Saturday, January 8, 2011

How to Spot Autism in Your Child and Manage It

Autism Spectrum Disorders include a number of chronic, no progressive disabilities characterized by lack of social interaction, communication, and behavior. Autism, pervasive developmental disorder NOS, Asperger disorder, childhood disintegrative disorder, and Rett disorder are all encompassed into the Autism Spectrum of Disorders.

Characteristics of Autism Spectrum Disorders

  • Limited eye contact and facial expression
  • Difficulty developing peer relationships
  • Indifference to social overtures
  • Lack of social reciprocity
  • Inflexibility
  • No engagement in pretend play
  • Impaired reciprocal communication
  • Language development delayed
  • Persistent question asking and repeating
  • Restrictive, stereotyped patterns of behavior
  • Repetitive, self-stimulatory behaviors (rocking, spinning)
  • Preoccupation or fascination with a single object or subject


Autism is more common in males and is usually diagnosed between 8 months and 3 years of age. Lack of attachment to mother during infancy is often present. It was believed in the past that MMR vaccine or thimerosal (vaccine preservative) causes autism, but current data research shows no link between MMR vaccines and autism. It is now more commonly believed that autism is caused by multiple environmental factors. The essential features of autism are impaired social interactions and communication. Restricted group of activities and interests, with stereotyped behaviors, rituals, or mannerisms. Siblings of children with autism appear to be at greater risk of developing the disorder.

Pervasive Developmental Disorder NOS (Not Otherwise Specified)

Pervasive Developmental Disorder NOS is the diagnosis given to children who have symptoms such as impaired social interaction and communication skills and/or repetitive, stereotyped behaviors, but with a symptom profile that does not meet diagnostic criteria for autism.

Asperger Syndrome

Asperger syndrome is characterized by difficulty forming relationships/relating to others and development of intense interest in very specific topics. Asperger does not necessarily need to have impaired language production, but very often these children do not understand abstract forms of language such as sarcasm and metaphors, and as a result have a hard time forming interpersonal relationships.

Childhood Disintegrative Disorder

This disorder is characterized by normal development up to the age of 2 years, followed by loss of previously achieved language, social, and motor developmental milestones. Affected children may show disordered communication and social interactions and may have repetitive movements or stereotypes. Loss of skills must occur before 10 years of age.

Rett Disorder

This is an x-linked disorder that occurs only in girls, as boys usually succumb to the disorder in utero and die. The children in this disorder develop normally until 6 months of age and begin to exhibit symptoms of autism, language delay, psychomotor retardation, decreased head growth, breathing abnormalities, seizures, and poor coordination of gait and trunk movements. Mutations in the MECP2 gene are strongly associated with Rett Disorder.

Management of Autism Spectrum Disorders

The management of autistic disorders is most successful when a multidisciplinary approach is adopted. Intensive behavioral and sensory integration therapy, speech and language training therapy, social modeling, family support, and pharmacologic intervention all must be undertaken as soon as diagnosis is established, although not much evidence exists that shows pharmacologic therapy with antipsychotic (risperidone and aripiprazole) helps these children, but research is currently under way to develop pharmacologic drugs for treatment of autism. The best prognostic indicator of future success in these children is the extent of language development present. The earlier that treatment begins, the better are the chances for the child to live a normal life.

Copyright © 2010 - Yana G. Yevstegneeva, 3rd-year Medical Student. All Rights Reserved Worldwide.

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