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Autism is not a disease, but a developmental disorder of brain function. People with classical
autism show three types of symptoms: impaired social interaction, problems with verbal and
nonverbal communication, and unusual or severely limited activities and interests. Symptoms of
autism usually appear during the first three years of childhood and continue throughout life.
Isolated in worlds of their own, people with autism appear indifferent and remote and are unable to
form emotional bonds with others. Although people with this baffling brain disorder can display a
wide range of symptoms and disability, many are incapable of understanding other people's
thoughts, feelings, and needs. Often, language and intelligence fail to develop fully, making
communication and social relationships difficult. Many people with autism engage in repetitive
activities, like rocking or banging their heads, or rigidly following familiar patterns in their
everyday routines. Some are painfully sensitive to sound, touch, sight, or smell.
Patient Profile for Autism: Usually starts in first 3 years, typically 18-36 months.
Profile for Autism: Symptoms usually appear during the first three years of childhood and
continue through life. Autism strikes males about four times as often as females, and has been
found throughout the world in people of all racial and social backgrounds
Gender Profile for Autism: 4 times more common in males than females
CAUSES OF AUTISM
Autism has no single cause. Researchers have identified a number of genes that play a role in the
disorder. In some children, environmental factors also may play a role in development of the
disorder. Studies of people with autism have found abnormalities in several regions of the brain,
including the cerebellum, amygdala, hippocampus, septum, and mamillary bodies. Neurons in
these regions appear smaller than normal and have stunted nerve fibers, which may interfere with
nerve signaling. These abnormalities suggest that autism results from disruption of normal brain
development early in fetal development. Other studies suggest that people with autism have
abnormalities of serotonin or other signaling molecules in the brain. While these findings are
intriguing, they are preliminary and require further study. The early belief that parental practices
are responsible for autism has now been disproved.
There are physical bases of autism’s development including genetic, infections, and traumatic
factors. Viral infection including rubella during pregnancy, have been studied as possible causes of
autism.
SYMPTOMS OF AUTISM
The symptoms vary greatly but follow a general pattern. Not all symptoms are present in all
autistic children.
Autistic infants may act relatively normal during their first few months of life before becoming
less responsive to their parents and other stimuli. They may have difficulty with feeding or toilet
training; may not smile in recognition of their parents' faces, and may put up resistance to being
cuddled.
They do not play with other children or toys in the normal manner, rather they remain aloof and
prefer to play alone. Parents often mention that their child is so undemanding that he or she is ?too
good?.
Verbal and nonverbal communication skills, such as speech and facial expressions, develop
peculiarly. Symptoms range from mutism to prolonged use of echoing or stilted language. When
language is present, it is often concrete, unimaginative, and immature.
Another symptom of autism is an extreme resistance to change of any kind. Autistic children tend
to want to maintain established behavior patterns and a set environment. They develop rituals in
play, oppose change (such as moving furniture), and may become obsessed with one particular
topic.
Other behavioral abnormalities that may be present are: staring at hands or flapping arms and
hands, walking on tiptoe, rocking, tantrums, strange postures, unpredictable behavior and
hyperactivity.
An autistic child has poor judgment and is therefore always at risk for danger. For instance, an
autistic child may run into a busy street without any sign of fear.
DIAGNOSIS OF AUTISM (DETECTION)
Properly diagnosing autism is very important, since confusion may result from inappropriate and
ineffective treatment.
Deafness is often the first suspected diagnosis, since autistic children may not respond normally to
sounds and often do not speak.
Occasionally, an autistic child has an outstanding skill (splinter skills), such as an incredible rote
memory or musical ability. Such children may be referred to as "autistic savants", and occur in
almost 10% of cases of autism. These skills can be quite astonishing. One example is the ability to
play a piece of music almost perfectly after hearing it one time.
Many children with autism have a second psychiatric disorder or a neurologic disorder. Mental
retardation and seizure disorders are very common in autistic children and a thorough neurologic
and psychiatric evaluation is necessary in every case of autism to ensure all the childs medical
problems are being addressed.
Some children who are autistic show abnormal but nonspecific EEG findings that suggest brain
dysfunction, possibly resulting from trauma, disease, or a structural abnormality.
For a diagnosis of Autism, the following list of conditions have been mentioned in sources as
possible alternative diagnoses to consider during the diagnostic process for Autism:
Hearing loss
Language delay
Language disorder
Speech delay (see Speech symptoms)
Selective Mutism
Mental retardation
Phenylketonuria
Congenital rubella
Appropriate early intervention is important. Once the diagnosis has been made, the parents,
physicians and specialists should discuss what is best for the child. In most cases, parents are
encouraged to take care of the child at home.
Special education classes are available for autistic children. Structured, behaviorally-based
programs, geared to the patient's developmental level have shown some promise.
The list of treatments mentioned in various sources for Autism includes the following list. Always
seek professional medical advice about any treatment or change in treatment plans.
• Behavioral therapies
o Individualized Education Programs (IEPs)
o Applied Behavior Analysis (ABA)
o Positive Behavioral Interventions and Support (PBS)
o Parent training
• Medications - usually only for specific behavior such as self-injury or aggression
Parents should be educated in behavioral techniques so they can participate in all aspects of the
child's care and treatment. The more specialized instruction and behavior therapy the child
receives, the more likely it is that the condition will improve.
The outlook for each child depends on his or her intelligence and language ability. Some people
with autism become independent adults. A majority can be taught to live in community-based
homes, although they may require supervision throughout adulthood.
Unresponsiveness to people
Infants with this disorder avoid eye contact, have little or no facial expression, and are indifferent
to affection and physical contact. Parents may report that the child becomes rigid or flaccid when
held, cries when touched, and shows little or no interest in human contact.
As the infant grows older, his smiling response is delayed or absent. He doesn’t lift his arms in
anticipation of being picked up or form an attachment to a specific caregiver. Nor does he show the
anxiety about strangers that’s typical in the 8-month-old infant.
The autistic child fails to learn the usual socialization games (peek-a-boo, pat-a-cake, or bye-bye).
He’s likely to relate to others only to fill a physical need and then without eye contact or speech.
The end result may be mutual withdrawal between parents and child.
Bizarre behavior
The autistic child shows characteristically bizarre behavior patterns, such as screaming fits, rituals,
rhythmic rocking, arm flapping, crying without tears, and disturbed sleeping and eating patterns.
His behavior may be self-destructive (hand biting, eye gouging, hair pulling, or head banging) or
self-stimulating (playing with his own saliva, stool, and urine).
His bizarre responses to his environment include an extreme compulsion for sameness.
Abnormal response
to sensory stimuli
The autistic child may underreact or overreact to sensory stimuli; he may ignore objects —
dropping those he’s given or not looking at them — or he may become excessively absorbed in
them — continually watching the objects or the movement of his own fingers over the objects. He
commonly responds to stimuli by head banging, rocking, whirling, and hand flapping. He tends to
avoid using sight and hearing to interact with the environment.