WHAT IS AUTISM

  Autism is a complex neurobehavioral condition that includes impairments in social interaction and developmental language and communication skills combined with rigid, repetitive behaviors. Because of the range of symptoms, this condition is now called Autism Spectrum Disorder (ASD). It covers a large spectrum of symptoms, skills, and levels of impairment. ASD ranges in severity from a handicap that somewhat limits an otherwise normal life to a devastating disability that may require institutional care.

Children with autism have trouble communicating. They have trouble understanding what other people think and feel. This makes it very hard for them to express themselves either with words or through gestures, facial expressions, and touch.

Autism can look different in different people. It’s a developmental disability that affects the way people communicate, behave, or interact with others. There’s no single cause for it, and symptoms can be very mild or very severe. 

Some children who are on the spectrum start showing signs as young as a few months old. Others seem to have normal development for the first few months or years of their lives and then they start showing symptoms.

But up to half of parents of children with ASD noticed issues by the time their child reached 12 months, and between 80% and 90% noticed problems by 2 years. Children with ASD will have symptoms throughout their lives, but it’s possible for them to get better as they get older.

The autism spectrum is very wide. Some people might have very noticeable issues, others might not. The common thread is differences in social skills, communication, and behavior compared with people who aren’t on the spectrum.

Social Skills

A child with ASD has a hard time interacting with others. Problems with social skills are some of the most common signs. He might want to have close relationships but not know how. 

If your child is on the spectrum, he might show some social symptoms by the time he’s 8 to 10 months old. These may include any of the following:

· He can’t respond to his name by his first birthday.

· Playing, sharing, or talking with other people doesn’t interest him.

· He prefers to be alone.

· He avoids or rejects physical contact.

· He avoids eye contact.

· When he’s upset, he doesn’t like to be comforted.

· He doesn’t understand emotions -- his own or others’.

· He may not stretch out his arms to be picked up or guided with walking.

Communication

About 40% of kids with autism spectrum disorders don’t talk at all, and between 25% and 30% develop some language skills during infancy but then lose them later. Some children with ASD start talking later in life.

Most have some problems with communication, including these: 

· Delayed speech and language skills

· Flat, robotic speaking voice, or singsong voice

· Echolalia (repeating the same phrase over and over)

· Problems with pronouns (saying “you” instead of “I,” for example)

· Not using or rarely using common gestures (pointing or waving), and not responding to them

· Inability to stay on topic when talking or answering questions

· Not recognizing sarcasm or joking

Patterns of Behavior

Children with ASD also act in ways that seem unusual or have interests that aren’t typical. Examples of this can include:

· Repetitive behaviors like hand-flapping, rocking, jumping, or twirling

· Constant moving (pacing) and “hyper” behavior

· Fixations on certain activities or objects

· Specific routines or rituals (and getting upset when a routine is changed, even slightly)

· Extreme sensitivity to touch, light, and sound

· Not taking part in “make-believe” play or imitating others’ behaviors

· Fussy eating habits

· Lack of coordination, clumsiness

· Impulsiveness (acting without thinking)

· Aggressive behavior, both with self and others

· Short attention span

Spotting Signs and Symptoms

The earlier treatment for autism spectrum disorder begins, the more like it is to be effective. That’s why knowing how to identify the signs and symptoms is so important.

Make an appointment with your child’s pediatrician if he doesn’t meet these specific developmental milestones, or if he meets but loses them later on:

· Smiles by 6 months

· Imitates facial expressions or sounds by 9 months

· Coos or babbles by 12 months

· Gestures (points or waves) by 14 months

· Speaks with single words by 16 months and uses phrases of two words or more by 24 months

Plays pretend or “make-believe” by 18 months 

The causes of autism are currently not known, but significant numbers of studies are underway with a view to learning how it develops.

Researchers have identified several genes that appear to have connections to ASD. Sometimes, these genes arise by spontaneously mutate. In other cases, people may inherit them.

Those with autism may also undergo changes in key areas of their brains that impact their speech and behavior. Environmental factors might also play a role in the development of ASD, although doctors have not yet confirmed a link.

However, researchers do know that some rumored causes, such as parenting practices, do not cause autism.

Do vaccines cause autism?

Another common misconception surrounding autism is that receiving vaccines, such as those for measles, mumps, and rubella (MMR), can contribute to autism.

However, the CDC report that there is no known condition between vaccines and autism.

A 2013 study confirmed that the number of antigens, or substances that trigger the production of disease-fighting antibodies are the same in children who do and do not have ASD.

Some people claim that thimerosal, a preservative that contains mercury and is in specific vaccines, has links to autism. However, at least nine different studies since 2003 have provided evidence that counters this claim.

The Lancet journal published the initial paper that triggered the controversy around vaccines and autism and retracted it twelve years later after evidence of data tampering, and research fraud became clear. Governing bodies stripped the author, Andrew Wakefield, of his credentials and permission to practice.

· There is no uniform treatment for autism, as every person with the condition presents differently.

· Therapies and strategies are available for managing the health issues that often accompany autism. These issues can include epilepsy, depression, obsessive-compulsive disorder (OCD), and sleep disturbances.

· While not all of these treatments will be effective for all people with ASD, there are many options to consider that may help people cope. Autism specialists or psychologists can refer a person for a treatment that reflects their presentation of autism.

· Among the treatment interventions that may be beneficial are:

· Applied Behavior Analysis (ABA): In ABA, an instructor at first tries to learn about the particular behaviors of a person with ASD. They will also want to know about the effects of their environment on this behavior, and how the person learns. ABA aims to increase desirable behaviors and reduce harmful or isolating ones by using positive reinforcement.

· ABA can help improve communication, memory, focus, and academic performance. By analyzing current behaviors and teaching new actions step-by-step, an instructor can provide both a person with ASD and the people around them with tools for support.

· Early Start Denver Model (ESDM): This type of behavioral therapy occurs during play and helps children between the ages of 1 and 4 years old.

· A psychologist, behavioral specialist, or occupational therapist uses joint activities and play to help a child with autism build positive relationships with a sense of fun. Parents can then continue the therapy at home.

· ESDM supports communication skills and cognitive abilities.

· Floortime: This involves parents joining children in the play area and building relationships. ABA therapies might also use floortime to support treatment and vice versa. Parents let the children lead the game, allowing the child's strengths to develop. Through this engagement, a child with ASD learns two-way and complex communication, emotional thought, and intimacy. They also learn to take the lead of regulating themselves and engaging with their environment.

· Occupational therapy (OT): This helps a person with autism develop the skills for everyday living and learn independence.

· These skills include dressing without assistance, grooming and hygiene, and fine motor skills. People with ASD then practice these skills outside of the therapy sessions, which are usually between 30 and 60 minutes long.

· Pivotal response treatment (PRT): This therapy aims to support motivation and the ability to respond to motivational cues in children with ASD. It is a play-based therapy that focuses on natural reinforcement.

· Many therapies for autism revolve around helping caregivers and teachers provide support. For example, if a child wants a toy car and asks in an appropriate way, they get the toy car, not an unrelated reward, such as candy. This also encourages children with ASD to start social interactions, as well as merely responding to them.

· Relationship development intervention (RDI): This treatment revolves around the importance of dynamic thinking, or the ability to adapt thoughts and process situations flexibly, to help improve quality of life in people with autism.

· The focus of RDI includes understanding other people's perspectives, processing change, and absorbing information from several sources at once, such as sight and sound, without experiencing distress.

· Speech therapy: This helps to address the challenges in communication that people with autism might experience.

· Assistance might include matching emotions with facial expressions, learning how to interpret body language, and responding to questions. A speech therapist might also try to teach the nuances of vocal tone and help the individual strengthen their speech and clarity.

· TEACCH: This program helps to integrate the needs of children with autism into a classroom environment, with an emphasis on visual learning and support for the attention and communication difficulties that might arise.

· Special education providers and social workers, as well as medical professionals providing other treatments, such as psychologists and speech therapists, can use this system to support children with ASD.

· Verbal behavior therapy (VBT): This helps a child with ASD connect language and meaning. Practitioners of VBT focus not on words, but the reasons for using them.

Coping strategies and skills

Children with ASD often develop a range of behaviors that help them process the isolating effects of the condition.

These behaviors are attempts by the child to protect themselves from stimuli that may overwhelm them and increase sensory input to enhance feeling. They may also enact these behaviors to bring some level or organization or logic to their everyday lives.

While not all coping strategies for autism are harmful, some can inhibit social interaction and lead to isolation and distress.

These behaviors include:

· isolating themselves and avoiding contact with others

· repetitive patterns while playing and relying on familiar occurrences during the day

· talking to themselves, humming, or whistling

· becoming highly attached to preferred objects

· choosing to seek out or avoid certain experiences to an extreme extent

The important factor in managing potentially isolating behaviors is not to discourage these behaviors, but to add other coping strategies that can make a child's journey through autism easier, such as:

· seeking help

· using language more openly

· relaxing and taking breaks

· making their needs clear

· managing sensory input

The following are effective ways to achieve this:

· Understanding that speech processing may undergo delays and accounting for this when speaking to a child with ASD.

· Restricting noise, movement, and the presence of nearby objects to help a child concentrate when presenting information to them.

· Helping a child to structure activities by giving the order-based cues, such as "First, do this, then..." or "Get ready... get set ... go!"

· Demonstrating appropriate adult socialization in front of the child with ASD.

· Clearly defining a play space by using visual markers, such as beanbags, to promote a feeling of safety around other children.

· Making sure information about events is both clear and visible, in terms of routine activities and those that fall outside of routine and may cause distress.

· Running through and practicing these coping strategies during play.

Different people experience ASD to varying extents and with a range of behaviors. However, these strategies and skills can help increase the tools available to each person with the condition and improve their quality of life.

Children with ASD also act in ways that seem unusual or have interests that aren’t typical. Examples of this can include:

· Repetitive behaviors like hand-flapping, rocking, jumping, or twirling

· Constant moving (pacing) and “hyper” behavior

· Fixations on certain activities or objects

· Specific routines or rituals (and getting upset when a routine is changed, even slightly)

· Extreme sensitivity to touch, light, and sound

· Not taking part in “make-believe” play or imitating others’ behaviors

· Fussy eating habits

· Lack of coordination, clumsiness

· Impulsiveness (acting without thinking)

· Aggressive behavior, both with self and others

Short attention span 

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