What is autism?
Autism is a brain disorder that often makes it hard to communicate with and relate to others. With autism, the different areas of the brain fail to work together.
Most people with autism will always have some trouble relating to others. But early diagnosis and treatment have helped more and more people who have autism to reach their full potential.
What causes autism?
Autism tends to run in families, so experts think it may be something that you inherit. Scientists are trying to find out exactly which genes may be responsible for passing down autism in families.
Other studies are looking at whether autism can be caused by other medical problems or by something in your child’s surroundings.
False claims in the news have made some parents concerned about a link between autism and vaccines. But studies have found no link between vaccines and autism. It’s important to make sure that your child gets all childhood vaccines. They help keep your child from getting serious diseases that can cause harm or even death.
What are the symptoms?
Symptoms almost always start before a child is 3 years old. Usually, parents first notice that their toddler has not started talking yet and is not acting like other children the same age. But it is not unusual for a child with autism to start to talk at the same time as other children the same age, then lose his or her language skills.
Symptoms of autism include:
- A delay in learning to talk, or not talking at all. A child may seem to be deaf, even though hearing tests are normal.
- Repeated and overused types of behavior, interests, and play. Examples include repeated body rocking, unusual attachments to objects, and getting very upset when routines change.
There is no “typical” person with autism. People can have many different kinds of behaviors, from mild to severe. Parents often say that their child with autism prefers to play alone and does not make eye contact with other people.
Autism may also include other problems:
Many children with autism have below-normal intelligence.
Teenagers with autism often become depressed and have a lot of anxiety, especially if they have average or above-average intelligence.
Some children get a seizure disorder such as epilepsy by their teen years.
How is autism diagnosed?
There are guidelines your doctor will use to see if your child has symptoms of autism. The guidelines put symptoms into categories such as:
- Social interactions and relationships. For example, a child may have trouble making eye contact. People with autism may have a hard time understanding someone else’s feelings, such as pain or sadness.
- Verbal and nonverbal communication. For example, a child may never speak. Or he or she may often repeat a certain phrase over and over.
- Limited interests in activities or play. For example, younger children often focus on parts of toys rather than playing with the whole toy. Older children and adults may be fascinated by certain topics, like trading cards or license plates.
Your child may also have a hearing test and some other tests to make sure that problems are not caused by some other condition.
How is it treated?
Treatment for autism involves special behavioral training. Behavioral training rewards appropriate behavior (positive reinforcement) to teach children social skills and to teach them how to communicate and how to help themselves as they grow older.
With early treatment, most children with autism learn to relate better to others. They learn to communicate and to help themselves as they grow older.
Depending on the child, treatment may also include such things as speech therapy or physical therapy. Medicine is sometimes used to treat problems such as depression or obsessive-compulsive behaviors.
Exactly what type of treatment your child needs depends on the symptoms, which are different for each child and may change over time. Because people with autism are so different, something that helps one person may not help another. So be sure to work with everyone involved in your child’s education and care to find the best way to manage symptoms.
How can your family deal with having a child with autism?
An important part of your child’s treatment plan is making sure that other family members get training about autism and how to manage symptoms. Training can reduce family stress and help your child function better. Some families need more help than others.
Core symptoms
The severity of symptoms varies greatly, but all people with autismhave some core symptoms in the areas of:
Social interactions and relationships. Symptoms may include:
- Significant problems developing nonverbal communication skills, such as eye-to-eyegazing, facial expressions, and body posture.
- Failure to establish friendships with children the same age.
- Lack of interest in sharing enjoyment, interests, or achievements with other people.
- Lack of empathy. People with autism may have difficulty understanding another person’s feelings, such as pain or sorrow.
Verbal and nonverbal communication. Symptoms may include:
Delay in, or lack of, learning to talk. As many as 40% of people with autism never speak.
Problems taking steps to start a conversation. Also, people with autism have difficulties continuing a conversation after it has begun.
Stereotyped and repetitive use of language. People with autism often repeat over and over a phrase they have heard previously (echolalia).
Difficulty understanding their listener’s perspective. For example, a person with autism may not understand that someone is using humor. They may interpret the communication word for word and fail to catch the implied meaning.
Limited interests in activities or play. Symptoms may include:
- An unusual focus on pieces. Younger children with autism often focus on parts of toys, such as the wheels on a car, rather than playing with the entire toy.
- Preoccupation with certain topics. For example, older children and adults may be fascinated by video games, trading cards, or license plates.
- A need for sameness and routines. For example, a child with autism may always need to eat bread before salad and insist on driving the same route every day to school.
- Stereotyped behaviors. These may include body rocking and hand flapping.
Symptoms during childhood
Symptoms of autism are usually noticed first by parents and other caregivers sometime during the child’s first 3 years. Although autism is present at birth (congenital), signs of the disorder can be difficult to identify or diagnose during infancy. Parents often become concerned when their toddler does not like to be held; does not seem interested in playing certain games, such as peekaboo; and does not begin to talk. Sometimes, a child with autism will start to talk at the same time as other children the same age, then lose his or her language skills. Parents also may be confused about their child’s hearing abilities. It often seems that a child with autism does not hear, yet at other times, he or she may appear to hear a distant background noise, such as the whistle of a train.
With early and intensive treatment, most children improve their ability to relate to others, communicate, and help themselves as they grow older. Contrary to popular myths about children with autism, very few are completely socially isolated or “live in a world of their own.”
Symptoms during teen years
During the teen years, the patterns of behavior often change. Many teens gain skills but still lag behind in their ability to relate to and understand others. Puberty and emerging sexuality may be more difficult for teens who have autism than for others this age. Teens are at an increased risk for developing problems related to depression, anxiety, and epilepsy.
Symptoms in adulthood
Some adults with autism are able to work and live on their own. The degree to which an adult with autism can lead an independent life is related to intelligence and ability to communicate. At least 33% are able to achieve at least partial independence.
Some adults with autism need a lot of assistance, especially those with low intelligence who are unable to speak. Part- or full-time supervision can be provided by residential treatment programs. At the other end of the spectrum, adults with high-functioning autism are often successful in their professions and able to live independently, although they typically continue to have some difficulties relating to other people. These individuals usually have average to above-average intelligence.
Other symptoms
Many people with autism have symptoms similar to attention deficit hyperactivity disorder (ADHD). But these symptoms, especially problems with social relationships, are more severe for people with autism.
About 10% of people with autism have some form of savant skills-special limited gifts such as memorizing lists, calculating calendar dates, drawing, or musical ability.
Many people with autism have unusual sensory perceptions. For example, they may describe a light touch as painful and deep pressure as providing a calming feeling. Others may not feel pain at all. Some people with autism have strong food likes and dislikes and unusual preoccupations.
Sleep problems occur in about 40% to 70% of people with autism.
Almost half of the children who have autism spectrum disorders tend to “wander off” from a caregiver, or “elope.” For many caregivers of these children, elopement is one of the most stressful behaviors they must learn to cope with. Studies show that behavioral assessment interventions, such as applied behavioral analysis, may reduce the number of times a child wanders off.
Other conditions
Autism is one of several types of autism spectrum disorders (ASDs), once known as pervasive developmental disorders. It is not unusual for autism to be confused with other ASDs, such as Asperger’s syndrome, or to have overlapping symptoms. A similar condition is called unspecified neurodevelopmental disorder. This condition occurs when children display similar behaviors but do not meet the criteria for autism. Also, other conditions with similar symptoms may also have similarities to or occur with autism.
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