A disorder that occurs in one in every 100 children in UK, causing significant communication, behavioural and social changes is Autism. However, Autism is not concerned about the disabilities of the person as many of them are found to have exceptional abilities and can navigate their own world. Autism can vary to great extent in terms of its severity as well as characteristics. It can occur in all socioeconomic and ethnic groups. According to the March 30, 2012 Morbidity and Mortality Weekly Report by Centres for Disorder Control and Prevention, 1 in every 88 children, who has ASD or autism spectrum disorder, is below the age of 8. In the United States of America, 1 in every 68 children has ASD or autism spectrum disorder, as per the CDC reports. It also states that the boys are 5 times more at risk for Autism than girls.
Definition of Autism:
Autism spectrum disorder or ASD, also known simply as Autism is a kind of brain disorder or a range of complex neurodevelopmental disorders that limits a person to social impairments, to relate to other people and communicate and is characterized by repetitive, restricted and stereotyped patterns of behaviour.
Signs and Symptoms of Autism:
Autism occurs right from infancy, but it does not express itself right away. It is only when the child reaches the third year of its age that Autism establishes its symptoms. But with a close and careful observation, Autism can be identified with its symptoms, even before a child turns three.
The usual symptoms or signs of Autism are associated with different inabilities and they are:
- Unable to point at things to show interest
- Would want to be alone and avoid eye contact with anyone
- Repeat same actions time and again
- Gradually lose skills that they once had learnt
- Can't express own feelings or understand the feelings of others
- Fail to communicate, especially with words
- Do not like 'pretend' games like feeding dolls
- Unusual reactions to smell, taste and sound
- Fail to respond to others even when they talk to him, but might respond to other sounds at the same time
- Changes in routine can be difficult for them to adapt
- Delay in learning to talk. 40% autistic children never talk at all
- Problems in starting a conversation and repetitive use of language
- Preoccupation with certain and limited topics
- Repetitive behaviours and movements which includes stereotypy like hand flapping, compulsive behaviours like arranging objects in a line or stack, sameness and ritualistic behaviour such as a follow the same rules and changing it is not welcomed, restricted behaviour viz., limited interest on objects and being preoccupied with one, and self-injury like hand-biting, eye-poking etc.
Early Warning Signs of Autism:
Determining the signs and symptoms at the earliest stage of the disorder will ensure that the child is diagnosed with Autism soon and started given treatments and therapies to live a better life.
The Early Signs of Autism at the Age of One are:
- The baby not turning to the mother's voice
- Have no babbling
- No eye contacts and smiling to others
The Early Signs of Autism in the Second Year:
- The baby failing to say single words within 16 months
- No two phrase words within 24 months
- Complete loss of language
- Fails to participate in 'pretend' games
- No interest in anything that is pointed out or not show interest by pointing out
Causes and Risk Factors of Autism:
The cause of ASD or autism spectrum disorder is still unknown. However, the most accepted reason behind Autism is abnormality in the brain structure or even the brain's functional abnormalities can also be a cause. But, the genetic causes are also strongly considered to be the reasons behind Autims. As the genetics of Autism is a complex procedure that is still unclear, it cannot be determined whether it is a rare mutation with major effect or if it is a multi-gene interaction that occur in common genetic variants. The specific causes are however, unclear; because whereas one wing of studies have stated the abnormal levels of serotonin and different other neurotransmitters in brain, others have found irregularities in different parts of the brain resulting from disruptions of normal brain development. This disruption occurs mainly in the early stages of foetal development as the various environmental factors affect the gene function and brain cell communication process.
The factors that contribute as environmental condition are pesticide exposure, vaccinations for immune disorders, limited prenatal vitamin intake and parental age of above 40, as well as exposure to certain pharmaceuticals within the womb.
Hence, due to these wide ranges of intriguing factors regarding the cause of the disorder, it is quite difficult to state the causes and thereby determine who are at more risk. But the general risk factors are:
- As genetic reasons are prominent cause for the development of Autism, those who have a sibling with this disorder, are likely to develop ASD or autism spectrum disorder in them.
- Children with fragile X syndrome and tuberous sclerosis are more likely to develop Autism as they significantly impact the genes.
- When the mothers during their pregnancies take drugs such as valproic acid and thalidomide, the babies are at higher risk for Autism.
- When the parents conceive the baby at a later age, that is if the baby is born to older parents, that baby is at higher risk for developing Autism.
How Autism Impacts the Brain Function – It's Mechanism:
How autism occurs can be divided into two different procedures and they are:
- Pathophysiology: According to the Neuroanatomical studies in association with teratogens, ASD or autism spectrum disorder is the alteration of brain development immediately after conception. The autistic children seem to have an overgrowth in their brain development right after their birth. These overgrowths include excessive neuron formations that lead to over connectivity with the key brain regions, unbalanced excitatory and inhibitory networks, disturbed neurological migration, abnormal formation of dendritic spines and synapses. Along with these over connectivity theory, there is the under connectivity theory that denotes an under-functioning of the neural connections and synchronization.
- Neuropsychology: According to one theory known as the Simon Baron-Cohen's theory, the autistic children can develop internal rules of operation in order to handle internal brain events. However, in handling events generated by other agents, it is less effective. Another theory by Kenworthy hypothesizes focuses on executive dysfunction. It also highlights the executive functions that many of the autistic children are endowed with, in contrast to the stereotyped behaviour.
How is Autism Diagnosed?
By the age of 2, all children with this disorder are generally diagnosed by the skilled professional which includes a Paediatrician, Neuropsychologist, Psychologist and Developmental Therapist. But there are many, who cannot be diagnosed as an autistic child before they are much older, as their behavioural characteristics might be different from the general. This leads to the delay in providing the treatment for Autism. The diagnosis must be done in two steps and they are:
- Developmental Screening: A neuropsychologist and developmental therapist will evaluate the learning, executing and behavioural changes of the child in regular intervals at the age of 9 months, 18 months, 24 months and 30 months. If there is any developmental and learning delay found in a child, he/she must be diagnosed with this developmental screening process. But those who are at a higher risk like premature birth, having a sibling with ASD or autism spectrum disorder or have had low birth weight should be checked earlier.
- Comprehensive Diagnostic Evaluation: In this test, genetic testing, hearing and vision screening, neurological testing, and many other medical tests are done to evaluate whether there is any trouble in the child's brain development.
Treatments for Autism:
- Medications to Treat Autism: Anti-psychotic medicines like Risperdal, Melatonin, and etc. are given to manage serious behaviour problems like aggression, self-injury, sleep apnea and tantrums. However, there is no particular medicine that can cure Autism.
- Diets for Autistic Child: Omega 3 Fatty Acids and vitamins must contain in high quantities in the diets of the autistic children. A diet free of gluten that is present in wheat in excess quantities and casein that is present in milk in excess quantities, is often recommended for the autistic children. But there is no evidence that has proven it as useful. 30% of autism patients are found to consume non-food items such as paper or dirt and hence, parents must be careful with that.
Home Treatments for Autism:
Having a child with autism is a difficult path to cover. However, to take care of the child, the parents too have to be well educated to tackle and handle Autism.
Behaviour and Communication Approaches towards an Autistic Child:
Depending on the individual characteristic traits of the children with autism, the parents need to deal with them. Most of the time, communication is a major trouble and hence, the parents must:
- Use the child's name as much as possible to refer to them and to make them understand that they are being referred to when calling that name
- Keep the background sound as minimum as possible
- Use simple gestures to communicate
- Start with using simple words
- Allow the Autistic child to express what he/she is trying to say
- Speak slowly so that the autistic child can understand and learn the words
Parent Education and Training:
By joining the local communities for teaching the parents regarding how to live with autistic children, the parents can educate themselves about the facts and figures of the disorder. How other parents deal with their autistic children and their stories can help you.
Makaton and PECS:
Parents can use the Makaton system or the alternative communication therapy in which the parents are taught how to communicate with the children through signs and symbols. Also the Picture Exchange Communication System is useful that can be used in home therapy to communicate with the autistic child.
Alternative Therapies for Treating Autism:
In some of the cases a few alternative therapies are used that do not have any scientific proof supporting the therapies and can be quite dangerous. In such a case, it is better to avoid them.
- Chelation Therapy: This includes the removal of metals like mercury from the body. But this does not have any significance as mercury and autism have no relation between them.
- Hyperbaric Oxygen Therapy: When oxygen is supplied to the patient under a pressured chamber, it is believed to help in the omission of the difficulties; however, this too is a dangerous process with no scientific justification to this.
The useful therapies for Autism include:
- Occupational Therapy for Autistic Child: This helps to support the child to eat, bathe and dress on their own and also to relate to people.
- Sensory Integration Therapy for Autistic Child: This helps the patients to deal with the visual, auditory, tactile, gustatory, olfactory, vestibular and proprioceptory sensory information. If your child does not like to be touched or is irritated with certain sounds, this therapy will be beneficial.
- Dance Movement Therapy for Autistic Child: This therapy has been found to be extremely useful for autistic children and helps them in self-expression, communication and also in reducing repetitive movements.
Autism has no proper 'cure'. But with the help of these therapies, they can be supported with a better life.
Prevention or Minimizing Risk Factors for Autism:
To minimize the risk factors for autism, the parent, right from the time of pregnancy, should take care of the following:
- A diet that includes organic food
- Regular exercise routine
- Removal of mercury-based amalgam dental fillings
- Minimizing the use of Electro Magnetic Radiation as much as possible
- Include extra vitamins during pregnancy and minimize intake of antibiotics as much as possible
- Take doctor's advice to make sure that the baby is not underweight
- Choose the right vaccines for the child and eliminate the idea if the child has had a disease recently or is coming down with another one or is continuing antibiotics
- Give 2 or 3 Echinacea drops and ½ tsp. cod liver oil or 250mg of Vitamin C, during vaccination phase.