Autism
(Pervasive Development Disorder)
Definition
Autism represents a spectrum of complex brain disorders resulting in social, behavioral, and language problems. People with autism have difficulty communicating and forming relationships. They may be preoccupied, engage in repetitive behaviors, and exhibit marked inflexibility. Autism occurs in about 1/1,000 children.
Causes
Autism is a neurodevelopmental disorder, meaning that problems in brain development cause autism. Scientists are searching for answers about what causes these development problems. Studies suggest:
- Autism seems to run in some families; several genes may be involved.
- Problems during pregnancy or delivery may interfere with normal brain development.
- Something in the environment that a child is exposed to may be a factor.
Risk Factors
These factors increase your chance of developing autism:
- Sex: male (Boys are four times more likely to have autism than girls.)
- Family history: Siblings of a child with autism have a 3%-7% chance of being autistic.
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A number of other conditions are associated with autism, although the relationship between them is not clear:
- Neurofibromatosis
- Tuberous sclerosis
- Fragile X syndrome
- Phenylketonuria (PKU)
- Möbius syndrome
- Epilepsy
- Herpes encephalitis
- Cytomegalovirus
- Problems during pregnancy or delivery
- Contracting rubella during pregnancy (a risk for the child)
The Conditions Above Primarily Affect the Central Nervous System
Symptoms
Autism first appears in children age three and younger. The severity of symptoms varies over a wide spectrum. Behaviors and abilities may differ from day to day; symptoms may decrease as the child grows older. Children with autism may exhibit a combination of abnormal behaviors.
Symptoms include:
- Avoiding social contact
- Loss of language
- Using words incorrectly, changing the meaning of a common word
- Gesturing frequently
- Avoiding eye contact
- Trouble with nonverbal communication
- Lack of interest in normal activities for that age
- Spending a lot of time alone
- Not playing imaginatively
- Not starting pretend games
- Not imitating others
- Sensitivity to sound, smell, taste, sights, and touch
- Responding to stimulation in an abnormal way
- Not reacting to smiles in the manner expected
- Hyperactivity
- Passiveness
- Tantrums
- Single-mindedness
- Aggression
- Hurting self, self-mutilation
- Repetitive movement, such as rocking or flapping a hand
- Resisting change
- Forming odd attachments to objects
- Sniffing or licking of toys
- Not understanding other peoples' feelings and needs
Some people with autism suffer from other disorders as well, including:
- Seizures
- Mental retardation
- Genetic disorders, such as fragile X syndrome
Some people with autism have unusual abilities. For instance, they may memorize things or be able to play a musical instrument without lessons. Children with autism may show varying signs of cognitive impairment, but have normal intelligence. According to the Autism Information Center, children with autism may be very good at putting puzzles together or solving problems, but instead have trouble in other areas like talking or making friends. Autism, a group of developmental disabilities caused by abnormality in the brain, is a highly individualized disorder.
Diagnosis
Doctors who specialize in autism will observe the child's behavior, social contacts, and communication abilities. They will assess mental and social development and ask parents about the child's behavior. Some doctors ask parents to bring in videotapes of the child at home.
Tests may include:
- Neuropsychological tests
- Questionnaires and observation schedules
- IQ tests
Medical tests to rule out other conditions that cause similar symptoms may include:
- Blood tests
- Urine tests
- DNA testing
- Electroencephalogram (EEG) —a test that records the brain's activity by measuring electrical currents through the brain
Treatment
There is no cure for autism. The severity of symptoms may decrease over the years, but the condition lasts for life. Children with autism and their families may benefit from early intervention. Children with autism respond well to a structured, predictable schedule. With help, many children with autism learn to cope with their disabilities. Most need assistance and support throughout their lives. Others are able to work and live independently when they grow up.
Interventions to help children with autism include:
Special Education
Programs designed to meet the child's special needs improve the odds of learning. Children with autism may have trouble with assignments, concentration, and anxiety. Teachers who understand the condition can build on the child's unique abilities. Programs should incorporate the child's interests. Some children do better in a small-group setting. Others do well in regular classrooms with special support. Vocational training can help prepare young adults for a job.
Therapy Services
Speech, physical, and occupational therapies may improve speech and activities. Children with autism need help developing social skills.
Family Services
Professional support helps a family cope with caring for a child with autism. Counselors help parents learn how to manage behaviors. Furthermore, caring for a child with autism can be exhausting and frustrating. Arranging occasional respite care is essential, so that the main caregiver can have some breaks.
Medication
Although there are no drugs to treat autism, several drugs are used to help manage symptoms. For example, drugs prescribed for anxiety and depression can help tone down obsessive and aggressive behaviors.
RESOURCES:
Autism Information Center
Centers for Disease Control and Prevention
http://www.cdc.gov/ncbddd/autism/index.htm/
Autism Society of America
http://www.autism-society.org/
CANADIAN RESOURCES:
Autism Canada Foundation
http://www.autismcanada.org/home.htm
Autism Society Canada
http://www.autismsocietycanada.ca/
References:
Autism information center. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/ncbddd/autism/index.htm .
Autism Society of America website. Available at: http://www.autism-society.org .
National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/ .
National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/ .
Rapin I. An 8-year-old boy with autism. JAMA . 2001;285:1749-1757.
Sykes NH, Lamb JA. Autism the quest for genes. Expert Rev Mol Med. 2007;9:1-15.
Last reviewed March 2009 by Rosalyn Carson-DeWitt, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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