The term autism refers to a lifelong developmental condition that affects the way individuals relate to their environment and other people. It is commonly used to refer to a spectrum of conditions, collectively known as autism spectrum disorder. Autism spectrum disorder has three main types:
It can affect individuals in varying degrees, with no two people with autism spectrum disorder being alike. Some people may experience only very mild difficulties and can lead a fairly normal life, while others may have more serious difficulties that require ongoing support.
Looking across the spectrum, Asperger's syndrome (also known as high-functioning autism) generally has milder symptoms, whereas autistic disorder commonly causes a greater impairment in function.
People with autism spectrum disorder may:
Autism spectrum disorder:
This is the mildest form of autism spectrum disorder, in terms of its impact on individuals. It affects boys three times more than girls. Children who have Asperger's syndrome:
As they approach adulthood, people with Asperger's syndrome are more likely to develop depression and anxiety.
This is the more common type of autism spectrum disorder and is associated with more severe symptoms than Asperger's syndrome, but less severe symptoms than autistic disorder. Children with PDD-NOS have:
This is a highly variable type of autism spectrum disorder. If a child appears autistic, but doesn't meet all the criteria for autistic disorder, they are classified as having PDD-NOS.
There is rigid criteria for classifying autistic disorder. Children with autistic disorder:
Parents usually first notice the signs of autism spectrum disorder in their child during the child's first year of life. Parents might sense something is unusual with their infant, such as a lack of:
Autism spectrum disorder is characterized by difficulties in:
People with autism spectrum disorder can struggle to deal with their environment and this may manifest as unusual behavior. Because they can feel overwhelmed by situations, people with autism spectrum disorder try and find ways to maintain some predictability and certainty. They may:
Because they often have a particular obsession about an activity, object or hobby, they may not be able to show interest in others, which can make it harder for them to make and keep new friends.
People with autism spectrum disorder may find it difficult to:
People with autism spectrum disorder may come across as being disinterested, aloof or even rude and may find it difficult to make new friends and maintain long-term friendships and relationships.
People with autism spectrum disorder may experience a range of communication problems. Their speech may be:
The speech of someone with autism spectrum disorder may be made up of repeated words, meaningless phrases, or they may repeat your own words back at you.
People with autism spectrum disorder may overreact or underreact to certain sounds, tastes, textures and smells. For example, they may at times show no response to being spoken to, while at other times they may be upset by quiet sounds. Some children with autism spectrum disorder might cope by making repetitive noises to drown out the offending sound, or by blocking their ears. Some children might become distressed by the feeling of certain fabric rubbing against their skin, or labels on clothing.
Autism spectrum disorder is a condition with which a person is born. It is commonly diagnosed during childhood and continues for the remainder of their life. However, in some people, if symptoms are very mild, it may go undetected until adulthood. These individuals usually suspect that they are 'different' throughout their life, but may not have had a formal clinical assessment. It is never too late to seek medical assessment, if you suspect having relevant symptoms.
It is not yet known what causes autism spectrum disorder. It is currently understood that changes during brain development, in combination with environmental and genetic factors, may be the cause. Having one child with autism spectrum disorder means you are more likely to have another child with autism spectrum disorder, but no specific gene has been isolated yet to prove the genetic link.
Autism spectrum disorder is:
A study published in 1998 by Dr Wakefield concluded that there was a causal link between the administration of the MMR vaccine and the development of autism spectrum disorder. This led to parental concern about risks of childhood vaccinations. Since then, this study has since been discredited, withdrawn from the journal in which it was originally published and Dr Wakefield's registration as a doctor in the UK was cancelled. Numerous other studies have since shown no link between childhood vaccinations and autism.
Thiomersal is a preservative that was formerly used in some childhood vaccines. There was some concern of a causal link between those childhood vaccines that contained thiomersal and the development of autism spectrum disorder. Extensive research failed to demonstrate any such link, but as a precaution thiomersal is no longer used in standard childhood vaccines in many countries.
The practice of administering a vaccine, a solution containing a microorganism (that causes a specific disease) in a dead or weakened state, or parts of it, for the purpose of inducing immunity in a person to that microorganism.
Certain factors may be associated with an increased risk of developing autism spectrum disorder.
Such risk factors include:
It is important to note that there is insufficient evidence to implicate any one factor in the development of autism spectrum disorder.
An inherited condition caused by damage to the X chromosome. It causes intellectual disability and results in a range of physical and behavioral problems.
A rare genetic disorder of the brain that mostly affects females, characterized by repetitive hand movements, seizures and a lack of verbal communication. Half of those affected with this condition do not walk.
An inherited neuropsychiatric disorder that is characterized by involuntary physical and at least one vocal tic.
A rare genetic disease that causes tumors to grow in the brain and other organs and causes a combination of symptoms that may include seizures, intellectual disability, behavioral problems, and kidney disease.
Behavioral problems associated with autism spectrum disorder usually become apparent before a child is three years old.
The diagnosis of autism spectrum disorder can be challenging, as its symptoms and behavioral problems can overlap with those associated with other disorders such as attention deficit hyperactive disorder (ADHD) and learning difficulties. Diagnosis of autism spectrum disorder usually requires a multidisciplinary approach and may involve a psychiatrist, psychologist, speech pathologist and, if the diagnosis relates to a child, a pediatrician.
There is no laboratory test that can conclusively diagnose this condition. Usually a range of clinical tests are performed to help in the diagnosis. Some of these include:
Some of the following factors may be associated with a diagnosis of autism spectrum disorder:
Some parents may feel traumatized if their child is diagnosed with autism spectrum disorder and may feel a sense of loss and grief about the potential future problems they envisage. In such instances, seeking emotional support from a family counsellor may prove helpful.
Because of improved understanding and knowledge of autism spectrum disorder, it is increasingly common for adults to now be diagnosed with this condition. Some adults might have read or seen something about autism spectrum disorder and may have recognized their own behavior and symptoms.
Some adults may choose to seek professional advice for clinical assessment. Even though someone may have reached adulthood without undergoing clinical assessment of their behavior and symptoms, having a clinical assessment may enable them to enhance their function and quality of life. Clinical guidance and assessment may also help their family and friends better understand the nature of their condition.
Adults may be diagnosed by an experienced psychologist or psychiatrist, who may ask questions relating to their childhood, friends, work and study to complete their assessment.
A doctor who specializes in the diagnosis and treatment of health conditions in children and babies.
A medical doctor specializing in the diagnosis and treatment of mental disorders.
Early intervention can help improve outcomes. The management plan for autism spectrum disorder needs to be tailored to accommodate the diverse nature of the symptoms and behavioral problems. Treatment may include behavioral and communication therapies, education therapies and medications.
People with autism spectrum disorder can struggle to interpret social situations. One strategy that has been devised is to create a short 'social story' using words and images that can help a person understand a certain social situation, such as going to a birthday party or to a shopping center. Reading the story prior to going into the situation can help to ease anxieties associated with being in a foreign situation.
People with autism spectrum disorder can experience behavioral problems. Applied behavior analysis is a program used to treat young children by reinforcing positive behavior and dissuading negative behavior.
People with autism spectrum disorder can experience communication difficulties. PECS can be used for children who do not speak freely, allowing them to express their needs and feelings. PECS uses pictures, objects and symbols, according to the child's age.
People with autism spectrum disorder can experience impaired social and communication skills. With the Hanen program, parents of children under the age of six years are taught various strategies to help their child improve their social and communication skills.
Choosing a school that will best meet the needs of a child will improve the long-term outcomes and help them reach their potential. There may be schools that cater for the needs of students with autism spectrum disorder.
Some strategies to help a child with autism spectrum disorder become comfortable with their new school may include:
People with autism spectrum disorder may struggle with a standard curriculum and education environment. TEACCH is a teaching program that provides a structured physical environment and uses visual supports to make the sequence of daily activities predictable and tasks more easily understood. It is customized for each child and doesn't involve a standard curriculum.
Risperidone may be used to treat challenging behaviors such as aggression and irritability in older children with autism spectrum disorder. However, risperidone doesn't treat the core features of autism spectrum disorder.
Many individuals with autism have concurrent mood changes, such as depression. Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), may be used to treat depression in adolescents and adults with autism spectrum disorder. However, antidepressants don't treat the core features of autism spectrum disorder.
Methylphenidate may be used to treat severe and debilitating hyperactivity in children with autism spectrum disorder.
When considering appropriate treatment, it is important to take into consideration that all medications can be associated with side effects of varying severity.
Adults with autism are encouraged to live independently in the community. Individual and shared accommodation facilities may be available, depending on the level of support needed and availability of funding. A doctor or social worker can help identify the available services.
Numerous local communities and related organizations are equipped to provide individuals with autism a range of social supports. These include alternatives to employment such as pre-employment training/volunteer work, transport services, and access to recreational activities and facilities.
Caring for individuals with autism can be both rewarding, but also challenging at times. Having a good understanding of the condition can help to predict challenges and reduce stress. Other parents and carers of individuals with autism can be good resources for support and understanding. As a carer of a child with autism, you may be entitled to financial support from various government departments.
To be able to provide ongoing care and support, it is equally important to also look after yourself. Some local community networks have family and carer services available to provide assistance with daily tasks such as light household duties, meal preparation and/or child care. Some organizations have support workers who can provide respite, which is temporary care for individuals with autism, to allow family and carers an opportunity to rest and recover.
Your local doctor can help you find the most appropriate support services and funding for your circumstances.
Depending on the severity of symptoms and behavior problems, the lives of people with autism spectrum disorder can be significantly affected by their condition.
People with autism spectrum disorder:
Although autism spectrum disorder is a lifelong condition that has no cure, there are many ways to help someone with this condition so that they can lead a fulfilling life. Increased awareness and education about this condition, both in the community and among medical professionals, is contributing to early intervention, which means better outcomes.
The exact cause of autism spectrum disorder is still to be determined, and currently there is no method of preventing this condition.