April is Autism Awareness Month and although there is no known specific cause or cure, it’s important to educate parents since early diagnosis can be an important factor in treatment.
Autism Spectrum Disorder (ASD) is defined by the American Psychiatric Association’s Diagnosis and Statistical Manual of Mental Disorders (DSM-5) as “a single disorder that includes disorders that were previously considered separate — autism, Asperger’s syndrome, childhood disintegrative disorder and pervasive developmental disorder not otherwise specified”. Autism spectrum disorder is a serious neurodevelopmental disorder that impairs a child’s ability to communicate and interact with others. It also includes restricted repetitive behaviors, interests and activities. These issues cause significant impairment in social, occupational and other areas of functioning.
More than 200,000 cases of autism are diagnosed each year, and according to Autism Speaks, it’s four to five times more common in boys than in girls. An estimated 1 out of 42 boys and 1 in 189 girls are diagnosed with autism in the United States. ASD occurs in every racial and ethnic group, and across all socioeconomic levels.
Though signs and symptoms are usually noticed between the ages of 2 and 3, children with ASD may seem different even from birth, especially when compared to other children their own age. They may become overly focused on certain objects, rarely make eye contact, and fail to engage in typical babbling with their parents. In other cases, children may develop normally until the second or even third year of life, but then start to withdraw and become indifferent to social engagement.
Social impairment characteristics include:
- not responding to their name
- avoiding eye contact
- only interacting with others to acheive a specific goal
- lack of understanding of how to play with others
- preferring to be alone
- difficulty understanding the feelings of others
- difficulty talking about their own feelings
- delayed speech or lack of speech (about 1/3 are non-verbal)
- fluent speech, but backward and in appropriate
- lack of understanding of non-verbal cues such as waving good-bye
- speaking in flat, robot-like, or a sing-song voice, but only about a few favorite topics
Repetitive and behavior characteristics include:
- flapping arms
- rocking side to side
- preoccupation with a particular part of a toy, like the wheels of a truck
- obsession with a particular topic such as a train schedule or airplanes
- anger or emotional outbursts if there is a change in routine, a new place or overly stimulating environment
Though there is no cure from ASD, therapy and behavioral intervention designed to meet the specific needs of the individual can help improve the quality of life for the individual. With early intervention, symptoms can improve with age and individuals can overcome some obstacles. Highly structured and intensive skill-oriented training sessions and speech therapy can help children develop social and language skills. Part of the challenge over time is that during adolescence, some people with ASD may become depressed or experience behavioral problems, and their treatment may need some modification as they transition to adulthood. In addition, family counseling for the parents and siblings of children with ASD often helps families cope with the particular challenges of living with a child with ASD. Depending on the severity of the disorder, individuals may be able to work and live independently as adults.
A growing body of research suggests that a woman can reduce her risk of having a child with autism by taking prenatal vitamins containing folic acid and/or eating a diet rich in folic acid (at least 600 mcg a day) during the months before and after conception.
While medication can’t cure ASD or even control symptoms, there are some that can help with related symptoms such as anxiety, depression, and obsessive-compulsive disorder. Antipsychotic medications, such as Risperidone or Quetiapineare, 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 in people with ASD. Parents, caregivers, and people with autism should use caution before adopting any unproven treatments.