Autism – Causes, Symptoms, Diagnosis and Treatment

Thanks to movies and books, there are many hitherto unknown disorders that people are now becoming aware of. One such disorder is Autism – a disability we have all probably heard of but don’t have complete knowledge of.

What is Autism

Autism is a developmental disorder that affects the brain’s normal development with respect to social and communication skills and appears in the first three years of life. It is a neurological condition (pertaining to the nervous system) where some alteration in the brain’s nerve cells and connections between them cause certain behavioural problems.

Causes of Autism

What causes Autism is not well understood despite extensive research. Genetic factors are implicated. For e.g., identical twins are more likely than fraternal twins or siblings to have Autism. Other causes are related to diet, vaccines, changes in the digestive tract and inability to absorb vitamins and minerals. Neurological conditions like intellectual disability are also seen in these children. Environmental agents like heavy metals (lead) and pesticides are also implicated.

Symptoms and signs of Autism

Most parents feel something is wrong with their child when the child is about 18 months old. By the time they seek help the child is around 2 years. In some cases the child is normal till 1 or 2 years of age and then loses his social and language skills (regressive Autism).

These children typically have problems in the areas of social interactions, pretend play (pretending to be a doctor for example) and verbal and non-verbal communication. The symptoms could vary from moderate to severe.

Some symptoms to look out for:

• The child is unduly distressed when there is a change in routine
• The child is overly sensitive when it comes to hearing, saying, smelling, touching or tasting (for e.g. the child may complain that the clothes are itchy and may get upset if forced to wear them)
• The child repeatedly enacts certain body movements

Complications due to Autism

Autism may be seen along with other neurological conditions like intellectual disability and seizures.

Communication hurdles an autistic child may face:

• Language development is slow or not seen
• Cannot start or maintain a social conversation
• Uses gestures instead of words to make a point
• Does not adjust gaze to look at an object others are looking at
• Repeats phrases or words (for e.g. television commercials)

Sensory problems faced by an autistic child:

• Does not get startled by a sudden noise
• May find noises painful and react by holding hands over ears
• Has heightened or low senses of hearing, sight, taste, touch or smell

Social problems faced by an autistic child:

• Prefers to be alone than with company
• Does not make friends and is withdrawn
• Avoids eye contact and does not respond to eye contact and smiles
• Has lack of empathy
• Shows no interest in playing interactive games
• Does not pretend play or have imaginative play

Behavioural problems faced by an autistic child:

• Has a short attention span, is prone to throwing tantrums
• Shows aggressive behaviour towards himself and others
• Has limited interests
• Is overactive or passive
• Uses the same body movements over and over again
• Shows a strong need for sameness

Diagnosing Autism

As parents, if you notice symptoms of Autism or have doubts about your child’s behaviour or responsiveness to senses, it is important to take him or her to the paediatrician before making any self-diagnosis. The doctor will then conduct a thorough examination and note all the milestones the child has reached.

In any case, children must have routine check-ups to monitor growth and development. There is cause for concern if the child cannot meet the following milestones:

• Pointing, waving bye and babbling by 12 months
• Saying single words by 16 months
• Making up two word phrases by 24 months
• Also get a check-up if the child loses language or social skills at any age

The child then undergoes further tests like hearing tests, blood tests for checking lead levels and screening tests for Autism. It’s important that the diagnosis be made by a paediatrician who is experienced in dealing with autistic children. A thorough neurological check-up is also important to detect other psychiatric conditions like intellectual disability, anxiety, genetic disorders, epilepsy (fits) and metabolic errors like phenylketonuria. Screening for genetic and metabolic disorders should be included.

As Autism includes many symptoms it helps to have a team of specialists to evaluate the child. Key areas like language and motor skills, communication, thinking processes and performance in school should be evaluated.

Treating Autism

Treatment options for Autism are diverse.

• Drug therapy – Risperidone is the drug of choice for children aged 5-16 years to control the aggression and irritability associated with Autism. Other psychiatric drugs are used symptomatically. There is no medicine to improve the autistic condition per se.
• Dietary guidelines – Some studies show that eliminating gluten and/or casein improves the condition. Gluten is present in wheat, barley and rye while casein is found in milk, cheese and other dairy products. Consult a nutritionist to make sure the child is receiving a balanced diet if restricting the above foods.
• Applied Behavioural Analysis (ABA) –This is a one-on-one teaching program that aims to teach basic skills so that the child can function as normally as possible.
• Occupational Therapy – It is important to empower a person with Autism with some skills so that he can earn a living.
• Speech Therapy – An experienced therapist should do this. Most children can have good basic speech skills like vocabulary and spellings if speech therapy is started early.
• Physical therapy – This is a good means for autistic children to be in a group (social setting) and vent out their anger and frustration through physical activities.

Conclusion

Due to increased awareness about Autism, the outlook today is more positive than before. Earlier, most autistic individuals were compelled to be institutionalised. Today, most symptoms can be improved resulting in autistic people being able to live with their families.