Causes Symptoms Diagnosis Treatment for Children & Kids:
Autism is a kind of problem where the children could not interact properly with others, where they have problems in social interactions and problems in communications where they are not able to able to express themselves properly and they have a repetitive behavior where they repeat the activities again and again. The repetitive activity might be a stereotyped behavior like making same kind of sounds repetitively or body rocking, or compulsive activity like following strictly certain rules such as arranging objects in a line , sameness in behavior, they are resistant to change or following a kind of ritual or restricted behavior such as preoccupation with television program, toy or a game and sometimes self injurious behavior such as hand biting , skin picking or head banging.
Though, they find it difficult to interact socially, still they believe in quality of friendship rather than the number of friends. They feel lonely sometimes and would like to interact with others but since they do not understand that why the other person is smiling at him and even if they are able to understand it they find it difficult to communicate with them as they found it difficult to find words and express themselves. Sometimes they also have speech defects or deficits and they are not able to communicate due to this.
For the treatment basically the speech therapy and behavior therapy and occupational therapy is recommended besides psychoactive drugs as prescribed by the clinical practioner.
Following is from NINDS, National Institutes of Health:
What are some common signs of autism?
The hallmark feature of ASD is impaired social interaction. A child’s primary caregivers are usually the first to notice signs of ASD. 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 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 lack empathy.
Many children with 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 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 ASD appear to have a higher than normal risk for certain co-occurring conditions, including Fragile X syndrome (which causes mental retardation), tuberous sclerosis (in which tumors grow on the brain), epileptic seizures, Tourette syndrome, learning disabilities, and attention deficit disorder. About 20 to 30 percent of children with ASD develop epilepsy by the time they reach adulthood. While people with schizophrenia may show some autistic-like behavior, their symptoms usually do not appear until the late teens or early adulthood. Most people with schizophrenia also have hallucinations and delusions, which are not found in autism.
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 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 ASD. 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 ASD, children with delayed speech development should also have their hearing tested.
Children with some symptoms of 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. Girls with autistic symptoms may have Rett syndrome, a sex-linked genetic disorder characterized by social withdrawal, regressed language skills, and hand wringing.
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 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 manic depression, 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 ASD may become depressed or experience behavioral problems, and their treatment may need some modification as they transition to adulthood. People with 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 ASD. 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 ASD often helps families cope with the particular challenges of living with a child with ASD.
Medications: Doctors may prescribe medications for treatment of specific ASD-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 for people with ASD, 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.
|*Dr Smita Pandey Bhat is a Counselor and Clinical Psychologist. She has completed her M.Phil and PhD in Clinical Psychology, from Central Institute of Psychiatry (C.I.P), Ranchi. She has seven years of experience in this field at different places. She provides psychological counseling, psychotherapies like, Supportive Therapy, Cognitive Behavior Therapy, Interpersonal Therapy, Social Skills Training, Assertiveness Training etc. as per the requirement of the people. She also provides assessments like Intelligence Tests and Personality Assessments for Children as well as Adults.
The areas of problems that require her services is ranging from mild emotional problems to severe mental problems. She provides counseling to children for the problems like, lying, stealing, truancy, identity problems, low self esteem or self confidence, poor performance in school, learning disabilities, autism, attention deficit and hyperactivity problems, emotional outbursts, anger outbursts, crying spells, sadness and depression, problems regarding the choice of career, problems in sleeping etc. She also provides counseling to parents called as Parental Management Training and counsel them for good parenting strategies.
For Adults she provide services for work related stress, stress within the family, tension, anxiety, depression, low self esteem or self confidence, problems in dealing with stress or coping or making adjustments, problems in married life, problems related with sleep, boredom and stress burnouts. She also provides management for obsessive and compulsive behaviors. She teaches them techniques so that they are able to cope better in their lives and have a good quality of life. She also provides cognitive rehabilitation to the patients of chronic schizophrenia, dementia and brain injury patients helping them to learn self help skills and help them refine their cognitive abilities like attention, memory, organization and planning etc. through cognitive retraining and other behavioral techniques.
Dr. Smita Pandey Bhat has given lectures on clinical psychology for nursing students and staff, as well as M.Phil students. She is a clinical psychologist of repute and has made appearances on several live television shows and appeared as Celebrity Guest on indiatimes.com
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