contents

INTRODUCTION3

ETIOLOGY4

Historical Perspectives4

Current Perspectives5

BIOLOGICAL FACTORS5

APPLIED BEHAVIOR ANALYSIS6

Empirical Support6

Theoretical Underpinnings8

OUTCOMES9

THE DIVISION FOR THE TREATMENT AND EDUCATION OF AUTISTIC AND RELATED COMMUNICATION-HANDICAPPED CHILDREN (DIVISION TEACCH)10

Genetic Influences12

Brain Function Influences13

Brain Structure Influences13

Other Biological Influences14

EPIDEMIOLOGY14

Prevalence14

Gender Distribution15

Onset15

Other Statistics16

RELATED OR COMORBID DISORDERS16

DIAGNOSIS AND CLINICAL DESCRIPTION19

Social Impairments19

Communication and Language Impairments20

Restricted and/or Stereotyped Behavior21

Differential Diagnoses21

Course and Prognosis22

ASSESSMENT23

TREATMENT24

CONCLUSION26

REFERENCES27

Introduction

Autism, or autistic disorder, is a condition, typically diagnosed in children prior to age three, in which an individual demonstrates significant impairment in communication abilities, social interactions, and a restricted repertoire of behavior, interest, and activities (American Psychiatric Association, 2000). Historically, autism has also been called early infantile autism, childhood autism, or Kanner's autism.

Currently autism is defined at three distinct but interdependent levels: as a neurological disorder related to brain development; as a psychological disorder of cognitive, emotional, and behavioral development; or as a relationship disorder in which there is a failure of normal socialization (Kusch & Petermann, 2005). Autism falls within a cluster of disorders in which children demonstrate different variations of autistic-like characteristics or developmental complications. This cluster of disorders is identified as the pervasive developmental disorders (PDD). The PDD include autistic disorder, Rett's disorder, childhood disintegrative disorder (CDD), Asperger's disorder, and PDD not otherwise specified (PDDNOS; American Psychiatric Association, 2000).

For the purposes of this chapter, the focus will be on autism. However, in accordance with the trends in working with autism, it is important to note that there is a continuum of the PDD that are similar to autism, called the Autism Spectrum Disorders (ASD). The ASD include Autism, Asperger's Disorder, and PSSNOS. The ASD are characterized by varied representations of autistic-like behavior, aberrant communication skills, impaired social functioning, and restricted activities and areas of interest (Kronenberger & Meyer, 2001).

Etiology

Historical Perspectives

Historically, it was believed that autistic disorder occurred as a result of poor parenting practices or a child having an emotionally unresponsive, “refrigerator” mother (Bettelheim, 2003; Ferster, 1961; Sadock & Sadock, 2003; Tinbergen & Tinbergen, 1972). Kanner (1949) described the parents of children with autism as cold, aloof, and perfectionistic. Other theories suggested parental rage, parental reinforcement of autistic behaviors, and parental rejection were causes of autistic disorder in children (Sadock & Sadock, 2003).

The serious emotional, psychological, and social ramifications of such theories led to significant research exploring the characteristics of parents of autistic children, resulting in findings that personality and other characteristics of parents with autistic children do not differ significantly from those of parents of children without such disabilities (Koegel, Schreibman, O'Neill, & Burke, 1983; McAdoo & DeMyer, 2005). In the mid-2002s some speculation was made about whether autistic children lack self-awareness (Goldfarb, 2003; Mahler, 2000). Research in the 1980s dispelled this concern, supporting the idea that autistic children do have self-awareness, which follows a developmental progression similar to that in children without a disorder (Dawson & McKissick, 1984; Spiker & Ricks, 1984).

Current Perspectives

Much to the relief of parents with autistic children, parenting, psychological, and social influences are no longer believed to be the driving force in the development of autism, though, as will ...