Autism causes kids to experience the world differently from the way most other kids do.

It's
hard for kids with autism to talk with other people and express themselves using words. Kids
who have autism usually keep to themselves and many can't communicate without special
help.

They also may react to what's going on around them in unusual ways. Normal sounds may
really bother someone with autism so much so that the person covers his or her ears. Being
touched, even in a gentle way, may feel uncomfortable.

Kids with autism often can't make connections that other kids make easily. For example, when
someone smiles, you know the smiling person is happy or being friendly. But a kid with autism
may have trouble connecting that smile with the person's happy feelings.

A kid who has autism also has trouble linking words with their meanings. Imagine trying to
understand what your mom is saying if you didn't know what her words really mean. It is
doubly frustrating then if a kid can't come up with the right words to express his or her own
thoughts.

Autism causes kids to act in unusual ways. They might flap their hands, say certain words over
and over, have temper tantrums, or play only with one particular toy. Most kids with autism
don't like changes in routines. They like to stay on a schedule that is always the same. They
also may insist that their toys or other objects be arranged a certain way and get upset if
these items are moved or disturbed.

If someone has autism, his or her brain has trouble with an important job: making sense of
the world. Every day, your brain interprets the sights, sounds, smells, and other sensations
that you experience. If your brain couldn't help you understand these things, you would have
trouble functioning, talking, going to school, and doing other everyday stuff. Kids can be mildly
affected by autism, so that they only have a little trouble in life, or they can be very affected,
so that they need a lot of help.

What Causes Autism?

Autism affects about 1 in every 150 kids, but no one knows what causes it. Some scientists
think that some kids might be more likely to get autism because it or similar disorders run in
their families. Knowing the exact cause of autism is hard because the human brain is very
complicated.

The brain contains over 100 billion nerve cells called neurons (say: nur-ahns). Each neuron
may have hundreds or thousands of connections to other nerve cells in the brain and body.
The connections (which are made by releasing neurotransmitters) let different neurons in
different areas of the brain areas that help you see, feel, move, remember, and much more
work together.

For some reason, some of the cells and connections in the brain of a kid with autism
especially those that affect communication, emotions, and senses don't develop properly or
get damaged. Scientists are still trying to understand how and why this happens.

What Do Doctors Do?

Figuring out if a kid has autism can be difficult. A parent is usually the first to suspect that
something is wrong. Maybe the kid is old enough to speak but doesn't, doesn't seem
interested in people, or behaves in other unusual ways. But autism isn't the only problem that
can cause these kinds of symptoms. For example, kids who have hearing problems may have
trouble speaking, too.

Usually, lab tests and other medical tests are normal in kids with autism, but doctors may do
them to make sure the kid doesn't have other problems. These medical tests may include
blood and urine tests, a hearing exam, an EEG (a test to measure brain waves), and an MRI (a
picture that shows the structure of the brain). Intelligence (IQ) tests also may be done.

Often, specialists work together as a team to figure out what is wrong. The team might include
a pediatrician, a pediatric neurologist, a pediatric develop mentalist, a child psychiatrist, a
child psychologist, speech and language therapists, and others. The team members study how
the child plays, learns, communicates, and behaves. The team listens carefully to what parents
have noticed, too. Using the information they've gathered, doctors can decide whether a child
has autism or another problem.

How Is Autism Treated?

There is no cure for autism, but doctors, therapists, and special teachers can help kids with
autism overcome or adjust too many difficulties. The earlier a kid starts treatment for autism,
the better.

Different kids need different kinds of help, but learning how to communicate is always an
important first step. Spoken language can be hard for kids with autism to learn. Most
understand words better by seeing them, so therapists teach them how to communicate by
pointing or using pictures or sign language. That makes learning other things easier, and
eventually, many kids with autism learn to talk.

Therapists also help kids learn social skills, such as how to greet people, wait for a turn, and
follow directions. Some kids need special help with living skills (like brushing teeth or making
a bed). Others have trouble sitting still or controlling their tempers and need therapy to help
them control their behavior. Some kids take medications to help their moods and behavior, but
there's no medicine for autism.

Students with mild autism sometimes can go to regular school. But most kids with autism
need calmer, more orderly surroundings. They also need teachers trained to understand the
problems they have with communicating and learning. They may learn at home or in special
classes at public or private schools.

Living With Autism

Some kids with mild autism will grow up and be able to live on their own. Those with more
serious problems will always need some kind of help. But all kids with autism have brighter
futures when they have the support and understanding of doctors, teachers, caregivers,
parents, brothers, sisters, and friends

Autism

From Wikipedia, the free encyclopedia

Jump to: navigation, search

Autism
Classification & external
resources

ICD-10

F84.0

ICD-9

299.0

OMIM

209850

MedlinePlus 001526
eMedicine

med/3202
ped/180

Autism is classified by the World Health Organization (WHO) and American

Psychological Association as a developmental disability that results from a disorder of the
human central nervous system.[1] It is diagnosed using specific criteria for impairments to
social interaction, communication, interests, imagination and activities.[2] The causes,
symptoms, etiology, treatment, and other issues are controversial.
Autism manifests itself "before the age of three years" according to the WHO's
International Classification of Diseases (ICD-10).[3] Children with autism are marked by
delays in their "social interaction, language as used in social communication, or symbolic
or imaginative play" (Diagnostic and Statistical Manual of Mental Disorders).[4]
Autism, and the other four pervasive developmental disorders (PDD), are all considered
to be neurodevelopmental disorders. They are diagnosed on the basis of a triad, or group
of three behavioral impairments or dysfunctions: 1. impaired social interaction, 2.
impaired communication and 3. restricted and repetitive interests and activities.[5] These
three basic characteristics reflect Dr. Leo Kanner's first reports of autism emphasizing
"autistic aloneness" and "insistence on sameness."
From a physiological standpoint, autism is often less than obvious in that outward
appearance may not indicate a disorder. Diagnosis typically comes from a complete
patient history and physical and neurological evaluation.

Obsessively stacking or lining up cans and other objects at a very young age may be an
early indicator of autism.
The incidence of diagnosed autism has increased since the 1990s.[6] Reasons offered for
this phenomenon include better diagnosis, wider public awareness of the condition,
regional variations in diagnostic criteria, or simply an increase in the occurrence of ASD
(autism spectrum disorders). The United States Centers for Disease Control (CDC)
estimate the prevalence of autism spectrum disorders to be about one in every 150
children.[7][8] In 2005, the National Institute of Mental Health (NIMH) stated the "best
conservative estimate" as 1 in 1000.[9] In 2006, NIMH estimated that the incidence was 26 in every 1000[10]
There are numerous theories as to the specific causes of autism, but they have yet to be
fully supported by evidence (see section on "Causes" below). Proposed factors include
genetic influence, anatomical variations (e.g. head circumference), abnormal blood vessel
function, oxidative stress, and vaccinations. Their significance as well as implications for
treatment remain speculative.
Conversely, some autistic children and adults are opposed to attempts to cure autism.
These people see autism as part of who they are,[11][12][13] and in some cases they perceive
treatments and attempts of a cure to be unethical.[14]

[edit] History

Dr. Leo Kanner introduced the label early infantile autism in 1943.
The word "autism" was first used in the English language by Swiss psychiatrist Eugene
Bleuler in a 1912 issue of the American Journal of Insanity. It comes from the Greek
word for "self," (autos).[15] Autism was actually confused with schizophrenia
during the early stages of observation.[16] Bleuler used the term to describe the
schizophrenics' seeming difficulty in connecting with other people.[17]
However, the classification of autism as a separate disorder or disease did not occur until
1943 when psychiatrist Dr. Leo Kanner of the Johns Hopkins Hospital in Baltimore

reported on 11 child patients with striking behavioral similarities and introduced the label
"early infantile autism."[18] He suggested the term "autism" to describe the fact that the
children seemed to lack interest in other people. Kanner's first paper on the subject was
published in a now defunct journal called The Nervous Child,[19] and almost every
characteristic he originally described is still regarded as typical of the autistic spectrum of
disorders.[20]
At the same time, an Austrian scientist named Dr. Hans Asperger made similar
observations, although his name has since become attached to a different higherfunctioning form of autism known as Asperger syndrome. Widespread recognition of
Asperger's work was delayed by World War II in Germany, and by his seminal paper not
being translated into English for almost 50 years. The majority of his work was not
widely read until 1997.[21]
Autism and Asperger syndrome are today listed in the DSM-IV-TR as two of the five
pervasive developmental disorders (PDD), which also include Childhood disintegrative
disorder,[22][23] Rett syndrome[24] and Pervasive Developmental Disorder Not Otherwise
Specified (or atypical autism). Health care providers also refer to autism spectrum
disorders (ASD) which includes only three of those listed in PDD: Autistic disorder,
Asperger syndrome, Pervasive Developmental Disorder Not Otherwise Specified.[25] All
of these conditions are characterized by varying degrees of deficiencies in
communication skills and social interactions, along with restricted, repetitive, and
stereotyped patterns of behavior.

[edit] Characteristics
On the surface, individuals who have autism are physically indistinguishable from those
without. Some studies show that autistic children tend to have larger head
circumferences[26][27] but the significance in the disorder is unclear. Sometimes autism cooccurs with other disorders, and in those cases outward differences may be apparent.
Individuals diagnosed with autism can vary greatly in skills and behaviors, and their
response to sensory input shows marked differences in a number of ways from that of
other people. Certain stimulations, such as sounds, lights, and touch, will often affect
someone with autism differently than someone without, and the degree to which the
sensory system is affected can vary greatly from one individual to another.[28]

[edit] Key behaviors

Autistic children may display unusual behaviors or fail to display expected behaviors.
Normal behaviors may develop at the appropriate age and then disappear or, conversely,
are delayed and develop quite some time after normal occurrence.[citation needed] In assessing
developmental delays, different physicians may not always arrive at the same
conclusions. Much of this difference between diagnosis is due to the disputed criteria for
autism.[29] Deciding how a child should behave is also difficult because diagnostic tests
have to be objective, which is not a simple thing to accomplish.[citation needed] Because of this
practitioners and researchers in pediatrics, child psychology, behavior analysis, and child
development are always looking for early indicators of autism.
The diagnosis of autism must meet specific criteria but there are also many characteristics
that are idiosyncratic. Thus, Autism is not a "one size fits all" label. In other words the
spectrum disorder encompasses a very wide range of behaviors and symptoms.

Some behaviors cited by the National Institute of Child Health and Human Development
(listed below) may simply mean a normal delay in one or more areas of development,
while others are more typical of ASDsAutistic Spectrum Disorders.[30]

A young boy with autism, and the precise line of toys he made
The list below is not all-inclusive, and generally applies to children and not adults.
Furthermore, while some of these behaviors might be seen in a person with autism, others
may be absent.[31]

[edit] Noted Behaviors in Children

stares into open areas, doesn't focus on anything specific.
does not respond to his/her name.
cannot explain what he/she wants.
language skills are slow to develop or speech is delayed.
doesn't follow directions.
will fuss if didn't get what wanted.
at times, the child seems to be deaf.
doesn't point or wave "bye-bye."
doesn't understand the concept of pointing; will look at the hand pointing rather than
the object being pointed at.
used to say a few words or babble, but now he/she doesn't.
throws intense or violent tantrums.
has odd movement patterns.
likes to spin around in a circle.
likes being in a place well known.
hands on ears often.
is overly active, uncooperative, or resistant.
doesn't know how to play with toys.
doesn't smile when smiled at.
has poor eye contact.
gets "stuck" doing the same things over and over and can't move on to other things.
seems to prefer to play alone.
gets things for him/herself only.
is very independent for his/her age.
does things "early" compared to other children.
seems to be in his/her "own world."
seems to tune people out.
is not interested in other children.
dislikes playing pretend.
walks on his/her toes.
shows unusual attachments to toys, objects, or schedules (e.g., always holding a string
or having to put socks on before pants).

spends a lot of time stacking objects, lining things up or putting things in a certain
order.
unconcerned about - or completely oblivious to - dangers around him/her (e.g.,
standing in the middle of the street without worrying about getting hit by a car).

[edit] Social development

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Typically developing infants respond socially and will look at faces or orient towards
voices. In contrast, most autistic children show little interest in faces and must learn to
engage in social interaction. Even in the first few months of life, many autistic children
seem indifferent to other people, lacking the eye contact and interaction with others that
non-autistic children exhibit naturally.[citation needed] Some infants with autism may appear
very calm and may cry less often or fail to seek parental attention.[citation needed] Other
children may develop normally for the first two years of life, but then regress
unexpectedly and fail to pass developmental milestones without intervention.[32]
Autistic children often seem to prefer being alone and may passively accept such things
as hugs and cuddling without reciprocating, or resist attention altogether.[citation needed] Later,
they seldom seek comfort from others or respond to parents' displays of anger or affection
in a typical way.[citation needed] Research has suggested that, despite popular belief, many
autistic children have bonded with their parents - and anecdotal evidence certainly
supports this notion. However, this bond may be difficult for others to recognize because
an autistic child's particular ways of expressing this attachment may differ from the
patterns of expression used by their typical peers.[citation needed] Though social deficits are
common, autistic children may vary significantly in their levels of social attachment and
interaction.
According to Simon Baron-Cohen et al (1985),[33] many autistic children appear to lack a
"theory of mind". Theory of mind refers to representing epistemic mental states such as
knowing, believing, deceiving or imagining, and tying them together "into a coherent
understanding of how mental states and actions are related."[34] This is a behavior cited as
being exclusive to human beings above the age of five and possibly, to a lesser degree, to
other higher primates such as adult gorillas, chimpanzees and bonobos.[35] Typical 5-yearolds can usually develop insights into other people's knowledge, feelings, and intentions
based on social cues (e.g., gestures, vocal tone and facial expressions). An autistic
individual may lack these interpretation skills, leaving them unable to predict or
understand other people's actions or intentions.
Many children with autism experience social alienation during their school-age years. As
a response to this, or perhaps because their social surroundings simply do not "fit" them,
many report inventing imaginary friends, worlds, or scenarios.[36] Making friends in real
life and maintaining those friendships often proves to be difficult for those with autism.
Although not universal, it is common for autistics to have difficulty regulating their
behavior, resulting in crying, verbal outbursts, or self-injurious behaviors that seem
inappropriate or without cause. Those who have autism may benefit from consistent
routines and environments, and they may react negatively to changes in their

surroundings. It is not uncommon for these individuals to exhibit poorly modulated

behaviors, increased levels of self-stimulatory behavior, self-injury, or extensive
withdrawal in overwhelming situations.[citation needed] However, as an affected individual
matures and receives specific socialization education and training, skill may be attained
in the recognition of behavioral triggers and more appropriate means of coping will be
available for difficult social circumstances.[citation needed]

[edit] Sensory system

Indicators of autism include oversensitivity or under reactivity to touch, movement,
sights, or sounds; physical clumsiness or carelessness; poor body awareness; a tendency
to be easily distracted; impulsive physical or verbal behavior; an activity level that is
unusually high or low; not unwinding or calming oneself; difficulty learning new
movements; difficulty in making transitions from one situation to another; social and/or
emotional problems; delays in speech, language or motor skills; specific learning
difficulties/delays in academic achievement. However, it is important to remember that
while most people with autism have some degree of sensory integration difficulty, not
every person who has sensory problems is autistic.
Autistic individuals may sometimes also develop obsessions or routines around foods,
restricting what is eaten to certain colors, textures or types of food; alternatively they may
obsessively avoid certain foods with similar characteristics.[37]
One common example is autistic hearing. An autistic person may have trouble hearing
certain people while other people are perceived as speaking at a higher volume. Or the
autistic person may be unable to filter out sounds in certain situations, such as in a large
crowd of people. However, this is perhaps a part of autism that tends to vary widely from
person to person, so these examples may not apply to every autistic person. Note that
such auditory difficulties fall under auditory processing disorders, and like sensory
integration dysfunction, are not necessarily experienced by all people with autism or
indicative of a diagnosis of autism.[citation needed]

[edit] Autism and blindness

The characteristics of a person with both an Autism Spectrum Disorder (ASD) and a
severe visual impairment (VI) may vary from a person with just ASD or just VI.[38]
Historically, many behaviors of blind children were seen as "autistic-like" but were
attributed to their blindness rather than pursuing possibilities of autism.[39]
Developmental trajectories of children with ASD-VI are often very similar as those
followed by children with typical autism, but the child with ASD-VI will have
particularly unusual responses to sensory information. The person may be overly
sensitive to touch or sound, or be less responsive to pain. Typically, touch, smell, and
sound are affected the most dramatically.[40]

[edit] Communication difficulties

This section called "Communication difficulties" is missing citations and/or
footnotes.
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inline citations helps guard against copyright violations and factual inaccuracies. You may
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Some people with autism demonstrate advanced cognitive ability, but lack
communicative skills or are not inclined to interact with others socially. An example of
this is the noted autistic Temple Grandin, who holds a PhD and is a successful developer
of livestock handling technologies. She describes her inability to understand the social
communication of neurotypicals as leaving her feeling "like an anthropologist on Mars."
Grandin's case was described by neurologist Oliver Sacks in his 1995 book titled An
Anthropologist on Mars: Seven Paradoxical Tales. Another person with extreme autism is
author Tito Mukhopadhyay, one of whose books is The Mind Tree.[41]
Perhaps due to their difficulties communicating with other humans, some autistics have
gravitated toward working with animals. Temple Grandin describes her observations and
theories about animals, taken from her work with cattle.[42] Dawn Prince-Hughes,
diagnosed with Asperger's, describes her observations of gorillas in Songs of the Gorilla
Nation.[43]
Some infants who later show signs of autism coo and babble during the first few months
of life, but stop soon afterwards. Others may be delayed, developing language as late as
the teenage years[citation needed]. Still, inability to speak does not mean that people with
autism are unintelligent or unaware. Once given appropriate accommodations, some will
happily converse for hours, and can often be found in online chat rooms, discussion
boards or websites and even using communication devices at autism-community social
events such as Autreat.
Since non-autistic people are often unfamiliar with the autistic body language, and since
autistic natural language may not tend towards speech, autistic people often struggle to let
other people know what they need. As anybody might do in such a situation, they may
scream in frustration or resort to grabbing what they want. While waiting for non-autistic
people to learn to communicate with them, people with autism do whatever they can to
get through to them. Communication difficulties may contribute to autistic people
becoming socially anxious or depressed or prone to self-injurious behaviors. Recently,
with the awareness that those with autism can have more than one condition, a significant
percentage of people with autism are being diagnosed with co-morbid mood, anxiety and
compulsive disorders which may also contribute to behavioral and functioning
challenges.

[edit] Repetitive behaviors

Although people with autism usually appear physically normal, unusual repetitive
motions, known as self-stimulation or "stimming," may set them apart. These behaviors
might be extreme or subtle. Some children and older individuals spend a lot of time
repeatedly flapping their arms or wiggling their toes, others suddenly freeze in position.
Some spend hours arranging objects in a certain way rather than engaging in pretend play
as a typical child might, and becoming agitated if they are re-arranged or moved.
Repetitive behaviors can also extend into the spoken word; perseveration of a single word
or phrase can also become a part of the child's daily routine. Some may repeat words
from movies and watch certain bits over and over again.[44][45] Autistic children may
demand consistency in their environment. A slight change in the timing, format or route
of a routine or trip can be extremely disturbing to them.[citation needed]. Autistics sometimes
have persistent, intense preoccupations. For example, the child might be obsessed with
learning all about computers, television programs, lighthouses or virtually any other
topic.[46]

[edit] Effects in education

This section called "Effects in education" is missing citations and/or

footnotes.
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citations helps guard against copyright violations and factual inaccuracies. You may improve the
article or discuss this issue on the talk page. Help on using footnotes is available. This article has
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Children with autism are affected by their symptoms every day, which set them apart
from unaffected students. Because of problems with receptive language and theory of
mind, they can have difficulty understanding some classroom directions and instruction,
along with subtle vocal and facial cues of teachers. This inability to fully decipher the
world around them often makes education stressful. Teachers need to be aware of a
student's disorder, and ideally should have specific training in autism education, so that
they are able to help the student get the best out of his or her classroom experiences.
Some students learn more effectively with visual aids as they are better able to
understand material presented visually. Because of this, many teachers create visual
schedules for their autistic students. This allows students to concretely see what is going
on throughout the day, so they know what to prepare for and what activity they will be
doing next. Some autistic children have trouble going from one activity to the next, so
this visual schedule can help to reduce stress.
Research has shown that working in pairs may be beneficial to autistic children.[47]
Autistic students have problems not only with language and communication, but with
socialization as well. By facilitating peer interaction, teachers can help their students with
autism make friends, which in turn can help them cope with problems or understand the
world around them. This can help them to become more integrated into the mainstream
environment of the classroom.
A teacher's aide can also be useful to the student. The aide is able to give more elaborate
directions that the teacher may not have time to explain to the autistic child and can help
the child to stay at an equivalent level to the rest of the class through the special one-onone instruction. However, some argue that students with one-on-one aides may become
overly dependent on the help, thus leading to difficulty with independence later on.
There are many different techniques that teachers can use to assist their students. A
teacher needs to become familiar with the childs disorder to know what will work best
with that particular child. Every child is going to be different and teachers have to be able
to adjust with every one of them.
Students with autism spectrum disorders sometimes have high levels of anxiety and
stress, particularly in social environments like school. If a student exhibits aggressive or
explosive behavior, it is important for educational teams to recognize the impact of stress
and anxiety. Preparing students for new situations, such as through writing social stories,
can lower anxiety. Teaching social and emotional concepts using systematic teaching
approaches such as The Incredible 5-Point Scale or other cognitive behavioral strategies
can increase a student's ability to control excessive behavioral reactions.

[edit] DSM definition

Autism is defined in section 299.00 of the Diagnostic and Statistical Manual of Mental
Disorders (DSM-IV) as:

1. A total of six (or more) items from (1), (2) and (3), with at least two from (1), and one
each from (2) and (3):
1. qualitative impairment in social interaction, as manifested by at least two of the
following:
1. marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye
gaze, facial expression, body postures, and gestures to regulate social interaction
2. failure to develop peer relationships appropriate to developmental level
3.
a lack of spontaneous seeking to share enjoyment, interests, or achievements with
other people (e.g., by a lack of showing, bringing, or pointing out objects of interest)
4. lack of social or emotional reciprocity
2. qualitative impairments in communication as manifested by at least one of the
following:
1. delay in, or total lack of, the development of spoken language (not accompanied by
an attempt to compensate through alternative modes of communication such as
gesture or mime)
2. in individuals with adequate speech, marked impairment in the ability to initiate or
sustain a conversation with others
3. stereotyped and repetitive use of language or idiosyncratic language
4. lack of varied, spontaneous make-believe play or social imitative play appropriate to
developmental level
3. restricted repetitive and stereotyped patterns of behavior, interests, and activities, as
manifested by at least one of the following:
1. encompassing preoccupation with one or more stereotyped and restricted patterns of
interest that is abnormal either in intensity or focus
2. apparently inflexible adherence to specific, nonfunctional routines or rituals
3. stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or
twisting, or complex whole-body movements)
4. persistent preoccupation with parts of objects
2.
Delays or abnormal functioning in at least one of the following areas, with onset
prior to age 3 years:
1.
social interaction
2.
language as used in social
communication
3.
symbolic or imaginative play.
3.
The disturbance is not better accounted for by Rett's Disorder or Childhood
Disintegrative Disorder.
These are rules of thumb and may not necessarily apply to all diagnosed autistics.

[edit] Types of autism

Autism presents in a wide degree, from those who are nearly dysfunctional and
apparently mentally disabled to those whose symptoms are mild or remedied enough to
appear unexceptional ("normal") to others. Although not used or accepted by
professionals or within the literature, autistic individuals are often divided into those with
an IQ<80 referred to as having "low-functioning autism" (LFA), while those with IQ>80
are referred to as having "high-functioning autism" (HFA).[48] Low and high functioning
are more generally applied to how well an individual can accomplish activities of daily
living, rather than to IQ. The terms low and high functioning are controversial and not all
autistics accept these labels. Additionally, a recent review questioned the validity of IQ
testing of autistic people.[49][50]

This discrepancy can lead to confusion among service providers who equate IQ with
functioning and may refuse to serve high-IQ autistic people who are severely
compromised in their ability to perform daily living tasks, or may fail to recognize the
intellectual potential of many autistic people who are considered LFA. For example,
some professionals refuse to recognize autistics who can speak or write as being autistic
at all, because they still think of autism as a communication disorder so severe that no
speech or writing is possible.
As a consequence, many "high-functioning" autistic persons, and autistic people with a
relatively high IQ, are under diagnosed, thus making the claim that "autism implies
retardation" self-fulfilling. The number of people diagnosed with LFA is not rising quite
as sharply as HFA, indicating that at least part of the explanation for the apparent rise is
probably better diagnostics. Many also think that ASD's are being over diagnosed: (1)
because the growth in the number and complexity of symptoms associated with autism
has increased the chances professionals will erroneously diagnose autism and (2) because
the growth in services and therapies for autism has increased the number who falsely
qualify for those often free services and therapies.

[edit] Asperger's and Kanner's syndromes

Dr. Hans Asperger described a form of autism in the 1940s that later became known as
Asperger syndrome.
Main article:
Asperger syndrome
In the current Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), the
most significant difference between Autistic Disorder (also known as Kanner's syndrome)
and Asperger's syndrome is that a diagnosis of the former includes the observation of
"delays or abnormal functioning in at least one of the following areas, with onset prior to
age 3 years: (1) social interaction, (2) language as used in social communication, or (3)
symbolic or imaginative play",[51] while a diagnosis of Asperger's syndrome observes "no
clinically significant delay" in the latter two of these areas.[52]
While the DSM-IV does not include level of intellectual functioning in the diagnosis, the
fact that those with Asperger's syndrome tend to perform better than those with Kanner's
autism has produced a popular conception that Asperger's syndrome is synonymous with
"higher-functioning autism", or that it is a lesser disorder than autism. Similarly, there is a
popular conception that autistic individuals with a high level of intellectual functioning in
fact have Asperger's syndrome, or that both types are merely 'geeks' with a medical label.
The popular depiction of autism in the media has been of relatively severe cases (for
example, as seen in the films Rain Man and Mercury Rising), and in turn many close
friends and relatives of those who have been diagnosed in the autistic spectrum choose to
speak of their loved ones as having Asperger's syndrome rather than autism.
The extent to which someone with higher functioning autism or Asperger's syndrome
may excel is theoretically quite high. For example, Henry Cavendish, one of history's

foremost scientists, may have been autistic. George Wilson, a notable chemist and
physician, wrote a book about Cavendish entitled, "The Life of the Honourable Henry
Cavendish", published in 1851. From Wilson's detailed description it seems that while
Cavendish may have exhibited many classic signs of autism, he nevertheless had an
extraordinary mind.[53]

[edit] Autism as a spectrum disorder

For more details on
this topic, see
Autistic spectrum.
Another view of these disorders is that they are on a continuum known as autistic
spectrum disorders. Autism spectrum disorder is an increasingly popular term that refers
to a broad definition of autism including the classic form of the disorder as well as
closely related conditions such as PDD-NOS and Asperger's syndrome. Although the
classic form of autism can be easily distinguished from other forms of autism spectrum
disorder, the terms are often used interchangeably.
A related continuum, Sensory Integration Dysfunction, involves how well humans
integrate the information they receive from their senses. Autism, Asperger's syndrome,
and Sensory Integration Dysfunction are all closely related and overlap.
Some people believe that there might be two manifestations of classical autism,
regressive autism and early infantile autism. Early infantile autism is present at birth
while regressive autism begins before the age of 3 and often around 18 months. Although
this causes some controversy over when the neurological differences involved in autism
truly begin, some speculate that an environmental influence or toxin triggers the disorder.
This triggering could occur during gestation due to a toxin that enters the mother's body
and is transferred to the fetus. The triggering could also occur after birth during the
crucial early nervous system development of the child.
A paper published in 2006 concerning the behavioral, cognitive, and genetic bases of
autism argues that autism should perhaps not be seen as a single disorder, but rather as a
set of distinct symptoms (social difficulties, communicative difficulties and repetitive
behaviors) that have their own distinct causes.[54] An implication of this would be that a
search for a "cure" for autism is unlikely to succeed if it is not examined as separate,
albeit overlapping and commonly co-occurring, disorders.

[edit] Epidemiology
Further information:
Frequency of autism
and Autism
(incidence).
Gender differences
There is not a clear-cut ratio of incidence between males and females. Studies have found
much higher prevalence in males at the high-functioning end of the spectrum, while the
ratios appear to be closer to 1:1 at the low-functioning end.[55] In addition, a study
published in 2006 suggested that males over 40 are more likely than younger males to
parent a child with autism, and that the ratio of autism incidence in males and females is
closer to 1:1 with older fathers.[56][57]

Reported increase with time

The number of reported cases of autism increased dramatically over a decade. Statistics
in graph from the National Center for Health Statistics.
There was a worldwide increase in reported cases of autism over the decade to 2006.
There are several theories about the apparent sudden increase.
Many epidemiologists argue that the rise in the incidence of autism in the United States is
largely attributable to a broadening of the diagnostic concept, reclassifications, public
awareness, and the incentive to receive federally mandated services.[58] However, some
authors indicate that the existence of an as yet unidentified contributing environmental
risk factor cannot be ruled out.[59] On the other hand, a widely-cited pilot study conducted
in California by the UC Davis M.I.N.D. Institute (17 October 2002), reported that the
increase in autism in California is real, even after accounting for changes to diagnostic
criteria.[60]
The question of whether the rise in incidence is real or an artifact of improved diagnosis
and a broader concept of autism remains controversial. Dr. Chris Johnson, a professor of
pediatrics at the University of Texas Health Sciences Center at San Antonio and co-chair
of the American Academy of Pediatrics Autism Expert Panel, sums up the state of the
issue by saying, "There is a chance we're seeing a true rise, but right now I do not think
anybody can answer that question for sure." (Newsweek reference below).[61]
The answer to this question has significant ramifications on the direction of research,
since a real increase would focus more attention (and research funding) on the search for
environmental factors, while the alternative would focus more attention to genetics. On
the other hand, it is conceivable that certain environmental factors (such as chemicals,
infections, medicines, vaccines, diet and societal changes) may have a particular impact
on people with a specific genetic constitution.
One of the more popular theories is that there is a connection between "geekdom" and
autism. This is hinted, for instance, by a Wired Magazine article in 2001 entitled "The
Geek Syndrome", which is a point argued by many in the autism rights movement.[62]
This article, many professionals assert, is just one example of the media's application of
mental disease labels to what is actually variant normal behaviorthey argue that
shyness, lack of athletic ability or social skills, and intellectual interests, even when they
seem unusual to others, are not in themselves signs of autism or Asperger's syndrome.
Others assert that children who in the past would have simply been accepted as a little
different or even labeled 'gifted' are now being labeled with mental disease diagnoses.
See clinomorphism for further discussion of this issue.

Due to the recent publicity surrounding autism and autistic spectrum disorders, an
increasing number of adults are choosing to seek diagnoses of high-functioning autism or
Asperger's syndrome in light of symptoms they currently experience or experienced
during childhood. Since the cause of autism is thought to be at least partly genetic, a
proportion of these adults seek their own diagnosis specifically as follow-up to their
children's diagnoses. Because autism falls into the pervasive developmental disorder
category, an individual's symptoms must have been present before age seven in order to
make a strict differential diagnosis.

[edit] Treatment
Main article: Autism
therapies
Autism is sometimes considered to be untreatable, although this point has been disputed.
[63][64]
There is a broad array of autism therapies with various goals, e.g. improving health
and well-being, emotional problems, difficulties with communication and learning, and
sensory problems for people with autism. The efficacy of each approach varies greatly
from person to person. To date, Applied Behavior Analysis (ABA) is the sole approach
that has been scientifically verified as effective in the treatment of autism,[65] though other
treatments may be revealed as effective if they are similarly tested.

[edit] Causes
Main article: Causes
of autism
The causes and etiology of autism are areas of debate and controversy; there is currently
no consensus, and researchers are studying a wide range of possible genetic and
environmental causes. Since the way autism manifests is different for each person, there
are likely multiple "causes" that interact with each other in subtle and complex ways, and
thus give slightly differing outcomes in each individual. Two environmental theories
include the impact of vaccines on the immune system (of which a statistically significant
link has never been found despite many attempts; see the vaccine theory for a more
extensive treatment) and a more recent theory relating autism to high levels of television
viewing while young.[66] A correlation has also been found between autism and the
mercury emitted from coal power plants, though the implications of this correlation is
uncertain.[67] Mercury measurements of hair samples from autistic children's first haircuts
were significantly lower than a matched group of normal children, declining as measures
of severity increased.[68]
Research claims also link autism with abnormal blood vessel function, and oxidative
stress. This line of research may lead to new medical therapies.[69]

[edit] Physiology and neurology

Autism appears to involve a greater amount of the brain than previously thought.[70] A
study of 112 children (56 with autism and 56 without), published in the Journal of Child
Neuropsychology, found those with autism to have more problems with complex tasks,
such as tying their shoelaces or writing, which suggests that many areas of the brain are
involved.[71] Children with autism performed simple tasks as well as or better than those
without. In tests of visual and spatial skills, autistic children did well at finding small
objects in complex pictures (e.g., finding the character Waldo in "Where's Waldo"

pictures). However, they found it difficult to tell the difference between similar-looking
people. Children with autism tended to do well in spelling and grammar, but found it
much more difficult to understand complex speech, such as idioms or similes when the
meaning of the phrase is figurative. They would, for example, not understand that "He
kicked the bucket" meant someone had died, or were likely to actually hop if told to "hop
to it".
The inference from this research, according to researchers at the Pittsburgh School of
Medicine, is that "These findings show that you cannot compartmentalize autism. It's
much more complex.[71]
The research from this perspective has a number of implications:

Autism is more than likely a global disorder which affects how the brain processes
the information it receives, while complex information tends to make this more
readily apparent.
Neurological wiring in people with autism manifest abnormalities in the areas of
the brain that communicate with each other.
Observed abnormalities provide a reasonable explanation for why children with
autism have problems with complex tasks which require multiple areas of the brain
to work together; autistic people tend to do better in tasks that only require one
region of the brain.
The causes of autism are possibly more pervasive than previously believed; for
example, more areas of the brain are affected than just those involving social
interaction, communication, interests, and imagination.
Autism may not be primarily a disorder of social interaction; research must now
take into account non-social aspects.

A possible explanation for the characteristics of the syndrome is a variation in the way
the brain itself reacts to sensory input and how parts of the brain then handle the
information. An electroencephalographic (EEG) study of 36 adults (half of whom had
autism) at Washington University in St. Louis found that adults with autism show
differences in the manner in which neural activity is coordinated. The implication seems
to be that there is poor internal communication between different areas of the brain.
(Electroencephalographs, or EEGs, measure the activity of brain cells.)
The study indicated that there were abnormal patterns in the way the brain cells were
connected in the temporal lobe of the brain. (The temporal lobe deals with language.)
These abnormal patterns would seem to indicate inefficient and inconsistent
communication inside the brain of autistic people.[72]
Studies in neuropathology[73] indicate abnormalities in the amygdala, hippocampus,
septum, mamillary bodies, limbic system, and the cerebellum.

Autistic brains are slightly larger and heavier and a larger than normal head
circumference is commonly noted.
In the limbic system, there is an excess of cells and they are too small. The neurons
themselves appear to be underdeveloped. Dendritic trees which provide the basis for
connections between neurons are truncated (i.e. shortened).
In the cerebellum, purkinje cells are widely affected. The anatomic differences
correlate to the curtailment of development earlier than 30 weeks gestation. In other
words, the development of the cells appears to have stopped at some time before the
30th week in utero

An enlarged third ventricle of the brain appears to accompany autism in those who
are non-mentally retarded, but the reasons for this and its effects are still unknown.[74]

Research has not yet established exactly what is specific to autism and what may be seen
in other disorders however.[75]
Individuals with autism are also far more likely to develop epilepsy than would otherwise
be expected (estimated 10-30% incidence).[76]

[edit] Genetic component

Main article:
Heritability of
autism
Genetic influence comprises a significant aspect of research in the causes of autism.[77] A
large database showing theoretical links between autism and genetic loci summarises
research indicating that the genetic influence may extend to every human chromosome.[78]
It has been observed in one twin-study in Britain that there was about a 60% concordance
rate for autism in monozygotic (identical) twins,[79] while dizygotic (non-identical) twins
and other siblings comparatively exhibited about 4% concordance rates.[80] Some research
posits that the chances that an identical twin of an autistic person will also be autistic are
85-90%.[81] The increased probabilities of siblings having autism has been calculated at
about 35-fold more than normal.[82]
Accompanying impairments are also a common feature of autism. Some people with
autism also have gastrointestinal, immunological or neurological symptoms in addition to
behavioral impairments. These associated complexes have also lead to the search for
specific genetic connections and helped to focus on reasonable genetic implications.[82]
Since genes provide the information for processes and structure at the level of the cell
and its components during the growth and development of a human as well as
maintenance during life, gene mutations (altered versions) and deletions (complete
absence of genetic material) and possibly extra copies of genes would mean that the
causes of autism begin very early. If a mutated gene fails to perform properly, then cells,
proteins, enzymes and other crucial aspects of normal function may be significantly
altered and operate incorrectly. Deletions could mean the complete absence of a sequence
of events due to missing proteins or cell components for example. These genetic
alterations and deletions will simply bring about a changed structure or process which
effects a great many other needed structures and processes.
Another important aspect of research in genetic factors is environmental effects and the
incidence of autism. During the lifetime of a person, gene mutations and deletions may be
environmentally triggered or exacerbated. Conversely, it may also be that environment
will not be a factor and nothing will change the autism characteristics. For autism, the
answer to these possible explanations is still being researched and there is evidence that
both may be true simply because there is more than one way a person may develop
autism.
[edit] Deletions and Mutations
Deleted genes have been noted as a probable influence or cause in autism.[83] By locating
specific missing genetic material the significance may be that specific genetic sites for

autism controlling or causing autism (autism susceptibility alleles) may be located

precisely. Another significant aspect of this research is that these deletions of genetic
material indicate that autism may be established in some cases during meiosis (errorprone meiosis model) and this places the genesis of autism in some at the very beginning
of life.
One very important question in this line of research is whether or not gene deletions are a
cause or consequence of autism-susceptibility loci located elsewhere in the
chromosomes.
Gene mutations may mean a gene does not function at all or does not function in the
normal way. Since genes direct how the body grows and develops, mutations, like
deletions, will effect a person at the most basic levels.
Mutation and deletion effects have been delineated in numerous research publications.[84]
[85][86] [87][88]
.
Correlated characteristics include global developmental delay, mild to severe delay of
speech, social communication disorders and cognitive abilities, autistic like behaviour,
high tolerance of pain, and repetitive mannerisms (e.g. chewing or mouthing).[89]
Gene interaction may also complicate the causes leading to multiple genetic origins of
autism,[90][91] In a cascade like effect, when a gene loci is altered or omitted, others are
effected due to change in interaction between genes and/or their functions.
Though not present in all individuals with autism, these mutations and deletions hold
potential to point the way to more the genetic components of spectrum disorders.[92] The
research also advanced basic understanding in the genetic architecture of the genome of
autistic individuals and will help in focusing future research.
One practical aspect of this type of research may be the development of a test that would
confirm the autism diagnosis in children exhibiting symptoms and identify families who
carry genetic defects that could be inherited by their children.
[edit] Mirror neurons
A theory featuring mirror neurons[93][94] states that autism may involve a dysfunction of
specialized neurons in the brain that should activate when observing other people. In
typically-developing people, these mirror neurons are thought to perhaps play a major
part in social learning and general comprehension of the actions of others.

[edit] Sociology
Due to the complexity of autism, there are many facets of sociology that need to be
considered when discussing it, such as the culture which has evolved from autistic
persons connecting and communicating with one another. In addition, there are several
subgroups forming within the autistic community, sometimes in strong opposition to one
another.

[edit] Community and politics

Further information:
Autistic community

and Autism rights

movement.
Curing autism is a very highly controversial and politicized issue. What some call the
"autistic community" has splintered into several strands. Some seek a cure for autism sometimes dubbed by pro-cure. Others do not desire a "cure", because they point out that
autism is a way of life rather than a "disease", and as such resist it. They are sometimes
dubbed anti-cure. Many more may have views between these two. Recently, with
scientists learning more about autism and possibly coming closer to effective remedies,
some members of the "anti-cure" movement sent a letter to the United Nations
demanding to be treated as a minority group rather than a group with a mental disability
or disease.[95]
There are many resources available for autistic people. Because many autistics find it
easier to communicate online than in person, a large number of these resources are
online. In addition, successful autistic adults, using their own experience in developing
coping strategies and/or interacting with society, are often involved at the community
level with children with autism, using their own experience in developing coping
strategies and/or interacting with society.
The year 2002 was declared Autism Awareness Year in the United Kingdom (see Autistic
Community article).

[edit] Culture
Main article:
Autistic culture
With the recent increases in autism recognition and new approaches to educating and
socializing autistics, an autistic culture has begun to develop. Similar to deaf culture,
autistic culture is based on a more accepting belief that autism is a unique way of being
and not a disorder to be cured. There are some commonalities which are specific to
autism in general as a culture, not just "autistic culture".
It is a common misperception that autistic people do not marry; many do seek out close
relationships and marry. Often, they marry another autistic, although this is not always
the case. Autistic people are often attracted to other autistic people due to shared interests
or obsessions, but more often than not the attraction is due to simple compatibility with
personality types, the same as for non-autistics. Autistics who communicate have
explained that companionship is as important to autistics as it is to anyone else.
It is also a common misperception that autistic people live away from other people, such
as in a rural area rather than an urban area; many autistics do happily live in a suburb or
large city. However, a metropolitan area can provide more opportunities for cultural and
personal conflicts, requiring greater needs for adjustment.
In schools it is commonplace for autistics to be singled out by teachers and students as
"unruly," though an autistic student may not understand why his or her actions are
considered inappropriate, especially when the student has a logical explanation for his or
her behavior.
The interests of autistic people and so-called "geeks" or "nerds" can often overlap as
autistic people can sometimes become preoccupied with certain subjects, much like

anyone else. However, in practice many autistic people have difficulty with working in
groups, which impairs them even in the most 'geeky' of situations. The connection of
autism with so-called geek or nerd behavior has received attention in the popular press,
but is still controversial within these groups.[96]
Speculation arises over famous people and celebrities who are now suspected, but
unconfirmed, of having autism and Asperger's syndrome. They are rumored to have most
symptoms of autism or autistic-spectrum disorder. Biographers, personal physicians and
media journalists continually investigate these rumors, but some say that the claims are
actually libellous of their character as public figures, being singled out as "odd" or
"nerdy" people.[97]

[edit] Autistic adults

Communication and social problems often cause difficulties in many areas of the
autistic's life. A much smaller proportion of adult autistics marry or have children than the
general population. Even when they do marry, some argue, it is more likely to end in
divorce than the norm,[98] although further research should perhaps be made.
Nevertheless, as more social groups form, progressively more diagnosed adults are
forming relationships with others on the spectrum.
A small proportion of autistic adults, usually those with high-functioning autism or
Asperger's syndrome, are able to work successfully in mainstream jobs, although
frequently far below their actual level of skills and qualification. Some have managed to
gain self-employment.[99]
Others are employed in sheltered workshops under the supervision of managers trained in
working with persons with disabilities. A nurturing environment at home, at school, and
later in job training and at work, helps autistic people continue to learn and to develop
throughout their lives.
It is often said that the Internet, since it is almost devoid of the non-verbal cues that
autistics find so hard to interact with, has given some autistic individuals an environment
in which they can, and do, communicate and form online communities. The internet has
also provided the option of occupations such as, teleworking and independent consulting,
which, in general, do not require much human interaction offline.
Under the public law, in the United States, the public schools' responsibility for providing
services ends when the autistic person is 21 years of age. The autistic person and their
family are then faced with the challenge of finding living arrangements and employment
to match their particular needs, as well as the programs and facilities that can provide
support services to achieve these goals.
Many parents of autistic children also face financial difficulties as they must often pay for
essential support and therapeutic services. Furthermore, autism is often linked to poverty
because autistics who might qualify for financial assistance in one country are not
eligible in another, because some nations do not recognize autism as a disability.

[edit] Terminology
When referring to someone who is diagnosed with autism, the term "autistic" is often
used. Alternatively, many prefer to use the person-first terminology "person with autism"
or "person who experiences autism." However, it has been noted that members of the

autistic community generally prefer "autistic person" for reasons that are fairly
controversial.[100] This article uses both terminologies.

[edit] Autistic savants

Main article:
Autistic savant
The autistic savant phenomenon is sometimes seen in autistic people. Savant syndrome
occurs in about 10% of autistic people and in about 1% of non-autistic people.[101] The
term "autistic savant" is used to describe a person who is autistic and has extreme talent
in one or more areas of study (the incidence of multiple skills tend to occur more often in
autistic savants than non-autistic savants). Although there is a common association
between savants and autism (an association made especially popular by the 1988 film
Rain Man), most autistic people are not savants and savantism is not unique to autistic
people, though there does seem to be some relation.[102] Mental calculators and fast
computer programming skills are the most common form. A well known example is
Daniel Tammet, the subject of the documentary film The Brain Man[103] (Kim Peek, one
of the inspirations for Dustin Hoffman's character in the film Rain Man, is not autistic).
Bright Splinters of the Mind by Beate Hermelin is a book that explores this issue further.

[edit] Other pervasive developmental disorders

Autism and Asperger's syndrome are just two of the five pervasive developmental
disorders (PDDs). The three other pervasive developmental disorders are Rett syndrome,
Childhood disintegrative disorder, and Pervasive developmental disorder not otherwise
specified. Some of these are related to autism, while some of them are entirely separate
conditions.

1. What are you doing?

2. They come form New Zealand
3. We are French
4. Where do you live?
5. How old are you?
6. When do your birthday?
7. Is she working there?
8. When? On 8 pm? I am sorry, I cant
9. Are you happy this time?
10. Whose pencil is that? Is that yours?
11. Which one is important?
12. What color do you like?
13. He wants a new book now.
14. She do not like mango
15. I know what is happening here.
16. She is not interested to join the club
17. Are they married?
18. Are those pens hers?
19. We do not understand why it can be this way.
20. Look, who is talking?

21. Where will she go?

22. Where is she?
23. Will she be happy?
24. Will they arrive?
25. Is he going to be a president?
26. Are they working there now?
27. Is she a student?
28. When will she leave?
29. When she is going to leave?
30. Whom are you talking with now?

1. Q :
A:
2. Q :
A:
3. Q :
A:
4. Q :
A:
5. Q :
A:
6. Q :
A:

Do you like fishing?

Absolutely, I like fishing very much?
How old Are you?
You may guess You can look at my face and predict my age.
Is she your neighbor?
No, She is not my neighbor.
How is your boss?
My boss? Hes just alright. Why?
Is it your pen?
I dont know. Its not my pen.
Where are you going to this end year?
We are going nowhere this end-year but staying at home.

7. Q :
A:
8. Q :
A:
9. Q :
A:
10. Q :
A:

Whom does she live with?

She lives with her parents.
Do you think learning English is easy?
No doubt! English is easy you can also make it.
When do you always get up every morning?
I always get up before 5 oclock every morning.
How do she go to work?
I think she drives to work. I saw her once driving.

Dear Mr./Ms. Counselor,

I need your advice to about my marriage, should I get a divorce?
We are on the10th year together, and now I am very tired to continue our marriage.
He is an army officer. I do not know what the correlation between his job and his
behavior, but since the beginning of our marriage, he treated me as his soldier. He is
crude, perfectionist, controlling, dominating, offensive, and demanding. He order me
to do much of anything around the house perfectly as I am his servant, he control me
when I will visit my parents, I also control my own salary and never give his salary to
me meanwhile he purchase branded things for himself. He yells at me and my kids
when he is mad, calls me at least 10 times a day at work and is suspicious of
relationship I have with others.
The condition got worse when five years ago my husband has numerous illnesses
such as Hepatitis B infection, and the worst is cancer. His behavior is also worse. I
can not defend myself caused of his sickness. And I also have to be more patient to
take care of him.
I feel that I trapped in my marriage since I promise to my God, to myself, to our
parents that I will not divorce whatever our marriage condition.
I am confused what should I do. I am afraid to get divorce as I dont want to share
custody of my children. Also I take pity on my husband caused of his sickness. I have
no clue to go out of it.
Thank you for honest advice.

Yours faithfully,

M Evy Purwitasari

Dictionary
1. Ablaze
2. Acknowledged
3. Allegations
4. Appease
5. Audacious
6. Blunder
7. Bound
8. Breakdown
9. Censor
10. Columnist
11. Consternation
12. Conversely
13. Counter
14. Curbing
15. Desperately
16. Dilemma
17. Drew
18. Filed
19. Grave
20. Hefty
21. In Jeopardy
22. In line with
23. Irreconcilable
24. Jumping
25. Liberate
26. Lift
27. Loyalty
28. Mocking
29. Obedient
30. Offensive
31. Outrage
32. Painful
33. Pariah
34. Petition
35. Proposed
36. Provocative
37. Refuted
38. Reigning
39. Remedies
40. Resemble
41. Resumption
42. Retaliatory
43. Rubber stamped
44. Scampering
45. Shooting
46. Sorry
47. Speculate
48. Speculation
49. Stricken
50. Supposedly
51. Unfeasible
52. Vandalizing

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On Fire
Accepted
Accusations
Win Over
Daring
Mistake
United
Failure
Edit
Journalist
Dismay
On the other side of coin
Against
Restraining
Try Hard
Tight Spot
Attracted
Applied
Serious
Large
At Risk
Following
clashing
Leaping
Free
: Remove
Allegiance
Ridiculing
Dutiful
Insulting
Limited
Traumatic
Reclusive
Application
Applied
Confrontational
Denied
Ruling
Solutions
Look Like
Continuation
Penalizing
Authorized
Hurrying
Filming
Regrettable
Guess
Rumors
Hit
Reputedly
Unworkable
Wrecking

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Sesuatu yang hangat

Diketahui
Tuduhan
Memenangi
Berani
Kesalahan
Menjadi satu
Kegagalan
Diperbaiki
Jurnalis
Kecemasan
Sebaliknya
Melawan
Perintah
Berusaha keras
Dilema
Menarik
Mengisi
Keadaan serius
Besar
Keadaan berbahaya
Sesuai dengan/berikut ini
Tidak bisa diperbaiki
Loncat
Kebebasan
: Meninggalkan
Loyalitas
Cemoohan
Kepatuhan
Penghinaan
Pembatasan
Menyedihkan
Rendahan
Isian
Mengajukan
Provokatif
Penolakan
Memerintah
Jalan Keluar
Seperti
Kelanjutan
Hukuman
Yang berkuasa
Cepat-cepat
Membuat Film
Menyesal
Menebak/berspekulasi
Gosip
Pukulan
Seharusnya
Tidak Bekerja
Pengrusakan/sampah