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AccordingtotheNationalInstituteofNeurologicalDisorderandStroke(NINDS),autism

spectrumdisorder(ASD)referstoarangeofcomplexneurodevelopmentaldisorders(Autism
factpar.1).ASDischaracterizedbysocialimpairments,difficultiessocializing,andthe
inabilitytocommunicatewithotherseffectivelyandefficiently.Despitethemanychallengesand
obstaclespeoplewithautismhavetoovercome,therearenumeroustherapiesthatcanhelpthese
peoplethroughouttheirlives.PeoplewithASDcanalleviatesymptomsandimprovethequality
oftheirlivesbyengaginginintensivetreatmentssuchasappliedbehavioranalysis,speechand
languagetherapy,andoccupationaltherapy.
ThetermAutismoriginatedfromtheGreekword
autos
,whichmeansself.ASwiss
psychiatrist,EugenBleuler,usedthetermautismtodescribewithdrawalintoonesinner
world,aphenomenonheobservedinindividualswithschizophrenia.Eugenhaddefinedthe
wordautismin1911,however,in1943itwasredefinedbyLeoKannertodescribethe
conditionasitisknowntoday(Blattpar.1).
Itiscommonlybelievedthatthetermautismislimitedtoclassicautismhowever,there
isalargerumbrellaofdisordersthatarereferredtoasAutismSpectrumDisorder.Classic
Autism,AspergerSyndrome,andpervasivedevelopmentaldisordernototherwisespecified
(PDDNOS)areincludedinthedisorderthatdoctorsrefertoasautism(Blattpar.2).
Autismisabioneurologicaldevelopmentaldisabilitythatgenerallyappearsbeforethe
ageofthree.Autismimpactsthenormaldevelopmentofthebrainintheareasofsocial
interaction,communicationskills,andcognitivefunction(Signspar.1).Atoneextreme,a
personmayhavenosocialskills,nolanguageskills,andmajorlearningdifficulties.Atanother
extreme,theindividualwhohasautismmayhaveanaverageoranaboveaverageIQandshow

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novisiblecharacteristicsofautism(BaronCohenpar.1)Bothoftheseextremesaresubgroups
ontheAutismSpectrum,andthoselivingoneithersideoftheextremeshareastrongpreference
forroutinesandrepetitionthatischaracterizedbyanobsessionalinterestinhighlyspecifictopics
(BaronCohenpar.2).
Astrikingfeatureofmanyyoungchildrenwithautismisanoticeableenlargementof
headsize.Thisevidenceissupportedbyresearchthattookplaceinthe1980s.Thisresearch
revealedthatpeoplewithAutismhadbrainsthatweighedmorethannormal.Theunusual
overgrowthisduetotheenlargementofthebrainswhitematter,whichisthenervefibersthat
connectanareaofthebrainwithanother.Researchersobservedthetemporalloberegionofthe
brainandidentifiedthattherewasanapparentdisproportionateenlargementofwhitematter.The
temporallobespecializesintheprocessofauditorystimuliandhousestheWernickearea,a
regionofmotorneuronsinvolvedinspeechcomprehension.Theresultsfromthesestudiesmake
itdifficulttodiagnoseautismbecausenotwocasesarealike(Signspar.2).
AlthoughAutismisdifficulttodiagnose,screeningisareliablewaytolookfor
developmentaldelaysanddisabilitiesduringregularcheckups.Screeningalsolooksforthe
absenceofbehaviorssuchaseyecontact,pointing,andpretendplay.Anotherwaytohelp
identifyautismishavingaparentcompleteaquestionnaireinvolvingsimpleyesandno
questions.Ifthechildrespondswithaspecificnumberofnoresponsestocriticalquestions,it
marksthethresholdforidentifyingchildrenatriskforASD(Blattpar.17).Ifscreening
instrumentsindicatethepossibilityofASD,amorecomprehensiveevaluationtakesplace
(Autismfactpar.7).Acomprehensiveevaluationrequiresapsychologist,neurologist,
psychiatrist,speechtherapist,andotherspecialistsifnecessary.Theteammemberswillconduct

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athoroughneurologicalassessmentandanindepthcognitiveandlanguagetest(Autismfact
par.8)ChildrenatriskforASDundergomedicalexaminationsthatincludes,butisnotlimited
to,hearingandvisiontests,testsforgeneticdefects,andneurologicalandpsychological
evaluations.Ifachildisdiagnosedwithautism,atreatmentprogramcanbedeveloped(Blattpar.
17).
Autismhasbeenreliablydiagnosedbytheageof18months.Thiswasshownbya
screeningapproachknownaschecklistforautismintoddlers,alsoknownasCHAT.CHAT
testsfortheabsenceofjointattentionbehaviors.Numerousstudieshavebeendoneanda
particularpopulationbasedstudyhasproventhatCHAThasexcellentspecificitywhen
diagnosingapersonwithautism.CHATwasdevelopedintheU.K.AutismbasedResearch
Centre(BaronCohenpar.2).
Asearlyasinfancy,ababywithASDmaybeunresponsiveorfocusonasingleobjectfor
longperiodsoftime(Autismfactpar.2).Bytoddlerhood,childrenwithautismhavedifficulty
playingsocialgames,prefertoplayalone,andhavedifficultyinrespondingtoothersemotions
(Factspar.3).Althoughchildrenmayappeartobedisconnectedfromtheworldaroundthem,
autisticchildrenareattachedtotheirparentshowever,thisattachmentisunusuallyexpressed
(Factspar.4)AchildwithASDmightbegintodevelopnormallyandlaterwithdrawand
becomeindifferenttosocialengagement(Autismfactpar.2).ChildrenwithASDhavea
varietyofsymptoms,however,therearenumerousnoticeableindicatorsthatcanhelpdetermine
ifachildhasASD.Earlyindicatorsinclude:nobabblingorpointingbyage1,nosinglewords
by16months,no2wordphrasesby2years,noresponsetotheirname,pooreyecontact,
minimalsocialresponsiveness,andanexcessiveliningupoftoysorobjects.IndicationsofASD

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inanolderchildinclude,butarenotlimitedto:animpairedabilitytomakefriendswithpeersor
sustainingaconversationwithothers,anabsenceofimaginationandsocialplay,stereotyped,
repetitive,orunusualuseoflanguage,andaninflexibleadherencetospecificroutines(Autism
factpar.6).Autismisdifferentforeveryperson,thismeansthatnotwopeoplewillhavethe
samesymptomsandcharacteristicsthatdefineautism.However,ithasbeenscientificallyproven
thateverypersonwithAutismhasthefollowingthreeissues,atleasttosomedegree:difficulty
communicatingverballyandnonverbally,relatingtoothersandtheworldaroundthem,and
thinkingandbehavingflexibly(Smithpar.3).Theseimpairmentscausemajorobstaclesfor
thosewhohaveautism.Childrenwithautismhavedifficultycomprehendinghowotherpeople
actaroundthemandhowtoreactwithanappropriatebehavior.Notonlydochildrenwithautism
havedifficultywithcomprehension,butalsoexperiencedifficultiesinbehavingappropriatelyin
socialsettings.AlthoughtherearehundredsofsymptomsforASD,therearedozensoftreatment
opportunitiesthatcanimprovethelivesofthosewhohaveautism.
OneofthemosteffectiveformsoftreatmentsisAppliedBehaviorAnalysis,whichis
commonlyreferredtoasABA.ABAistheprocessofperiodicallyapplyinginterventionsbased
uponthepatientsseverityofautism.ABAisusedtoimprovesociallysignificantbehaviorsand
todemonstratethattheinterventionsbeingappliedarethecauseoftheimprovementofbehavior.
ABAisascientificallyvalidatedapproachtounderstandingbehaviorandhowitisaffectedby
theenvironment(Factspar.2).Abehavioranalystscientificallystudiesbehaviorandclosely
examinestheroletheenvironmentplaysinthisbehavior(Guldpar.5).TheapplicationofABA
hasbeendemonstratedtobeextremelyeffectiveinavarietyofareas,especiallyinthefieldof
autismandintellectualanddevelopmentaldisabilities(Guldpar.1).Theprinciplesandmethods

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ofABAhavehelpedpatientsdevelopskillsthatvaryfromhealthierlifestylestothemasteryofa
newlanguage(Factspar.3).ABAcanalsofosterbasicskillssuchaslooking,listening,and
imitatingwhilemorecomplexskillscanbeaccomplished,suchasreading,conversing,and
understandinganotherperson'sperspective(Factspar.8).Asamatteroffact,ABAhasbeen
usedtohelpchildrenwithautismandrelateddevelopmentaldisorders(Factspar.3).
AccordingtotheassociationAutismSpeaks,appliedbehavioranalysisfocuseson
bringingmeaningfulandpositivechangesinconduct.Appliedbehavioranalysisisbrokendown
intotwodifferentcategories,behaviorandenvironment.Thebehaviorreferstodirectactions
andskills.However,environmentreferstoanythingthatimpactsthebehaviorofsomeonewith
ASD.Forexample,anysocial,mental,orphysicalinfluencesthataffectthepersonwithASD
wouldbeclassifiedasanenvironmentalfactor.ABAtherapyallowssomeonewithASDtohave
abetterunderstandingofeverydayskills,suchascomprehending,conversing,andunderstanding
otherpeoplesperspectives.
AppliedBehaviorAnalysiswasfoundedbyIvarLovaas,whoisconsideredasthe
pioneerofABA(Padawerpar.12).Ivarpublishedastudythatincluded19autisticpreschoolers
withmorethan40hoursaweekofoneononeABA.Healsousedacontrolgroupwiththesame
amountofchildrenhowever,theyweregetting10orfewerhoursofABAeachweek.Ivar
Lovaasclaimedthatnearlyhalfthechildrenreceivingmoretreatmentreducedtheirsymptoms
andimprovedtheirliveswhilenoneinthecontrolgrouphadrecovered(Padawerpar.12).
Researchindicatedthatearly,intensiveABAtherapyimprovedlanguage,cognition,aswellas
socialfunctions.Althoughappliedbehavioranalysisisoneofthemosteffectiveformsof
therapyforautism,thereareothertherapiesthathavebeenprovenjustaseffective.

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Thesignsandsymptomsofspeechandlanguagedifficultiesinpeoplewithautism,which
includespeakinginanabnormaltoneofvoice,repeatingthesamewordsandphrases,
respondingtoaquestionbyrepeatingit,referringtothemselvesinthirdperson,failingto
understandsimpledirections,statements,orquestions,andbeginstakingwhatissaidtooliterally
(Smithpar.18).Thismakesitdifficultforsomeonewithautismtocomprehendsituationsand
makeitdifficulttofunctiondaytoday.Someabnormalitiesthatcausespeechdisorderscanbe
correctedtovariousdegree(Smithpar.1).Speechandlanguagetherapyisusedtocorrect
defectsinspeaking.Thedefectstypicallyoriginateinthebrain,ear,oranywherealongthevocal
tract.Thesedefectsmayaffectthevoice,articulation,languagedevelopmentortheabilityto
speakafteralanguagehasbeenlearned.Speechandlanguagetherapybeginswiththediagnosis
ofunderlyingphysical,physiological,oremotionaldysfunctions(Niralapar.1).
Speechandlanguagetherapyisoneofthemosteffectiveandcommonwaystoassist
someonewithASD.AspeechandlanguagepathologistworkswithpeoplewhohaveASD,to
improvearticulation,expressivedisorders,andfluencydisorders.Expressivedisordersare
typicallyresolvedthroughtheuseofadevicecalledanelectronictalker.Anelectronictalker
allowsapersontoexpressthemselvesthroughanelectronicdevice.Anelectronicdevicealso
allowssomeonewithautismtolearnhowtospeakinamorefluentmanner.Speechandlanguage
therapyallowspeoplewithautismtoimprovetheircommunicationskills.Peoplewithautism
canbetterunderstandsituationsaroundthemandreactinamoreappropriatemanner.Engaging
inspeechandlanguagetherapycanbeincrediblyeffectiveandallowspeopletoalleviate
symptomsandimprovethequalityoftheirlives.

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Anothereffectiveformoftherapyisknownasoccupationaltherapy.Occupational
therapyprimarilyfocusesonadaptingtheenvironmenttofitthepersonwhohasASD,which
resultsinachangeinapersonsbehavior.AccordingtotheAmericanOccupationalTherapy
Association,occupationaltherapistsservicesvaryfromcomprehensiveevaluationsto
recommendationstomakeanenvironmentmoresuitableforthosewhosufferfromASD.
Occupationaltherapyisaskilledhealth,rehabilitation,andeducationservicethathelps
peopleacrosstheirlifespanparticipateinactivities(Livingpar.7).Commoninterventions
includehelpingchildrenwithdisabilitiestoparticipatefullyinschoolanddevelopsocialskills
(Livingpar.3).ChildrenwithASDtypicallyhaveanoutoftheordinaryclassroomsetting
thatallowsthemtoactandreactinappropriatewaystohelpimprovetheirsocialskills.
Customizedinterventionsareusedtoimprovethepersonsabilitytoperformdailyactivitiesand
reachcertaingoals.Duringinterventions,anindividualizedevaluationtakesplacethatincludes
theclient,theclientsfamily,andtheoccupationaltherapisttodeterminetheclientsgoals.
Outcomeevaluationsareusedtoensurethatgoalsarebeingmetortomodifytheintervention
planbasedonthepatientsneedsandskills(Livingpar.4).Forexample,ifapatienthasaset
goaltospeakasentencefluentlyeachdaytheoccupationaltherapistwillmakesurethatthisgoal
isreached.Ifthegoalisntbeingachievedinthesetperiodoftimethenthegoalwillbe
modified.Thismodificationwillallowthepatienttosuccessfullyachievetheirgoaluntilthey
arepreparedtobeginanewactivityorexercise.
Occupationaltherapycanhelpsomeonewithautismlessentheseverityoftheirdisorder
throughnumerousactivitiessuchasfunactivities,rehearsalsofsocialbehaviors,andpromptsto
improvesocialbehaviorsifnecessary.Therearesocialandlifeskillsprogramsforchildrenwith

Sieracki,A8

intellectualimpairmentsanddevelopmentaldelays(Smithpar.2).Theseprogramsare
effectivetoimprovelifeandconversationalskills,initiationofsocialinteraction,self
managementandcompliance,andthedecreaseofproblematicbehaviors(Smithpar.3).
Anotheroptionishomemodificationandadaptiveequipmentthatisprovidedbyoccupational
therapypractitionerstoreducefunctionaldeclineandimprovesafety(Smithpar.5).
Althoughitisbelievedthatchildrenwithautismareunabletoalleviatesymptomsand
improvethequalityoftheirlives,therehavebeenmultipleinstancesinwhichpeoplenolonger
meetthecriteriaforAutism.MarkMacluskie,ananimated16yearoldwhonolongerhas
autism,isoneexampleoutofmany(Padawerpar.20).Today,Markspendshissparetime
playingvideogames,buildingrobots,writingcomputercode,andhangingoutwithfriendsatthe
localparknearhishomeinaPhoenixsuburb(Padawerpar.1).Whatismoreimpressiveisthat
hecohostsaweeklyinternetradioshowcalledTechTeam,whichhasover32,000listeners
eachweek(Padawerpar.20).
WhenMarkwas3,hereceivedamediumtoseverediagnosisofautism(Padawerpar.
21).Heshowednoapparentinterestinthosearoundhimandseemedtounderstandfewwords.
Hethrewstunningtantrumsandevenwhenhedidnotseemangry,hewouldrunheadlonginto
wallsandfallover,thengetupanddoitagain,likearobotprogrammedtorepeatthesame
patterneternally(Padawerpar.21).Marksparents,CynthiaandKevin,sentMarktotheir
districtspreschoolfordevelopmentallydelayedchildrenwherehewasplacedinthehighest
functioningclass.Marksautismhadonlyworsened,hehadevenmorefitsandlostevenmoreof
hisspeechandlanguage.Withinafewmonths,Marksautismworsenedsohewasmovedtothe

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lowestfunctioningclass.AneurologisttoldCynthiatobepreparedforheronlychildtobe
institutionalizedsomeday(Padawerpar.22).
Markwastakenfromschoolandhisparentstookouta$100,000secondmortgageso
CynthiacouldquitherjobandworkwithMarkfulltime,eventhoughshewastheprimary
breadwinner.ShegavehersonshotsofVitaminB12andstartedhimonadairyfree,
glutenfree,andsoyfreediet.Cynthiaalsocreateda40hourbehavioralprogramand5hoursa
weekofspeechandoccupationaltherapy(Padawerpar.23).Earlyoninthisnewprogram
Cynthiacreated,Markwouldthroweggsatthewallandpourmilkonthefloor.Marksparents
emptiedtheirlivingroomoffurnitureandreplaceditwithaninflatabletrampolineandrubber
walls(Padawerpar.24).CynthiadecidedtokeephomeschoolingMark.Bythetimeheturned8,
hisspeechandbehaviorwereonparwithhispeers(Padawerpar.25).Isortofknewtherewere
rules,butIjustcouldntrememberwhatthoseruleswere,Markstated.
CynthiawaseagertofindopportunitiesforMarktopracticesocializing,soCynthia
formedarobotclub.Theyearprior,MarkreceivedarobotkitforChristmas,whichheloved.At
first,theyjustbuiltrobots,buttheybeganwritingprogrammingcodeandenteringcompetitions
(Padawerpar.29).Afteryearsofhardworkandtherapy,Markhadnolongermetthecriteriafor
autism.Markstated,Theresnothingwrongwithbeingautistic,butmylifeismucheasiernot
havingit.Healsostated,ForaslongasIcanremember,IveknownIwasautistic,butInever
feltautistic.Ijustfeltlikeme.ThatsallIknewhowtofeel.(Padawerpar.30)Hismother
Cynthiasaid,Evendoctorssay,wellhemusthavebeenmisdiagnosed,becauseapersoncant
stophavingAutism.Itssofrustrating.Markworkedsohard.Todenyeverythinghedidtoget
thisfarisntfair.(Padawerpar.31).ThisstoryisnottheonlycaseinwhichpeoplewithAutism

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havenolongermetthecriteriaofautism.Treatment,especiallyatanearlyage,iskeyto
improvementandsuccessforthosewhohaveautism.Therehavebeenstudiesthathave
scientificallyproventhatpeoplewithautismcanalleviatesymptomsandimprove.
Althoughmanypeopledobelievethatautismcanimproveandsymptomscanbe
alleviatedtotheextentofcuringautism,therearepeoplewhobelievethatpeoplewithautism
willstrugglewithautismfortheirentirelives.Onceachildisdiagnosedwithautism,people
believethattheywillneverbeindependentandwillalwaysneedtorelyonotherstolivea
normallife.Nomatterhowmuchtherapysomeonewithautismisinvolvedin,theycannotbe
treatedandtheirsymptomswillneverbealleviated.Peoplewithautismwillalwayshave
difficultiesinsocialenvironments,aminimalamountoflanguageskills,andmajorlearning
difficulties.Althoughpeoplewithautismcanprogress,thereisnoscientificevidencethatpeople
withautismcanrecoverandnolongermeetthecriteriaforautism.Evenifearlyinterventionis
putintoplace,apersonmaybeabletorecoverfromautismmoreeffectively,however,theywill
remainwithsymptomstoacertaindegree.
ASDcanbeidentifiedwithinthefirstfewyearsofachildslife.Treatmentplansare
basedontheseverityofapatientsautismandcanbeputintoeffectalmostimmediately.
Autismisadifficultdisordertoovercomehowever,throughvariousamountsofABA,speech
andlanguagetherapy,andoccupationaltherapy,apersoncanalleviatealloftheirsymptomsand
nolongermeetthecriteriaforautism.Althoughtherearesocialimpairmentsandalackof
communicationandcomprehensiveskills,someonewithASDcanleadanefficient,successful,
andindependentlifestyle.

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