Glossary

ABA (Applied Behavior Analysis) – ABA is the application of behavior analysis that modifies human behaviors, especially as part of a learning or treatment process. By functionally assessing the relationship between a targeted behavior and the environment, the methods of ABA can be used to change that behavior. ABA often consists of intensive behavioral interventions which research has demonstrated to be effective for children with ASD.

ADA (Americans with Disabilities Act) – A set of laws requiring government entities, government-supported endeavors, and most businesses to provide accommodations for people with disabilities.

ADI-R (Autism Diagnostic Interview, Revised) – A semi-structured and standardized interview developed by Lord, Rutter, and Le Couteur (1994) that is conducted with the parents or caregivers of those individuals suspected of having an Autism Spectrum Disorder (ASD). It is composed of 100 items or questions that assess the core aspects that might be compromised in ASD: language/communication; reciprocal social interactions; and restricted, repetitive, and stereotyped interests and behaviors. The sensitivity and specificity of the scale in order to differentiate autism from other developmental disorders is greater than 90% for subjects with mental ages of 18 months and older.

ADOS-2 (Autism Diagnostic Observation Schedule, 2nd edition) – A semi-structured, standardized assessment of communication, social interaction, play, and restricted and repetitive behaviors. It presents various activities that elicit behaviors directly related to a diagnosis of ASD. The ADOS-2 includes five modules, each requiring just 40 to 60 minutes to administer. The individual being evaluated is given only one module, selected on the basis of his or her expressive language level and chronological age. Training is required for proper administration; it is often considered the gold standard for both clinical and research evaluations.

Advocacy groups – Groups that advocate for improvement of some aspect of people’s lives. Advocacy groups for autism commonly advocate for autism awareness, autism research, or better treatment of people who have autism. Many autism advocacy groups provide some education about autism or links to autism-related services, such as legal, educational, and support resources. Well-known autism advocacy groups include Autism Society, Autism Speaks and the Autism Self-Advocacy Network.

Asperger Syndrome – A previous diagnostic category for some people with autism. People with Asperger syndrome were more likely to be verbal and less likely to be diagnosed at a young age than other people on the autism spectrum. This category has been controversial and diagnostically problematic. It has been eliminated from the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

ASD (Autism Spectrum Disorders) – Autism is an umbrella term for a wide spectrum of disorders referred to as Pervasive Developmental Disorders (PDD) or Autism Spectrum Disorders (ASD). The terms PDD and ASD are used interchangeably. They are a group of neurobiological disorders that affect a child’s ability to interact, communicate, relate, play, imagine, and learn. Signs and symptoms are seen in early childhood. The term spectrum is important to understanding autism because of the wide range of intensity, symptoms and behaviors, types of disorders, and considerable individual variation. Children with ASD may have a striking lack of interest and ability to interact, limited ability to communicate, and show repetitive behaviors and distress over changes, as in the case of many with classic autism, or Autistic Disorder. On the other end of the spectrum are children with a high-functioning form of autism who may have unusual social, language, and play skills, as in Asperger Syndrome. The autism spectrum consists of the following disorders (per DSM-IV definition): Autistic Disorder or Classic Autism, Rett’s Disorder or Rett Syndrome, Childhood Disintegrative Disorder, Asperger’s Disorder or Asperger Syndrome, and Pervasive Developmental Disorder – Not Otherwise Specified (PDD-NOS). The DSM-5 defines Autism Spectrum Disorders as “Persistent deficits in social communication and social interaction across multiple contexts along with restricted and repetitive patterns of behavior. These disorders start in the early developmental period and cause significant impairment of functioning.” The term Autism Spectrum Disorders, with levels of severity, officially replaces the DSM-IV category of Pervasive Developmental Disorders and encompasses autism, PDD-NOS and Asperger’s.

ATN (Autism Treatment Network) – The Autism Speaks Autism Treatment Network is a collaboration of medical centers dedicated to providing families with state-of-the-art, multidisciplinary care. The ATN was established to provide places for families to go for high-quality, coordinated medical care for children and adolescents with autism and associated conditions.

Behavioral therapy – Therapy that aims to change behavior through reinforcement. This therapy is primarily concerned with behavior, not thoughts. It is based on Skinnerian concepts of stimulus and reinforcement.

Biomedical treatment diet – Biomedical treatment typically refers to complementary alternative treatments, including specialized diets. The gluten-free, casein-free diet is the most popular of these for autism. Many or most of these treatments have not been well researched, and may lack scientific evidence of efficacy.

Case manager – A person, usually through an agency such as the board of developmental disabilities or healthcare organization, who assists families with identification and linkage to resources.

Challenging behavior – Refers to behavior that is difficult for caregivers to manage, including aggression,  noncompliance, hyperactivity, unsafe behavior such as wandering off, property destruction, to name a few.

Cranial-sacral therapy – An alternative therapy focused primarily on the concept of regulating the flow of cerebrospinal fluid by using therapeutic touch to manipulate the bones of the skull. This is one type of alternative medical therapy that some families seek. Its efficacy has not been evaluated in autism.

Cultural competency – An ability to work with people of another culture. People new to cultural competency often mistakenly assume that it requires encyclopedic knowledge of another culture. Instead, cultural competency refers to a set skills and attitudes and focuses largely on communication. Culturally competent practitioners find ways to work in another culture by respecting other cultural attitudes towards illness and treatment as valid, asking patients about their beliefs, expectations, and practices, and adapting their practice to respect these beliefs, expectations, and practices.

Culture of disabilityDisability culture is a controversial term that refers to the culture common to groups of people with disabilities. This culture does not see impairments as “special,” atypical, or remarkable. Instead, the culture of disability emphasizes the stigma and discrimination faced by people with disabilities and the “naturalness” of disability as part of the human experience. Disability may be seen as a life stage or a part of human variation, instead of as a defect.

Developmental milestonesA set of functional skills or age-specific tasks that most children can do at a certain age range.

DSM (Diagnostic and Statistical Manual of Mental Disorders) – A reference book published by the American Psychological Association that contains the diagnostic criteria for psychological and developmental disorders. Autism Spectrum Disorders diagnostic criteria are included in the DSM-V. The book is commonly used for both clinical and billing purposes. It has been updated repeatedly, often with controversy.

DTI (Discrete Trial Intervention) – A specific type of applied behavioral intervention.

Expressive language – Language used for expression, speaking, or typing. This phrase is commonly used to differentiate abilities to express oneself in language from receptive language or the ability to understand language.

Family- and patient-centered care – Patient-centered care supports active involvement of patients and their families in the design of new care models and in  decision making about individual options for treatment. The IOM (Institute of Medicine) defines patient-centered care as: “Providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions.”

Flapping – A type of “stimming” that involves flapping the hands or arms.

Functional Behavior Assessment (FBA) – FBA is used to identify the type and source of reinforcement for challenging behaviors as the basis for intervention efforts designed to decrease the occurrence of these behaviors.

“High-functioning” label – This label is controversial and should be avoided. It is typically used on individuals who are more verbal and more interactive. Some people will self-identify as high-functioning. More appropriate labeling includes “more involved” and “less involved” cases.

IDD (Intellectual and Developmental Disabilities) – The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) defines intellectual disability as a disorder with onset during the developmental period that includes both intellectual and adaptive functioning deficits in conceptual, social and practical domains. This replaces the older term mental retardation and typically refers to individuals with an IQ below 70 as well as adaptive skills deficits as measured by standardized instruments.

IDEA (Individuals with Disabilities Education Act) – Legislation that requires schools to provide education to all children in the least restrictive environment in order to receive federal funding. This legislation is the basis for most disability accommodations in schools.

IEP (Individualized Education Plan) – This is both a process and a written educational document for children ages 3 to 21 with a disability. The plan outlines specialized instruction and related services that the child will receive in schools.

IFSP (Individual Family Service Plan) – A written plan that is developed for an eligible infant or toddler up to age 3, who has a developmental delay or a disability. It outlines all of the services or interventions that the child and family will receive.

Learning disability – Any learning style that is incompatible with the way material is expected to be learned.

Manipulative and body-based therapies – A group of alternative therapies used to treat musculoskeletal pain and disability. It most commonly includes kneading and manipulation of muscles, joint mobilization and joint manipulation.

Mannerisms – Specific behaviors, usually repetitive, that may include hand flapping or unusual movements. Although hand flapping can be associated with autism, there are no mannerisms that absolutely indicate autism. Likewise, the absence of unusual movements does not rule out autism.

Medical home – An approach to providing comprehensive primary care that facilitates partnership between patients, physicians, and families. The goal of a medical home is to address and integrate high-quality health promotion, acute care and chronic condition management in a planned, coordinated, and family-centered manner.

Neurodiversity – A term referring to the full breadth of mental ways of being. This term is often used by people who believe that autism is one of many valid ways to be, and not a deficit to correct.

Neurotypical – A word used by some in the autism spectrum community to designate people without autism. People using this word often see autism as a difference instead of a deficit.

OMT (Osteopathic Manipulative Treatment) – The hands-on, manual medical system of treatment that utilizes the distinct osteopathic philosophy, structural diagnosis, and use of osteopathic manipulative techniques in the diagnosis and management of the patient by a Doctor of Osteopathic Medicine (DO). Research indicates that OMM is effective at reducing lower back pain and may be useful for treating certain other conditions. Its use in autism has not been researched.

OT (Occupational Therapist) – Occupational therapists work with infants, toddlers, children, and youth and their families in a variety of settings including schools, clinics, and homes. Occupational therapists assist children and their caregivers to build skills that enable them to participate in meaningful occupations. Occupational therapists also address the psychosocial needs of children and youth to enable them to participate in meaningful life events, including normal growth and development, feeding, play, social skills, and education.

PDD (Pervasive Developmental Disorders) – See ASD (Autism Spectrum Disorders).

PDD-NOS (Pervasive Developmental Disorders – Not Otherwise Specified) – See ASD (Autism Spectrum Disorders).

PECS (Picture Exchange Communication System) – This is an augmentative or alternative communication system used primarily by individuals with communicative and/or cognitive disabilities.

Perseveration – A tendency to continue with one task or idea beyond normal or reasonable expectations.

Person-first language – A type of language that emphasizes a person over any one attribute. This language is generally seen as more respectful than attribute-first language. This type of language is embraced beyond the disability community. Examples include “people with autism” instead of “autistic people,” “People with HIV” instead of “AIDS patients” and “people of color” instead of “minorities.”

Pica – The placement of nonfood items in the mouth, often for consumption. Pica is seen in some people on the autism spectrum. This behavior can place individuals at risk of gastric blockage and poisoning, especially lead poisoning.

Positive behavior support – A form of applied behavior analysis (ABA) that uses a system to understand what maintains an individual’s challenging behavior.

Positive reinforcement – In behavioral psychology, reinforcement is a strengthening of a specific behavior due to its association with a stimulus. Reinforcement is an important part of operant or instrumental conditioning. A reinforcer is the stimulus that strengthens the behavior, in contrast to punishment that weakens the behavior.

Primary reinforcer – A primary reinforcer, sometimes called an unconditioned reinforcer, is a stimulus that does not require pairing to function as a reinforcer and most likely has obtained this function through the evolution and its role in species’ survival.

PT (Physical Therapist) – Physical therapy or physiotherapy (sometimes abbreviated to PT or physio) is a healthcare profession primarily concerned with the remediation of impairments and disabilities and the promotion of mobility, functional ability, quality of life and movement potential.

Receptive language –Reception and comprehension of language. This phrase is used to differentiate the ability to understand what has been communicated from expressive language or the ability to communicate using language.

Rocking – A “stimming” behavior that involves rocking back and forth for an extended time.

Routine-oriented – Many individuals with autism have difficulty with transitions and change, preferring things be done in a particular set way or routine.

Selected hearing – An apparent lack of response to certain noises despite adequate hearing.

Sensory issues (hyper- and hyposensitivity) – Abnormal sensitivity to stimuli. Autistic individuals often report hypersensitivity — an increased reaction to a small amount of stimulus — to visual, auditory, or touch-based stimuli. Individuals may be hyposensitive to — or less aware of — these or other stimulus channels, such as proprioception.

Sensory Integration Disorder or Sensory Processing Disorder

Sensory Processing Disorder is a condition that existed previously to explain how the brain processes sensation and the resulting motor, behavior, emotion, and attention responses.  In 2007, a new nosology was proposed with distinct categorization based on the sensory processing challenges:

  • Sensory Modulation Disorder (SMD): results when a person has difficulty responding to sensory input with behavior that is graded relative to the degree, nature or intensity of the sensory information.  SMD has 3 subtypes: Sensory Overresponsivity (SOR), Sensory Underresponsivity (SUR), and Sensory Seeking/Craving (SS).  Many children with autism will present with these symptoms.
  • Sensory Discrimination Disorder (SDD): results when a person has difficulty interpreting qualities of sensory stimuli and are unable to perceive similarities and differences of those stimuli.
  • Sensory-Based Motor Disorder (SBMD): results when a person has poor postural or volitional movement as a result of sensory problems.  SBMD has 2 subtypes: Postural Disorder (PD), and Dyspraxia.
  1. J. Miller, M. E. Anzalone, S. J. Lane, et al. Concept Evolution in Sensory Integration: A Proposed Nosology for Diagnosis.  Am J Occup Ther. 2007;61(2):135–140.

Stereotypy – A type of behavior characterized by an abnormal or excessive repetition of an action carried out in the same way over time. This may include repetitive movements or posturing of the body or repetitive movements with objects.

Stimming – Self-stimulation, often through movement. Stimming refers to a variety of behaviors such as “flapping” and “rocking” that people on the autism spectrum may employ to soothe themselves or feel good.

Visual learning – A preference for learning through visual means, by seeing something in print, picture or video or by watching someone do something