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#Post#: 12--------------------------------------------------
What is Autism?
By: BMHC Date: December 27, 2013, 10:25 pm
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Prepared by:
Office of Communications and Public Liaison
National Institute of Neurological Disorders and Stroke
National Institutes of Health
Bethesda, MD 20892
NINDS health-related material is provided for information
purposes only and does not necessarily represent endorsement by
or an official position of the National Institute of
Neurological Disorders and Stroke or any other Federal agency.
Advice on the treatment or care of an individual patient should
be obtained through consultation with a physician who has
examined that patient or is familiar with that patient's medical
history.
All NINDS-prepared information is in the public domain and may
be freely copied. Credit to the NINDS or the NIH is appreciated.
URL of this page:
http://www.ninds.nih.gov/disorders/autism/detail_autism.htm
http://www.ninds.nih.gov/disorders/autism/detail_autism.htm
[quote]
What is autism?
Autism spectrum disorder (ASD) is a range of complex
neurodevelopment disorders, characterized by social impairments,
communication difficulties, and restricted, repetitive, and
stereotyped patterns of behavior. Autistic disorder, sometimes
called autism or classical ASD, is the most severe form of ASD,
while other conditions along the spectrum include a milder form
known as Asperger syndrome, and childhood disintegrative
disorder and pervasive developmental disorder not otherwise
specified (usually referred to as PDD-NOS). Although ASD varies
significantly in character and severity, it occurs in all ethnic
and socioeconomic groups and affects every age group. Experts
estimate that 1 out of 88 children age 8 will have an ASD
(Centers for Disease Control and Prevention: Morbidity and
Mortality Weekly Report, March 30, 2012). Males are four times
more likely to have an ASD than females.
What are some common signs of autism?
The hallmark feature of ASD is impaired social interaction. As
early as infancy, a baby with ASD may be unresponsive to people
or focus intently on one item to the exclusion of others for
long periods of time. A child with ASD may appear to develop
normally and then withdraw and become indifferent to social
engagement.
Children with an ASD may fail to respond to their names 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.
Many children with an ASD engage in repetitive movements such as
rocking and twirling, or in self-abusive behavior such as biting
or head-banging. They also tend to start speaking later than
other children and may refer to themselves by name instead of
�I� or �me.� Children with an ASD don�t know how to play
interactively with other children. Some speak in a sing-song
voice about a narrow range of favorite topics, with little
regard for the interests of the person to whom they are
speaking.
Children with characteristics of an ASD may have co-occurring
conditions, including Fragile X syndrome (which causes mental
retardation), tuberous sclerosis, epileptic seizures, Tourette
syndrome, learning disabilities, and attention deficit disorder.
About 20 to 30 percent of children with an ASD develop epilepsy
by the time they reach adulthood. .
How is autism diagnosed?
ASD varies widely in severity and symptoms and may go
unrecognized, especially in mildly affected children or when it
is masked by more debilitating handicaps. Very early indicators
that require evaluation by an expert include:
no babbling or pointing by age 1
no single words by 16 months or two-word phrases by age 2
no response to name
loss of language or social skills
poor eye contact
excessive lining up of toys or objects
no smiling or social responsiveness.
Later indicators include:
impaired ability to make friends with peers
impaired ability to initiate or sustain a conversation with
others
absence or impairment of imaginative and social play
stereotyped, repetitive, or unusual use of language
restricted patterns of interest that are abnormal in intensity
or focus
preoccupation with certain objects or subjects
inflexible adherence to specific routines or rituals.
Health care providers will often use a questionnaire or other
screening instrument to gather information about a child�s
development and behavior. Some screening instruments rely
solely on parent observations, while others rely on a
combination of parent and doctor observations. If screening
instruments indicate the possibility of an ASD, a more
comprehensive evaluation is usually indicated.
A comprehensive evaluation requires a multidisciplinary team,
including a psychologist, neurologist, psychiatrist, speech
therapist, and other professionals who diagnose children with
ASDs. The team members will conduct a thorough neurological
assessment and in-depth cognitive and language testing. Because
hearing problems can cause behaviors that could be mistaken for
an ASD, children with delayed speech development should also
have their hearing tested.
Children with some symptoms of an ASD but not enough to be
diagnosed with classical autism are often diagnosed with
PDD-NOS. Children with autistic behaviors but well-developed
language skills are often diagnosed with Asperger syndrome. Much
rarer are children who may be diagnosed with childhood
disintegrative disorder, in which they develop normally and then
suddenly deteriorate between the ages of 3 to 10 years and show
marked autistic behaviors.
What causes autism?
Scientists aren�t certain about what causes ASD, but it�s likely
that both genetics and environment play a role. Researchers
have identified a number of genes associated with the disorder.
Studies of people with ASD have found irregularities in several
regions of the brain. Other studies suggest that people with
ASD have abnormal levels of serotonin or other neurotransmitters
in the brain. These abnormalities suggest that ASD could result
from the disruption of normal brain development early in fetal
development caused by defects in genes that control brain growth
and that regulate how brain cells communicate with each other,
possibly due to the influence of environmental factors on gene
function. While these findings are intriguing, they are
preliminary and require further study. The theory that parental
practices are responsible for ASD has long been disproved.
What role does inheritance play?
Twin and family studies strongly suggest that some people have a
genetic predisposition to autism. Identical twin studies show
that if one twin is affected, there is up to a 90 percent chance
the other twin will be affected. There are a number of studies
in progress to determine the specific genetic factors associated
with the development of ASD. In families with one child with
ASD, the risk of having a second child with the disorder is
approximately 5 percent, or one in 20. This is greater than the
risk for the general population. Researchers are looking for
clues about which genes contribute to this increased
susceptibility. In some cases, parents and other relatives of a
child with ASD show mild impairments in social and communicative
skills or engage in repetitive behaviors. Evidence also
suggests that some emotional disorders, such as bipolar
disorder, occur more frequently than average in the families of
people with ASD.
Do symptoms of autism change over time?
For many children, symptoms improve with treatment and with age.
Children whose language skills regress early in life�before the
age of 3�appear to have a higher than normal risk of developing
epilepsy or seizure-like brain activity. During adolescence,
some children with an ASD may become depressed or experience
behavioral problems, and their treatment may need some
modification as they transition to adulthood. People with an
ASD usually continue to need services and supports as they get
older, but many are able to work successfully and live
independently or within a supportive environment.
How is autism treated?
There is no cure for ASDs. Therapies and behavioral
interventions are designed to remedy specific symptoms and can
bring about substantial improvement. The ideal treatment plan
coordinates therapies and interventions that meet the specific
needs of individual children. Most health care professionals
agree that the earlier the intervention, the better.
Educational/behavioral interventions: Therapists use highly
structured and intensive skill-oriented training sessions to
help children develop social and language skills, such as
Applied Behavioral Analysis. Family counseling for the parents
and siblings of children with an ASD often helps families cope
with the particular challenges of living with a child with an
ASD.
Medications: Doctors may prescribe medications for treatment of
specific autism-related symptoms, such as anxiety, depression,
or obsessive-compulsive disorder. Antipsychotic medications are
used to treat severe behavioral problems. Seizures can be
treated with one or more anticonvulsant drugs. Medication used
to treat people with attention deficit disorder can be used
effectively to help decrease impulsivity and hyperactivity.
Other therapies: There are a number of controversial therapies
or interventions available, but few, if any, are supported by
scientific studies. Parents should use caution before adopting
any unproven treatments. Although dietary interventions have
been helpful in some children, parents should be careful that
their child�s nutritional status is carefully followed.
"Autism Fact Sheet," NINDS. Publication date September 2009.
NIH Publication No. 09-1877[/quote]
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