Autism
Autism is a perplexing and often difficult problem to diagnose, especially to diagnose early. It is a severely handicapping disorder, which begins at birth or within the first 2 ½ years of life. For many years autism occurred in about 5 children per 10,000 live births. However, since the early 1990's, the rate of autism has increased enormously throughout the world, so that figures as high as 60 per 10,000 are being reported.
Most autistic children are perfectly normal in appearance, but spend their time engaged in puzzling and disturbing behaviors, which are markedly different from those of normal children. They may stare into space for hours, throw uncontrollable tantrums, show no interest in people (including their parents) and pursue strange, repetitive activities with no apparent purpose. They have been described as living in a world of their own. Some autistic individuals are remarkably gifted in certain areas such as music or mathematics, as depicted in the film Rain Man. All need help. Like children from a primal existence, they live in their solitary existence with only sporadic excursions into the world of their parents or their siblings. There are screening tests which can identify a child at risk , the most simple of these is to ask an eighteen month old child to point to objects while reading to him or her.
What is the Cause? The causes of autism are poorly understood, although it is clear that autism is a biological brain disorder. The Autism Research Institute is investigating various possible causal factors.
What is the Outlook? In recent years there has been a marked increase in the percentage of children who have been able to attend school with normal children, and to live more or less independently in community settings. The majority of autistic persons, however, remain severely handicapped in their ability to communicate and socialize with other people.
- The
patient fulfills a total of at least 6 criteria from the following
3 lists, distributed as indicated:
Impaired social interaction (at least 2):
-Markedly deficient regulation of social interaction by using multiple non-verbal behaviors such as eye contact, facial expression, body posture and gestures
-Lack of peer relationships that are appropriate to the developmental level
-Doesn't seek to share achievements, interests or pleasure with others
-Lacks social or emotional reciprocity - Impaired
communication (at least 1):
-Delayed or absent development of spoken language for which the patient doesn't try to compensate with gestures
-In patients who can speak, inadequate attempts to begin or sustain a conversation
-Language that is repetitive, stereotyped or idiosyncratic
-Appropriate to developmental stage, absence of social imitative play or spontaneous, make-believe play - Activities,
behavior and interests that are repetitive, restricted and stereotyped
(at least 1 of):
Preoccupation with abnormal (in focus or intensity) interests that are restricted and stereotyped (such as spinning things)
-Rigidly sticks to routines or rituals that don't appear to have a function
-Has stereotyped, repetitive motor mannerisms (such as hand flapping) Persistently preoccupied with parts of objects - Before
age three, the patient shows delayed or abnormal functioning in 1
or more of these areas:
-Social interaction
-Language used in social communication
- Imaginative or symbolic play - These symptoms are not better explained by Childhood Disintegrative Disorder or Rett's Disorder.
The Diagnostic Statistical Manual IV defines autism as a condition where:
The therapies for autism are multifaceted, intensive, often exceeding forty hours a week, and they must be started early for the maximum effect. Parents with children who have autism must advocate strongly and often for their children. Achieving success with autism is extremely time intensive.
http://www.autism.org/contents.html Center for the study of autism, a website with multiple resources.
http://www.autism.com/ Another site with multiple resources
