Childhood Disorders 635
Like children with mental retardation (but unlike other children), children whohave autism (1) tend to engage in very repetitive play and (2) often display stereo-
typed behaviors. They insist on repeating the same behaviors or activities for much
longer periods than other children do. People with autism also become distressed
when certain routines are not carried out or completed, as was Richie when his
father varied the evening activities in any way; to calm themselves down, they may
rock themselves, as did Richie.
For the most part, people with autism do not go through childhood milestones(language, social, or motor) in a normal fashion. They may speak with a monotone
voice, and the rhythm of their speech may be
odd. Moreover, they often have a variety of
problems with attention and may be impul-
sive or aggressive; they may be more sensi-
tive to sensory stimuli, leading them to shun
physical contact with others. Typically, chil-
dren with autism have only one narrow in-
terest, such as the names of subway stations.
Richie probably has mental retardation and
autism: Mental retardation best explains his
general cognitive slowing and his language
problems, which are not limited to social in-
teractions. His other odd behaviors—such as
avoidance of eye contact, lack of social in-
terest in his siblings, and extreme preoccupa-
tion with his ball—are best accounted for by
autism. Table 14.5 provides additional facts
about autism.
What Is Asperger’s Disorder?
A disorder related to autism, but less severe,
isAsperger’s disorder (also referred to as
Asperger’s syndrome, or simply, Asperger’s),
which involves similar types of problems with
social interaction and narrowed behaviors.
However, unlike individuals with autism,
the diagnostic criteria specify that those with
Asperger’s have language and cognitive abili-
ties that are within the normal range—and so
mental retardation cannot be present.
Children with Asperger’s disorder oftenhave problems with the relatively subtle so-
cial cues related to language—the indirect or
implied meanings behind words. For instance,
someone with Asperger’s might interpret “I’d
Table 14.5 • Autistic Disorder Facts at a Glance
Prevalence- Signifi cantly less than 1% of the population has this disorder; prevalence estimates range
from 0.02% to o.2%. - The reported prevalence of autism is increasing (Atladóttir, 2007; Hertz-Picciotto & Delwiche,
2009), at least in part because of earlier diagnosis of the disorder (Parner, Schendel, &
Thorsen, 2008).
Onset- Symptoms usually arise during infancy and include an indifference or aversion to physical
contact, no eye contact or smiles, a lack of response to parents’ voices, a lack of emotional
attachment to parents, and the unusual use of toys (Ozonoff et al., 2008). - According to the DSM-IV-TR criteria, symptoms must arise by age 3.
- Autism may be diagnosed as early as 14 months of age (Landa, Holman, & Garrett-Mayer, 2007).
Comorbidity- Mental retardation is a common comorbid disorder—between 50% and 70% of those with
autism also have mental retardation (Sigman, Spence, & Wang, 2006). However, some
researchers believe the high comorbidity is an overestimate (Edelson, 2006), particularly be-
cause individuals with autism tend to have higher IQs when tested using nonverbal IQ tests. - Some researchers make a distinction between autism that co-occurs with mental retardation,
which leads to a relatively low level of functioning, and autism without mental retardation, which
is not generally associated with as low a level of functioning (Koyama et al., 2007).
Course- Children with autism often improve in some areas of functioning during the elementary
school years (Shattuck et al., 2007). - During adolescence, some children’s symptoms worsen, whereas other children’s symptoms
improve (American Psychiatric Association, 2000; Shattuck et al., 2007).
Gender Differences- Males are four to fi ve times more likely than females to develop autism.
Source: Unless otherwise noted, the source for information is American Psychiatric Association, 2000.
4½Ω years, he began to echo long and complicated sentences, some of which his mother
reported he may have heard days or even weeks before. He was able to complete puzzles
designed for 8- and 9-year olds quickly, but was unable to reproduce a line or circle.
At about age 5, James made his first spontaneous statement. His mother reported that
he had been looking at the sky and said, “It looks like a fl ower.” He did not speak again for
8 months, but then began talking in full sentences.... When he met strangers, he mechani-
cally introduced himself without ever establishing eye contact, and then rushed on to ask
what the person’s birthday, anniversary, and social security number were, often appearing to
pause long enough to get the answers. Years later, upon re-meeting the person, he was able
to recite back these facts.
(Caparulo & Cohen, 1977, pp. 623–624; case printed in Sattler, 1982, p. 474)Asperger’s disorder
A psychological disorder on the autism
spectrum characterized by problems with
social interaction and narrowed behaviors—
similar to but less severe than autism—but in
which language and cognitive development
are in the normal range; also referred to as
Asperger’s syndrome.