Why does Autism look so different in so many people?
Most of us are really confused about what having autism really means. It is particularly
confusing because it is a spectrum disorder including many people who seem to be
"normal" but perhaps odd, to individuals with profound disability who no one would
mistake for typical. Research now suggests that there are really many many types of
"autism". These autisms can be present with other complicating issues including known
genetic syndromes, intellectual disability, and even other brain disorders like ADHD and
Depression. When people are talking about an individual it helps to clarify what part of
behavior is due to "autism" and what may be influenced by other conditions which may be
treated in another way, or will not be responsive to traditional ABA therapies.
Co-occuring conditions may include:
In the past other terms to describe this included mental retardation, or at the turn of the 19th century even moron was used. These terms are no longer used and many people consider them offensive. You may see the abbreviation I/DD used. It means intellectual and or developmental disability. A developmental disability usually refers to something you were born with. There is a federal legal definition of DD. It is used when implementing the law, or determining if individuals qualify for certain services. It is rapidly becoming an "old fashioned" diagnosis because our understanding of genetic expression is so much more complicated than it used to be.
These may include depression, bipolar disorder, ADHD and can be very difficult to diagnose as independent from the ASD. These disorders as well as Schizophrenia have been shown to be linked by a common gene pool.
Fragile X, Tuberous Sclerosis, Downs syndrome all include a higher proportion of kids with ASD than typical populations. Science is telling us that much of what causes ASD is related to changes in how some genes replicate, and then, how that genetic expression interacts with the environment it is developing in. So, strictly speaking most ASD is related to a genetic condition, just not an identifiable syndrome.
Altered sensory experiences
These include sensory processing disorder and other names, but the trend is away from noting these as independent problems, towards seeing these issues as part of ASD.
Altered gastrointestinal function
This may start at the tongue with altered sensory experience, down to the stomach with altered swallowing (lots of gastrointestinal reflux) and through the colon with symptoms of diarrhea, constipation, and irritable bowel. Again, room for lots of research here. Unfortunately most of the research in nutrition does not support the idea of gluten intolerance as a cause of autism. This is not to say that there aren't people who have gluten intolerance and autism.
This is defined as two or more unprovoked seizures (meaning no fever, no head injury). They seem to come on at 2 different times, before age five, or during adolescence. There are suggestions that seizure disorders may be more likely with kids with more severe intellectual disability. To complicate matters, up to 70% of kids with ASD have abnormal EEG’s even with out the presence of seizures.