Autism Definition

Autism is a developmental disability which may occur concurrently with other disabilities. Onset appears during infancy or early childhood and is behaviorally defined to include disturbances in: (1) developmental rates and/or sequences; (2) responses to sensory stimuli; (3) speech, language, and cognitive capacities; and, (4) capacities to relate to people, events, objects, and which adversely affects educational performance. Educational performance shall be interpreted as not only classroom applications of academic skills and concepts, but also as generalization of skills and behaviors such as social interaction, functional communication, and prevocational and vocational skills and behaviors to other environments.

Essential Features Include:

1. Disturbances of developmental rates and sequences: Normal coordination of the developmental areas (cognition/adaptive behavior, speech, language, fine motor, gross motor, and social/emotional/behavioral) is disrupted. Delays, arrests, and/or regressions occur among or within one (1) or more of the areas.

Within areas: For example, within the social/emotional/ behavioral area, the student may respond to attempts by others to interact but not initiate interactions with others; or within the cognitive/adaptive area nonverbal intelligence scores may be markedly higher than verbal scores yet significantly lower than adaptive abilities.

Between areas: For example, excellent gross motor and balance skills may be present while social interaction skills are delayed; or speech may be present but not used for social communication purposes.

Arrests, delays, and regressions: For example, development may be normal up to a point at which there is an arrest, such as walking stops; or some cognitive skills may develop at expected times while others are delayed or absent; or imitative behavior and/or speech may be delayed in onset followed by rapid acquisition of some skills in these areas.

2. Disturbances of responses to sensory stimuli: There may be generalized hyperactivity or hypoactivity and/or alternation of these two states over periods ranging from hours to months.

Visual symptoms (seeing): there may be close scrutiny of visual details; apparent nonuse of eye contact; staring, prolonged regarding of hands or objects; attention to changing levels of illumination.

Auditory symptoms (hearing): there may be close attention to self-induced sounds; non-response or over-response to varying levels of sound.

Tactile symptoms (touch): there may be over- or under-response to touch, pain, and temperatures; prolonged rubbing of surfaces; sensitivity to food textures.

Vestibular symptoms (balance): there may be over- or under-reactions to gravity stimuli, whirling without dizziness, and preoccupation with spinning objects.

Olfactory and gustatory symptoms (smelling and tasting) there may be repetitive sniffing, specific food preferences, and licking of inedible objects.

Proprioceptive symptoms (movement): there may be posturing, darting/lunging movements, hand flapping, gesticulations, and grimaces.

3. Disturbances of speech, language-cognitive, and nonverbal communication:

Speech symptoms: elective mutism, delayed onset, immature syntax, immature articulation, and modulated but immature inflections.

Language-cognition symptoms: specific cognitive capacities such as rote memory and visual-spatial relations may be intact with failure to develop the use of abstract terms, concepts, and reasoning; immediate or delayed echolalia with or without communicative intent; non-logical use of concepts; neologisms.

Nonverbal communications: absent or delayed development of appropriate gestures, dissociation of gestures from language, and failure to assign symbolic meaning to gestures.

4. Disturbances of the capacity to relate appropriately to people, events, or objects: There is failure to develop appropriate responsivity to people and to assign appropriate symbolic meaning to objects or events.

Examples in relation to people: absence, arrests, and/or delays of smiling response,stranger anxiety, anticipatory response to gestures, playing peek-a-boo, patty-cake games or waving bye-bye, failure to make eye contact or display facial responsivity, failure to make reciprocal responsiveness to physical contact, and failure to develop a relationship with significant caretakers. For example, caretakers may be treated indifferently, interchangeably, with only mechanical clinging, or with panic at separation. Cooperative play and friendships, usually appearing between the ages of five (5) and seven (7) years, may develop but are superficial, immature, and only in response to strong social cues.

Examples in relation to objects: absent, arrested or delayed capacities to use objects, and/or to assign them symbolic and/or thematic meaning.

Objects are often used in idiosyncratic, stereotypic, and/or perseverative ways. Interference with this use of objects often results in expressions of discomfort and/or panic.

Examples in relation to events: there may be a particular awareness of the sequence of events and disruption of this sequence may result in expressions of discomfort and/or panic.

Associated Features May Include:

Other disturbances of thought, mood, and behavior and vary with age.

Mood may be labile: crying may be unexplained or inconsolable; there may be giggling or laughing without identifiable stimuli.

There may be a lack of appreciation of real dangers such as moving vehicles as well as inappropriate fears.

Self-injurious behaviors, such as hair pulling and hitting or biting parts of the body, may be present.

Stereotypic and repetitive movements of limbs or the entire body are common.

Criteria for Initial Determination of Eligibility

After completing all previous steps required in the special education process, the multidisciplinary team may determine that a student displays autism if disturbances in ALL four (4) of the following areas are present or can be documented in past behavior.

Behaviors may be present at any combination of levels. These behaviors should be assessed in terms of difference from those appropriate for the student's cognitive ability levels.

1. Disturbance of developmental rates and sequences: The student may exhibit delays, arrests, or regressions in physical, social, or learning skills. Areas of precocious skill development may also be present, while other skills may develop at normal or extremely depressed rates. The order of skill acquisition frequently does not follow normal developmental patterns.

2. Disturbances of responses to sensory stimuli: The student's behavior may range from being hyperactive to being unresponsive to people and objects in their environment and can alternate between these two (2) states over periods ranging from hours to months. Disturbances may be apparent in auditory, visual, olfactory, gustatory, tactile, and kinesthetic responses. The student may respond to stimulation inappropriately and in repetitive or non-meaningful ways.

3. Disturbances of speech, language-cognitive, and nonverbal communication: The student displays abnormalities which extend beyond speech to many aspects of the communication process. Communicative language may be absent or, if present, language may lack communicative intent. Characteristics may involve both deviance and delay. There is a basic deficit in the capacity to use language for social communication, both receptively and expressively.

4. Disturbance of the capacity to relate appropriately to people, events, or objects: The student displays abnormalities in relating to people, objects, and events. There is a basic deficit in the capacity to form relationships with people. The capacity to use objects in an age appropriate or functional manner may be absent, arrested, or delayed. The student may seek consistency in environmental events to the point of exhibiting rigidity in routines.

5. These characteristics are not PRIMARILY caused by:

Visual, auditory acuity, or motor deficits
Behavior disorder/emotional disturbance
Mental retardation
Environmental or economic disadvantage, or cultural differences

The multidisciplinary evaluation team is qualified to interpret evaluation data and diagnose the condition of autism. The evaluation process must include input from a person with competence in autism.

Evaluation of students with autism for educational programming generates unique issues. These issues include the need for assessment of functionality. This is made necessary by the inherent difficulties in skills generalization that most autistic persons exhibit. In data gathering, particular attention should be paid to developmental history, including a family interview and complete medical information; direct behavioral observations conducted on different days in multiple environments including, but not necessarily limited to school settings; and written, dated anecdotal records of a behavioral nature.

NOTE: Any identification such as autism does not dictate a specific placement. Since Missouri does not have teacher certification for autism, it is important in considering an educational placement for students with autism to base such decisions on the assessed strengths and needs of the student, rather than
on stereotypical reactions to the label of autism. Any certified teacher(s) qualified to provide the services delineated in the IEP may do so. Students with autism may be served in a variety of educational settings. It is critical to have access to staff who have competence in working with students with autism and who will respond to the unique learning characteristics of these students.