The Autism Spectrum: A pediatrician’s explanation
An expert guides us through diagnosis and explains the range of spectrum disorders
Recently, we reported on the increase in children, ages 3 to 17, diagnosed with autism in the United States.
Joyce Mauk, M.D., CEO and medical director of the Child Study Center, believes the increase in more kids being diagnosed is because examiners are now more aware of the autism spectrum than ever before because of the attention autism has gotten in recent years.
So what exactly is the spectrum?
Dr. Mauk, who is a Cook Children’s pediatrician and board certified in pediatrics and neurodevelopmental pediatrics, says that most human characteristics aren’t spread evenly across the public.
She compares it to the ability to draw. A few people are excellent. Some are natural artists. The majority of us do Ok and some of us have no skill at all.
Dr. Mauk says that’s also the way to look at the autism spectrum, and some other disorders as having a range or continuum. Children are generally diagnosed with an autism spectrum disorder in the preschool years. Those at the severe end of the spectrum are diagnosed at an earlier age and those at the milder end are diagnosed later. Dr. Mauk says this is because the severe end is associated with more severe developmental delays such intellectual disability or mental retardation.
More severe problem behaviors (self-injury, aggression) are likely to be nonverbal and more likely to have a known genetic cause (etiology).
At the milder end are children whose cognitive abilities are in the normal range and have less significant problem behaviors (rhythmic, repetitive movement, or stereotypies, and rigid behaviors).
“An experienced clinician will make the determination of degree of severity,” Dr. Mauk said. “There is no specific test that will alone determine the diagnosis or the level of severity. In the past children at the milder end of the spectrum would not have been diagnosed with autism. They may have had a diagnosis of Asperger Disorder or a language disorder with atypical features. In general those on the mild end have a better prognosis and will need less lifetime supports.”
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