Autism Facts: Symptoms, Causes And Treatment | Mental Health slideshows | Emotional & Mental Health center

There's no laboratory or medical test for detecting autism

Autism is clinically diagnosed by assessing symptoms in accordance with clinical guidelines. According to the journal of autism and developmental disorders, babbling at twelve months, gesturing by twelve months, single word use by sixteen months, regular use of two word phrases by twenty four months and a loss of language skill at any age make it absolutely essential to investigate further into autism and autistic spectrum disorders. Even though about 15% of autistic children have a detectable single gene abnormality, using genetic screening methods are not practical yet. Metabolic tests and imaging methods may be helpful but not done routinely.

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Photo courtesy of Myfuture.com by Flickr : www.flickr.com/photos/myfuturedotcom/6052491343/
Illustrated textbook of pediatrics by Lissauer and Graham
Biological psychiatry
Clinical medicine by Kumar and Clark
Clinical pharmacology by Bennett and Brown

What Is Autism And How Can You Recognize It?

Autism is due to abnormal development of the nervous system. Autistic children have difficulty making friends, playing in a group, poor speech, poor body language and show repetitive, stereotyped movements like stacking boxes and lining up toys. Autism first appears in childhood or infancy. It features three main symptoms. They are poor social interactions, impairment of communication, restricted interests and repetitive behaviors. Due to poor interactions they fail to make friends, play alone and remain possessive. They find it difficult to speak and express feelings through body language. They develop a unique set of behaviors that they hardly ever change. They like to stack objects, line up toys and adhere strictly to a daily routine. Symptoms become apparent around one to two years of age. Some children develop normally before regressing. During adulthood the symptoms are rather muted.

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Photo courtesy of ToNToNi by Wikimedia Commons : ca.m.wikipedia.org/wiki/Fitxer:Autism-stacking-cans.jpg
Illustrated textbook of pediatrics by Lissauer and Graham
Biological psychiatry
Clinical medicine by Kumar and Clark, Clinical pharmacology by Bennett and Brown

Autism Is On The rise

From 1996 to 2007, the incidence of autism has increased dramatically. In 1996 less than 1 in 1000 children suffered from autism. In 2007 more than 5 children out of 1000 have autism. This rise may be due to new methods of diagnosis, awareness, referral system, availability of services and also actual rise of prevalence. Because of data insufficiency, the magnitude of true rise of prevalence is difficult to identify. Autism affects boys more than girls. There is a genetic background to autism while advanced age of either parent, diabetes and psychoactive drugs in pregnancy are associated with a higher incidence of autism.

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Photo courtesy of Julie Jordan Scott by Flickr : www.flickr.com/photos/juliejordanscott/4545538411/
Illustrated textbook of pediatrics by Lissauer and Graham
Biological psychiatry
Clinical medicine by Kumar and Clark
Clinical pharmacology by Bennett and Brown

Connection Between Vaccines And Autism

The center for disease control and prevention, the American academy of pediatrics and the world health organization assure that there is no link between vaccination and autism. Previously there was a concern that a certain preservative in vaccines caused autism. Therefore, the CDC withdrew all vaccines containing that preservative. But there was no significant change in the disease pattern suggesting that there was no such causative link. Also a study done by the Institute of medicine uncovered that there is no causal relationship between vaccination and autism. Recent statistics suggest that the 8 vaccines in routine use in USA are safe and almost always free of adverse effects.

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Photo courtesy of Sanofi Pasteur by Flickr : www.flickr.com/photos/sanofi-pasteur/5570806219/
Illustrated textbook of pediatrics by Lissauer and Graham
Biological psychiatry
Clinical medicine by Kumar and Clark
Clinical pharmacology by Bennett and Brown

Bigger Head, Bigger Risk ?

Leo Kanner, who first described autism, linked it with a large head size. But current systematic reviews suggest that the supposed link is not as sound as it was once thought to be. A review published in Biological psychiatry took 7 methodically correct studies into consideration. Four linked autism with a large head while the other three did not. Another study published in the same journal concluded that while autistic children do have a larger head compared to their unaffected peers, the difference is insignificant; only 2 millimeters on average. Other studies have shown that children with regressive autism have larger heads than normal. Thus the current norm is that the head size tends to be larger in autism but only in a certain subset of children with autism spectrum disorders.

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Photo courtesy of David Farrell-Shaw by Wikimedia Commons : commons.wikimedia.org/wiki/File:Chocolate_mouth.jpg
Illustrated textbook of pediatrics by Lissauer and Graham
Biological psychiatry
Clinical medicine by Kumar and Clark
Clinical pharmacology by Bennett and Brown

Blame Genes

Geneticists have linked about 40% of cases of autism to genetic causes, and 15% of autistic children have identifiable genetic disorders. But the problem with applying genetic diagnostic methods is, according to current knowledge, genetic testing is indicated only when clinical evaluation suggests a possible genetic involvement. Unlike other disorders, autism appears to alter certain factors of neural development. Its impact appears to be on the timing and rate of development rather than the functionality of the nervous system itself. Current theories suggest poor migration of neural precursor cells during early fetal development, excessive local over connectivity in key brain regions and abnormal transmission of neural impulse along faulty circuits as disease mechanisms.

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Photo courtesy of Spirit-Fire by Flickr : www.flickr.com/photos/spirit-fire/4739023417/
Illustrated textbook of pediatrics by Lissauer and Graham
Biological psychiatry
Clinical medicine by Kumar and Clark
Clinical pharmacology by Bennett and Brown

Autistic Spectrum Disorder

The name autism spectrum covers a range of conditions where there are communication difficulties, social difficulties and ritualistic behaviors. These are classified as pervasive developmental disorders in the diagnostic and statistical manual of mental disorders. There are four diseases. They are autism, Asperger syndrome, pervasive developmental syndrome not otherwise specified, childhood disintegrative disorder and Rett syndrome. Normally only the first three are considered as parts of the autistic spectrum. Rett syndrome is also known as cerebro-atrophic hypo-ammonemia. It is due to disordered development of gray matter of the brain. It is only found in females. It features retarded head growth, seizures, repetitive hand wringing and associated gastro-intestinal disorders.

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Illustrated textbook of pediatrics by Lissauer and Graham
Biological psychiatry
Clinical medicine by Kumar and Clark
Clinical pharmacology by Bennett and Brown

Asperger Syndrome

Asperger syndrome refers to a child with social impairment of an autistic spectrum disorder but at the milder end, and near normal speech development. Such children have significant difficulties in give-and-take of ordinary social encounters, a stilted way of speaking and narrow, strange interests which they do not share with others, and are often clumsy. In reality autistic spectrum disorders are a continuum of behavioral states ranging from a severe form of autism with or without severe learning difficulties to the milder Asperger syndrome, to autistic features occurring secondary to other clinical problems. No cause has been identified. It is not due to emotional abuse, deviant parenting or vaccination.

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Illustrated textbook of pediatrics by Lissauer and Graham
Biological psychiatry
Clinical medicine by Kumar and Clark
Clinical pharmacology by Bennett and Brown

Pervasive Developmental Disorder

Pervasive development disorder is also known as atypical autism simply because it does not meet the diagnostic criteria of autism. It is defined in the diagnostic and statistical manual of mental disorders as “severe and pervasive impairment in the development of reciprocal social interaction or verbal and nonverbal communication skills, or when stereotyped behavior, interests, and activities are present, but the criteria are not met for a specific PDD”. Generally atypical autism is milder than autism but some symptoms can be severe. Atypical autism features difficulty in using and understanding language, poor social relationships, restricted behavioral patterns, haphazard skill development, repetitive body movements and strange likes and dislikes.

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Photo courtesy of Shannon Des Roches Rosa by Flickr : www.flickr.com/photos/shannonrosa/3200260963/
Illustrated textbook of pediatrics by Lissauer and Graham
Biological psychiatry
Clinical medicine by Kumar and Clark
Clinical pharmacology by Bennett and Brown

Early Treatment Is Crucial

The earlier the treatment starts, the better the outcome. The main goals are to improve quality of life and to improve social interactions and communication. The regime should be tailored to the child’s needs. No single method is foolproof. Occupational therapy, social skills therapy, structured teaching, speech and language therapy should be employed as needed in each individual case. Statistics suggest that half the patients with autism get drug therapy. Anticonvulsant use has scientific evidence to back it up but others do not. A clear and present danger of drug use is some may respond abnormally to drug treatment. Treatment for autism is expensive. A study estimates a lifetime cost of around $4 million for one patient on average.

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Photo courtesy of Allen Sheffield by Flickr : www.flickr.com/photos/awsheffield/8490915468/
Illustrated textbook of pediatrics by Lissauer and Graham
Biological psychiatry
Clinical medicine by Kumar and Clark
Clinical pharmacology by Bennett and Brown