AUTISM -- About Autism

Not until the middle of the twentieth century was there a name for a disorder that now appears to affect an estimated 3.4 every 1,000 children ages 3-10, a disorder that causes disruption in families and unfulfilled lives for many children. In 1943 Dr. Leo Kanner of the Johns Hopkins Hospital studied a group of 11 children and introduced the label early infantile autism into the English language. At the same time a German scientist, Dr. Hans Asperger, described a milder form of the disorder that became known as Asperger syndrome. Thus these two disorders were described and are today listed in the Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR (fourth edition, text revision) as two of the five pervasive developmental disorders (PDD), more often referred to today as autism spectrum disorders (ASD). All these disorders are characterized by varying degrees of impairment in communication skills, social interactions, and restricted, repetitive and stereotyped patterns of behavior.

Autism is a lifelong developmental. It is classified as a neurodevelopmental disorder that manifests in delays of "social interaction, language as used in social communication, or symbolic or imaginative play," with "onset prior to age 3 years and in some cases as early as 18 months," according to the Diagnostic and Statistical Manual of Mental Disorders. The ICD-10 also requires symptoms to "manifest before the age of three years". Studies suggest that many children eventually may be accurately identified by the age of 1 year or even younger. The appearance of any of the warning signs of ASD is reason to have a child evaluated by a professional specializing in these disorders.Autism is often not physiologically obvious, in that outward appearance may not indicate a disorder, and diagnosis typically comes from a complete physical and neurological evaluation.

Parents are usually the first to notice unusual behaviors in their child. In some cases, the baby seemed "different" from birth, unresponsive to people or focusing intently on one item for long periods of time. The first signs of an ASD can also appear in children who seem to have been developing normally. When an engaging, babbling toddler suddenly becomes silent, withdrawn, self-abusive, or indifferent to social overtures, something is wrong. Research has shown that parents are usually correct about noticing developmental problems, although they may not realize the specific nature or degree of the problem.

The pervasive developmental disorders, or autism spectrum disorders, range from a severe form, called autistic disorder, to a milder form, Asperger syndrome. If a child has symptoms of either of these disorders, but does not meet the specific criteria for either, the diagnosis is called pervasive developmental disorder not otherwise specified (PDD-NOS). Other rare, very severe disorders that are included in the autism spectrum disorders are Rett syndrome and childhood disintegrative disorder.

However, some children with milder forms of autism, such as Asperger's syndrome don't show significant delays in language and cognitive development. Except for a delay in social interaction, these children have a normal acquisition of self-skills or adaptive behaviour for their age. Intelligence tests in these children tend to be within the normal range and, on the whole, their prognosis appears to be significantly better. Several children with Asperger's syndrome can enjoy normal schooling and grow into adults who are capable of gainful employment and personal self-sufficiency. Others on the other hand, will need special schooling and may require further help in adult life.

Children with autism will display very different symptoms. The severity of these symptoms will also differ from child to child. All children with autism will display characteristics of impaired social interaction, impaired communication and social skills and delayed language development or absence of speech. They will also have a restricted range of interests and activities. A number of children will show severe symptoms and will need special care for the rest of their lives.

However, some children don't seem to want to do these things and appear distant and aloof. It's as if they are not aware of their physical surroundings. These children find it difficult to verbalize or communicate their needs and tend to display repetitive and other odd behaviours. In severe cases the child doesn't speak at all. Such children lack any awareness of others and show a disinterest in social situations. These are the common characteristics of autism.

It affects the way a person communicates and limits his/her ability to relate to others in a meaningful way, develop friendships, show signs of affection, appreciate cuddles or understand other people's feelings. Because the severity and variation of symptoms, the disorder is often referred to as Autistic Spectrum Disorder or ASD. Autism affects more children than cancer, cystic fibrosis and multiple sclerosis combined. One in every 250 babies has autistic spectrum disorder. The autism spectrum disorders can often be reliably detected by the age of 3 years, and in some cases as early as 18 months. Studies suggest that many children eventually may be accurately identified by the age of 1 year or even younger. The appearance of any of the warning signs of ASD is reason to have a child evaluated by a professional specializing in these disorders. The condition is four to five times more common in boys than in girls.

Because the symptoms of autism vary so much and can surface at different stages, they are often difficult to recognize. Parents may not always be immediately aware that their child has a problem and don't seek advice and help from their doctor or a healthcare professional until much later, when the child's behaviour causes serious problems. This will have an impact on the diagnosis and the outcome for the child. Leaving autism undiagnosed and untreated can have a negative impact, not only on the development and the wellbeing of the child in question, but also on family-life.

There is no proven cure for autism and its exact cause is still not known. However, children with autism will benefit from an early diagnosis and early intervention. This will enable the implementation of dedicated developmental, behavioural and educational programmes tailored to the child's needs. For instance, a special education programme can help reduce the core symptoms and behaviours of autism. This not only improves the quality of life for the child, but also for the parents, siblings and other relatives. After all, autism poses a very heavy burden on families.