Autism
1. What Is Autism or Autism Spectrum Disorder?
Autism spectrum disorder (ASD) is a complex developmental condition that involves persistent challenges in social interaction, speech and nonverbal communication, and restricted/repetitive behaviors. The effects of ASD and the severity of symptoms are different in each person.
ASD is usually first diagnosed in childhood with many of the most-obvious signs presenting around 2-3 years old, but some children with autism develop normally until toddlerhood when they stop acquiring or lose previously gained skills. Approximately one in 59 children is estimated to have autism. Autism spectrum disorder is also three to four times more common in boys than in girls, and many girls with ASD exhibit less obvious signs compared to boys. Autism is a lifelong condition. However, many children diagnosed with ASD go on to live independent, productive, and fulfilling lives.
2. What are the characteristics of children with Autism Spectrum Disorders?
Autism differs from person to person in severity and combinations of symptoms. There is a great range of abilities and characteristics of children with autism spectrum disorder — no two children appear or behave the same way. Symptoms can range from mild to severe and often change over time.
Characteristics of autism spectrum disorder fall into two categories.
- Social interaction and communication problems: including difficulties in normal back-and-forth conversation, reduced sharing of interests or emotions, challenges in understanding or responding to social cues such as eye contact and facial expressions, deficits in developing/maintaining/understanding relationships, and others.
- Difficulty relating to people, things and events: including trouble making friends and interacting with people, difficulty reading facial expressions and not making eye contact.
- Restricted and repetitive patterns of behaviors, interests or activities:
hand-flapping and toe-walking, playing with toys in an uncommon way (such as lining up cars or flipping objects), speaking in a unique way (such as using odd patterns or pitches in speaking or “scripting” from favorite shows), having significant need for a predictable routine or structure, exhibiting intense interests in activities that are uncommon for a similarly aged child, experiencing the sensory aspects of the world in an unusual or extreme way (such as indifference to pain/temperature, excessive smelling/touching of objects, fascination with lights and movement, being overwhelmed with loud noises, etc), and others.
Also, while many people with autism have normal intelligence, many others have mild or significant intellectual delays. Also, those with ASD are at greater risk for some medical conditions such as sleep problems, seizures and mental illnesses.
3. Diagnosis and Risk Factors
Early diagnosis and treatment are important to reducing the symptoms of autism and improving the quality of life for people with autism and their families. There is no medical test for autism. It is diagnosed based on observing how the child talks and acts in comparison to other children of the same age. Trained professionals typically diagnose autism by talking with the child and asking questions of parents and other caregivers.
If you have concerns that your infant or toddler is not developing normally, it is important to bring that concern to your pediatrician, who may then refer to a pediatric neurologist or a Neurodevelopmental pediatrician for further evaluation.
4. Are there any red-flags for parents to watch out for early?
- Not responding to his/her name by 12 months of age
- Not pointing at objects to show interest by 14 months
- Not playing “pretend” games by 18 months
- Avoiding eye contact or preferring to be alone
- Getting upset by minor changes
- Flapping their hands, rocking their body or spinning in circles
- Having unusual and sometimes intense reactions to the way things smell, taste, feel
and/or look
If there is a strong concern that your child is showing possible signs of autism, then a diagnostic evaluation should be performed. This typically involves an interview and play-based testing with your child done by a psychologist, developmental-behavioral pediatrician, child psychiatrist or other providers.
5. What causes autism?
Scientists do not clearly understand what causes autism spectrum disorder. Several factors probably contribute to autism, including genes a child is born with or environmental factors. A child is at greater risk of autism if there is a family member with autism. Research has shown that it is not caused by bad parenting, and it is not caused by vaccines.
6. What can I do once my child has been diagnosed with autism?
- Learn as much as possible about autism spectrum disorder
- Provide consistent structure and routine
- Connect with other parents of children with autism
- Seek professional help for specific concerns
- Take time for yourself and other family members
Having a child with autism affects the whole family. It can be stressful, time-consuming and expensive. Paying attention to the physical and emotional health of the whole family is important.
7. How is autism treated?
The mainstay of treatment is therapy by a team of professionals like Neurodevelopmental pediatrician, occupational therapists, psychologists and speech and language therapists. Some terminologies in treatment used are sensory integration therapy, oromotor therapy and applied behavioural analysis; these will be individually customized to suit your child’s needs. There is no single medication to treat this condition, and regular therapy is essential to see for improvement. Also, the aim of therapy is to make children settle in to a routine in life, for them to be able to make educational progress and for them to be able to live independently. Most parents are disappointed that their child is not like other children despite therapy, hence realistic goals and expectations and appropriate counseling right at the outset is important.
8. Are there any medicines for autism?
In some cases, if significant perceived hyperactivity or undue aggression prevents the child from accessing the therapy, then the pediatric neurologist will prescribe medications to help the behaviour to ensure on-going therapy. Despite the medications, the child may have some subtle behaviour problems related to specific situations – also called ‘melt-downs’, this needs to be managed by behaviour counseling. Good quality sleep is also important for learning and behaviour, and ensuring good sleep hygiene and in some cases a short course of medicines for sleep may also be recommended.
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