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Autism Insights

Posted by : Dr. Neelu Desai, 22 Jan 2015 08:53 AM
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What is Autism?

Autism is a developmental disorder characterized by impaired social interaction, verbal and non-verbal communication, and by restricted and repetitive behaviours. These symptoms become evident before a child turns three years old.

Incidence of autism has been rising over the years. A recent report by Centers for Disease Control and Prevention says one in 68 U.S. children has an autism spectrum disorder (ASD), which has increased by 30% from 1 in 88 two years ago. However, symptoms and their severity vary widely across the three core areas.

What causes autism?

The exact cause of autism is not well understood but various genetic and environmental factors have been implicated. Autism affects information processing in the brain by altered connections and organization.

Is autism inherited?

Both genetic and environmental factors have been implicated in autism though the exact genes have not yet been identified. Recurrence risk in identical twins is highest and there is increased risk up to 5-10% in siblings of affected child according to various studies. Family members of an autistic child may show minor difficulties in social interactions and communication.

How is autism picked up early?

Early detection and treatment in autism improves outcome, often dramatically. One of the most important things one can do as a parent or caregiver is to learn the early signs of autism.

Usually developing infants are social in nature. They look at faces, respond to voices, and smile by 2 to 3 months of age. In contrast, most children with autism have problems in the day to day human interactions. By one year of age, infants with autism have symptoms such as failure to respond to their name, delayed babbling and reduced interest in people. By toddlerhood, many children with autism prefer to play alone, do not imitate the actions of others and have delayed speech and communication skills.   Some children with autism spend hours lining up toys in a specific way or spinning them instead of using them for pretend play. They do not respond to parental anger or affection and have poor separation anxiety.

Facial expressions, gestures and tone of voice may fail to reflect their feelings. This failed communication, in turn, leads to frustration and inappropriate behaviour (such as screaming or tantrums).   The signs usually develop gradually, but some autistic children first develop more normally and then regress.

RED FLAGS FOR AUTISM:

• No social smile or other joyful expressions by six months or thereafter
• No back-and-forth sharing of sounds, smiles or other facial expressions by nine months
• No babbling by 12 months
• No pointing, showing, reaching or waving by 12 months
• No words by 16 months
• No meaningful, two-word phrases (not including imitating or repeating) by 24 months
• Any loss of speech, babbling or social skills at any ageIf any of these red flags are present, please get your child evaluated immediately. The average age of diagnosis of autism is still over age 4, even though autism can be diagnosed by age 2. The earlier a child is diagnosed with autism, the better their chances of overcoming the difficulties that come with the disorder.

What other problems can occur in autism?

Gastrointestinal discomfort is common and affects up to 85 percent of children with ASD. This can be chronic constipation or diarrhea or inflammatory bowel disease.

Epilepsy occurs in as many as 20-40% per cent of those with autism.

Sleep problems are common among children with autism and may likewise affect many adults.

Sensory issues are common in children with autism. They have difficulty processing and integrating sensory information, or stimuli, such as sights, sounds, smells, tastes and/or movement. Some are hypersensitive to sounds or touch, a condition also known as sensory defensiveness. Others are under-responsive, or hyposensitive.

Is autism treatable?

Early intensive behavioral intervention improves learning, communication and social skills in young children with autism spectrum disorders (ASD). It is not a cure, but it redirects the trajectory. If the person with autism learns to communicate what he or she wants, challenging behaviors often subside. Early behavioral, occupational or speech interventions can help autistic children to achieve self-care, social, and communication skills.   Many of the sensory processing problems can be addressed with occupational therapy and/or sensory integration therapy.

Medications can also be given for hyperactivity, depression, anxiety and obsessive compulsive disorder. Epilepsy can be treated with antiepileptic drugs. Dietary modifications have been found useful in a subset of children who have allergic tendencies with food items.

Though autism spectrum disorders can cause mild to profound disability, a diagnosis of ASD is an important turning point in a long journey.
 

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Dr. Franzina Coutinho, PhD (Occupational Therapy); Affiliate Member : McGill University (Canada)
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