AUTISM

In people with autism, the different brain areas fail in working together.

Having its onset in early childhood, usually before the age of 3, autism is a common brain disorder that affects one’s behavior and the ability to communicate and interact with others. An alarming number of children are affected by autism (1 in each 88).

Although symptoms accompanying the different forms of autism vary and each child affected by an ailment included in the autism spectrum disorders (ASD) has his individual pattern of behavior, speech and communication, manifestations often overlap and there are certain symptoms that can signal the presence of such an ailment in its early stages.

CAUSES AND RISK FACTORS

While there’s no clear answer on what causes autism, and the main triggers of these disorders aren’t fully known, it’s quite obvious that autism tends to run in families so scientists agree that genes play a very important role in the occurrence of the typical manifestations.

However, genetic problems aren’t the only culprits behind autism. Being a physical condition linked with biological and chemical abnormalities of the brain, this disorder seems to be triggered by environmental factors as well. Air pollutants, viral infections, medical problems such as the Tourette syndrome or epilepsy, advanced parental age, the child’s sex, premature or difficult birth and complications during pregnancy seem to be involved in the development of ASD. Diet, poisoning with metals like mercury, digestive tract changes and the body’s inability to properly use minerals and vitamins are all suspected but not proven possible causes of autism

SYMPTOMS OF AUTISM AND POTENTIAL COMPLICATIONS

Early diagnosis of autism is crucial for improving the child’s cognitive and social skills, as even if some people will still have difficulties with language and social integration as they mature, those with least severe problems and those who receive proper and timely treatment will eventually lead near-normal lives.

Children affected by autism usually have problems in three areas of development mentioned before: language, social skills and behavior. For the first area, the typical signs are delayed speech, abnormal speaking rhythm or tone, illogical repetition of words or the loss of the ability to say previously learned words.

Symptoms affecting social skills include the child’s failure to respond to his name, poor eye contact or the preference for individual activities that allow the child to retreat into his own world. Children suffering from autism appear not to hear the others at times, dislike holding and cuddling, are unaware of others’ feelings and rarely ask for help.

Last, symptoms affecting behavior include repetitive movements, constant agitation, specific routines or rituals, increased sensitivity to touch, sound or light, fascination for details of objects and failure in understanding the “big picture” as well as failure in engaging in imitative games. Odd food preferences and activities that cause self-harm can also be signs of autism.

DIAGNOSIS OF AUTISM

Given that there aren’t biological tests for autism, the diagnosis is usually based on specific criteria that evaluate the physical and nervous development of the child. Hearing evaluations, screening tests for autism, such as the M-CHAT test or the Autism Screening Questionnaire, a blood lead test, genetic tests meant to discover potential chromosome abnormalities as well as metabolic tests may be performed for diagnosing this condition.

Also, specific screening tools like the Gilliam Autism Rating Scale, the Autism Diagnostic Observation Schedule (ADOS), the Autism Diagnostic Interview – Revised (ADI-R) or the Childhood Autism Rating Scale (CARS) can be used for testing the child’s abilities and cognitive development. Given the complexity of this condition, in most cases the child will be tested by a team of specialists that will evaluate not only his language and communication skills but also his thinking abilities and patterns, motor skills, speech and school performance and behavior.

TREATMENT ALTERNATIVES FOR AUTISM SPECTRUM DISORDERS

Given the wide variety of symptoms and manifestations appearing in autism patients, finding the proper treatment scheme can be overwhelming but there are some treatment options that usually work in most patients.

The goal of these therapies is to maximize the child’s ability to function and develop as normally as possible. The most common form of therapies for autism patients are applied behavior analysis (ABA), occupational therapy, speech-language therapy and sensory integration therapy.

ABA is probably the most validated program shown to improve all areas of autism including cognitive areas. It is usually performed at home under the supervision of a behavioral psychologist and is far more effective when started at an earlier age.

Educational therapies that focus on improving communication, behavior and social skills, concentrate on well-structured and complex education programs. TEACCH programs (Treatment and Education of Autistic and Related Communication Handicapped Children) that use pictures and other visual cues for helping children organize and structure their activities and environments in order to work independently are also useful in managing this condition.

Family therapies focusing on teaching family members how to interact with their kids in order to minimize their problems and help them live normal lives, as well as support groups, can also help in improving the child’s social behavior, cognitive function and speaking and learning abilities. A social skills group led by psychologists may be helpful particularly for school age children. Diet changes, such as gluten-free and casein-free diets, seem to be effective in some children dealing with autism.

Medications meant to temporary relieve certain symptoms can be helpful in keeping the disruptive symptoms under control. Medicines help in reducing anxiety, aggression, hyperactivity, irritability and impulsiveness, mood swings, sleep difficulties, compulsions, attention problems and outbursts. Still, keep in mind that regardless of the class of drugs used for controlling these manifestations – SSRIs, mood stabilizers, stimulants and so on – no medicine can treat the underlying cause of this condition.

The following “red flags” may indicate that your child is at risk for an autism spectrum disorder. If your child exhibits any of the following, please don’t delay in asking your pediatrician or family doctor for an evaluation:

• No big smiles or other warm, joyful expressions by six months or thereafter
• No back-and-forth sharing of sounds, smiles or other facial expressions by nine months
• No babbling by 12 months
• No back-and-forth gestures such as pointing, showing, reaching or waving by 12 months
• No words by 16 months
• No meaningful, two-word phrases (not including imitating or repeating) by 24 months
• Any loss of speech, babbling or social skills at any age