AUTISM AUTISTIC DISORDER
Category: Child Health
Abstract : Autistic disorder (also called autism; more recently described as
"mindblindedness") is a neurological and developmental disorder that usually
appears during the first three years of life. A child with autism appears to
live in his/her own world, showing little interest in others, and a lack of
social awareness. The focus of an autistic child is a consistent routine and
includes an inter
Autistic disorder (also called autism; more recently described as
"mindblindedness") is a neurological and developmental disorder that usually
appears during the first three years of life. A child with autism appears to
live in his/her own world, showing little interest in others, and a lack of
social awareness. The focus of an autistic child is a consistent routine and
includes an interest in repeating odd and peculiar behaviors.
Autistic children
often have problems in communication, avoid eye contact, and show limited
attachment to others.
One or two people per 1,000 in the US have been
diagnosed with some form of autism. Autism can prevent a child from forming
relationships with others (in part, due to an inability to interpret facial
expressions or emotions). A child with autism may resist cuddling, play alone,
be resistant to change, and/or have delayed speech development. Persons with
autism tend to exhibit repeated body movements (such as flapping hands or
rocking) and have unusual attachments to objects. However, many persons with
autism excel consistently on certain mental tasks (i.e., counting, measuring,
art, music, memory).
Causes and symptoms
The cause of autism is not
known. Research suggests that autism is a genetic condition. It is believed that
several genes are involved in the development of autism. Research studies in
autism have found a variety of abnormalities in the brain structure and
chemicals in the brain, however, there have been no consistent findings. One
theory is the possibility that autistic disorder is a behavioral syndrome that
includes several distinct conditions. However, parenting behaviors are not the
cause or a contributing factor to the cause or causes of autism.
The
following are the most common symptoms of autism. However, each child may
experience symptoms differently. Symptoms may include:
- does not socially interact well with others, including parents
- shows a lack of interest in, or rejection of physical contact. Parents
describe autistic infants as "unaffectionate." Autistic infants and children are
not comforted by physical contact.
- avoids making eye contact with others, including parents
- fails to develop friends or interact with other children
- does not communicate well with others
- is delayed or does not develop language
- once language is developed, does not use language to communicate with
others
- has echolalia (repeats words or phrases repeatedly, like an
echo)
- demonstrates repetitive behaviors
- has repetitive motor movements (such as rocking and hand or finger
flapping)
- is preoccupied, usually with lights, moving objects, or parts of
objects
- does not like noise
- has rituals
- requires routines
The symptoms of autism may resemble other conditions or
medical problems. Always consult your child's physician for a diagnosis.
Who's affected
Approximately 15 out of every 10,000 children born are
diagnosed with autism. Autism is more prevalent in boys than girls, with four
times as many boys affected than girls.
Diagnosis For the first time, standard
guidelines have been developed to help identify autism in children before the
age of 24 months. In the past, diagnosis of autism was often not made until late
preschool-age or later. The new guidelines can help identify children with
autism early, which means earlier, more effective treatment for the disorder.
The standardized guidelines were developed with assistance
from 11 different organizations and were published in Neurology, a journal of
the American Academy of Neurology. According to the guidelines, all children
before the age of 24 months should routinely be screened for autism and other
developmental delays at their well-child check-ups. Children that show
developmental delays and other behavior disorders should be further tested for
autism. According to the guidelines, less than 30 percent of children undergo
age-appropriate screening at their well-child check-ups.
By screening children early for autism, those diagnosed with
the disorder can be treated immediately and aggressively.
Guidelines
The standardized guidelines developed for the diagnosis of
autism actually involve two levels of screening for autism. Level one screening,
which should be performed for all children coming to a physician for well-child
check-ups during their first two years of life, should check for the following
developmental deficits:
- no babbling, pointing, or gesturing by age 12 months
- no single words spoken by age 18 months
- no two-word spontaneous (non-echolalic, or not merely repeating the sounds
of others) expressions by age 24 months
- loss of any language or social skills at any age
The second level of screening should be performed if a child
is identified in the first level of screening as developmentally delayed. The
second level of screening is a more in-depth diagnosis and evaluation that can
differentiate autism from other developmental disorders. The second level of
screening may include more formal diagnostic procedures by clinicians skilled in
diagnosing autism, including medical history, neurological evaluation, genetic
testing, metabolic testing, electrophysiologic testing (i.e., CT scan, MRI, PET
scan), psychological testing, among others.
Genetic testing involves an evaluation by a medical
geneticist (a physician who has specialized training and certification in
clinical genetics), particularly as there are several genetic syndromes which
may cause autism, including Fragile-X, untreated phenylketonuria (PKU),
neurofibromatosis, tuberous sclerosis, Rett syndrome, as well as a variety of
chromosome abnormalities. A geneticist can determine whether the autism is
caused due to a genetic disorder, or has no known genetic cause. If a genetic
disorder is diagnosed, there may be other health problems involved. The chance
for autism to occur in a future pregnancy would depend on the syndrome found.
For example, PKU is an autosomal recessive disorder with a reoccurrence risk of
one in four, or 25 percent, chance, while tuberous sclerosis is an autosomal
dominant disorder, with a reoccurrence risk of 50 percent.
In cases where no genetic cause for the autism is identified,
there is still a slightly increased chance for a couple to have another child
with autism, with ranges averaging from 3 to 7 percent. The reason for this
increase over the general population is thought to be because autism may result
from several genes inherited from both parents acting in combination, in
addition to unknown environmental factors. There is no action/inaction known
that parents could have done, or did not do, to cause autism to occur in a
child.
Always consult your child's physician for a diagnosis and for
more information.
Treatment
Specialized behavioral and educational programs are designed
to treat autism. Behavioral therapy is used to teach social skills, motor skills
and cognitive (thinking) skills. Behavior modification is also useful in
reducing or eliminating maladaptive behaviors. Individualized treatment planning
for behavioral therapy is important as autistic children vary greatly in their
behavioral needs. Intensive behavior therapy during early childhood and
home-based approaches training and involving parents are considered to produce
the best results.
Special education programs that are highly structured focus
on developing social skills, speech, language, self-care, and job skills.
Medication is also helpful in treating some symptoms of autism in some children.
Mental health professionals provide parent counseling, social skills training,
and individual therapy. They also help families identify and participate in
treatment programs based on an individual child's treatment needs. Specific
treatment will be determined by your child's physician based on:
- your child's age, overall health, and medical history
- extent of the disorder
- your child's symptoms
- your child's tolerance for specific medications or therapies
- expectations for the course of the disorder
- your opinion or preference
Prevention
Preventive measures
to reduce the incidence or severity of autistic disorders are not known at this
time
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