Autism

What Is Autism?

Autism is one of the most common developmental disabilities. Including the milder form of autism known as pervasive developmental disorder or PDD, autism affects more than six out of every 1,000 children.

Children with autism have trouble communicating. They have trouble understanding what other people think and feel. This makes it very hard for them to express themselves either with words or through gestures, facial expressions, and touch.

A child with autism can be greatly troubled — sometimes even pained — by sounds, touches, smells, or sights that seem normal to others.

Children with autism may have repeated body movements such as rocking or hand flapping. They may have unusual responses to people, attachments to objects, resistance to change in their routines, and/or aggressive or self-injurious behavior. At times they may seem not to notice people, objects, or activities in their surroundings. Some children with autism also develop seizures, in some cases not until adolescence.

Many people with autism have problems in certain areas, especially the ability to communicate and relate to others. But they may have unusually developed skills in other areas, such as drawing, creating music, solving math problems or memorizing facts. For this reason, they may test higher — perhaps even in the average or above-average range — on nonverbal intelligence tests.

Autism typically appears during the first three years of life. Some children show signs from birth; others seem to develop normally at first, only to slip suddenly into symptoms when they are 18 to 36 months old. Autism is four times more common in boys than in girls. Autism knows no racial, ethnic, or social boundaries; family income, lifestyle, and educational levels do not affect a child’s chance of having autism.

Some of the different types of autism include:

• Autistic disorder. This what most people think of when they hear the word “autism.” It refers to problems with social interactions, communication, and imaginative play in children younger than 3 years.
• Asperger’s syndrome. These children don’t have a problem with language — in fact, they tend to score in the average or above-average range on intelligence tests. But they have the same social problems and limited scope of interests as children with autistic disorder.
• Pervasive developmental disorder or PDD — also known as atypical autism. This is a kind of catchall category for children who have some autistic problems but who don’t fit into other categories.
• Rett’s disorder. Known to occur only in girls, Rett’s children begin to develop normally. Then they begin to lose their communication and social skills. Beginning at the age of 1 to 4 years, repetitive hand movements replace purposeful use of the hands.
• Childhood disintegrative disorder. These children develop normally for at least two years, and then lose some or most of their communication and social skills.

Core symptoms

The severity of symptoms varies greatly between individuals; however, all people 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 50% of people with autism never speak.
  • Problems taking steps to start a conversation. Also, people with autism have difficulties continuing a conversation once 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. Older children and adults are often fascinated by train schedules, weather patterns, 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 include body rocking and hand flapping.

What Are the Treatments?

There is no known cure for autism, but it is treatable. Many people with autism become more responsive as they come to better understand the world. Some children lose all symptoms of autism. The goals of treatment include:

• Stopping inappropriate behaviors so the child can relate better to others.
• Teaching the child to attend to purposeful activity. This can help the child succeed in educational settings.
• Helping the child learn self-care skills.
• Providing opportunities for the child to socialize with others.
• Improving the child’s communication skills.
• Teaching parents how to provide helpful educational and social experiences for their child.
• In most cases, treatment is provided in an individualized program that focuses on behavior modification and skills development. Treatment also may involve medication to help control specific symptoms. Usually a team of specialists is involved. The team may include a psychologist, a special education teacher, a speech therapist, a child development specialist, and trained aides.
• In general, treatment programs tend to be more effective if they build on the child’s unique interests; if they engage the child in highly structured activities according to a predictable schedule; and if they provide regular rewards for desired behavior. Also, the parents’ involvement is very important to the development of autistic children.

The earlier treatment begins, the better the child’s chance of developing important skills. Early treatment can greatly help most children with autism. No matter how late treatment begins, there is hope. Treatment usually reduces symptoms of autism regardless of the child’s age or the severity of the condition.