Autism

Autism is an early childhood developmental disorder of brain function that causes impaired social interaction; difficulty with imagination and communication, both verbal and nonverbal; and unusual or limited interests and activities. Sometimes autistic spectrum disorders include autism, pervasive developmental disorder and Asperger's disorder. The individual behavior and abilities of a person who has autism often vary from mild to severe, depending on factors such as age and developmental level.


Causes/associated factors
Autism cuts through economic, social, racial and ethnic backgrounds. Parental practices and behaviors were once blamed for autism in children, but this is now understood to be untrue. Although the cause remains unknown, autism appears to have a hereditary connection. In families with one child who has autism, research suggests the risk of having a second child with the disorder is about 5 percent.
Certain genes and environmental factors, such as viruses or chemicals, may contribute to the development of autism. In a few cases, disorders such as fragile X syndrome (a condition caused by a mutation of the X chromosome and the most common inherited cause of mental retardation), untreated phenylketonuria (PKU, a congenital defect of a specific enzyme that disrupts normal metabolism and may cause developmental delays and IQ loss if left untreated) and exposure to rubella during the first trimester of pregnancy may lead to autistic behavior.

To date, there is no research to support any link of childhood vaccines to autism.

Today, about three to five children in 10,000 are diagnosed with autism. Although the disorder affects males four times as often as females, severe mental retardation is more likely to accompany autism in females.


Characteristics
Infants who have autism may arch their backs away from you in order to avoid physical contact. Infants or toddlers who have autism may not cuddle, make eye contact, or respond to affection or touching. These babies may be described as especially quiet and nondemanding or on the other end of the spectrum -- extremely irritable with frequent crying. Dysfunctional self-stimulating behaviors such as rocking, clapping, hand biting or head banging can also emerge during infancy. Other difficulties may be related to sleeping, eating, attention, and extreme active or passive behavior patterns.
About one-third of children diagnosed with autism develop normally until ages 1½ to 3. Mild forms of autism may resemble a personality disorder or learning disability. More severe forms of autism often involve extremely repetitive, unusual, self-injurious or aggressive behavior. Because 75 percent of children with autism function at a retarded level, a diagnosis of mental retardation is often made in association with autism. There's also an increased risk of seizures or epilepsy in children who have autism.

Language development may be absent or delayed in children who have autism. Speech may be abnormal in tone, pitch, rate or rhythm. The verbal language of children who have autism is often repetitive. For those who function at a higher level, comprehension is often lower than vocabulary development. Children who have autism may fall behind their peers in communication, social skills and cognition.

People who have autism are often fascinated with moving objects, such as spinning wheels, running water or other fast-moving items. It's common for children who have autism to develop object fixations or attachments to things such as rubber bands, bricks or toys.

Some people diagnosed with autism are able to lead fairly independent lives, especially when language skills and overall intellectual level are solid. A small percentage of adults who have autism are able to live and work independently. Even the highest-functioning adults who have autism continue to have difficulties with communication and social situations, however. They also have limited interests and activities. Because of their inability to form meaningful attachments, few people who have autism develop romantic relationships or marry.

About 10 percent of people who have autism have savant skills. These exceptional talents are often in areas of music, art or math.

Various disorders may share typical autistic behaviors, including Asperger's disorder, childhood-onset schizophrenia, fragile X syndrome, Landau-Kleffner syndrome, Rett's syndrome and Williams syndrome. These disorders are characterized by obsessions with certain topics, excellent memories, and concrete and literal thinking. These disorders are not autism, however.


Signs/symptoms
Keeping in mind that each person who has autism may behave differently, here are a few traits caregivers may notice:
Communication: absent or slow language development, short attention span

Social interaction: little interest in making friends; decreased responsiveness to social cues, such as eye contact; little spontaneous play; infrequent initiation of play; and limited imaginary play

Sensory impairments: interference with certain senses, such as a ringing in the ears, and unusual responses to sensory stimuli (An example is a high pain tolerance or hypersensitivity to smell, touch or sounds. Some people with autism become uncomfortable when exposed to certain sounds or frequencies. At the other end of the spectrum, there may be a lack of sensory response. Some autistic children are initially thought to be hearing-impaired due to their lack of response to sounds.)

Emotions: inappropriate emotional reactions, such as laughing or crying for no apparent reason, and the apparent absence of any emotional reaction

Behavior: hyperactivity or passive behavior, such as throwing temper tantrums without apparent reason or showing aggressive or violent behavior toward themselves or others
People who have autism often insist that their environments remain unchanged. They may also have specific rituals, such as sitting in a specific seat at the table, eating or drinking the same things, or wearing certain items of clothing. If any of these factors change, the person may have a behavioral outburst. These responses and their subsequent behaviors may be caused by the person's inability to understand and cope with new situations.


Diagnosis
The diagnosis of autism is made through observation of a child's communication, behavior and development. However, some behaviors associated with autism are shared by other disorders. The doctor may order certain medical tests to rule out other conditions.

Treatment
Today, there is no cure for autism. Instead, treatment focuses on therapies and interventions to alleviate a person's particular symptoms. Because of the wide and varied spectrum of symptoms, no single approach is most effective for everyone. Treatment may need to be adapted as the person's needs change.
Early intervention is key. Highly structured and intensive skill-oriented instruction can help people who have autism develop social and language skills, particularly when it begins at an early age. Research indicates that early interventions have a good chance for positively influencing brain development.

There are no specific medications to treat autism. Medications are sometimes prescribed to help treat specific factors that may accompany autism, however. For example, neuroleptics may be prescribed to modify self-injurious or aggressive behavior. A class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs, such as Prozac) may be used to help control obsessive-compulsive symptoms.

Finally, counseling, support groups and training sessions can help families, teachers and caretakers learn to cope with a person who has autism.


Senior-specific information
Autism is an early childhood developmental disorder. Growing older isn't a risk factor for this condition.