Autism : an overview
Autism spectrum disorder includes conditions previously called autism, pervasive developmental disorder, and Asperger’s syndrome. The causes are not known.
Autism – Symptoms :
The severity of symptoms may vary from person to person , but all people affected with autism have some core symptoms in the areas of:
- Social interactions and relationships .Symptoms may include:
- Significant problems developing nonverbal communication skills, such as eye to eye gazing, facial expressions, and body posture.
- Failure to establish friendships with children the same age.
- Lack of interest in sharing enjoyment, interests, or achievements with other people.
- Lack of empathy. People with autism may have difficulty understanding another person’s feelings, such as pain or sorrow.
- Verbal and nonverbal communication.Symptoms may include:
- Delay in, or lack of, learning to talk. As many as 40% of people with autism never speak.
- Problems taking steps to start a conversation. Also, people with autism have difficulties continuing a conversation after it has begun.
- Stereotyped and repetitive use of language. People with autism often repeat over and over a phrase they have heard previously (echolalia).
- Difficulty understanding their listener’s perspective. For example, a person with autism may not understand that someone is using humor. They may interpret the communication word for word and fail to catch the implied meaning.
- Limited interests in activities or play.Symptoms may include:
- An unusual focus on pieces. Younger children with autism often focus on parts of toys, such as the wheels on a car, rather than playing with the entire toy.
- Preoccupation with certain topics. For example, older children and adults may be fascinated by video games, trading cards, or license plates.
- A need for sameness and routines. For example, a child with autism may always need to eat bread before salad and insist on driving the same route every day to school.
- Stereotyped behaviors. These may include body rocking and hand flapping.
- Symptoms during childhood
Symptoms of autism are usually noticed first by parents and other caregivers sometime during the child’s first 3 years. Although autism is present at birth (congenital), signs of the disorder can be difficult to identify or diagnose during infancy. Parents often become concerned when their toddler does not like to be held; does not seem interested in playing certain games, such as peekaboo; and does not begin to talk. Sometimes, a child with autism will start to talk at the same time as other children the same age, then lose his or her language skills. Parents also may be confused about their child’s hearing abilities. It often seems that a child with autism does not hear, yet at other times, he or she may appear to hear a distant background noise, such as the whistle of a train.
With early and intensive treatment, most children improve their ability to relate to others, communicate, and help themselves as they grow older. Contrary to popular myths about children with autism, very few are completely socially isolated or “live in a world of their own.”
Some quick pointers during childhood :
- By 12 months:
- not making eye contact
- absence of smile
- not upset on mothers going away
- not pointing towards the things/objects he or she wants
- not waving bye-bye/tata
- 12 to 15 months :
- not raising hands to be picked up/lifted
- not speaking mama/dada/papa
- not able to imitate actions like clap/hand extension
- not responding to name
- 15 to 18 months
- unable to play with simple toys/unable to follow pretend games
- unable to pick up new words
- unable to point towards body parts
- not picking up objects and bringing them back
- 18 to 24 months
- not using noun and verb in the sentence
- hands flapping repeatedly,walking on toes/spinning head etc.
- nil or limited facial expression
- 2 to 3 years
- repetitive banging of objects/spinning/lining up
- breaking up parts of objects and showing interest in parts of toys etc
- unable to follow instructions to imitate simple household work
- 3 to 5 years
- highly limited and out of the way unusual interest sometimes beyond years
- adamant and inflexible adherence and insistence of routines
- Symptoms during teen years
During the teen years, the patterns of behavior often change. Many teens gain skills but still lag behind in their ability to relate to and understand others. Puberty and emerging sexuality may be more difficult for teens who have autism than for others this age. Teens are at an increased risk for developing problems related to depression,anxiety, and epilepsy.
Symptoms in adulthood
Some adults with autism are able to work and live on their own. The degree to which an adult with autism can lead an independent life is related to intelligence and ability to communicate. At least 33% are able to achieve at least partial independence.
Some adults with autism need a lot of assistance, especially those with low intelligence who are unable to speak. Part- or full-time supervision can be provided by residential treatment programs. At the other end of the spectrum, adults with high-functioning autism are often successful in their professions and able to live independently, although they typically continue to have some difficulties relating to other people. These individuals usually have average to above-average intelligence.
Other symptoms
Many people with autism have symptoms similar to attention deficit hyperactivity disorder (ADHD). But these symptoms, especially problems with social relationships, are more severe for people with autism.
About 10% of people with autism have some form of savant skills—special limited gifts such as memorizing lists, calculating calendar dates, drawing, or musical ability.1
Many people with autism have unusual sensory perceptions. For example, they may describe a light touch as painful and deep pressure as providing a calming feeling. Others may not feel pain at all. Some people with autism have strong food likes and dislikes and unusual preoccupations.
Sleep problems occur in about 40% to 70% of people with autism.
Almost half of the children who have autism spectrum disorders tend to “wander off” from a caregiver, or “elope.” For many caregivers of these children, elopement is one of the most stressful behaviors they must learn to cope with. Studies show that behavioral assessment interventions, such as applied behavioral analysis, may reduce the number of times a child wanders off.
Other conditions
Autism is one of several types of autism spectrum disorders (ASDs), once known as pervasive developmental disorders. It is not unusual for autism to be confused with other ASDs, such as Asperger’s syndrome, or to have overlapping symptoms. A similar condition is called unspecified neurodevelopmental disorder. This condition occurs when children display similar behaviors but do not meet the criteria for autism. Also, other conditions with similar symptoms may also have similarities to or occur with autism.
Autism – Exams and Tests
The American Academy of Pediatrics (AAP) recommends screening children for autism during regularly scheduled well-child visits. This policy helps doctors identify signs of autism early in its course. Early diagnosis and treatment can help the child reach his or her full potential.
When a developmental delay is recognized in a child, further testing can help a doctor find out whether the problem is related to autism, another autism spectrum disorder, or a condition with similar symptoms, such as language delays or avoidant personality disorder. If your primary care provider does not have specific training or experience in developmental problems, he or she may refer your child to a specialist—such as a developmental pediatrician, a psychiatrist, a speech therapist, a psychologist, or a child psychiatrist—for the additional testing.
- Behavioral assessments.Various guidelines and questionnaires are used to help a doctor determine the specific type of developmental delay a child has. These include:
- Medical history. During the medical history interview, a doctor asks general questions about a child’s development, such as whether a child shows parents things by pointing to objects. Young children with autism often point to items they want, but do not point to show parents an item and then check to see if parents are looking at the item being pointed out.
- Diagnostic guidelines for autism. The American Association of Childhood and Adolescent Psychiatry (AACAP) has established guidelines for diagnosing autism.The criteria are designed so a doctor can assess a child’s behavior relating to core symptoms of autism.
- Clinical observations. A doctor may want to observe the developmentally delayed child in different situations. The parents may be asked to interpret whether certain behaviors are usual for the child in those circumstances.
- Developmental and intelligence tests. The AACAP also recommends that tests be given to evaluate whether a child’s developmental delays affect his or her ability to think and make decisions.
- Physical assessments and laboratory tests.Other tests may be used to determine whether a physical problem may be causing symptoms. These tests include:
- Physical exam, including head circumference, weight, and height measurements, to determine whether the child has a normal growth pattern.
- Hearing tests, to determine whether hearing problems may be causing developmental delays, especially those related to social skills and language use.
- Testing for lead poisoning, especially if a condition called pica(in which a person craves substances that are not food, such as dirt or flecks of old paint) is present. Children with developmental delays usually continue putting items in their mouth after this stage has passed in normally developing children. This practice can result in lead poisoning, which should be identified and treated as soon as possible.
Autism – Treatment Overview
Early diagnosis and treatment helps young children with autism develop to their full potential. The primary goal of treatment is to improve the overall ability of the child to function.
Symptoms and behaviors of autism can combine in many ways and vary in severity. Also, individual symptoms and behaviors often change over time. For these reasons, treatment strategies are tailored to individual needs and available family resources. But in general children with autism respond best to highly structured and specialized treatment. A program that addresses helping parents and improving communication, social, behavioral, adaptive, and learning aspects of a child’s life will be most successful.
The American Academy of Pediatrics (AAP) recommends the following strategies for helping a child to improve overall function and reach his or her potential:
- . Behavioral training and management uses positive reinforcement, self-help, and social skills training to improve behavior and communication. Many types of treatments have been developed, including Applied Behavioral Analysis (ABA), Treatment and Education of Autistic and Related Communication Handicapped Children (TEACCH), and sensory integration.
- Specialized therapies. These include speech, occupational, and physical therapy. These therapies are important components of managing autismand should all be included in various aspects of the child’s treatment program. Speech therapy can help a child with autism improve language and social skills to communicate more effectively. Occupational and physical therapy can help improve any deficiencies in coordination and motor skills. Occupational therapy may also help a child with autism to learn to process information from the senses (sight, sound, hearing, touch, and smell) in more manageable ways.
- Medicines. Medicines are most commonly used to treat related conditions and problem behaviors, including depression, anxiety, hyperactivity, and obsessive-compulsive behaviors.
- Community support and parent training: Talk to your doctor or contact an advocacy group for support and training.
Many people with autism have sleep problems. These are usually treated by staying on a routine, including a set bedtime and time to get up. Your doctor may try medicines as a last resort. Stories about alternative therapies, such as secretin and auditory integration training, have circulated in the media and other information sources. When you are thinking about any type of treatment, find out about the source of the information and about whether the studies are scientifically sound. Accounts of individual success are not sufficient evidence to support using a treatment. Look for large, controlled studies to validate claims.
This information is not intended to replace the advice of a doctor. Health wise disclaims any liability for the decisions you make based on this information.
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