Autism

What is autism?

Autism is a developmental disorder. Autistic children have problems with social skills and communication. They also have unusual, repetitive, or severely limited activities or interests. In every 1000 children, about 3 to 6 have autism. Boys are 4 times more likely to have autism than girls.

There is a wide range of symptoms and abilities. A child with autism can be very high-functioning or very severe. Autism is the most common disorder in a group of conditions called autistic spectrum disorders (ASD), also called Pervasive Developmental Disorders (PDD).

What is the cause?

In autism there is a problem in the brain. Brain scans show that the structure or shape of the brain is different in children with autism. The cause is still not known. There are many possible causes.

Autism and similar disorders sometimes run in families. There may be certain genes linked to autism. Researchers are also studying if a problem during pregnancy or environmental factors, such as exposure to chemicals, may be a cause.

Children with other brain problems and genetic syndromes such as congenital rubella syndrome, neurofibromatosis, and fragile X syndrome, are sometimes also autistic.

What are the symptoms?

Children with autism may appear normal for the first few months of life. Your child may then become more and more unresponsive to you. Many parents first notice a problem when their child does not develop language skills like other children of the same age. Your child may have a number of symptoms in the following areas listed below (depending on age). No child with autism will have all of the symptoms listed below and they may have some symptoms that are not on this list.

• Social skills: Your child may resist being cuddled and may scream to be put down when held. He may withdraw from you and fail to form relationships. You may notice that he avoids eye-to-eye contact and prefers to play alone. Your child may be indifferent to the feelings of others and to social norms.
• Language and imagination: An autistic child usually speaks later than other children of the same age. He often cannot understand or copy speech or gestures. The rate, pitch, tone, or rhythm of speech is abnormal. Your child will probably be unable to start a conversation or keep one going and respond inappropriately to sounds. His speech will be immature and unimaginative. He may just make up words or echo what someone says. Your child will probably be unable to engage in fantasy or imaginative play such as role playing and storytelling.
• Behavior, activities, and interests: Autistic children develop habit behavior and compulsive routines. Your child may resist even the slightest change and become very upset if his obsessive routine is altered or activities are disrupted. Your child may be obsessed with one topic or idea and may become attached to unusual objects. He may walk on tiptoe or flick or twiddle his fingers for long periods. He may even bang his head, rock, stare, or have sudden screaming spells. He may injure himself on purpose. Autistic children often have trouble learning manual tasks and are sometimes hyperactive.

How is it diagnosed?

Specific criteria must be met for a child to be diagnosed with autism. These criteria include specific information about how your child socializes, uses language, and behaves. All children with autism will meet these criteria. However, there may be a wide range in abilities because of age and how severe the symptoms are.

Your child's doctor will probably do lab tests to rule out other medical problems. Your child will also have a hearing test. Most children with autism are found to have normal health and no medical reason for the symptoms. Because it can be inherited, your health care provider may want to screen your other children for symptoms.

What is the treatment?

The treatment of autistic children focuses on educational and behavioral therapy. Even very young children can benefit from language therapy and behavior programs designed for autistic children and their families. Special teachers and classrooms can help older children improve their academic level and behavior. Contact your local school district before your child starts school. Children with autism usually require special class placement or special classroom changes. A team of professionals will help evaluate your child and put this plan together. You may also ask your health care provider to review the plan. Ask and find out all the services that may be available for your child.

Sometimes medicine can help. Mood- or behavior-altering drugs can improve behaviors that may cause self-injury or greatly interfere with school or social ability. These medicines must be prescribed by a doctor experienced with their use in children with autism. There is no medicine that will take away the symptoms of autism.

Parents of children with autism often become aware of new or alternative treatments through friends or the media. Your provider can help you decide if these treatments could help or harm your child.

What can we expect in the future?

The great variety in type and number of symptoms in autistic children makes this a difficult question to answer. Most experts agree that the more the child is around people and social situations, the more likely it is that he will be able to live independently as an adult.

Intelligence is another factor that can help predict how your child will do in the future. Most autistic children score in the retarded range on IQ tests. However, when these same children are given tests that measure visual-spatial and memory skills, many score much higher. These skills may help an autistic child be self-sufficient as an adult.

Temperament is also important in predicting whether a child will live independently as an adult. People with autism who are calm and cooperative will be more able to adapt to new rules and situations than those who are not.

It is likely that they will need special education. Some of these children can go to regular schools to some degree, especially in the higher grades. Successful independent living as an adult mostly depends on how well they develop their social and communication skills and what degree of retardation they have.

Where can my family get help and support?

When parents hear that their child has autism, they may feel fear, anger, guilt, and other difficult emotions. Many families find that having professional help with these feelings helps them to cope.

Children with autism can cause stress on the entire family. It can effect recreation and family finances. It can also strain your marriage and relationships between siblings.

You will probably want to explore community and government resources as well as local support groups. Support groups can help by sharing common concerns and solutions to problems with other families in the same situation. You can find these services through your health care provider, schools, therapy programs, and local and national support organizations.