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Autism (ASD)

Autism is a life-long, incapacitating developmental disability. A variety of forms of autism and related conditions have been identified over the past few decades and, together, these conditions are referred to as Autism Spectrum Disorders (ASD). ASD usually makes its appearance within the first three years of life. Autism can occur alone or coincident with other disorders that affect brain function. ASD is a neurological disorder that inhibits normal brain function. Adults and children with autism have difficulty with verbal and non-verbal communication, social interaction and personal interactive skills, as well as leisure activities. Because autism is a ‘spectrum disorder’, patients display a wide variety of symptoms and each individual may exhibit these symptoms differently. Severe forms of ASD can include symptoms of self-injury, repetitive, unusual, or aggressive behavior. Though autism is second only to mental retardation as a diagnosed developmental disorder, autism is NOT retardation and the treatments for autism are distinctly different from those for mental retardation. The cause of Autism has not yet been discovered, but research indicates a hereditary component that may cause a person to be predisposed to ASD.

Some adult ASD patients, especially those with ‘high-functioning’ autism, or Asperger syndrome, are able to work and hold jobs in the community. Others can work in sheltered workshops with supervision from managers who receive training to work with developmentally disabled employees.

Since public schools only provide services to ASD children until the age of 22, the family of an Autistic child must plan for the future to find suitable residence and work accommodations for their child as they become an adult and face the prospect of living without parental guidance.

What are the symptoms?

Because there are several forms of Autism, and because nearly every Autistic patient exhibits various symptoms with varying levels of severity, it is difficult to neatly define the symptoms of this disorder.

The autistic child is typically diagnosed by age three, but as early as 12-36 months, they may begin to exhibit unusual behaviors and reactions to people and to their environment.

Possible Signs of ASD

Does not point, babble or make gestures by age 1, does not speak single word by 16 months, does not combine two or more words by age 2, does not respond to name, does not smile, is attached to one specific object, order or lines up objects or toys, poor eye contact,

Here are some of the symptoms that patients may display:

• Child rejects people, act oddly, loses language, social skills he/she previously acquired
• Exhibits tendency toward self-injury or becomes aggressive towards others
• Is anti-social or asocial (many ASD children are normally sociable)
• Resists physical contact, hugging, cuddling
• Difficulty understanding ‘feelings’ or talking about their own feelings
• About 10% of patients have ‘savant skills’: an ability considered remarkable. Most are spatial (music or art). Some are mathematical (multiply large numbers, determine the day of the week from specific date in history, memorize train and airline schedules.
• Little or no language skill (40% of patients), simply repeats or echoes words or phrases (many ASD children can often speak normally), or delayed language
• Does not like change in routine, or exhibits repetitive behavior
• Does not recognize when someone is trying to get their attention or talk to them
• Resists eye contact, likes to be left alone
• Difficulty in listening or paying attention to what people are saying

Other Forms of Autistic Spectrum Disorder:

• Landau-Kleffner Syndrome: social withdrawal, language skill problems, insistence on routines and sameness (symptoms are often delayed until age 3-7)
• Williams Syndrome: delayed language skills, sensitivity to sound, attention deficit, and problems with social interaction. Often accompanied by heart problems.
• Asperber Syndrome: concrete, literal thinking, obsessed with a specific topic or set of topics, excellent memory skills, eccentric behavior
• Fragile X Syndrome: a form of mental retardation. About 15% of Fragile X patients have autistic behaviors like delayed speech, hyperactivity, lack of eye contact, hand ‘flapping’
• Rett Syndrome: degenerative disorder, found mostly in female patients, including loss of language skills, repetitive hand wringing, rocking motions and social withdrawal.

How is it diagnosed and treated?

The earlier the diagnosis is made, the better the proven outcome for most children with ASD. Intense early intervention for at least two preschool years has achieved good results. Doctors look for problems in at least one area of communication, socialization, or behavior.

The child will have a medical evaluation to be sure that the symptoms are not coming from other sources. Screening tools, like the Childhood Autism Rating Scale (CARS) are often used in the diagnosis, and a hearing evaluation and lead screening are completed.

Treatments include:

• Medication (Ritalin, B6 with magnesium supplements, Nystatin, Di-methylglycine (DMG), antipsychotic medications, Risperdal, antidepressants (SSRIs))
• Sensory Integration techniques
• Dietary changes to remove gluten and casein
• Social skills training for patient, family therapy
• From age 3-21, the Federal Disabilities Act guarantees education, service and support for developmentally disabled children
• Music and Occupational therapy
• Applied Behavior Analysis (ABA)
• Coordination and Body Awareness Training

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