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The degree to which autism effects individuals can range from mild to severe. Some, but not all, people with autism are non-verbal. Some people with autism are relatively high-functioning, with speech and intelligence intact. Others are mentally retarded, mute, or have serious language delays. Severely afflicted individuals can appear profoundly mentally retarded. By standard definition, that means they have intellectual limitations associated with seriously impaired adaptive behavior and cannot attain a level of social responsibility and personal independence appropriate to their age, either as children or adults. Etiology Researchers have developed general theories about the nature of autism. Each of the three main groups of symptoms has been chosen as most important or fundamental. Some believe the main problem is an emotional incapacity for human contact, perhaps caused by too high a level of arousal (or, according to an older view now generally discredited, by parental indifference or rejection). Others contend that the pathology is mainly perceptual, that the autistic air of preoccupied concentration and human indifference comes from straining for order in the chaos of the senses. A third view is that the disorder is chiefly cognitive, the
result of an inability to think in certain ways. In a version of this
idea that has become popular recently, individuals with autism are said
to lack "a theory of mind". That is, they are not, at least primarily,
perceptually confused or emotionally aloof. Instead, they are unable to
share experience and express emotion normally because they cannot
anticipate the thoughts and actions of others or even understand that
others have their own intention, feelings, and points of view.
Communication, according to this theory, is a way of influencing others
to construct a picture of the world similar to one's own. The missing
"theory of mind" is said to explain some of the odd strengths and
limitations of high-functioning individuals with autism. They may be
able to master complex technical operations and can sometimes learn the
syntax and vocabulary of a language, but they cannot use speech
effectively. Their gestures are poorly coordinated with their words;
they ask annoying, pointless questions and indulge in tedious
monologues. They cannot take hints, keep secrets, or understand irony
and humor. The earliest signs may appear in the first months of life. Infants with autism often shrink from touch. Instead of cuddling when picked up, they may go limp or stiffen, and they do not cling to parents who return after absence. Normally, children will smile at the sound of their mother's voice when they are two or three months old. Later in the first year they begin to reach with their hands, carry on wordless "conversation," and eventually progress to syllables like "ma" and "pa". Before the end of the first year they are pointing out objects to others' attention and looking sad when someone else looks sad or anxious. Many children with autism never reach these stages or pass through them at a later age. In infancy, the symptoms may be subtle and almost unnoticeable
or optimistically disregarded by parents, but it is usually clear by
age two or three that sometimes is wrong. Children with autism have
little interest in others or understanding of their needs and feelings.
They ignore other children and prefer repetitious, solitary play, such
as staring at revolving objects or arranging things in meaningless
patterns. They may repeatedly lay out objects in lines, or sit silently
watching sand dribble through their hands for hours.
Play schemes and Rigid Behavior Language and Behaviors A few unusually intelligent and articulate adults with autism
have been able to tell us about their lives as children. They speak of
a chaotic world in which everything seemed inconsistent and
unpredictable. Noises were too loud, smells overpowering, and the touch
of other people unbearable. Other children frightened them, and complex
feelings confused them. Because they could not find words, they felt
they had to scream and kick to make their needs understood. Their
excruciatingly heightened sensation sometimes provoked violent rage.
Because they lacked an intuitive understanding of human relations and
social conventions, they had to infer the feelings and intentions of
other people laboriously. |
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