Autism

Autism is a complex syndrome of childhood in which intellectual growth is uneven and social development is impaired. Common characteristics include unresponsiveness, inability to speak or communicate and understand, refusal to seek or accept physical comforting, and an unusual insistence upon routines. Autistic children often make repetitive body movements, and even the most trivial change in their physical environment or routine can provoke rage or extreme anxiety. Some autistic children mimic sounds or develop intelligible speech patterns, and some are mute. About 20 to 40 percent have seizures. The cause of autism is unknown, but it is classified as a neurophysiologic disorder. Parental behavior has no bearing on it, though some cases have been linked to rubella contracted before birth, hereditary metabolic disorders, encephalitis, and meningitis. Some times autism develops in children who have appeared to be normal, but then inexplicably regress. Autistic boys out number girls at least two to one. A number of autistic children appear to have low IQs, others are normal, and a few are extremely intelligent but can not adjust socially. Occasionally, an autistic child will have unusual talent in math or art.

Diagnostic Studies and Procedures

Although babies may demonstrate some symptoms of autism, the problem usually is not diagnosed until about age three when it becomes clear that the child's speech is delayed or abnormal. Diagnosis requires a careful physical and neurologic examination to rule out other causes. A specialist in childhood developmental disorders may administer psychological tests, but testing is difficult if the child does not yet speak or is intellectually impaired.

Medical Treatments

Because there is no cure for autism, treatment focuses on trying to help a child develop language and social skills. This usually entails a combination of speech and behavioral therapy, special education, and in some cases, medication. Antipsychotic drugs are sometimes prescribed for children who are aggressive or self destructive. Anticonvulsant medications such as carbamazepine (Tegretol) or phenobabital (Bellatal, Donnatal, and others) are given to children who suffer seizures. Since autism involves so many variables, each child must be evaluated individually to develop the most appropriate treatment program. Children with near normal or normal IQs are often helped by psychotherapy, with emphasis on behavior modification designed to foster social skills. Some autistic children do well living at home; others improve while living in a closely supervised treatment facility with other learning disabled children.

Alternative Therapies

In recent years, a few alternative therapies have been used experimentally with autistic children, often producing marked improvement. These include:

Therapists working with autistic children encourage them to use a variety of materials clay, crayons, paints, and cutouts, for example. The goal is to help them express themselves while overcoming ritualistic behavior.

These modalities are used separately or in combination. Group dance and music therapy fosters social interaction while breaking ritualistic patterns. Music may also be used to calm agitated or aggressive behavior; in some cases, it also provides a means of self expression.

This is a relatively new approach that has met with considerable success. In an experimental program in Florida, autistic and other developmentally impaired children have been learning to swim and interact with dolphins. Another program on Long Island in New York has been using cats to encourage autistic children to connect with other living creatures. Researchers report that such approaches seem to take many children out of their solitude, boost their learning skills, and increase their interrelationships with people.

Self Treatment

About IS percent of autistic children eventually become self sufficient, although most continue to require a sheltered environment. Otherwise, autism demands life long care, a task that is trying, even under the best circumstances. Because the strain often leads to depression, anger, and guilt among parents and siblings, it's important for them to work with qualified mental health professionals. Recommended home treatment includes:

Teaching Verbal Skills

This should be done in brief, one on one sessions in which the child is encouraged to communicate verbally. Because autistic children learn by rote, a single word or concept must be repeated many times in the same way. Children who cannot speak are taught to communicate through body language, art, or other creative therapies. Special education programs that use computers to foster communication skills also appear to be promising.

Teaching Social Skills

Parents can apply many of the tactics used by professionals to encourage an autistic child to break out of self imposed isolation. Plan activities that are simple and unthreatening, such as listening to music or dancing together. In all activities, go slowly, breaking each task or skill into small steps.

Other Causes of Autistic Symptoms

Before diagnosing autism, doctors should rule out a thyroid hormone deficiency, deafness, an organic brain disease such as encephalitis, and such metabolic disorders as phenylketonuria, or PKU. Sometimes child abuse and post traumatic stress syndrome can also produce symptoms similar to those of autism.