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Autism

(Autism Spectrum Disorders; Pervasive Developmental Disorders)

Definition

Autism is a spectrum of complex brain disorders. The disorders result in social, behavioral, and communication problems. Other conditions that are part of this spectrum include Asperger syndrome and pervasive developmental disorder.

Causes

Autism is a neurodevelopmental disorder. This means that problems in brain development cause autism. Scientists are searching for answers about what causes these development problems. Studies suggest:
  • Autism seems to run in some families. Several genes may be involved.
  • Problems during pregnancy or delivery may interfere with normal brain development.
  • Something in the environment that a child is exposed to may be a factor.

Risk Factors

Factors that increase the risk of developing autism include:
  • Sex: male
  • Family history: siblings of a child with autism are at higher risk
  • Having parents who are older
  • Problems during pregnancy or delivery
  • Mother with rubella during pregnancy
  • Epilepsy —especially when diagnosed under age 2 years
  • A number of other conditions are related to autism, although the relationship between them is not clear:
The Conditions Above Primarily Affect the Central Nervous System
Central Nervous System
Copyright © Nucleus Medical Media, Inc.

Symptoms

Autism usually first appears during early childhood between 2-6 years old. The severity of symptoms varies. Behaviors and abilities may differ from day to day. Symptoms may decrease as the child grows older. Children with autism may have a combination of abnormal behaviors.
Symptoms include:
  • Avoiding social contact
  • Having problems with language such as loss of language
  • Using words incorrectly
  • Communicating with motions instead of words
  • Avoiding eye contact
  • Having trouble with nonverbal communication
  • Lacking interest in normal activities for that age
  • Spending a lot of time alone
  • Not playing imaginatively
  • Not starting pretend games
  • Not imitating others
  • Having sensitivity to sound, smell, taste, sights, and touch
  • Reacting to stimulation in an abnormal way
  • Not reacting to smiles
  • Delayed motor skill development
  • Being hyperactive
  • Being passive
  • Having tantrums
  • Being single-minded
  • Being aggressive
  • Hurting self
  • Repetitive movement, such as rocking or flapping a hand
  • Resisting change
  • Forming unusual attachments to objects
  • Sniffing or licking of toys
  • Not understanding other peoples' feelings and needs
  • Being a picky eater
  • Having gastrointestinal problems, such as diarrhea, constipation, or frequent abdominal pain
Some people with autism suffer from other disorders as well, including:

Diagnosis

Doctors who specialize in autism will observe the child's behavior, social contacts, and communication abilities. They will evaluate mental and social development. Parents will be asked about the child's behavior. Some doctors ask parents to bring in videos of the child at home.
Tests may include:
  • Neuropsychological tests
  • Questionnaires and observation schedules
  • Intelligence tests
Medical tests to rule out other conditions that cause similar symptoms may include:
  • Blood tests
  • Urine tests
  • DNA testing
An electroencephalogram (EEG) may also be done to record brain activity.

Treatment

There is no cure for autism. The severity of symptoms may decrease over the years. Children with autism and their families may benefit from early intervention. Children aged 18-30 months who had high-intensity intervention showed improvements in their IQ, language, and behavior.
Children with autism respond well to a structured, expected schedule. Many children with autism learn to cope with their disabilities. Most need assistance and support throughout their lives. Others are able to work and live independently when they grow up.
Children with autism can benefit from:

Special Education

Programs that meet the child's special needs improve the odds of learning. Children with autism may have trouble with assignments, concentration, and anxiety . Teachers who understand the condition can work with the child's abilities. Programs should use the child's interests. Some children do better in a small-group setting. Others do well in regular classrooms with special support. Vocational training can help prepare young adults for a job.

Therapy Services

Speech, physical, and occupational therapies may improve speech and activities. Children with autism need help developing social skills. Mental health professionals can help a family cope with caring for a child with autism. Counselors help parents learn how to manage behaviors.

Applied Behavioral Analysis

ABA is a type of behavior program. It can be used in school, in a therapy setting, and at home. There are a number of different kinds of ABA programs. Talk to your child's doctor about which one might be helpful for your child.

Medication

There are no drugs to treat autism. Some drugs are used to help manage symptoms. Medicines for anxiety and depression can also help treat obsessive and aggressive behaviors. Your child's doctor may use other medicines to help control other disruptive behaviors.

Other Therapies

There are other treatments available. These include dietary changes and alternative therapies. Talk with your child's doctor first to see if any of these would be helpful for your child.

Prevention

There are no guidelines to prevent autism. The cause is unknown. Scientists are searching for its underlying causes.

RESOURCES

Autism Spectrum Disorders (ASDs) Centers for Disease Control and Prevention http://www.cdc.gov

The Autism Society http://www.autism-society.org

CANADIAN RESOURCES

Autism Canada Foundation http://www.autismcanada.org

Autism Society Canada http://www.autismsocietycanada.ca

References

Autism 101: a free online course. The Autism Society website. Available at: http://support.autism-society.org/site/PageServer?pagename=about%5Fcourse. Accessed May 14, 2013.

Autism fact sheet. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/autism/detail%5Fautism.htm. Updated May 7, 2013. Accessed May 14, 2013.

Autism spectrum disorders. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 6, 2013. Accessed May 14, 2013.

Autism spectrum disorders (ASDs). Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/ncbddd/autism/index.html. Updated August 7, 2012. Accessed May 14, 2013.

Autism spectrum disorders (pervasive developmental disorders). National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-pervasive-developmental-disorders/index.shtml. Updated May 14, 2013. Accessed May 14, 2013.

Dawson G, Rogers S, Munson J, et al. Randomized, controlled trial of an intervention for toddlers with autism: the early start Denver model. Pediatrics. 2009 Nov 30.

Rapin I. An 8-year-old boy with autism. JAMA. 2001;285:1749-1757.

Sykes NH, Lamb JA. Autism the quest for genes. Expert Rev Mol Med. 2007;9:1-15.

10/30/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Ibrahim S, Voigt R, Katusic S, Weaver A, Barbaresi W. Incidence of gastrointestinal symptoms in children with autism: a population-based study. Pediatrics. 2009;124(2):680.

12/31/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Rice C. Prevalence of autism spectrum disorders—Autism and Developmental Disabilities Monitoring Network, United States, 2006. MMWR Surveill Summ. 2009;58(SS10):1.

11/11/2013 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Chaidez V, Hansen RL, et al. Gastrointestinal problems in children with autism, developmental delays, or typical development. J Autism Dev Disord. 2013 Nov 6.

5/12/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: MacDonald M, Lord C, et al. The relationship of motor skills and social communicative skills in school-aged children with autism spectrum disorder. APAQ. 2013 July. 30, 271-282. Available at: http://journals.humankinetics.com/AcuCustom/Sitename/Documents/DocumentItem/04MacDonald.pdf. Accessed May 12, 2014.

8/19/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Reilly C, Atkinson P, et al. Neurobehavioral comorbidities in children with active epilepsy: a population-based study. Pediatrics. 2014;133(6):e1586-1593.

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