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Autism
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Problem Overview
Autism is a complex brain disorder that causes a range of developmental problems, most notably in the ability to communicate and socialize with other people. The first signs of this disorder typically appear by age 3 and continue through life.
Although the exact prevalence of autism isn't known, it's estimated that one in 1,000 children has autism, including three to four times as many boys as girls. This figure seems to indicate a steep increase in the number of autism cases in the United States, but the increase may be the result of better diagnosis and changes in diagnostic criteria.
The cause of this disorder isn't clear, and there's no cure. But autism is a treatable condition. Children with autism, benefit from early individualized, intensive interventions.
Signs and symptoms
Autism is one of five conditions referred to as autism spectrum disorders or pervasive developmental disorders (PDD). These five conditions have different signs:
Autism - Children with autism exhibit a wide range of problems with varying degrees of severity. In general, they have problems in three crucial areas of development — social skills, language and behavior. The most severe cases of autism are marked by repetitive and unusual behaviors, sometimes including self-injurious and aggressive behaviors. Children with autism may require lifelong care and supervision, depending on the severity of their condition.
Asperger's syndrome - People with Asperger's syndrome usually have average intelligence and normal language development, but impaired social skills and awkward movements. Others often see them as odd or eccentric.
Childhood disintegrative disorder (CDD) - Children with this rare condition develop normally during their early years before losing many of their language and social skills after age 3. Children with CDD may also show other signs of autistic behavior.
Rett syndrome - This very rare genetic disorder affects only girls. It causes them to develop autism-like behaviors after seemingly normal early development.
Pervasive developmental disorder not otherwise specified (PDD-NOS) - This term applies to children with some signs of autism, but not enough to be diagnosed with the classic form of the disorder.
Two children with the same diagnosis may act quite differently and have strikingly different skills. If your child has any of these autism spectrum disorders, he or she may develop normally for the first few months — or years — of life, then become less responsive to other people, including you.
You may recognize the following signs in the areas of social skills, language and behavior:
Social skills- Fails to respond to his or her name
- Has poor eye contact
- Appears not to hear you at times
- Resists cuddling and holding — screams to be let down
- Appears unaware of others' feelings
- Seems to prefer playing alone — retreats into his or her "own world"
Language- Starts speaking later than other children
- Loses previous ability to say words or sentences
- Speaks with an abnormal tone or rhythm — may use a singsong voice or robot-like speech
- Can't start a conversation or keep one going
- May repeat words or phrases verbatim, but doesn't understand how to use them
Behavior- Performs repetitive movements, such as rocking or hand-twisting
- Develops specific routines or rituals
- Becomes disturbed at the slightest change in routines or rituals, such as if you move objects that your child has lined up
- Hyperactive
- May be fascinated by parts of an object, such as the spinning wheels of a toy car
- May be sensitive to sensory stimulation, such as light, sound and touch
Children with autism also show signs of poor joint attention — or shared attention — at a young age. Joint attention is an early-developing social skill in which two people — usually a young child and an adult — share the experience of looking at an object or observing an event. It includes the ability to point at objects and follow another person's gaze. This skill is crucial to later language and social development.
In some children with autism, problems improve as they mature. Some people, usually those with the least severe impairments, eventually may lead normal or near-normal lives. For other people, however, there's little improvement in language or social skills, and the adolescent years can mean a worsening of behavior problems.
The majority of children with autism also have mental retardation, which means they're slow to acquire new knowledge or skills. However, some children with autism have normal to high intelligence. These children learn quickly yet have trouble communicating, applying what they know in everyday life, and adjusting in social situations. An extremely small number of children with autism are "autistic savants," which means they have exceptional skills in a specific area, such as art or math.
Causes
Autism has no single, identifiable cause. The disorder seems to be caused by abnormalities in several regions of the brain. Neurons in these regions appear to be smaller than normal and have stunted connections to other areas of the brain, but researchers don't know why.
A number of genetic factors may be behind these abnormalities. Autism also seems to occur more frequently in children who have other medical conditions, including fragile X syndrome, tuberous sclerosis, untreated phenylketonuria and congenital rubella syndrome. Researchers are investigating a number of theories about the cause of autism.
In recent years, some news reports have raised concerns about a connection between autism and vaccines. These reports have targeted the measles-mumps-rubella vaccine (MMR), as well as vaccines containing thimerosal, a preservative that contains a very small amount of mercury. However, extensive reports from the American Academy of Pediatrics, the Institute of Medicine, and the Centers for Disease Control and Prevention conclude that there's no scientifically proven link between these vaccines and autism.
When to seek medical advice
Babies develop at their pace, and many don't stick to the exact timelines found in parenting books. But children with autism usually show some signs of delayed development by 18 months. If you suspect that your child may have autism, talk to your doctor.
Your doctor may recommend further evaluation if your child:
- Doesn't babble or coo by 12 months
- Doesn't gesture — such as point or wave — by 12 months
- Doesn't say single words by 16 months
- Doesn't say two-word phrases by 24 months
- Has any loss of language or social skills at any age
Screening and diagnosis
Your child's doctor will look for signs of developmental delays at regular checkups. If your child shows some signs of autism, you may be referred to a doctor who specializes in treating children with autism. This specialist, working with a team of professionals, can perform a formal evaluation for the disorder.
Because autism varies widely in severity and signs, making a diagnosis may be difficult. There isn't a medical test to pinpoint the disorder. Instead, a formal evaluation consists of observing your child and talking to you about how your child's social skills, language skills and behavior have changed over time. To help reach a diagnosis, your child may undergo a number of developmental tests covering speech, language and psychological issues.
Although the signs of autism often appear by 18 months, formal diagnosis usually isn't made until age 2 or 3, when there may be more obvious delays in language development. Early diagnosis is important, because early intervention — preferably before age 2 1/2 or 3 — seems to be associated with the best chance for significant improvement.
Treatment
There's no cure for autism, and there's no "one-size-fits-all" treatment. In fact, the range of home-based and school-based treatments and interventions for autism can be overwhelming. Your doctor can help identify resources in your area that may work for your child. Treatment options may include:
Behavioral and communication therapies - Many programs have been developed to address the range of social, language and behavioral difficulties associated with autism. Some programs focus on reducing problem behaviors and teaching new skills. Other programs focus on teaching children how to act in social situations or how to communicate better with other people.
Drug therapies - Some medications may improve specific behaviors, such as hyperactivity. Right now, there are no medications that seem to directly improve the core signs of autism. Your doctor likely won't prescribe medication for your child unless your child's behavior is potentially dangerous or it interferes with his or her ability to participate in educational programs.
Complementary approaches - Some parents choose to supplement educational and medical intervention with complementary therapies, such as art therapy, music therapy, special diets, vitamin and mineral supplements, and sensory integration — which focuses on reducing a child's hypersensitivity to touch or sound. Discuss these therapies with your child's doctor or psychologist before including them in an overall treatment plan.
Children with autism seem to respond well to highly structured, specialized education programs that are tailored to meet their needs. Successful programs often incorporate a team of specialists and a variety of interventions to improve social skills, communication and behavior.
Your child won't "outgrow" autism. But he or she can learn to function within the confines of his or her disability, especially if treatment begins early. Preschool children who receive intensive, individualized behavioral interventions show good progress.
Coping skills
Researchers are hunting for clues to the cause of autism, in the hopes that better understanding of the disorder will lead to better treatments. The future looks bright, but that doesn't necessarily help families who face the challenge of living with autism today.
Raising a child with autism can be physically exhausting and emotionally draining. These ideas may help:
Find a team of trusted professionals. You'll need to make important decisions about your child's education and treatment. Find a team of teachers and therapists who can help evaluate the options in your area and explain the federal regulations regarding children with disabilities. Make sure this team includes a case manager or service coordinator, who can help access financial services and government programs.
Take time for yourself and other family members. Caring for a child with autism can be a round-the-clock job that puts stress on your marriage and your whole family. To avoid burnout, take time out to relax, exercise or enjoy your favorite activities. Try to schedule one-on-one time with your other children and plan date nights with your spouse — even if it's just watching a movie together after the children go to bed.
Seek out other families of autistic children. Other families struggling with the challenges of autism can be a source of useful advice. Many communities have support groups for parents and siblings of children with autism.
Learn about the disorder. There are many myths and misconceptions about autism. Learning the truth can help you better understand your child and his or her attempts to communicate. With time, you'll likely be rewarded by seeing your child grow and learn and even show affection — in his or her own way.
Courtesy article provided by www.mayoclinic.com
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