1 in 68 American children is on the autism spectrum, according to the national organization Autism Speaks. This represents a ten-fold increase in prevalence in 40 years, based on data from the U.S. Centers for Disease Control.
In the private sector, autism spectrum disorder (ASD) and autism are both general terms for a group of complex disorders of brain development. These disorders are characterized, in varying degrees, by difficulties in social interaction, verbal and nonverbal communication problems, and repetitive behaviors.
Although ASD is generally diagnosed based on behavioral symptoms between 2 and 3 years of age, ASD is genetically linked. A research collaboration involving 13 institutions around the world, published in Cell magazine July 3, 2014, has recently revealed that many cases of autism are related to a mutation in the CHD8 gene.
Previously, the American Psychiatric Assocation (APA) separated autistic-like symptoms into distinct subtypes; these subtypes included Autistic Disorder, Childhood Disintegrative Disorder, Pervasive Developmental Disorder – Not Otherwise Specified (PDD-NOS), and Asperger Syndrome. With the May 2013 publication of the APA’s DSM-5 diagnostic manual, all autism disorders were merged into one umbrella diagnosis of ASD.
Although the APA-style diagnosis of autism is commonly used by private psychologists, licensed educational psychologists, and psychiatrists for private or medical evaluations, this method of diagnosis is not commonly used in the public school system. In order to qualify for special education services, students must meet specific special education eligibility criteria; whether or not a student meets these criteria is usually assessed through a psycho-educational assessment conducted by a credentialed school psychologist.
While a private diagnosis will be considered in a psycho-educational assessment, a private diagnosis of ASD does not necessarily indicate a student will be eligible for special education services under the eligibility criteria for autism. This is because the Individuals with Disabilities Education Act (IDEA), a federal law that ensures services to children with disabilities, defines the criteria for autism somewhat differently from the APA’s DSM-5 manual.
According to IDEA, “autism” means a developmental disability significantly affecting verbal and nonverbal communication and social interaction, generally evident before age three, that adversely affects a child's educational performance. The IDEA states that other characteristics often associated with autism are engagement in repetitive activities and stereotyped movements, resistance to changes in environment or daily routines, and unusual responses to sensory experiences. IDEA also notes that students who begin to exhibit the characteristics of autism after age 3 can be eligible if the other criteria is met
California state special education laws also have their own specific criteria for eligibility under the autism category. The state of California refers to this category as "autistic-like behaviors." Similar to the IDEA definition, there is no requirement for an actual diagnosis of autism; instead, the criteria focus on whether the child requires special education and related services due to the presentation of characteristics associated with autism.
Under this definition, students diagnosed with Obsessive-Compulsive Disorder, anxiety disorders, or other disorders could feasibly qualify under the eligibility criteria for autism, as long as they demonstrate certain "autistic-like" characteristics which adversely affect educational performance.
In California, "autistic-like behaviors" are defined as follows in Title 5, California Code of Regulations, section 3030(g):
A pupil exhibits any combination of the following autistic-like behaviors, to include but not limited to:
(1) An inability to use oral language for appropriate communication
(2) A history of extreme withdrawal or relating to people inappropriately, and continued impairment in social interaction from infancy through early childhood
(3) An obsession to maintain sameness
(4) Extreme preoccupation with objects and/or inappropriate use of objects
(5) Extreme resistance to controls
(6) Displays peculiar motoric mannerisms and motility patterns
(7) Self-stimulating, ritualistic behavior
Since California and the IDEA both require consideration of whether a student's autistic-like behaviors "adversely affect educational performance," this criteria can become a subject of contention in Individualized Education Program (IEP) teams. Generally, the term "adverse effect" implies a significant negative impact; that is, a negative impact that cannot be attributed to factors that would normally impact a student receiving general education services. The term "educational performance" generally refers to academic performance and/or inclusion and participation in educationally relevant academic or social activities.
For more information on autism spectrum disorders, click here.