Autism is a term used for a number of developmental disabilities called Autism Spectrum Disorder (ASD). It is a neurobiological disorder that affects how the person perceives and interprets their world, particularly the social environment. Experts believe that Autism presents itself during the first three years of a person's life. Being a wide- spectrum disorder means that no two people with autism will have exactly the same symptoms. As well as experiencing varying combinations of symptoms, some people will have mild symptoms while others will have severe ones.
SYMPTOMS OF AUTISM
Below is a list of the most commonly found characteristics identified among people with autism.
The way in which a person with an ASD interacts with another individual is quite different compared to how the rest of the population behaves. If the symptoms are not severe, the person with ASD may seem socially clumsy, sometimes offensive in his/her comments, or out of synch with everyone else. If the symptoms are more severe, the person may seem not to be interested in other people at all.
It is common for relatives, friends and people who interact with someone with an ASD to comment that the ASD sufferer makes very little eye contact. However, as health care professionals, teachers and others are improving their ability to detect signs of autism at an earlier age than before, eye contact among people with autism is improving.
In many cases, if the symptoms are not severe, the person can be taught that eye contact is important for most people and he/she will remember to look people in the eye. A person with autism may often miss the cues we give each other when we want to catch somebody's attention. The person with ASD might not know that somebody is trying to talk to them. They may also be very interested in talking to a particular person or group of people, but does not have the same skills as others to become fully involved. To put it more simply, they lack the necessary playing and talking skills.
A person with autism will find it much harder to understand the feelings of other people. His/her ability to instinctively empathize with others is much weaker than other people's. However, if they are frequently reminded of this, the ability to take other people's feelings into account improves tremendously.
In some cases - as a result of frequent practice - empathy does improve, and some of it becomes natural rather than intellectual. Even so, empathy never comes as naturally for a person with autism as it does to others. Having a conversation with a person with autism may feel very much like a one-way trip. The person with ASD might give the impression that he is talking at people, rather than with or to them. He may love a theme, and talk about it a lot. However, there will be much less exchanging of ideas, thoughts, and feelings than there might be in a conversation with a person who does not have autism.
Almost everybody on this planet prefers to talk about himself/herself more than other people; it is human nature. The person with autism will usually do so even more.
A number of children with an ASD do not like cuddling or being touched like other children do. It is wrong to say that all children with autism are like that. Many will hug a relative - usually the mother, father, grandmother, grandfather, teacher, and or sibling(s) - and enjoy it greatly. Often it is a question of practice and anticipating that physical contact is going to happen.
For example, if a child suddenly tickles another child's feet, he will most likely giggle and become excited and happy. If that child were to tickle the feet of a child with autism, without that child anticipating the contact, the result might be completely different.A person with autism usually finds sudden loud noises unpleasant and quite shocking. The same can happen with some smells and sudden changes in the intensity of lighting and ambient temperature. Many believe it is not so much the actual noise, smell or light, but rather the surprise, and not being able to prepare for it - similar to the response to surprising physical contact.
If the person with autism knows something is going to happen, he can cope with it much better. Even knowing that something 'might' happen, and being reminded of it, helps a lot.
The higher the severity of the autism, the more affected are a person's speaking skills. Many children with an ASD do not speak at all. People with autism will often repeat words or phrases they hear - an event called echolalia. The speech of a person with ASD may sound much more formal and woody, compared to other people's speech.
Teenagers with Asperger's Syndrome can sometimes sound like young professors. Their intonation may sound flat.
A person with autism likes predictability. Routine is his/her best friend. Going through the motions again and again is very much part of his/her life. To others, these repetitive behaviors may seem like bizarre rites. The repetitive behavior could be a simple hop-skip-jump from one end of the room to the other, repeated again and again for one, five, or ten minutes - or even longer. Another
could be drawing the same picture again and again, page after page. People without autism are much more adaptable to changes in procedure. A child without autism may be quite happy to first have a bath, then brush his teeth, and then put on his pajamas before going to bed - even though he usually brushes his teeth first. For a child with autism this change, bath first and then teeth, could completely put him/her out, and they may become very upset. Some people believe that helping a child with autism learn how to cope better with change is a good thing, however, forcing them to accept change like others do could adversely affect their quality of life.
Physical tics and stimming
It is not uncommon for people with autism to have tics. These are usually physical movements that can be jerky. Some tics can be quite complicated and can go on for a very long time. A number of people with autism are able to control when they happen, others are not. People with ASD who do have tics often say that they have to be expressed, otherwise the urge does not stop. For many, going through the tics is enjoyable, and they have a preferred spot where they do them - usually somewhere private and spacious.
When parents first see these tics, especially the convoluted ones, they may experience shock and worry.
How is autism diagnosed?
ASD varies widely in severity and symptoms and may go unrecognized, especially in mildly affected children or when it is masked by more debilitating handicaps. Very early indicators that require evaluation by an expert include:
- no babbling or pointing by age 1
- no single words by 16 months or two-word phrases by age 2
- no response to name
- loss of language or social skills
- poor eye contact
- excessive lining up of toys or objects
- no smiling or social responsiveness.
- Later indicators include:
- impaired ability to make friends with peers
- impaired ability to initiate or sustain a conversation with others
- absence or impairment of imaginative and social play
- stereotyped, repetitive, or unusual use of language
- restricted patterns of interest that are abnormal in intensity or focus
- preoccupation with certain objects or subjects
- inflexible adherence to specific routines or rituals.
Health care providers will often use a questionnaire or other screening instrument to gather information about a child’s development and behavior. Some screening instruments rely solely on parent observations, while others rely on a combination of parent and doctor observations. If screening instruments indicate the possibility of an ASD, a more comprehensive evaluation is usually indicated.
A comprehensive evaluation requires a multidisciplinary team, including a psychologist, neurologist, psychiatrist,
speech therapist, occupational therapist and other professionals who diagnose children with ASDs. The team members will conduct a thorough neurological assessment and in-depth cognitive and language testing. Because hearing problems can cause behaviors that could be mistaken for an ASD, children with delayed speech development should also have their hearing tested.
Children with some symptoms of an ASD but not enough to be diagnosed with classical autism are often diagnosed with PDD-NOS. Children with autistic behaviors but well-developed language skills are often diagnosed with Asperger syndrome. Much rarer are children who may be diagnosed with childhood disintegrative disorder, in which they develop normally and then suddenly deteriorate between the ages of 3 to 10 years and show marked autistic behaviors.
What causes autism?
Scientists aren’t certain about what causes ASD, but it’s likely that both genetics and environment play a role. Researchers have identified a number of genes associated with the disorder. Studies of people with ASD have found irregularities in several regions of the brain. Other studies suggest that people with ASD have abnormal levels of serotonin or other neurotransmitters in the brain. These abnormalities suggest that ASD could result from the disruption of normal brain development early in fetal development caused by defects in genes that control brain growth and that regulate how brain cells communicate with each other, possibly due to the influence of environmental factors on gene function. While these findings are intriguing, they are preliminary and require further study.
The theory that parental practices are responsible for ASD has long been disproved.
What role does inheritance play?
Twin and family studies strongly suggest that some people have a genetic predisposition to autism. Identical twin studies show that if one twin is affected, there is up to a 90 percent chance the other twin will be affected. There are a number of studies in progress to determine the specific genetic factors associated with the development of ASD. In families with one child with ASD, the risk of having a second child with the disorder is approximately 5 percent, or one in 20. This is greater than the risk for the general population.
Researchers are looking for clues about which genes contribute to this increased susceptibility. In some cases, parents and other relatives of a child with ASD show mild impairments in social and communicative skills or engage in repetitive behaviors. Evidence also suggests that some emotional disorders, such as bipolar disorder, occur more frequently than average in the families of people with ASD.
How is autism treated?
There is no cure for ASDs. Therapies and behavioral interventions are designed to remedy specific symptoms and can bring about substantial improvement. The ideal treatment plan coordinates therapies and interventions that meet the specific needs of individual children. Most health care professionals agree that the earlier the intervention, the better.
Therapists use highly structured and intensive skill-oriented training sessions to help children develop social and language skills, such as Applied Behavioral Analysis. Family counseling for the parents and siblings of children with an ASD often helps families cope with the particular challenges of living with a child with an ASD.
Doctors may prescribe medications for treatment of specific autism-related symptoms, such as anxiety, depression, or obsessive-compulsive disorder. Antipsychotic medications are used to treat severe behavioral problems. Seizures can be treated with one or more anticonvulsant drugs. Medication used to treat people with attention deficit disorder can be used effectively to help decrease impulsivity and hyperactivity.
There are a number of controversial therapies or interventions available, but few, if any, are supported by scientific studies. Parents should use caution before adopting any unproven treatments. Although dietary interventions have been helpful in some children, parents should be careful that their child’s nutritional status is carefully followed.