What is Autism?
Autism is considered a neurological disorder that affects the normal functioning of the brain. It typically appears in the first three years of life and impacts the development of communication skills and social interaction. Autism is a spectrum disorder, which means it affects individuals differently, but there is a diagnostic set of behaviors used by clinicians to evaluate individuals for autism. For example, most individuals with autism have difficulty with verbal and non-verbal communication, social interaction, and play. There is no known cause or cure for autism, but children who are diagnosed early and receive the appropriate interventions can have markedly improved outcomes. The prevalence of autism in the United States is currently 1 in every 88 American children and approximately 1 in every 54 boys.
One of the most common characteristics of autism is impaired social interaction. For example, a baby with autism may be unresponsive to people or focus on one item exclusively. Children with autism may also avoid eye contact, fail to respond to their name, and fail to watch people's faces for social cues, such as facial expressions. As previously stated, autism is a “spectrum disorder”, meaning each person with autism has a unique combination of characteristics that will place them somewhere on the spectrum. Each individual with autism processes and responds to information in their own unique way. However, people with autism may possess some of the following traits:
- Talking “at” others instead of “with” others
- Aggressive or self-injurious behaviors
- Resistance to change
- Preference for solitude
- Difficulty in expressing needs
- Dislike of human contact, i.e. not wanting to be cuddled
- Obsessive attachment to objects
- No fear of danger
- Non-responsive to language; seeming deaf even if hearing is normal
- Noticeable under-or-over activity
- Little or no eye contact
- Little interest in peer relationships or play
- Lack or delay in spoken language
- Fixation on parts of an object
- Repetitive use of language
- Repetitive motor movements (mannerisms)
The American Academy of Pediatrics recommends that all children be screened for autism by their family pediatrician at 18 months and again at 24 months. There is no medical test, like a blood test, for example, to determine if an individual has autism. Additionally, a brief observation of a child in a single setting is not enough for a physician to diagnose a child with autism. An accurate diagnosis of autism is based on an observation of a child's communication, behavior, and development that is supported with feedback from parents, caregivers, and teachers.
An evaluation for autism requires a multidisciplinary team that may include your pediatrician, a psychologist, a neurologist, a speech therapist, and a psychiatrist. Doctors will probably use established screening instruments like standardized questionnaires to compile information on your child's development and behavior. Your child's hearing will also be tested, as difficulties in hearing can cause behaviors and developmental delays that can be mistaken for autism.
You may have heard teachers or physicians speak about the importance of early intervention. In fact, the American Academy of Pediatrics recommends that treatment for autism begins as soon as the disorder is suspected, rather than waiting for a formal diagnosis. Research has shown that early intervention or services that are delivered to children under the age of 3, when their brains are the most flexible, has a big impact on reducing the symptoms of autism. Early intervention has been shown to reduce the need for intensive supports for some children by the time they reach Kindergarten and can improve overall functioning.
The ideal intervention targets the core symptoms of autism, such as impaired social interaction, nonverbal communication, and obsessions with routines or interests. Treatment typically includes two key components: medication paired with education/ behavioral interventions. Medications can be helpful in managing symptoms like anxiety, depression, behavioral disorders, and problems with attention.
What causes Autism?
It is not clear what causes autism. Researchers believe that both genetics and the environment play a role. Many parents believe that there is a link between vaccination and autism; however, a court decision in 2009 ruled that there is no proven link between vaccination and autism. One thing is certain though; parental practices do not cause autism.