Autism

What is autism?
Autism or Autism Spectrum Disorders (ASD) or Autism Spectrum Condition (ASC) are a category of developmental disorders that are marked by deficits in communication and social interaction along with stereotyped or repetitive and rigid ways of functioning. Children with ASD very often show atypical sensory perceptions (for example: hypersensitivity to sounds). The exact nature of deficits and the level of impairment differ from child to child.
ASD is a part of a larger category of disorders known as the Pervasive Developmental Disorders (PDD). Autism the best known and most studied of the PDDs. Aspereger’s Syndrome is the next most known PDD. The diagnosis of Aspereger’s Syndrome is being strongly debated in professional circuits. Some experts believe that it is the same as High Functioning Autism (HFA) and should therefore be subsumed under the Autism Spectrum. Others still believe that it is a distinct PDD not falling on the Autism Spectrum.
Other PDDs include Childhood Disintegrative Disorder and Rett’s Syndrome.

What causes ASD?
The cause(s) of ASD (or any of the PDDs) are not yet known. Several possible causes have been associated with and implicated in causing PDD and/or Autism Spectrum Conditions but no single cause or underlying neurological substrates have been isolated.

How common is ASD?
Large scale epidemiological studies in various countries reveal varying incidence rates. According to the Autism Epidemiology Network (http://www.autismepidemiology.net/) the incidence in the USA is an average of 1 in 110 births (1 in 70 male births), and 1 in 112 births in Japan while it is around 1 in 800 births in Scandanavian countries. The statistics in India are still inconclusive. Autism is known to affect more boys than girls.

Diagnosis:
As there are no known biological markers for ASC, there is no medical test to determine the existence of an Autism Spectrum Condition, ASC are diagnosed based on behavioural manifestations. There are several standardized checklists that are used to measure the nature and extent

Check links for developmental “red flags”
http://www.autismspeaks.org/whatisit/learnsigns.php#redflags
http://www.helpautismnow.com/?page_id=13

Videos:
http://www.youtube.com/watch?v=1VA6Q3vTC_o

Intervention:
There is still no cure for Autism Spectrum Disorders. Related or co-morbid medical conditions must be dealt with symptomatically and as per physicians’ instructions. Attention deficits and aggression are seen very often in children with PDD/ASD.

Behaviour management and training starting at a very young age goes a long way to reduce impairments later on in life. Management and intervention with children diagnosed with PDD/ASD is usually based on Applied Behavioural Analysis (ABA) principles of behaviourism. Some of the well known method of intervention with children with ASD are mentioned below.

• Dr. Ivar Lovaas of UCLA has been one of the pioneers of and he developed a method called Discrete Trial Training (DTT) to work with children with developmental disabilities. His method has become synonymous with ABA itself. http://www.lovaas.com

Pivotal Response Training (PRT) is a naturalistic, behavioural intervention approach developed by Dr. Robert L. Koegel & Dr. Laura Schreibman of the University of California, San Diego. http://autismlab.ucsd.edu/

Treatment and Education of Autistic and Communication related handicapped CHildren (TEACCH) developed by Eric Schopler of the University of North Carolina is a comprehensive system of intervention for children with ASD. http://www.teacch.com/

DIR/FloortimeTM

Early Start Denver Model (ESDM).

Children falling within the PDD/ ASD spectrum are said to be visual learners. The Picture Exchange Communication System (PECS) has been widely used as a means to aid communication for children who have difficulties with typical verbal communication.

Sensory Integration Therapy to deal with their sensory issues has been found to be very effective with children with ASD.

http://www.autismspeaks.org/whattodo/index.php

Professionals that ought to be consulted if you suspect that your child has ASD:
• Paediatrician and Neurologist to rule out physical and structural neurological problems. Seizures are often seen in children with Autism.
• Psychologist – for behavioural assessment and structured intervention
• Occupational Therapist – for sensory problems as well as activities of daily living.
• Speech Therapist
• Psychiatrist – usually for related problems in attention and tantrums
• Cytogenetist (Metabolic Expert) – Modifications in diet may help with attention and aggressive behaviour.