The word autism was first used in 1908 to describe a subset of schizophrenic patients who were described as withdrawn and self-absorbed (A Timeline of the History of Autism Spectrum Disorder). From then to now, the word autism has evolved into a term used to describe a much broader variety of conditions characterized by challenges in social skills, behavior, speech and nonverbal communication, with a restricted range of interests and often stereotyped repetitive behaviors/mannerisms. Although a ton of research has been conducted on the condition, especially in the past ten years, really putting a label on autism spectrum disorder is hard since it is a contested illness. A contested illness, such as autism spectrum disorder, is an illness in which the biomedical cause is unknown, and there is no set way to manage it. Autism is particularly hard to manage due to the variation of conditions that place people on the spectrum, and due to the fact that it is a developmental disorder with change constantly occurring over time.
According to the Action Behavior Centers, recent data indicates that 1 in 42 boys and 1 in 189 girls are diagnosed with autism spectrum disorder, for a running total of around three million Americans being placed on the spectrum. These numbers show that males are four to five times more likely to be at risk of the contested illness, and hypothesis as to why include sex-linked biological reasons and gender relations/interactions at an early age. (Action Behavior) Autism does not discriminate by gender or race, however due to health care disparities there is often a delay in diagnosis and treatment for African American children. Diagnostic bias, a lack of health care accessibility, symptom presentation, and the family’s interpretation of the child's symptoms are a few potential reasons for this delay in diagnosing African American children, making children born into white upper-class homes more likely to receive the proper diagnosis earlier on (African American Families on Autism).
The social perceptions of Autism Spectrum Disorders are ever changing. Overall, public awareness has increased and negative stigmatization and stereotyping of the disorder has decreased; however, the general social understanding of autism spectrum disorders has room for improvement. Originally, the term autism was used as reference to another form of schizophrenia. Introducing this new syndrome as an outcropping of schizophrenia, a disorder that is so negatively perceived in the public eye, set those with autism spectrum disorders at an immediate social disadvantage. Social stigma comes to those diagnosed with autism due to the individualized nature of the syndrome, the associated different speech and actions, and the lack of understanding in its physical basis.
The Diagnostic and Statistical Manual of Mental Disorders (DSM) is referred to as the “bible” for mental disorders. The latest revision, DSM-5 collapsed several separate autism disorders listed in the DSM-4 into one single diagnostic category of autism spectrum disorder. The elimination of widely applied labels of disorders such as Asperger’s reclassifies them as part of autism spectrum disorders. DSM-5 also restructured the diagnosis criteria in a way that significantly reduces the number of ways to be diagnosed with autism; There were 2,027 different symptom combinations in the DSM-4, but only 11 ways to be diagnosed in the DSM-5 (Diagnostic Domain Defense).
Receiving a diagnosis of autism is difficult because there is no existing biological test to diagnose the illness, and symptoms/behaviors vary greatly both over time and from one person on the spectrum to another. With that being said, a reliable diagnosis can be made between 2 to 3 years of age, and many signs (such as your baby not babbling or making other gestures around one year of age) are identifiable in the first 18 months of a child’s life. A child being diagnosed with the contested illness does not only affect the individual, but it affects the family as well. Parents of the child will often feel despair and self-blame, but in hopes will eventually be overcome with acceptance. Parents of children diagnosed with an autism spectrum disorder tend to have higher rates of depression and worse immune function; they also report greater stress-related complaints than parents caring for normally developing children (De Andrés-García et al. 2012). The nature of autism spectrum disorder also makes it hard for the child, particularly in social settings. Individuals on the autism spectrum differ, along with their sense of self. There are high-functioning children on the spectrum who may not struggle as much as the next kid in social environments, making it much easier for them to create friendships and last longer amounts of times in social settings. However, lower functioning children on the spectrum will often feel stress and anxiety in social settings, preferring to be secluded and often therefore having less friends. Higher functioning children will be more accepted by both family and society, while lower functioning children will find themselves excluded from things and often negatively stereotyped by peers. I therefore believe that the severity of the disorder is what affects the individuals sense of self.
The goal is to diagnose and treat the contested illness earlier rather than later. “Treating” children with autism spectrum disorder depends purely on the child and the ability in their language, social and behavioral skills. These skill levels determine whether the child is in need of speech therapy, implemented behavioral programs, various therapeutic training programs, etc. Children with autism function best when provided structure and a set routine/schedule, in environments that do not distract, and when given verbal reminders of what will happen next. Studies on the different recommended treatments for autism are limited. In one review of outcome studies, Intensive Behavioral Intervention (IBI) is recognized as the most effective treatment for autism. However, families who use such behavioral treatments often use other treatments simultaneously, such as relationship-based treatments, skill-based treatments, physiologically oriented interventions, psychopharmacologic treatments and combined programs (Treatments for Autism). As far as medication goes, evidence supports the benefit of medications risperidone and aripiprazole for challenging and repetitive behaviors in children on the spectrum. However, evidence also shows adverse effects of these medications such as increased appetite and weight gain (Autism Speaks). There is no one treatment for autism, seeing as the disorder is different in type and severity for every child.
Autism Spectrum Disorder is an extremely common contested illness affecting approximately 1 in 160 children worldwide (Autism Spectrum Disorders). A variation of symptoms, none of which are biological, make both diagnosing and treating the contested illness hard. Each diagnosis is different depending on the child’s skills in social communication, social interaction, and social imagination. Although a contested illness, research on finding one set cause and treatment option for Autism Spectrum Disorders frantically continues. We tend to take the medicalized, genetic approach to autism too far. The disease construct is overemphasized to the extent that we fail to recognize the uniqueness of each individual child placed on the spectrum. When comparing children with autism spectrum disorders with the same diagnosis, many different personalities, strengths and weaknesses will be encountered, making this a contested illness distinctive to each individual.