Autism disorder

Wednesday, September 01, 2004

Autism Can be Cure with New Theraputical Approach

- Autism is a complex and variable developmental disorder diagnosed in some young children.

- It is typified by what is referred to as the triad of impairments affecting social skills, language development and behaviour.

- Autism is usually first recognised or diagnosed from 18 to 30 months of age.

- Diagnosis may be difficult, because the condition varies widely in terms of symptoms and severity.

- Treatment may include educational and behavioural therapy, drug therapy, speech and occupational therapy, and dietary intervention.

- Whether autistic children will be able to live independently as adults depends mainly on their development of social skills and/or intellectual ability.

- Boys are four times more likely to be autistic than girls.

Alternative names
Autistic spectrum disorder; infantile autism

What is autism?
Autism is a developmental disorder that causes a wide variety of abnormalities in social skills, language skills and behaviour in people. These may become apparent as delays or regression in development, unresponsiveness to other people, poor communication and unusual responses to environmental stimuli.
What causes autism?
The cause of autism is currently unknown. A widely accepted hypothesis is that there is no one cause but a genetic predisposition that gets triggered by environmental factors.
The role of several genetic and environmental factors that may contribute to the disorder is being researched. One such is the recently proposed link between the development of autism and the MMR vaccination.
Who gets autism and who is at risk?
The incident figures vary with a definite and steady increase. An explanation for this includes better professional diagnostic ability and that autism is not seen as a discreet entity but as a spectrum with variations in degree and symptom clusters. According to most studies, autism occurs in 10 to 20 people out of every 10 000, although these figures may be conservative. The disorder is commonly diagnosed or recognised between 18 and 30 months of age. Boys are about four times more likely to be affected than girls.
Autistic Spectrum disorder can coexist with other well-known disorders such as:

- Congenital rubella syndrome: an infectious disease acquired from the mother during pregnancy
- Down Syndrome
- Neurofibromatosis: a condition in which there are tumours of the nervous tissue
- Tuberous sclerosis: an inherited disease of the nervous system and skin
- Fragile X syndrome: an abnormality of the X-chromosome that can cause mental deficiency
- Phenylketonuria (PKU): an inherited disorder of metabolism

Most children with autism are healthy and have no apparent medical reason for their symptoms. At present there is no laboratory test that can detect the presence of autism. It is essentially a diagnosis made through clinical observation by trained professionals, unlike most of the above mentioned disorders.

Symptoms and signs of autism
If your child has autism, he or she may be experienced as normal for the first few months of life before symptoms may be noticed. These are usually recognised before the age of three and are typified by poor social skills, impaired language development, and repetitive or stereotypical behaviours.
Symptoms may include:

Social skills
- Seeming lack of attachment to parents or caretakers; little or no interest in human contact generally; prefers to play alone and remains withdrawn or has very abnormal social interaction; fails to form normal relationships.
- Fails to respond to own name.
- Avoids eye-to-eye contact.
- Resists being held and cuddled; may scream to be put down; may have rigid or flaccid muscle tone while being held.
- Appears unaware of or indifferent to other people's feelings.
- Lack of awareness of boundaries, may constantly want to be held or stroked.
- Lack of joint attention.
- Lack of enjoyment in baby games like peekabooh.

Use of language and imagination
- Skips babbling stage
- Starts speaking later than other children of the same age.
- Speech is immature and unimaginative.
- Loses previous ability to say words or sentences.
- Rate, pitch, tone or rhythm of speech is abnormal; may use a sing-song voice.
- Can't start a conversation or keep one going.
- Can't understand or copy speech or gestures.
- Responds inappropriately to sounds.
- Meaningless repetition of words or phrases; may echo what someone says.
- Unable to engage in fantasy or imaginative play such as role-playing and storytelling.

- Performs bizarre or repetitive movements or behavioural patterns, such as rocking, hand twisting, finger twiddling, head banging, arm flapping, walking on tip-toe, staring.
- Develops specific compulsive routines or rituals.
- Becomes distressed or enraged by minor changes in the environment or in routines or rituals.
- Engages in self-destructive behaviour, such as head-banging or biting.
- Hyperactive.
- Preoccupied with one topic; may become attached to or fascinated by unusual objects or parts of an object, such as the spinning wheels of a toy car.
- Over or under-reaction to sensory stimuli.
- Has screaming fits.

A child with autism will not have all of these symptoms, and may display some not listed here.

Two-thirds to three-quarters of autistic children also have severe learning difficulties.

However, some autistic children learn quickly but have difficulty communicating, applying their knowledge in everyday life and adjusting to social situations.

How is autism diagnosed?
Autistic Spectrum Disorder cannot be diagnosed through discreet medical tests. A diagnosis is made through clinical observation normally over a period of time and in different situations.
Diagnosis of autism may be difficult, because the condition varies widely in terms of its symptoms and degree of severity. Autism may be overlooked if your child's symptoms and signs are mild or if he or she has other diseases or conditions.

Many parents start becoming worried when their children don't develop language skills as expected. This is why many children with autism are diagnosed around the age of two, when parents start investigating their language development. Most of these children have previously had their hearing tested, as their parents think they must be deaf or otherwise they would be talking. One professional leads to another as it becomes apparent that the children are delayed in more than one area. It is often parents' concern about their child's development that gets them to look for explanations, rather than a GP recognizing the problem and making the recommendations.

Specific criteria must be met for a child to be diagnosed with autism. Children with autism may have different behaviours and abilities because of the severity of their symptoms.

If you think your child may have Autistic Spectrum Disorder, ask your GP to refer you to someone who specializes in the disorder and will be able to diagnose it correctly.

The specialist will make a diagnosis based on observing your child and discussing with you how social and language skills and behaviour have developed or changed over time. Your child may undergo a number of developmental tests related to speech, language and psychological issues. Clinical assessment tools may include the DSM IV, the Childhood Autism Rating Scale, and The Griffiths Scales of Mental Development and other developmental scales.

Children who appear normal in their first few years and then lose their language and social skills and begin to show autistic behaviour, may have childhood disintegrative disorder (CDD) or Rett’s Disorder. This differs from autism in that the child has at least two years of normal development before a marked regression in multiple areas of functioning.

Other metabolic and genetic syndromes may have characteristics similar to those of autism.

Family members of a child with autism may need professional counselling to help them deal with the difficult emotions they often feel on hearing the diagnosis such as as anxiety, guilt as anxiety, guilt, inadequacy or anger.

How is autism treated?
There is currently no cure for autism, but many therapies and interventions aimed at alleviating specific symptoms and signs have been developed.

The most studied therapies include educational-behavioural therapy and medications. The treatment's success may depend on the severity of symptoms. Medication tends to be used in South Africa to treat specific behaviours related to autism such as hyperactivity; it is not used to treat the autism per se.

Some children with very mild impairment may improve quite well with early and persistent intervention. Children with more severe symptoms and signs will probably not respond as well to treatment, but are still likely to function better with intensive behavioural therapy.

Educational-behavioural therapies
Educational-behavioural therapies involve highly structured, intensive training, designed to help the individual child develop social and language skills.

Treatment may be in an institution, a specialised school, day-care centre or at home. Therapists, parents and teachers work together to learn how best to encourage social adjustment and communication in the child. Because we learn most effectively when young, educational-behavioural therapy should begin as early as possible.

Positive reinforcement techniques, such as offering food or favourite toys for appropriate behaviour or language responses, can be used successfully in promoting skills development.
Mood-altering or behaviour-altering drugs can sometimes improve autistic behaviours that cause self-injury or serious interference with educational programmes and social interaction. These medications must be prescribed by a doctor experienced with their use in children with autism.
Most medications used to treat autism affect the levels of serotonin, a brain chemical responsible for mood.

Parents of children with autism or Pervasive Developmental Disorder (Not otherwise specified) often learn of new or alternative treatments through friends or the media. Your doctor can help you decide whether these treatments are viable.
Coping Strategies
Having a child with autism can place great stress on your family. You may find it helpful to start a support group for families with autistic children, where you can share common concerns, experiences and coping mechanisms.
What is the outcome of autism?
The great variety in type and number of symptoms makes prognosis difficult for individual autistic children. It is likely that children who meet the criteria for Autistic Spectrum Disorder will need special education. In some cases, symptoms and signs improve as the children mature, and it will be possible to integrate them to some degree, especially in the higher grades. In other children, however, there's little improvement in language or social skills, and behaviour problems worsen in adolescence.
Whether autistic children will be able to live independently as adults depends largely on their cognitive ability and how well they develop social skills.

Can autism be prevented?
Because the cause is not yet understood, autism cannot be prevented.
When to call the doctor
If your baby or toddler shows any of the behaviours or developmental problems listed under symptoms and signs, consult your doctor as to whether autism might be the cause. If you suspect autism, it's best to have your child evaluated by a doctor as early as possible.

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