"Autism is not a dead-end diagnosis. It
is the beginning of a journey into faith, hope, love, and recovery."
........Jerry J. Kartzinel, M.D., F.A.A.P
Autism
Spectrum Disorders
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What is Autism?
Autism is one of five disorders coming under the umbrella of Pervasive
Developmental Disorders (PDD), a category of neurological disorders
characterized by "severe and pervasive impairment in several areas of
development," including social interaction and communications skills. The
five disorders under PDD are Autistic Disorder, Asperger's Disorder,
PDD-Not Otherwise Specified (PDD-NOS), Childhood Disintegrative Disorder
(CDD), and Rett's Disorder
Autism
is a brain disorder that affects a person's ability to communicate, to
reason, and to interact with others. It is a spectrum disorder that
affects individuals differently and to varying degrees of severity.
Definition from KidsHealth (it's a
good one for parents to read too)
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How common is Autism?
According to the Centers for Disease Control, autism now affects one in
every 150 children born in the United States. Autism is the
fastest-growing development disability in the nation. Each day, 50
children receive the devastating diagnosis. Autism is more common than
childhood cancer, cystic fibrosis and multiple sclerosis combined.
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What are the signs of Autism?
Autistic children have difficulties with social interaction and problems
with verbal and nonverbal communication. They have repetitive behaviors
(like handflapping) and narrow, obsessive interests. These behaviors can
range in impact from mild to disabling.
Children with autism may fail to respond to their name and often avoid eye
contact with other people. They have difficulty interpreting what others
are thinking or feeling because they can’t understand social cues, such as
tone of voice or facial expressions, and don’t watch other people’s faces
for clues about appropriate behavior. They may lack empathy.
Other signs:
Tantrums
Do not return a smile
Difficulty expressing needs
Echolalia (repeats words instead of responding)
Improper use of pronouns (yours, mine, me, etc.)
Sustained odd play (lines toys up, etc.)
Aloof manner
Shows distress for no clear reason
Little or no eye contact
Insists on sameness
Inappropriate attachment to objects
Noticeable physical over or under activity
Over or under sensitivity to pain, light, sounds
Uneven
gross/fine motor skills
Typical story:
They weren't concerned about their son's communication skills until sometime after his second birthday.
He was way ahead of others academically -- he knew all of his
letters, numbers, colors, and shapes when he was 18 months old. What
they first noticed was that he didn't answer yes or no to questions. He would
also
repeat sentences he had heard before (echolalia). He would say
things like, "Billy, do you want some milk?" They could tell
that he understood what was being said because when they told him to do
something, he would do it. He was not able to verbalize what he
wanted or was thinking. One day he
brought his shoes to his grandmother. What he was trying to communicate was that
he wanted to go outside.
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What are some time-related
red flags?
No
babbling by 12 months
No pointing or gesturing by 12 months
No single words by 6 months
No two-word spontaneous phrases by 24 months
Any loss of language at any time
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How is Autism diagnosed?
Diagnosis is based on observation on the person's communication, behavior,
and development levels by a team of professionals. Autism typically
appears by age 3. Doctors often miss the diagnosis.
Typical story: On two separate occasions before his 3rd birthday,
the mother voiced her concern about her son's lack of interest in other
children. Unfortunately, it was dismissed by the doctor. When
she took him in for his 3 year old well checkup with a new doctor, he was
referred to a development specialist. The parents were asked to fill
out a lengthy form about his development before their appointment. The doctors used that
information to help them make their diagnosis of Autism.
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What causes Autism?
Scientists aren’t certain what causes autism, but it’s likely that both
genetics and environment play a role. Is it caused by vaccines,
environmental toxins, food allergies, immune deficiencies, structural
differences in the brain, biomedical factors (toxins,
immune deficiencies, inflammation in the "gut," and/or a combination of
these and other issues)
or a combination of all or some of these? Autism is not caused by bad
parenting and children with autism are not unruly kids who choose to
misbehave.
I believe that it is caused by a combination of genetics and environmental
factors, and that if a child is predisposed to having Autism, something
like a vaccination laced with thimerosal can trigger it. The government
denies that there is any connection between vaccinations and Autism. In
July 2005 Senator Robert F. Kennedy, Jr. questioned whether there is a
coverup. I'm in his corner. Who knows, someday researchers may find
that something like the Herpes Simplex 6 Virus may a factor.
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How is Autism treated?
Although it is said that there is no known cure for Autism, evidence shows
that early intervention results in positive outcomes for children with
Autism, and the earlier the better. Studies show that those with
autism respond well to a highly-structured specialized education program
tailored to their needs. Because it is a spectrum disorder, no one
method alone is effective in treating the disorder. Some children
cannot tolerate the food coloring dyes, especially the red #40. Red #40 is even found in medications.
Some parents try the DAN! Doctor Protocol
-- a gluten and
casein-free diet and takes fish oil, Vitamin C and probotic (culturelle)
supplements.
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Early detection of Autism
Given
the potential benefits of early diagnosis, is it possible to reliably
diagnose autism before age 2? The answer is yes. A number of researchers
have now studied the early development of children with autism-a not so
easy task given that the average age of diagnosis in the United States is
3 to 4 years of age.
Early development of children with autism has been studied by:
* screening large numbers of children for autism-specific
behaviors during well-baby checks at 18 months of age;
* asking parents of children with autism to remember back to
whether their child showed certain behaviors at certain developmental
ages;
* and having parents bring in home videos of children
diagnosed with autism when these children had their first or second
birthday parties (which parents often videotape).
From these studies, five distinct areas of development are flagged for
consideration. All parents should consider these "Big Five" if they
suspect that their child may have autism.
1) Does the baby respond to his or her name when called by the
caregiver? Within the first few months of life, babies respond to
their own name by orienting toward the person who called them. Typical
babies are very responsive to the voices of familiar people, and often
respond with smiles and looks.
In contrast, infants later diagnosed with autism often fail to respond to
their own name. That is, when called by name, they tend to turn and look
at the person only about 20% of the time as found- in the videotaped one
year-old birthday parties of children with autism. They also are often
selectively responsive to sounds. They may ignore some sounds and respond
to others that are of the same loudness. Thus, they may fail to respond to
their parent calling their name, but immediately respond to the television
being turned on. It is not unusual for parents to suspect their child has
a hearing loss.
2) Does the young child engage in "joint attention"? Near the end
of the first year of life, most infants begin to join with their
caregivers in looking at the same object or event. To aid in this process
of "joint attention", typical infants begin to shift their gaze from toys
to people, follow other's points, monitor the gaze of others, point to
objects or events to share interest, and show toys to others. These
behaviors have a distinct sharing quality to them. For example, the young
infant may point to an airplane flying over head, and look to the parent,
as if to say, "do you see that!"
In contrast, young children with autism have particular difficulties in
jointly attending with others. They rarely follow another's points, do not
often shift their gaze back and forth from objects to people, and do not
seem to share "being with" the caregiver as they watch and talk about
objects, people, or events. They also tend not to "show" a toy to the
parent.
3) Does the child imitate others? Typical infants are mimics. Very
young infants can imitate facial movements (e.g., sticking out their
tongue). As early as 8-10 months, mothers and infants say the same sounds
one after another, or clap or make other movements. Indeed, imitation is a
major part of such common infant games as pat-a-cake and So Big ("How big
is baby? Soooo big!" as infant raises hands to sky).
Young children with autism, however, less often imitate others. They show
less imitation of body and facial movements (waving, making faces, playing
infant games), and less imitation with objects.
4) Does the child respond emotionally to others? Typical infants
are socially responsive to others. They smile when others smile at them,
and they initiate smiles and laughs when playing with toys and others.
When typical infants observe another child crying, they may cry
themselves, or looked concerned. Somewhat older infants may crawl near the
person, pat, or in other ways offer comfort. These latter behaviors are
suggestive of empathy and are commonly observed among children in the
second year of life.
In contrast, children with autism may seem unaware of the emotions of
others. They may not take notice of the social smiles of others, and thus
may not look and smile in response to other's smiles. They also may ignore
the distress of others. Several researchers have now shown that when an
adult feigns pain and distress after hitting herself with a toy, or
banging her knee, young children with autism are less likely to look at
the adult, or show facial concern.
5) Does the baby engage in pretend play? Someone once noted that
"play is the work of children." Young children love to pretend-to be a
mother, father, or baby, to be a firefighter or police officer. Although
children start to play with toys around six months or so, play does not
take on a pretend quality until the end of the first year. Their first
actions may involve pretending to feed themselves, their mother or a doll,
brush the doll's hair, or wipe the doll's nose. Nearer their second
birthday, children engage in truly imaginative play as dolls may take on
human qualities of talking or engaging in household routines. Children may
pretend that a sponge is a piece of food, a block is a hat, or a plastic
bowl is a swimming pool that contains water.
In contrast, the play of children with autism may be lacking in several
ways. The young child may not be interested in objects at all, paying more
attention to the movement of his hands, or a piece of string. If
interested in toys, only certain ones may catch his interest, and these
may be used in a repetitive way that is not consistent with how most
children would play with the toy. They may be more interested in turning a
toy car upside down and spinning the wheels than pushing the car back and
forth. Overall, pretend qualities are nearly absent in the play of
children with autism under 2 years of age.
It is important to note that in each of the 5 areas we have flagged, we
are most concerned with behaviors that are absent or occur at very low
rates. The absence of certain behaviors may be more difficult to pinpoint
than the presence of atypical behaviors. But concerns in any of the above
areas should prompt a parent to investigate screening their child for
autism. Several screening measures are now available, and information from
the screener will help to determine if the parent should pursue further
evaluations. If the parent is convinced their child has autism, then they
should seek an evaluation with an expert in autism. Most likely, this
evaluation will involve an interview with the parents to obtain a complete
developmental history of the child, and direct observations of the child
in different situations.
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Sensory integration problems
Our bodies are
intended to function as "well-oiled machines," which receive input from
the senses, and organize and process that information to be able to use it
appropriately, or to act on it. Our senses include hearing, seeing,
touching, tasting, and feeling, as well as the processes of movement and
gravity. When these systems are all working properly, and the brain
is able to correctly interpret the information they send, we refer to this
process as sensory integration; the senses are working together!
However, when there are imperfections in this system, we call that
"sensory integration dysfunction." Although there are many variations in
the ways that sensory integration dysfunction (or sensory processing
difficulties) can present itself, there are two main underlying problems.
The first is when a person receives too much sensory input; in effect,
their brain is overloaded. The second is when a person does not receive
enough sensory input, resulting in a "craving" of sensory information. The
following section will discuss how each of the senses affects behaviors,
as well as potential problems which arise when sensory integration
dysfunction is present. Click here for more information on
sensory integration dysfunction.
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Links to Autism information or web
sites
Autism Spectrum Disorders
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