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August 28, 2014 / 2 Elul, 5774
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The Autism Spectrum


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I am Ethan.
You may not understand me, or the way I feel today.
You may not understand my reasoning for things I do or say.

The reasons why I’m so loud and say things over and over again,
Why I run so differently or lose my homework every now and then.

I write my letters backwards and sometimes numbers too,
and when in a conversation, I’ll say “Guess what” 100 times to you.

Too much noise, light, or excitement can set me in a spin.
I don’t like the way these pants feel rubbing against my skin.

I try to be good, but sometimes it’s hard to control,
I have to do it, it’s an impulse, I don’t always do what I’m told.

Ketchup, Ranch and BBQ sauce on everything I eat,
sometimes I have days that I just can’t sit still in my seat.

I like to talk a lot even when it’s out of turn,
my mind plays tricks on me and interrupts what I’m trying to learn.

Sit up straight, wipe my face, and play ever so soft,
some of these things I have trouble with and I usually lose my train of thought.

I didn’t mean to spill the milk mom, or slam the door so hard,
everyone else is done with their homework, I don’t know where to start?

My heart’s as big as gold, my feelings get hurt too,
I get sad, cry and have bad days just like you.

My brain works differently than other girls and boys,
but one thing always holds true, I can give your life so much joy.

I get frustrated so easily and my hand won’t work that way,
I don’t understand why those other kids won’t let me come over and play.

Please don’t think of me any differently or love of me any less,
I’m just like other kids and trying to do my best.

I am very special in my own unique way, and every moment with me
you’ll never have a dull day.

The above poem was written by Kelly Graham, the mother of an autistic child named Ethan. In the poem, Kelly describes what she imagines Ethan must be feeling – but in reality she has no idea because Ethan cannot fully describe it to her.

Lately, people talk a lot about the “spectrum” rather than autism specifically. In order to elucidate what people mean when they say the spectrum, I have put together a short guide to the different categories that fall within the umbrella.

PDD-NOS stands for Pervasive Developmental Disorder – Not Otherwise Specified. Essentially, it is a diagnosis that means “on the autism spectrum, but not falling within any of the specific categories of autism.”

Within the DSM IV, a manual that practitioners use to diagnose neurological disorders, there are five disorders that fall under the category of Pervasive Development Disorder (PDD): autism, Asperger syndrome, Rett syndrome, fragile X syndrome, and PDD-NOS. A child would be diagnosed with PDD-NOS if he has symptoms of Pervasive Developmental Disorders, but not enough of any of the four specific disorders to receive a diagnosis.

If your child has PDD, but he does not have autism, Asperger syndrome, Rett syndrome, or fragile X syndrome, then he will be classified in the catch-all diagnosis of PDD-NOS.

Many of the disorders that fall into the category of PDD have overlapping symptoms. Below, I have explained some of the symptoms that are particular to each one of the four specified disorders in the DSM IV.

Autism:

Late talking (after the age of two), and other developmental delays by 30 months

Chooses to play alone, rather than interact with others

Repetitive movements such as rocking, spinning, or hand-flapping

Aspergers syndrome:

Above average verbal capabilities

Obsession with complex topics as patterns or music

Scripted, robotic, or repetitive speech

Rett syndrome:

Half or more of children with Rett syndrom have seizures

Normal verbal development until around 12-18 months, then a subsequent loss in the ability to communicate

Slowed growth, especially apparent in head size at six months of age

Fragile X:

In males, a decreased IQs; in females, variable IQs

Social anxiety when placed in situations in which they are forced to interact with others

Spoken language often characterized by stuttering and omitted sounds in a sentence

Right now, physicians do not agree when exactly a child should be diagnosed with PDD-NOS, autism, or Aspergers syndrome. This makes it possible for the same child to receive different diagnoses from different doctors even as he exhibits exactly the same symptoms.

Regardless of the diagnosis, research has shown that children with Pervasive Developmental Disorders have significantly better results when treated from an early age. In fact, studies have shown that children who began treatment at the age of two had fewer than half of the symptoms as compared to children who began treatment after the age of eight.

Treatments for PDD-NOS vary depending on the range and severity of the symptoms. However, some typical and effective treatments include:

Play therapy: Through play (a child’s natural mode of expression) children learn to cope with emotional issues. In this way, children can manipulate the world on a smaller scale, something that cannot be done on everyday basis.

Sensory integration therapy: Through a gradual introduction of aversive stimuli, children become used to situations that might have otherwise made them uncomfortable. (For example, some children with PDD might not tolerate the noise the scissors make during a haircut. A trained specialist would slowly integrate the scissors, the noise, and then the noise near the child’s head in order to make haircuts more bearable).

Social skills training: Coaching in non-verbal communication and everyday interactions can help children gain the essential skills to make friends and pay attention to teacher that do not come naturally because of PDD. This can greatly improve the child’s social experience for the rest of his life.

About the Author: An acclaimed educator and education consultant, Mrs. Rifka Schonfeld has served the Jewish community for close to thirty years. She founded and directs the widely acclaimed educational program, SOS, servicing all grade levels in secular as well as Hebrew studies. A kriah and reading specialist, she has given dynamic workshops and has set up reading labs in many schools. In addition, she offers evaluations G.E.D. preparation,, social skills training and shidduch coaching, focusing on building self-esteem and self-awareness. She can be reached at 718-382-5437 or at rifkaschonfeld@verizon.net. Visit her on the web at rifkaschonfeldsos.com.


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