Autism

Definition

Autism is classified by the American Psychiatric Association as a pervasive

developmental disorder (PDD). It is characterized by difficulties in social

interaction; problems with verbal and nonverbal communication; and

patterns of repetitive behaviors coupled with a

narrow range of interests

the child is three years old. Autism is considered

a spectrum disorder, because children diagnosed

with it vary widely in the severity of their

symptoms; some may be only mildly affected

and eventually live independently, while others

suffer from severe mental retardation and

require lifelong care.

—all beginning before

Description

Though defined as a disorder for less than a

century, autism has certainly existed for a much

longer period of time. The term

appears to have been coined independently by

Hans Asperger (1906

pediatrician who first used it in a German-language

medical journal in 1938, and Leo

Kanner (1894

who had moved to the United States and published

a paper on what he called infantile

autism in 1943. Since the 1940s, the definition

has expanded to include children who might

have simply been described as odd or strange in the 1960s, as well as children

who are severely disabled by the disorder.

With regard to social interaction, children with autism are commonly

described as loners who are unaware of other people

not respond to their names or make eye contact, and they dislike being

held or cuddled. In terms of behaviors, autistic children prefer sameness

and are upset by change. They may make repetitive gestures like flapping

their hands, spinning, or rocking back and forth. They are often unusually

sensitive to lights, noises, or touch, but at the same time they may be completely

unaware of danger. Many autistic children seem to be insensitive to

pain and do not tell their parents when they are hurt or sick.

Language skills are the third major area in which autistic children are

different from others. They often start talking later than other children and

may speak in a mechanical, sing-song, or robot-like voice. A child with

autism may repeat someone else

how to form a sentence of their own. He or she may have trouble asking

for something in words, using gestures or

pointing instead. In some cases children with

autism do not refer to themselves as

“I” or

“

me,” but use their names instead.

Demographics

There has been considerable controversy in

recent years because the rate of autism in

the United States appears to be rising fairly

rapidly. For many years, doctors estimated that

autismaffected only four or five children in every

10,000. When the Centers for Disease Control

and Prevention (CDC) released a report in February

2007 stating that the rate of autism among

American children had increased to one in 150

(and one in every 94 boys), many people were

quite upset. Although the CDC acknowledges

that some of the increase is due to changes in the

definition and classification of autistic spectrum

disorders or ASDs, some is likely to represent a

true increase in the number of affected children.

Autism is presently the second most common

developmental disability in the United States

after mental retardation. The CDC estimates

that there are about 560,000 persons in the

United States between the ages of one and

twenty-one years who have an ASD.

Boys are more likely than girls to have

autism; the male/female ratio in the United

States is four to one. The reason for the gender

difference is not known. Autism is thought to

be equally common in all racial and ethnic

groups in the United States.

The Autism Society of America estimates that the lifetime cost of

caring for an autistic person ranges from $3.5 to $5 million, and that

autism costs the United States an average of $90 billion each year

(including special education, housing, and transportation services as well

as direct health care costs).

Causes and Symptoms

The causes of autism are not well understood. In the 1950s many psychiatrists

thought that autism was caused by cold or distant parenting

“

disorder. This theory has been disproved by careful studies of families with

autistic children. In the 1990s some people theorized that autism is caused

by childhood immunizations, particularly the measles-mumps-rubella or

MMR vaccine. In 2007, however, a report published in the

Journal of Medicine

that the early symptoms of autism often appear at the age when children are

given the MMR vaccine.

Other possible causes of autism that are still being investigated

include:

—refrigerator mothers” was a common term—and blamed parents for theNew Englandshowed that vaccines do not cause autism; it is simply

•

an increased risk (one chance in twenty) of having a second child

with the disorder. No specific gene or genes associated with autism

has been identified, however.

Genetic factors. It is known that parents of an autistic child have

•

pregnancy have an increased risk of having an autistic child.

Viruses or other disease agents. Women who have rubella during

•

child was born are six times as likely to have an autistic child as

fathers who were thirty or younger. The mother

to make a difference.

Father’s age. One study showed that fathers over forty when their’s age doesn’t seem

•

damage to a baby

in autism.

Difficult pregnancy or childbirth. Some doctors think that’s brain before or during birth may play a role

•

evidence from two studies done in California in 2007 that women

exposed to certain pesticides during the first three months of pregnancy

have an increased risk of having autistic children.

Common symptoms of autism have already been described; others

are listed in the sidebar. Conditions that are often found in children with

autism include:

Exposure to pesticides and other toxic chemicals. There is some

•

mentally retarded, which complicates diagnosis of the disorder.

Mental retardation. About 75 percent of children with autism are

•

Seizures.•

•

appears to develop normally until about fourteen months of age

and then starts losing his or her ability to talk and interact with

others.

A loss of previously attained language or social skills. The child

Diagnosis

The diagnosis of autism is complex; there is no single diagnostic test for

the disorder. In many cases the parents start noticing problems in the

child

and eighteen months old. The diagnosis may not be made, however,

until the child is two to three years of age because of the number of evaluations

that may be needed. It usually takes a team of experts in child

development to make the diagnosis, including a psychiatrist, a neurologist,

a speech therapist, and a pediatrician, all of whom should have specific

experience in evaluating and treating children with autism. There are

several checklists and screeners for symptoms of autism that these health

care professionals may use. In addition, they may order imaging studies, a

hearing test, or (in a few cases) a blood test to rule out other possible

causes of the child

Even though the diagnosis of autism can be complicated, it is important

for parents to have their child evaluated as soon as they notice indications

that the child may be autistic. The reason for early evaluation is

that it improves the child

Studies have shown that children who begin treatment at or before age

three do better than those diagnosed and treated later.

’s speech and interactions with them when the child is between fourteen’s behaviors.’s chances of making good progress in therapy.

Treatment

There is no cure for autism. Treatment usually involves several different

types of therapy. An important form of therapy is behavior and communication

therapy, which is aimed at improving the child

problem behaviors and to interact with others. In some cases the

parents are taught new ways of interacting with their child while he or she

is still a toddler. After the child enters school, highly structured education

programs have been shown to increase the child

skills.

Medications may be prescribed to treat seizures, depression, anxiety,

and other behavioral problems that the child may have.

Because autism is a disorder that places heavy emotional as well

as financial burdens on other members of the family, many families with

autistic children benefit from family therapy or joining a support group.

Prognosis

The prognosis of autism depends largely on the child

and symptom severity. Some autistic children with above-average intelligence

and relatively mild symptoms have successfully completed college,

married, and started families; severely retarded autistic children, however,

may require lifelong care at home or in an institution. Autistic children

who start losing previously acquired language skills before age three are

at increased risk of seizures as they grow older.

’s intelligence level

Prevention

There is no known way to prevent autism.

The Future

Researchers are looking in a number of different directions for new treatments

for autism and improved diagnostic techniques. Some are studying

serotonin, a chemical in the brain that affects the transmission of

impulses from one cell to another, to see whether the high levels of this

chemical in the blood of some children with autism are related to the disorder

in some way. Other scientists are continuing to look for genes that

may be linked to autism. In terms of behavior, researchers are testing the

effectiveness of a program that combines parent training and medication

to reduce the aggressive or disruptive behavior of some children with

autism.

SEE ALSO Asperger syndrome; Rubella; Seizure disorder’s ability to control’s social as well as communicationSelf-injury or aggressive behaviors toward others.autism itself–1980), an Austrian–1981), an Austrian psychiatrist’s feelings. They may’s words or sentences but may not know

Autism