Association for Advancement of Behavior Therapy

Fact Sheet on

AUTISM

Autism is a pervasive developmental disorder. It is termed pervasive because it affects all major areas of functioning. The disorder begins prior to 30 months of age. Although the specific etiology of autism is not yet known, the predominant opinion is that it is of biological origin and that there may be several causes. However, the severity of autism may also be significantly influenced by environmental and psychological variables.

Major characteristics

    The major characteristics of autism are
    1) Lack of responsiveness to people (e.g., acts aloof, avoids eye contact, won't cuddle or tolerate physical contact, doesn't play with other children)
    2) Severe language impairment (e.g., mute, or, if speech is present, it is often characterized by echolalia, pronoun reversal, and perseveration)
    3) Strong resistance to change in routine or the environment (e.g., has tantrums when normal routine is altered, has many rituals or overly rigid patterns of activity, is very resistive to teaching interactions)

Other characteristics

    Other characteristics often association with autism are:
    1) Extreme inattention (e.g., acts as if blind or deaf)
    2) Little or no appropriate play with toys
    3) Unusual reactions to normal environmental stimulation (e.g., hyper- or hypo-sensitivity to sight, taste, smell, touch, and hearing)
    4) Self-stimulation (rocking, hand waving, twirling, spinning objects, or other rhythmic, repetitive motions)
    5) Hard to manage (e.g., cries and is inconsolable, has frequent temper tantrums, may engage in self-injurious behavior such as head-banging, self-biting, and self-hitting, and may display aggressive and destructive behavior)
    6) Unusual attachment to or fascination with objects
    7) Uneven development and abilities (very poor skills in some areas, but age-appropriate or exceptional abilities in others, such as music, memory, or manual dexterity - manipulation of puzzles and mechanical objects)

Accurate diagnosis of autism is sometimes difficult because not all of the above characteristics and behaviors are present in each person, and there are substantial variations in intensity and frequency of these behaviors. Diagnostic criteria are specified in DSM-III (the Diagnostic and Statistical Manual of the American Psychiatric Association) and also by the Autism Society of America.
Most individuals with autism are characterized by moderate to severe intellectual retardation, but a small proportion do demonstrate normal intellectual functioning.

Frequency

Autism is seen in approximately 5 per 10,000 children. It is therefore relatively rare when compared to approximately 5 per 100 for mental retardation. Since the criteria for diagnosis do vary, however, some estimates are as high as 15-20 per 10,000. This results in a national population of approximately 300,000 to 400,000 individuals.
Autism ranks fourth in prevalence compared with disorders such as mental retardation, epilepsy, and cerebral palsy.

Treatment

    Strategies and procedures for the assesment and treatment of autism have been developed over the past 25 years through basic and applied research in behavior therapy. It emphasizes a detailed assessment of the individual that includes:
    1) the current living situation (such as family, school placement, and other significant factors in the individual's current life circumstances
    2) learning style and ability
    3) assets and deficits
    4) family expectations
    5) medical status
    6) prior history of development, education, and treatment.

Thus, focus is placed upon analysis of the individuals' behavior, whether it is a skill that is lacking or a behavior which is excessive. This information is then used, in the context of the individual's unique abilities, history, and living environment to structure the social, learning, and physical environment to promote positive and beneficial change.
Specific individualized treatment procedures are developed based on the on-going process of assessment, and drawing upon important basic principles such as reinforcement, discrimination learning, stimulus control, shaping, fading, chaining, and generalization.

The development of specific procedures must also draw upon research concerning learning anomalies associated with autism, sensitivity to developmental patterns and timing, the particular setting (home, school, group home, vocational, residential, foster care, etc.), and the other individuals associated with treatment (parents, siblings, normal peers, teachers, neighbors, etc.).

    Recent research indicates the very powerful positive effect of comprehensive habilitative programs that are based upon the behavioral approach (especially if such programs are begun before 4 years of age). Such programs emphasize the systematic choice of goals that are functional and age-appropriate, on-going assessment, precise specification of intervention procedures, careful monitoring of progress, and the inclusion of input from the professional areas of psychology, education, speech and language, medicine, and vocational habilitation in treatment planning and implementation.
    Focused, individualized treatment programs also explicitly involve parents or caregivers as active participants in the planning and implementation of the comprehensive treatment program.
    It is not a hallmark of behavior therapy to endorse the isolated use of particular techniques. Rather, behavioral treatment is characterized by a comprehensive, consistent, and individualized approach that is sensitive to the uniqueness of the individual, the physical and social environment, and the use of basic and applied research information in decision making.

The ASSOCIATION FOR ADVANCEMENT OF BEHAVIOR THERAPY is a professional interdisciplinary organization which is concerned with enhancing the human condition through the scientific investigation and application of the principles of human behavior.

For more information, please contact AABT at 15 West 36 Street, New York, NY 10018 - 212-279-7970.

May, 1988