Question 1A: Myth 1 - People with ASD never make eye contact

An integral part of social communication is making eye contact, maintaining eye-gaze

and joint-attention. Individuals who are affected by Autism Spectrum Disorder (ASD)
have difficulty with social communication; therefore it is logical that this myth exists.
People with ASD may have difficulty making eye contact, however to make a
generalised statement that infers that all individuals with ASD are the same and never
make eye contact is untrue and harmful. In most cases, it seems that people with ASD
avoid direct eye contact, however, with a range of therapeutic interventions, it is
evident that social communication skills improve in people with ASD (Carbone et al,
2013). Hobson, (1992), found that children with ASD make as many social interaction
bids as other typically developing children however the quality of the interaction is
not as good.
Recent research shows that some people with ASD feel physical pain when forced to
give direct eye contact. Robledo et al (2012) interviewed five individuals with ASD;
one of which was Matt, who explained, It is painful for me to look people in the
eye This lack of eye contact sometimes make people (especially teachers) think
I'm not paying attention to them.
Thegeneralpopulationmustbecomemoreeducatedaboutautismandofthemyths
thatareperpetuatedandtheramificationsasaresult.Everyoneisdifferentandnotwo
peoplewithASDarethesame.SomeindividualswithASDmayfinditextremely
difficulttomaintaindirecteyecontact,whilstothersmaynotshowanydifficultyat
all.

References
1. Hobson, 1992
2. Vincent J. Carbone, Leigh OBrien, Emily J. Sweeney-Kerwin, Kristin M. Albert
Teaching Eye Contact to Children with Autism: A Conceptual Analysis and Single
Case Study - Education and Treatment of Children Volume 36, Number 2, May 2013
pp. 139-159
3. Robledo, J., Donnellan, A. M., & Strandt-Conroy, K. (2012). An exploration of
sensory and movement differences from the perspective of individuals with autism.
Frontiers in Integrative Neuroscience, 6, 107.

Question 1B: Myth 2 - All people with ASD have savant abilities
All people with Autism spectrum disorder (ASD) do not have savant abilities; in fact,
to have savant abilities is extremely rare. Savant syndrome occurs to individuals with
autism and other central nervous system disabilities, however, approximately one in
ten persons with autism has savant skills; so nine out of ten do not Treffert, D.A
(2014).
The Diagnostic Statistical Manual of Mental Disorders- edition IV by the American
Psychiatric Association specifies the more severe and milder sub-types of autism such
as PDD-NOS, Aspergers syndrome and Savant syndrome. In the recent updated
edition 5 (DSM-5), a blanket term of ASD has been made that does not include these
milder subtypes. This change in the standardised protocol in which autism is
diagnosed, further illustrates the reduced emphasis placed on individuals with savant
abilities previously referred to within PDD-NOS.
Film, television and media are also very significant contributing factors in how this
myth began. Its feasible to hypothesise that most of society do not have a thorough
understanding of individuals with ASD, which may lead them to believe
characterisations depicted within various media channels. For many citizens with
limited exposure to individuals with specific impairments, film, regardless of its
accuracy, serves as a major source of information on the very nature of disabilities
(Safran, 1998, p. 227). Many individuals with ASD have been described and
understood as having the same disability as those characters within the popular films
Rain Man, A Beautiful Mind and Mercury Rising (Young, 2012).
The way particular stories, characters and situations are portrayed and indeed, how
experienced an audience is, contributes to the longevity of the myth.

References
1.Saffran,S(1998)Disability portrayal in film: reflecting the past, directing the
future. Exceptional Children, 64(2)
2. Treffert, D.A (2014) Savant Syndrome: Realities, Myths and Misconceptions
Journal of Autism and Developmental Disorders March 2014, Volume 44, Issue 3, pp
564-571
3. Young, L.S. (2012) Awareness with Accuracy: An analysis of the representation of
Autism in Film and Television

Question 2. Diagnosis of ASD

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) was
updated in 2013 and major modifications have been made to the criteria in diagnosing
Autism spectrum disorder (ASD). Its predecessor, the DSM-IV incorporated five
disorders including Autistic disorder, Aspergers disorder, Retts disorder, child
disintegrative disorder, and pervasive developmental disorders not otherwise specified
(PDD-NOS). Currently within the DSM-5, the term pervasive developmental disorder
has been replaced with the diagnosis of autism spectrum disorder and the diagnostic
categories of Retts disorder, child disintegrative disorder, PDD-NOS and Aspergers
disorder are no longer included (Attwood, 2014). These changes were made due to the
growing need to have a more specific diagnostic tool for ASD.
Additionally, the DSM-5 has reduced the triad of impairments into a dyad that now
diminishes the social-related elements of autism into Social communication
impairment and Repetitive/Restricted behaviours (APA, 2013). This move was
needed to also become more specific in diagnosing ASD and to clarify any
uncertainties across the field.
The DSM-5 has now included levels of severity within the two diagnostic criteria
categories: Social Communication and Restricted, Repetitive Behaviours. This
move is to indicate the levels of support required. The reasons for these levels is that
1) the DSM-IV wasnt precise enough and 2) autism is defined by a common set of
behaviours and it should be characterised by a single name according to severity
(http://www.autism.com/news_dsmV).
In order to make a diagnosis within the current DSM-5, the criteria now allows a
multidisciplinary team to describe any further developmental disabilities and any
other significant behavioural markers. Additional information relevant to the

diagnosis is now called specifiers (APA, 2013). This seems to be a positive step for
families and children affected by ASD due to the nature of a team approach, necessary
in formulating an individualised therapeutic plan.
Another positive step for the DSM-5 is the inclusion of hyper and hypo reactivity to
sensory input within the category of restrictive and repetitive behaviours. These
sensory symptoms have long been observed in individuals with autism but have never
been formally recognised within the DSM-IV. This change is intended to improve
the specificity of the diagnosis (Hazen, et al 2013). A multitude of research on the
sensory profiling of children with ASD has successfully proven to the international
community that it was necessary for inclusion in the current manual.
These controversial changes have impacted the autism community worldwide with
divided arguments for and against the move for a more refined diagnostic
measurement of ASD. There has been an impact on the number of children diagnosed
with having ASD because of this stricter diagnostic criterion (Mazefsky et al 2012).
Matson, J et al (2012) concluded in their study that 47.79% fewer toddlers were being
diagnosed with ASD compared to those on the DSM-IV. The Aspergers community
seems to have lost their sense of identity due to the loss of its status and this should be
reviewed from a psychosocial standpoint on the effects of now being termed autistic.
There is also the concern and likelihood that some governments across the world
could abandon these individuals in regards to their services that they can access.
The diagnosis of ASD has needed an upheaval since the fourth edition of the DSM;
the teething problems that have been raised above are only the tip of the iceberg.
Further explorations and research into the effects of these changes need to be
considered for future change.
References

1. Eric P. Hazen, MD; Christopher J. McDougle, MD; and Fred R. Volkmar, MD,
Changes in the Diagnostic Criteria for Autism in DSM-5: Controversies and
Concerns Clinical Psychiatry 2013, July, 74(7): 739
2. Attwood, T, (2014). Chapter 2, An Overview of Autism Spectrum Disorders
Learners on the Autism Spectrum Preparing highly qualified educators and
related practitioners.
3. American Psychiatric Association (2013): The Diagnostic and Statistical
Manual of Mental Disorders, 5th Edition (DSM-5)
4. Matson, J L, Kozlowski A.M, Hattier, M.A, Horovitz, M & Sipes, M (2012)
DSM-IV vs DSM-5 diagnostic criteria for toddlers with Autism
5. Mazefsky, C. A, McPartland, J. C, Gastgeb, H. Z, Minshew, N.J (2012)
Report: Comparability of DSM-IV and DSM-5 ASD Research Samples

3. Characteristics of Individuals with ASD Early Childhood (15 Marks)

Brief

Autism spectrum disorder (ASD) influences how a child perceives and socialises with
others, impacting crucial areas of development - social communication and restricted
and repetitive behaviour (www.mayoclinic.com).
ASD involves a variety of characteristics and can vary in severity from person to
person. When a parent suspects that their child is not meeting developmental
milestones, an assessment needs to be carried out immediately so that the child is
given the best possible options in regard to early intervention.
The onset of early childhood ASD may present in a range of signs including but not
limited to: difficulty comforting the child, who also may not be drawn towards social
activities, preferring to play alone, and who does not point to interesting objects he or
she want them to notice and share the experience (Attwood, 2014 pp 38).
Illustrated in the table below is a brief comparison between development in
neurotypical children and children with ASD between the age of 2-5 years old.
Neurotypical Children
Eye contact and smiling by 6 months old
Speech begins to develop from 9-18 months
Cooing and baby sounds by 12months
Shows intentional communication

Children with ASD

Eye contact is limited
Doesnt respond to his/her name
No baby talk or babbling
Doesnt show interest in shared

characterised by development of joint

experiences/lack of reciprocity

attention 9-13 months old

Plays with a wide variety of toys and stimuli Preoccupation with narrow topics
Beginning to show symbolic understanding Doesnt imitate movement/expressions
through gestures 12 months
Generally enjoys affection from birth
Doesnt initiate or respond to cuddling
(http://www.autismtreatmentcenter.org/information/autism_symptoms.php)
These early signs along with others are further identified within the diagnostic criteria
for Autism Spectrum Disorder in the Diagnostic Statistical Manual for Mental
Disorders (APA, 2013). Due to the heterogeneous nature of the symptoms shown in
each child, severity levels can sometimes be complicated to ascertain. The

implications for young children between the ages of 2-5 years old can greatly depend
on the parents awareness and early intervention. It is during this time that it is
imperative for the childs development to be positively influenced through therapeutic
goal setting within a multidisciplinary approach. We can now reliably identify the
signs of autism in some children prior to one year old (Attwood, 2014 pp 39).
Without such interventions, the implications will present themselves within the two
main categories specified within the DSM-5, which are social communication and
restrictive and repetitive behaviours. The following characteristics are represented
within social communication impairments:

Eye contact is limited

Doesnt respond to his/her name
No baby talk or babbling
Doesnt show interest in shared experiences/lacks reciprocity
Doesnt initiate or respond to cuddling
Doesnt imitate movement/expressions

The implications of not being able to sustain eye contact within a social context may
include poor joint attention skills, which may lead to the needs of the young child, not
being met. Relationships are then affected and bonds between parent and child may
not be strengthened. If a child does not respond to his or her name, people may
assume that the child is deaf only to realise that his or her hearing is within normal
range. If this was the case with a neurotypically developing child, the parent would
have the child tested and if there were hearing issues, the child would then be fitted
with hearing aids or cochlear implants. When babies do not coo or have limited baby
talk, this would impact speech development and further social communication such as
gestures, expressions and movements. A neurotypically developing child of the same
age (before 12 months old) would be babbling and improvising with the tones and
rhythms he or she is hearing. For most people, language production is controlled by

the left side (of the brain), while the right side is responsible for interpreting the
emotional content of speech through its tone and rhythm (www.babycentre.com).
Showing affection in early childhood is a highly important attribute as it develops the
hormonal balances within the pre-frontal cortex of the brain (Child Trauma Academy
www.ChildTrauma.org) If a child is not displaying affection towards parents and
carers, the impact that this may have on the retardation of the growth of the brain at an
early age may be catastrophic.
The following characteristics are represented within restricted and or repetitive
behaviours:

Preoccupation with narrow topics

Seeks or avoids sensory experiences
Begins to show difficulty in adapting to new situations or changes to routine
May begin to show attachments to unusual objects
May line up toys or play with toys in a restrictive manner (ie spinning)
May begin to show signs of stimming (i.e hand flapping)

The implications of a young child having preoccupations with narrow topics may
include missing out on learning important skills that other toys, books, interests may
have to offer. These preoccupations can also limit social communication with
neurotypical peers of the same age group who would be interested in a wide range of
stimuli. This may also be demonstrated when a child may begin to show attachments
to unusual objects such as plastic lids or rubber bands. When children line up toys or
play with toys in a restrictive manner it displays rigidity and the need for a predictable
routine. This may reflect what the child with ASD is seeking, for example, if a child
has a stick and is tapping a variety of surfaces incessantly and without purpose; the
child may be seeking this regularity and sense of expected outcome to help them
settle. The child could also be seeking the sensory experience in order to regulate or
calm their nervous system. (First M. 2005)

Young children develop at varying rates, yet within a predictable scope of what is
expected in regards to language acquisition, gross and fine motor control, self help
skills, eye contact, play and social interaction. Parents know their children the best
and develop an intuitive feeling that something is wrong with their childs ability to
relate (Attwood, 2014). It is with this intuition that parents of children with ASD
have been required to pursue. These child need to be given the best opportunity to
develop, achieve and enjoy life like any neurotypical child in the same age group.

References
1. www.mayoclinic.org
2. Attwood, T, (2014). Chapter 2, An Overview of Autism Spectrum Disorders
Learners on the Autism Spectrum Preparing highly qualified educators and
related practitioners.
3. http://www.autismtreatmentcenter.org/information/autism_symptoms.php
4. American Psychiatric Association (2013): The Diagnostic and Statistical
Manual of Mental Disorders, 5th Edition (DSM-5)
5. www.babycentre.com
6. www.ChildTrauma.org
7. First M. (2005) Sensory Processing Disorder: Possible Pathways to DSM-V.
Available: www.spdnetwork.org/research/swg.first.html.