Prevalence of Autism
Autism is the most common of the Pervasive Developmental Disorders,
affecting an estimated 1 in 150 births (Centers for Disease Control Prevention,
2007). Roughly translated, this means as many as 1.5 million Americans today
are believed to have some form of autism, and this number is on the rise. Based
on statistics from the U.S. Department of Education and other governmental
agencies, autism is growing at a startling rate of 10-17 percent per year. At
this rate, the ASA estimates that the prevalence of autism could reach 4
million Americans in the next decade. Autism knows no racial, ethnic, social
boundaries, family income, lifestyle, or educational levels and can affect any
family, and any child. And although the overall incidence of autism is
consistent around the globe, it is four times more prevalent in boys than in
girls.
Common Characteristics of Autism
Symptoms and
behaviors of autism can combine in many ways and vary in severity. Autistic
children and adults may or may not have speech, or quite often times the speech
could be delayed. They make non-speech sounds (e.g. rrrrrrr), echolalia, and
mimicking words without understanding what the word means. One characteristic
which is quite common in autism is the individual's ‘insistence on sameness’ or
'perseverative' behavior. Many children become overly insistent on routines; if
one is changed, even slightly, the child may become upset. Some common examples
are: drinking or eating the same food at every meal, wearing certain clothing
or insisting that others wear the same clothes, and going to school using the
same route. One possible reason for insistence on sameness may be the person's
inability to understand, and cope with novel situations. Lack of eye contact is
another characteristic of autism. They appear to be unaware of people around
them or show no real interaction with peers. Sometimes lack of imaginative play
and pretend games can be seen in autistic kids. Autistic children and adults do
not like being touched, hugged or being picked up. Some other distinguishing
behaviors are spinning, movements and flapping of hands especially when they
are over stimulated or particularly excited about something. Repetitive
behaviors like re-winding a video and watch it several times, over and over
again or lining up things such as their toys.
Some autistic children and adults love drawing;
some can be musical, like numbers and mathematics, skilled at using computers,
computer games, or using complex video/audio equipments. In general, people with autism can often have
accompanying learning disabilities, but everyone with in this condition shares
a difficulty in making sense of the world.
Causes of Autism
Although
there is not any known unique cause for autism; there is growing evidence that
autism can be caused by a variety of problems. There is some indication of a
genetic influence in autism (90%). For example, there is a greater likelihood
that two monozygotic twins (identical twins) will have autism than two
dizygotic twins. Results of the five-year study led by the Autism Genome
Project is reported in the Journal Nature
Genetics has implicated a previously unidentified region of chromosome
11; and neurexin 1, a member of a gene family believed to play a key role in
communication between brain cells. The neurexin finding highlighted a group of
brain cells called glutamate neurons and the genes affecting their development
and function, suggesting that they play a critical role in autism spectrum
disorders. There is also evidence that the genetic link to autism may be a
weakened or compromised immune system. Other research has shown the depression
and dyslexia are quite common in one or both sides of the family when autism is
present. There is also evidence that a virus can cause autism. There is an
increased risk in having an autistic child after exposure to rubella during the
first trimester of the pregnancy. Cytolomegalo virus has also been associated
with autism. Additionally, there is also a growing concern that viruses
associated with vaccinations, such as the measles component of the
measles-mumps-rubella (MMR) vaccine and the pertussis component of the DPT shot
may cause autism. There is growing concern that toxins and pollution in the
environment can also lead to autism. The highest proportion of autism cases
were found in the homes down-wind from the factory smokestacks. Medical conditions associated with an increased risk for
autism include the following:
Fragile
X syndrome (more common in males; may cause mental retardation),Tuberous
sclerosis (syndrome that causes seizures, mental disorders, and
tumors),Congenital rubella syndrome (results from transmission of the rubella
virus in utero), Untreated phenylketonuria (PKU; hereditary
disease caused by a defective enzyme). After all, no single region of the brain or
pathophysiological mechanism has yet been identified as being associated with
autism.
Diagnosing the Autism
There
are no medical tests for diagnosing autism. An accurate diagnosis must be based
on observations of the child's communication, behavior and developmental
levels. However, because many of the behaviors associated with autism are
shared by other disorders, a doctor may complete various medical tests to rule
out other possible causes. Since the characteristics of the disorder vary so
much, a child should be evaluated by a multidisciplinary team, which may
include a neurologist, psychologist, and developmental pediatrician,
speech/language therapist, learning consultant or other professionals
knowledgeable about autism.
Treatment
The
primary goal of treatment is to improve the overall ability of the child to
function. A program that addresses helping parents and improving communication,
social, behavioral, adaptive, and learning aspects of a child's life will be
most successful.
The
American Academy of Pediatrics (AAP) recommends the following strategies for
helping a child to improve overall function and reach his or her potential:
·
Behavioral training and management. Behavioral training
and management uses positive reinforcement, self-help, and social skills
training to improve behavior and communication. Many types of treatments have
been developed, including Applied Behavioral Analysis (ABA), Treatment and
Education of Autistic and Related Communication Handicapped Children (TEACCH),
and sensory integration. Applied Behavior Analysis is
the design, implementation, and evaluation of environmental modifications to
produce socially significant improvement in human behavior. ABA includes
the use of direct observation, measurement, and functional analysis of the
relations between environment and behavior. ABA uses antecedent stimuli and
consequences, based on the findings of descriptive and functional analysis, to
produce practical change.
·
Specialized therapies. These
include speech, occupational, and physical therapy. Occupational therapy helps
to improve independent functions and teaches basic skills (e.g., buttoning a
shirt, bathing). Physical therapy involves using exercise and other physical
measures (e.g., massage, heat) to help patients control body movements.
·
Medications. In addition to
behavioral, communicative and social learning approaches, Medications are most
commonly used to treat related conditions. A variety of medications are used
with autistic patients, including antidepressant, anti-anxiety, psychotropic
and stimulant medications that help regulate behavior and mood.
·
Community support and parent
training. Talking to the doctor or contacting an advocacy group for support and
training.
Works Cited
Santangelo
SL, Tsatsanis K. “What is known about autism: genes, brain, and
behavior.” American Journal of Pharmacogenomics 2005;5(2):71-92.
Ho A ,Todd RD
,Constantino JN. “Autistic traits in twins vs. non-twins--a preliminary study.”
Journal of Autism and Developmental Disorders
2005 Feb;35(1):129-33.
Pinto-Martin J, Levy SE. “Early Diagnosis of Autism Spectrum Disorders.” Current Treatment Options in Neurology 2004 Sep;6(5):391-400.
“About autism.” <http://www.autism-awareness.org.uk>.
“Common Characteristics of Autism.”
<http://www.ukautism.com/id1.html>.
“Autism
Spectrum Disorders (Pervasive Developmental Disorders).” National Institute
of Mental Health Publication No.04-5511April 2004
“New
Genetic Links for Autism.” Psych Central
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