Autism is a developmental disorder that appears in the first 3 years of life and affects 4-5 times more boys than girls. It is a physical condition linked to abnormal biology and chemistry in the brain, and affects the brain's normal development of social and communication skills.

Types of autism

There are two main types of autism:  "Kanner/Classic Autism" where in addition to the autism, there is also intellectual impairment. Statistically, it is consider that 76% of people with autism have "Kanner/Classic". Whereas 24% of people with autism do not have any intellectual impairments, nor speech delay in early childhood years and these people are classified as having "Asperger Syndrome", displaying a normal or more than often, above average intellectual ability.

Causes

The exact causes of these abnormalities remain unknown, but this is a very active area of research. Genetic factors seem to be important. For example, identical twins are much more likely than fraternal twins or siblings to both have autism. Similarly, language abnormalities are more common in relatives of autistic children. Chromosomal abnormalities and other nervous system (neurological) problems are also more common in families with autism.

A number of other possible causes have been suspected, but not proven. They involve:

• Diet
• Digestive tract changes
• Mercury poisoning
• The body's inability to properly use vitamins and minerals
• Vaccine sensitivity

Symptoms

Most parents of autistic children suspect that something is wrong by the time the child is 18 months old and seek help by the time the child is age 2. Children with autism typically have difficulties in:

• Social interactions
• Verbal and nonverbal communication

• No babbling by 11 months of age
• No simple gestures by 12 months (e.g., waving bye-bye)
• No single words by 16 months
• No 2-word phrases by 24 months (noun + verb - e.g., "baby sleeping")
• No response when name is called, causing concern about hearing
• Loss of any language or social skills at any age
• Rarely makes eye contact when interacting with people
• Does not play peek-a-boo
• Doesn't point to show things he/she is interested in
• Rarely smiles socially
• More interested in looking at objects than at people's faces
• Prefers to play alone
• Doesn't make attempts to get parent's attention; doesn't follow/look when someone is pointing at something
• Seems to be "in his/her own world"
• Odd or repetitive ways of moving fingers or hands
• Lack of interest in toys, or plays with them in an unusual way (e.g., lining up, spinning, opening/closing parts rather than using the toy as a whole)
• Compulsions or rituals (has to perform activities in a special way or certain sequence; is prone to tantrums if rituals are interrupted)

 Some children with autism appear normal before age 1 or 2 and then suddenly "revert" and lose language or social skills they had previously gained. This is called the regressive type of autism.

Signs and tests

All children should have routine developmental exams done by their pediatrician. Further testing may be needed if the doctor or parents are concerned. This is particularly true if a child fails to meet any of the above language milestones.

These children might receive a hearing evaluation, blood lead test, and screening test for autism.

A health care provider experienced in diagnosing and treating autism is usually needed to make the actual diagnosis. Because there is no biological test for autism, the diagnosis will often be based on very specific criteria from a book called the Diagnostic and Statistical Manual IV.

An evaluation of autism will often include a complete physical and nervous system (neurologic) examination. It may also include a specific screening tool, such as:

• Autism Diagnostic Interview - Revised (ADI-R)
• Autism Diagnostic Observation Schedule (ADOS)
• Childhood Autism rating Scale (CARS)
• Gilliam Autism Rating Scale
• Pervasive Developmental Disorders Screening Test - Stage 3

Treatment

An early, intensive, appropriate treatment program will greatly improve the outlook for most young children with autism. Most programs will build on the interests of the child in a highly structured schedule of constructive activities. Visual aids are often helpful.

Treatment is most successful when it is geared toward the child's particular needs. An experienced specialist or team should design the program for the individual child. A variety of therapies are available, including:

• Applied behavior analysis (ABA)
• Medications
• Occupational therapy
• Physical therapy
• Speech-language therapy

Sensory integration and vision therapy are also common, but there is little research supporting their effectiveness. The best treatment plan may use a combination of techniques.

Diet

Some children with autism appear to respond to a gluten-free or casein-free diet. Gluten is found in foods containing wheat, rye, and barley. Casein is found in milk, cheese, and other dairy products. Not all experts agree that dietary changes will make a difference, and not all studies of this method have shown positive results.

If you are considering these or other dietary changes, talk to both a doctor who specializes in the digestive system (gastroenterologist) and a registered dietitian. You want to be sure that the child is still receiving enough calories, nutrients, and a balanced diet.

Other approaches

Beware that there are widely publicized treatments for autism that do not have scientific support, and reports of "miracle cures" that do not live up to expectations. If your child has autism, it may be helpful to talk with other parents of children with autism and autism specialists. Follow the progress of research in this area, which is rapidly developing.

Calling your health care provider

Parents usually suspect that there is a developmental problem long before a diagnosis is made. Call your health care provider with any concerns about autism or if you think that your child is not developing normally.

This article is cited from Autism South Africa and Pub Med Health.

Sources:

• Autism South Africa
• Pubmed Health

 

Page Updated: 08 May 2012

Disclaimer

Every effort is made to ensure that the information made available on this article is accurate and up to date. However, the City of Cape Town cannot guarantee the accuracy of such information, nor that this information is up to date.