In Context

In the film Best Kept Secret, Janet Mino teaches a class of six students, five of whom are on the autism spectrum. Autism spectrum disorder (ASD), commonly referred to simply as autism, is a neurological and developmental variation that affects learning, communication and social interaction.

Autism can be found across all racial, ethnic and social groups and is associated with a wide range of behaviors and characteristics that may include intense focus on a specific subject; unconventional means of learning and problem-solving; a strong need for routine and consistency; repetitive movement or self-stimulation, such as rocking or humming; difficulty with social interpretation and expression; and an under- or over-sensitivity to sensory experiences like sound, light and touch.

Each individual on the autism spectrum is different, with a unique set of characteristics and behaviors that may change depending on stress or anxiety levels and sensory stimulation. Individuals on the far end of the autism spectrum may be non-verbal, harm themselves or depend heavily on support from family and professionals, while other adults with autism may live and work independently. The exact cause of autism is unknown, though genetics and environmental conditions are thought to be possible factors.

Prior to May 2013, diagnosticians separated the varying degrees of autism spectrum disorder into subsets that included autism disorder, Asperger's syndrome, pervasive development disorder not otherwise specified, Rett syndrome and childhood disintegrative disorder. Since these subsets were differentiated solely by behaviors, they were often difficult to determine. In an effort to provide more clarity and diagnostic precision, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (the manual published by the American Psychiatric Association and used as the standard for classifying mental disorders), released in May 2013, eliminated these subsets and instead breaks down positions on the autism spectrum by levels (for example, autism spectrum disorder, level 1, level 2 or level 3).

As of March 2013, the Centers for Disease Control and Prevention estimate that one in 50 children are identified with autism spectrum disorder, compared to about 1 in 155 in 2002 and 1 in 88 in 2012. However, this rapid increase may be more attributable to greater awareness and more frequent diagnosis than to an actual increase in the incidence rate. Diagnosing autism accurately is not easy and, according to the Diagnostic and Statistical Manual of Mental Disorders, there are more than 600 different symptom combinations that meet the minimum criteria for diagnosing autism disorder--just one of the formerly used subsets of autism spectrum disorder.

The Autism Diagnostic Observation Schedule (ASOD) and the Autism Diagnostic Interview, Revised (ADI-R) are the standard assessment tools used for diagnosis, but many other screening tests exist. Administering assessments that are accurate and comprehensive is a difficult task, as traits associated with autism exist on a continuum and may be observed among those not clinically diagnosed with a related disorder.

Sources:
» Armstrong, Thomas. The Power of Neurodiversity: Unleashing the Advantages of Your Differently Wired Brain. Cambridge: Da Capo Lifelong, 2011.
» The Autism Education Network. "Diagnosing Autism."
» Autism Research Institute. "DSM-V: What Changes May Mean."
» Autism Society.
» Autistic Self Advocacy Network.
» Carey, Benedict. "Diagnoses of Autism on the Rise, Report Says." The New York Times, March 29, 2012.
» Centers for Disease Control and Prevention.
» Gever, John. "Amygdala Enlarged in Young Autistic Children." MedPage Today, May 4, 2009.
» Grandin, Temple. "The World Needs People with Asperger's Syndrome" The DANA Foundation, October 1, 2002.
» Grandin, Temple and Richard Panek. The Autistic Brain: Thinking Across the Spectrum. New York: Houghton Mifflin Harcourt, 2013.
» Hamilton, Jon. "What's Different About the Brains of People with Autism?" NPR, June 4, 2012.
» Jaarsma, Pier and Stellan Welin. "Autism as a Natural Human Variation: Reflections on the Claims of the Neurodiversity Movement." Health Care Analysis, March 2012.
» Autistic Self Advocacy Network.
» National Institute of Neurological Disorders and Stroke.
» PBS. History of Autism Blame.
» PBS. Refrigerator Mothers. What Is Autism?
» PBS. This Emotional Life. What Is Autism?
» Salahi, Lara. "10 Myths About Autism." ABC News, October 23, 2008.
» Science Daily. "In Autism, Age at Diagnosis Depends On Specific Symptoms."