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Autism

Alternate Names

  • autistic disorder
  • PDD

Definition

Autism is a condition that affects development of the brain. Autism severely affects a person's social, mental, emotional, and communications skills.

What is going on in the body?

Autism is the most severe form of a spectrum of pervasive developmental disorders, which affect a person's ability to interact with others. The hallmark signs of autism are extreme difficulty in responding to social interactions and communicating with others.
Autism is most often noticed before the age of 3. It occurs four times more often in boys than in girls. It seems to appear equally among all parts of society.
Although estimates of the frequency of autism in the population vary depending on how strict a definition is used, autism has clearly been increasing and may now affect as many as 3 to 6 per 1,000 children.
Some people who have autism may also have other disorders that affect the brain. These include:
  • epilepsy
  • Down syndrome
  • fragile X syndrome
  • Turner syndrome

Risks

What are the causes and risks of the condition?

Experts now believe that genetic factors are responsible for autism, though the responsible genes are still being identified and the mechanism of causation of autism is still not understood.
It is known is that none of the following can cause autism.
  • bad parenting
  • mental illness
  • a child's naughty behavior
Psychological factors have also not been found to contribute to autism. Some cases of autism have been associated with trauma, disease, or structural abnormalities before or during birth. These include:
  • encephalitis or other serious infections affecting the brain as an infant
  • lack of oxygen during birth
  • the mother having rubella, formerly called German measles, while she was pregnant
  • untreated phenylketonuria, a genetic problem in the body's ability to handle certain chemicals named phenylketones
A considerable body of research has also shown that autism is not linked to childhood immunizations.

Prevention

What can be done to prevent the condition?

Not enough is known yet about the cause of autism to prevent it. Early recognition and treatment may decrease the effects of autism.

Diagnosed

How is the condition diagnosed?

A team of healthcare professionals should evaluate the person with symptoms of autism. The team may include:
  • a physician with training in child development
  • a psychologist
  • a neurologist
  • a speech therapist
  • a learning consultant
Diagnosis begins with a medical history and physical exam. Further testing is then needed to identify other possible causes of the symptoms. These may include blood tests, cranial CT scans, cranial MRI scans, and electroencephalograms (EEGs).

Long Term Effects

What are the long-term effects of the condition?

Long-term effects of autism depend on how severe the symptoms are. Long-term effects also depend on how soon a person starts treatment. The symptoms of autism may last a lifetime, but the person's condition can often be improved with careful intervention and treatment. An individual with autism may develop seizure disorders and depression.

Other Risks

What are the risks to others?

Autism is not contagious. Genetic counseling may be helpful if a couple has a family history of autism.

Treatments

What are the treatments for the condition?

Treatment for autism first focuses on education. This should be tailored to each person's specific needs and symptoms. Some of the treatments include:
  • audiovisual therapies, which provide structured cues
  • behavioral therapy to help the person deal with his or her environment
  • dietary changes
  • "inclusion programs" to help the person adapt to the outside world as much as possible
  • medicines, including antipsychotic medicines
  • music therapy
  • physical therapy
  • speech therapy
  • providing a structured environment for the person
Treatment may also include teaching the person how to handle new situations. This can include asking for help, directions, and other needs. An individual with autism often needs guidance in getting jobs and handling the daily work routine.
The families and friends of people with autism need support as well. The more support they have, the better the adjustment to living with a person with autism. Sometimes the person may need to go to a group home if the family is not able to function and treat the person with autism.

Side Effects

What are the side effects of the treatments?

Side effects depend on the treatments used. Behavioral therapy can cause frustration for the person and the family going through it. Medicines may cause stomach upset, rash, irritability, depression, and allergic reactions.

After Treatment

What happens after treatment for the condition?

Treatment for autism will usually last a lifetime. A person with a mild form of autism may need to monitor himself or herself for new or worsening symptoms. A person with a more severe form of autism may need assistance with treatment and therapy programs.

Monitor

How is the condition monitored?

Autism needs to be monitored closely. Treatments need to be adjusted over time. Someone with a mild form of autism may improve as he or she matures. By contrast, an individual with a more severe form of autism may worsen over time and may need adjustments to the treatment program. The person may also have to rely on a caregiver to monitor behavior and help with activities of daily living.

Sources

[hyperLink url="http://www.autism-society.org/" linkTitle="www.autism-society.org"]www.autism-society.org[/hyperLink]

Current Pediatric Diagnosis and Treatment, Hathaway, Hay, Groothuis, Paisley, 1993

Professional Guide to Diseases, Springhouse,1995

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