Autism (sometimes called “classical autism”) is the most common condition in a group of developmental disorders known as the autism spectrum disorders (ASDs). Autism is characterized by impaired social interaction, problems with verbal and nonverbal communication, and unusual, repetitive, or severely limited activities and interests. Other ASDs include Asperger syndrome, Rett syndrome, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified (usually referred to as PDD-NOS). Experts estimate that three to six children out of every 1,000 will have autism. Males are four times more likely to have autism than females.Some kids with mild autism will grow up and be able to live on their own. Those with more serious problems will always need some kind of help. But all kids with autism have brighter futures when they have the support and understanding of doctors, teachers, caregivers, parents, brothers, sisters, and friends.

Causes

There is no known single cause for autism, but it is generally accepted that it is caused by abnormalities in brain structure or function. Brain scans show differences in the shape and structure of the brain in children with autism versus neuro-typical children. Researchers are investigating a number of theories, including the link between heredity, genetics and medical problems. In many families, there appears to be a pattern of autism or related disabilities, further supporting a genetic basis to the disorder. While no one gene has been identified as causing autism, researchers are searching for irregular segments of genetic code that children with autism may have inherited. It also appears that some children are born with a susceptibility to autism, but researchers have not yet identified a single “trigger” that causes autism to develop.

Other researchers are investigating the possibility that under certain conditions, a cluster of unstable genes may interfere with brain development, resulting in autism. Still other researchers are investigating problems during pregnancy or delivery as well as environmental factors, such as viral infections, metabolic imbalances, and exposure to environmental chemicals.

Signs and Symptoms

Signs of autism may appear during infancy and the disorder is usually diagnosed by the age of 3. Sometimes the child’s development appears normal until about 2 years old and then regresses rapidly. Symptoms of autism occur in various combinations, from mild to severe.

Autistic children do not express interest in other people and often prefer to be alone. They may resist changes in their routine, repeat actions (e.g., turn in circles, flap their arms) over and over, and engage in self-injurious behavior (e.g., bite or scratch themselves, bang their head).

Symptoms of autism include:

  • Extreme difficulty in learning language.
  • Inappropriate response to people. A child with autism may avoid eye contact, resist being picked up or cuddled, and seem to tune out the world.
  • Inability or reduced ability to play cooperatively with other children or to make friends.
  • Inability to understand other people’s feelings.
  • Need for a rigid, highly structured routine — and being very distressed by changes in routines.
  • Extreme hyperactivity or unusual passivity, and extreme resistance to change.
  • Repetitive body movements including pacing, hand flicking, twisting, spinning, rocking or hitting oneself.
  • Insensitivity to pain or lack of response to cold or heat.
  • Impulsive behavior and no real fear of dangers.
  • An unusual attachment to inanimate objects such as toys, strings or spinning objects.
  • Frequent crying and tantrums for no apparent reason.
  • Peculiar speech patterns. An autistic child may use words without understanding their meanings.
  • Abnormal responses to sensations such as light, sound and touch. At times an autistic child may appear deaf. At other times the child may be extremely distressed by everyday noises.
  • Appears indifferent to surroundings
  • Appears content to be alone, happier to play alone
  • Displays lack of interest in toys
  • Displays lack of response to others
  • Does not point out objects of interest to others (called protodeclarative pointing)
  • Marked reduction or increase in activity level
  • Resists cuddling

Some of these symptoms occur in children with other disabilities. Symptoms can change as the child grows older

Treatment of Autism

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.

Most behavioral treatment programs include:

  • clear instructions to the child
  • prompting to perform specific behaviors
  • immediate praise and rewards for performing those behaviors
  • a gradual increase in the complexity of reinforced behaviors
  • definite distinctions of when and when not to perform the learned behaviors

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.

Medication can be recommended to treat specific symptoms such as seizures, hyperactivity, extreme mood changes, or self-injurious behaviors.

The autistic child requires much of the parents’ attention, often affecting the other children in the family. Counseling and support may be helpful for the parents.

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.

Diet and Nutrition

Adjusting both diet and nutrition may help some people with mental illnesses manage their symptoms and promote recovery. For example, research suggests that eliminating milk and wheat products can reduce the severity of symptoms for some people who have schizophrenia and some children with autism. Similarly, some holistic/natural physicians use herbal treatments, B-complex vitamins, riboflavin, magnesium, and thiamine to treat anxiety, autism, depression, drug-induced psychoses, and hyperactivity.

Expresive Therapies

Art Therapy:

Drawing, painting, and sculpting help many people to reconcile inner conflicts, release deeply repressed emotions, and foster self-awareness, as well as personal growth. Some mental health providers use art therapy as both a diagnostic tool and as a way to help treat disorders such as depression, abuse-related trauma, and schizophrenia. You may be able to find a therapist in your area who has received special training and certification in art therapy.

Dance/Movement Therapy:

Some people find that their spirits soar when they let their feet fly. Others-particularly those who prefer more structure or who feel they have “two left feet”-gain the same sense of release and inner peace from the Eastern martial arts, such as Aikido and Tai Chi. Those who are recovering from physical, sexual, or emotional abuse may find these techniques especially helpful for gaining a sense of ease with their own bodies. The underlying premise to dance/movement therapy is that it can help a person integrate the emotional, physical, and cognitive facets of “self.”

Music/Sound Therapy:

It is no coincidence that many people turn on soothing music to relax or snazzy tunes to help feel upbeat. Research suggests that music stimulates the body’s natural “feel good” chemicals (opiates and endorphins). This stimulation results in improved blood flow, blood pressure, pulse rate, breathing, and posture changes. Music or sound therapy has been used to treat disorders such as stress, grief, depression, schizophrenia, and autism in children, and to diagnose mental health needs.

Technology-Based Applications

The boom in electronic tools at home and in the office makes access to mental health information just a telephone call or a “mouse click” away. Technology is also making treatment more widely available in once-isolated areas.

Telemedicine: Plugging into video and computer technology is a relatively new innovation in health care. It allows both consumers and providers in remote or rural areas to gain access to mental health or specialty expertise. Telemedicine can enable consulting providers to speak to and observe patients directly. It also can be used in education and training programs for generalist clinicians.

Telephone counseling: Active listening skills are a hallmark of telephone counselors. These also provide information and referral to interested callers. For many people telephone counseling often is a first step to receiving in-depth mental health care. Research shows that such counseling from specially trained mental health providers reaches many people who otherwise might not get the help they need. Before calling, be sure to check the telephone number for service fees; a 900 area code means you will be billed for the call, an 800 or 888 area code means the call is toll-free.

Electronic communications: Technologies such as the Internet, bulletin boards, and electronic mail lists provide access directly to consumers and the public on a wide range of information. On-line consumer groups can exchange information, experiences, and views on mental health, treatment systems, alternative medicine, and other related topics.

Radio psychiatry: Another relative newcomer to therapy, radio psychiatry was first introduced in the United States in 1976. Radio psychiatrists and psychologists provide advice, information, and referrals in response to a variety of mental health questions from callers. The American Psychiatric Association and the American Psychological Association have issued ethical guidelines for the role of psychiatrists and psychologists on radio shows.

Sources: Webmd, Ninds Nih

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