Autism

Verbal and non-verbal communication is central to autism

Autism is a neurodevelopmental disorder characterized by impaired social interaction, impaired verbal and non-verbal communication, and restricted and repetitive behavior. Parents usually notice signs in the first two years of their child’s life.

These signs often develop gradually, though some children with autism reach their developmental milestones at a normal pace and then regress. The diagnostic criteria require that symptoms become apparent in early childhood, typically before age three. Boys are nearly five times more likely than girls to have autism. Autism is caused by a combination of genetic and environmental factors. Autism affects information processing in the brain by altering how nerve cells and their synapses connect and organize; how this occurs is not well understood.

Autism spectrum disorder has no single known cause. Given the complexity of the disorder and the fact that symptoms and severity vary, there are probably many causes. Both genetics and environment may play a role. Several different genes appear to be involved in autism spectrum disorder. For some children, autism spectrum disorder can be associated with a genetic disorder, such as Rett syndrome or fragile X syndrome. For other children, genetic changes (mutations) may increase the risk of autism spectrum disorder. Still, other genes may affect brain development or the way that brain cells communicate, or they may determine the severity of symptoms. Some genetic mutations seem to be inherited, while others occur spontaneously.

Researchers are currently exploring whether factors such as viral infections, medications or complications during pregnancy, or air pollutants play a role in triggering autism spectrum disorder.

Isolation & repetitive behavior are the most common symptoms

Autism spectrum disorders (ASD) are characterized by social-interaction difficulties, communication challenges and a tendency to engage in repetitive behaviors. However, symptoms and their severity vary widely across these three core areas. Taken together, they may result in relatively mild challenges for someone on the high functioning end of the autism spectrum. For others, symptoms may be more severe, as when repetitive behaviors and lack of spoken language interfere with everyday life. While autism is usually a life-long condition, all children and adults benefit from interventions, or therapies, that can reduce symptoms and increase skills and abilities.

Some children show signs of autism spectrum disorder in early infancy, such as reduced eye contact, lack of response to their name or indifference to caregivers. Other children may develop normally for the first few months or years of life, but then suddenly become withdrawn or aggressive or lose language skills they’ve already acquired. Signs usually are seen by age 2 years. Each child with autism spectrum disorder is likely to have a unique pattern of behavior and level of severity — from low functioning to high functioning.

Some children with autism spectrum disorder have difficulty learning, and some have signs of lower than normal intelligence. Other children with the disorder have normal to high intelligence — they learn quickly, yet have trouble communicating and applying what they know in everyday life and adjusting to social situations.

Because of the unique mixture of symptoms in each child, severity can sometimes be difficult to determine. It’s generally based on the level of impairments and how they impact the ability to function.

Symptoms of autism can be identified as follows:

• Weak social interaction.
• Weak communication.
• Limited activities, actions & interests.
• Failure to respond to the normal means of education.
• Aggression and self-injury.
• A significant increase or decrease in efficiency and activity.
• Sudden outbursts of rage and anger.
• Lack of attention.
• Abnormal sleeping and eating patterns and the child may only eat certain types of food.
• Playing in unusual ways.
• Abnormal association with things

How is autism diagnosed?

Your child’s doctor will look for signs of developmental delays at regular checkups. If your child shows any symptoms of autism spectrum disorder, you’ll likely be referred to a specialist who treats children with autism spectrum disorder, such as a child psychiatrist or psychologist, pediatric neurologist, or developmental pediatrician, for an evaluation.

Because autism spectrum disorder varies widely in symptoms and severity, making a diagnosis may be difficult. There isn’t a specific medical test to determine the disorder. Instead, a specialist may observe your child and ask how your child’s social interactions, communication skills, and behavior have developed and changed over time, give your child tests covering hearing, speech, language, developmental level, and social and behavioral issues, present structured social and communication interactions to your child and score the performance, include other specialists in determining a diagnosis and recommend genetic testing to identify whether your child has a genetic disorder such as Rett syndrome or fragile X syndrome.

Behavioral therapies

No cure exists for autism spectrum disorder, and there is no one-size-fits-all treatment. The goal of treatment is to maximize your child’s ability to function by reducing autism spectrum disorder symptoms and supporting development and learning. Early intervention during the preschool years can help your child learn critical social, communication, functional and behavioral skills.

The range of home-based and school-based treatments and interventions for autism spectrum disorder can be overwhelming, and your child’s needs may change over time. Your healthcare provider can recommend options and help identify resources in your area. If your child is diagnosed with autism spectrum disorder, talk to experts about creating a treatment strategy and build a team of professionals to meet your child’s needs. Treatment options may include behavioral and communication therapies, educational therapies and family therapies. Many programs address the range of social, language and behavioral difficulties associated with autism spectrum disorder. Some programs focus on reducing problem behaviors and teaching new skills. Other programs focus on teaching children how to act in social situations or communicate better with others. Applied behavior analysis (ABA) can help children learn new skills and generalize these skills to multiple situations through a reward-based motivation system.

Children with autism spectrum disorder often respond well to highly structured educational programs. Successful programs typically include a team of specialists and a variety of activities to improve social skills, communication and behavior. Preschool children who receive intensive, individualized behavioral interventions often show good progress. Parents and other family members can learn how to play and interact with their children in ways that promote social interaction skills, manage problem behaviors, and teach daily living skills and communication.

How to deal with an autistic child

Learning all you can about autism and getting involved in treatment will go a long way toward helping your child. Children with ASD have a hard time applying what they’ve learned in one setting to others, including the home. For example, your child may use sign language at school to communicate, but never think to do so at home. Creating consistency in your child’s environment is the best way to reinforce learning. Explore the possibility of having therapy take place in more than one place in order to encourage your child to transfer what he or she has learned from one environment to another. Children with ASD tend to do best when they have a highly-structured schedule or routine. Again, this goes back to the consistency they both need and crave. Set up a schedule for your child, with regular times for meals, therapy, school, and bedtime. Try to keep disruptions to this routine to a minimum.  Positive reinforcement can go a long way with children with ASD, so praise them when they act appropriately or learn a new skill, being very specific about what behavior they’re being praised for. Also look for other ways to reward them for good behavior. Teaching independence is a baby steps process that starts at an early age. When working with children with autism on any skill, you have to think it forward. There are small, gradual ways to build independence. Teaching the concept of time fosters independence. Letting children see there is a beginning, end and time limit for activities is a good way to teach patience and transitioning.