Dr. Catherine Lord gives a glimpse into the development of individuals with autism

Dr. Catherine Lord speaking at Memorial Union on the MU campus

“Autism is more than the sum of its parts.” said Dr. Catherine Lord as she concluded her talk with faculty and staff at the MU Thompson Center for Autism and Neurodevelopmental Disorders on Monday, January 24, 2011.

As the Director of the University of Michigan Autism and Communication Disorders Center (UMACC) and an Urie Bronfenbrenner Collegiate Professor of Psychology, Psychiatry and Pediatrics, Dr. Lord knows a little something about autism. She is one of the developers of two standardized diagnostic instruments for autism spectrum disorders (ASD). The Autism Diagnostic Observation Schedule (ADOS), an observational scale, and the Autism Diagnostic Interview – Revised (ADI-R), a parent interview; both are considered the gold standard for research diagnoses.

Her afternoon talk focused on the development of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). DSM-5 is the standard classification for mental disorders used by mental health professionals in the United States and contains a listing of diagnostic criteria for every psychiatric disorder recognized by the U.S. health care system, including autism.

During her presentation, Lord said the hope of the DSM-5 Autism Work Group is to make the diagnosis of autism faster and more specific. Currently, the diagnostic process can take a full six to eight hours to complete, but the hope of Dr. Lord and her colleagues is to help refine the criteria used to diagnose autism, thus reducing the time needed for a diagnosis and reducing the variables in diagnosis that currently exist. One way the work group hopes to limit variability in diagnosis is by making autism a single spectrum rather than an umbrella that includes Asperger syndrome and Pervasive Developmental Disorder - Not Otherwise Specified (PDD-NOS). This change will give an autism diagnosis more scientific validity and will reduce variability in diagnosis.

The primary areas identified for a diagnosis of autism using the DSM-5 will be:

Clinically significant, persistent deficits in social communication and interactions, as manifest by ALL of the following:

• Marked deficits in nonverbal and verbal communication used for social interaction
• Lack of social reciprocity
• Failure to develop and maintain peer relationships appropriate to developmental level

Restricted, repetitive patterns of behavior, interests, and activities, as manifested by at least TWO of the following:

• Stereotyped motor or verbal behaviors or unusual sensory behaviors
• Excessive adherence to routines and ritualized patterns of behavior
• Restricted, fixated interests

Following her afternoon presentation at the Thompson Center, Dr. Lord gave a public lecture titled Longitudinal Studies of Autism Spectrum Disorder at Memorial Student Union on the University of Missouri Columbia campus.

Dr. Lord speaks with an audience member during her evening talk.

Around 100 people attended the lecture where Dr. Lord shared information about a study of children with autism who were followed and evaluated from ages two into their teenage years to examine changes in behavior and adaptive skills over time.

Video footage of children with autism was shown, documenting their receptive and expressive language skills and social interactions as well as their restricted or repetitive patterns of behavior and/or interests and activities at two, nine and into the teen years.

Through the video and accompanying research data, Dr. Lord showed that a diagnosis of autism given at an early age usually remains stable throughout the child’s development and that, with intervention and treatment, most individuals in the study showed improved Verbal I.Q.’s over time and became better at social interaction.

As part of her research, Dr. Lord asked the parents of the children involved in the study what advice they would give to parents of newly diagnosed children. The same parents were asked this question when their child was 5-years-old, 9-years-old and 14-years-old. The responses were very telling.

At the five-year mark, parents said, “ Don’t forget your other children.” And, “Things do get better.”

At the nine-year mark, they said, “Don’t give up too much information too soon.”; “Don’t stress the negative” and “Present all options.”

The final comments received at the fourteen-year mark were, “ Give more information about children with less positive progress (more planning for those that need more care as adults).” and, “Present all options.”

During both presentations Dr. Lord offered opportunities for questions and provided evidence supporting the idea that individuals with autism can and do progress as they age.