The Changing Face of Autism.
I started an Internship for my Social Work degree in 1978 on the Children’s Unit of the Utah State Hospital. I worked with many children that at that time were called Pervasive Developmental Disorder. These children had a plethora of problems and symptoms that caused interaction with them to range from pulling each word carefully from them to trying to contain them so that a treatment provider could get a word into the dialogue. I read the book Son-Rise by Barry Neil Kaufman I believe that was the first book I read where there was a person with Autism that had any level of speech. Son-Rise is the story of Raun Kaufman a young boy that was diagnosed as being extremely withdrawn. Of the six clinics where he received treatment only one diagnosed him as Autistic. Unlike Raun Kaufman many of the children I worked with were as I mentioned diagnosed as have Pervasive Developmental Disorders. Attempts to build relationships varied some children were able to interact and share emotions and describe feeling while others did not seem to have that capacity.
Flash forward to the 1990’s. The term Asperger Syndrome is now becoming prevalent in the mental health community. Children with diagnosed with Asperger's Syndrome are becoming more prevalent. Controversy arises as to whether these children are a separate diagnosis from Autism, if so how is the difference determined. Many articles I have read have trouble with differentiating between High Functioning Autism and Asperger's Syndrome.
Taking another leap forward to the 2013 publication of the latest Diagnostic and Statistical Manual or DSM 5. Here many diagnoses with similar traits are placed together in the Diagnosis of Autism Spectrum Disorder. A few of the Diagnoses including Asperger’s Syndrome, Pervasive Developmental Disorder Not Otherwise Specified are now under this umbrella of Autism Spectrum Disorder.with severity given by adding level 1, 2 or 3 Level 1 needing the least structure and accommodations to Level 3 which requires more structure and accommodations.
With the changes in the diagnostic criteria and more facilities diagnosing there has been a dramatic increase in the number of individuals diagnosed with Autism Spectrum Disorder. The question remains, is there an increase in the rate of Autism or is it an increased awareness. I suspect that it is both. The Diagnostic Criteria have accepted more individuals to be treated for Autism. As more families and schools looked for the best service for their family member or student, the diagnosis Autism Spectrum Disorder fit not only the symptoms but needs of the students. So the remarkable increase in the rate of autism over the past 20 years.
Another source of the increase is the number of adults being diagnosed with autism. In the 70’s and 80’s while working at the State Hospital there were no new diagnosis of autism for adults. In fact if a child diagnosed with autism matured into the adult service it was likely the diagnosis would not have followed him to that system. Today there are many people with a diagnosis of ASD that would have been diagnosed as several different diagnoses including Inadequate Personality Disorder, Schizophrenia, Mood Disorder, or even Bipolar Disorder. These adults now with the proper diagnosis can receive the proper treatment.
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