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Autism is a brain disorder that often makes it hard to communicate with and relate to others. With autism, the different areas of the brain fail to work together.
Most people with autism will always have some trouble relating to others. But early diagnosis and treatment have helped more and more people who have autism to reach their full potential.
Autism tends to run in families, so experts think it may be something that you inherit. Scientists are trying to find out exactly which genes may be responsible for passing down autism in families.
Other studies are looking at whether autism can be caused by other medical problems or by something in your child's surroundings.
False claims in the news have made some parents concerned about a link between autism and vaccines. But studies have found no link between vaccines and autism. It's important to make sure that your child gets all childhood vaccines. They help keep your child from getting serious diseases that can cause harm or even death.
Symptoms almost always start before a child is 3 years old. Usually, parents first notice that their toddler has not started talking yet and is not acting like other children the same age. But it is not unusual for a child with autism to start to talk at the same time as other children the same age, then lose his or her language skills.
Symptoms of autism include:
There is no "typical" person with autism. People can have many different kinds of behaviours, from mild to severe. Parents often say that their child with autism prefers to play alone and does not make eye contact with other people.
Autism may also include other problems:
There are guidelines your doctor will use to see if your child has symptoms of autism. The guidelines put symptoms into categories such as:
Your child may also have a hearing test and some other tests to make sure that problems are not caused by some other condition.
Treatment for autism involves special behavioural training. Behavioural training rewards appropriate behaviour (positive reinforcement) to teach children social skills and to teach them how to communicate and how to help themselves as they grow older.
With early treatment, most children with autism learn to relate better to others. They learn to communicate and to help themselves as they grow older.
Depending on the child, treatment may also include such things as speech therapy or physiotherapy. Medicine is sometimes used to treat problems such as depression or obsessive-compulsive behaviours.
Exactly what type of treatment your child needs depends on the symptoms, which are different for each child and may change over time. Because people with autism are so different, something that helps one person may not help another. So be sure to work with everyone involved in your child's education and care to find the best way to manage symptoms.
An important part of your child's treatment plan is making sure that other family members get training about autism and how to manage symptoms. Training can reduce family stress and help your child function better. Some families need more help than others.
Take advantage of every kind of help you can find. Talk to your doctor about what help is available where you live. Family, friends, public agencies, and autism organizations are all possible resources.
Remember these tips:
Raising a child with autism is hard work. But with support and training, your family can learn how to cope.
The severity of symptoms varies greatly, but all people with autism have some core symptoms in the areas of:
Symptoms of autism are usually noticed first by parents and other caregivers sometime during the child's first 3 years. Although autism is present at birth (congenital), signs of the disorder can be difficult to identify or diagnose during infancy. Parents often become concerned when their toddler does not like to be held; does not seem interested in playing certain games, such as peekaboo; and does not begin to talk. Sometimes, a child with autism will start to talk at the same time as other children the same age, then lose his or her language skills. Parents also may be confused about their child's hearing abilities. It often seems that a child with autism does not hear, yet at other times, he or she may appear to hear a distant background noise, such as the whistle of a train.
With early and intensive treatment, most children improve their ability to relate to others, communicate, and help themselves as they grow older. Contrary to popular myths about children with autism, very few are completely socially isolated or "live in a world of their own."
During the teen years, the patterns of behaviour often change. Many teens gain skills but still lag behind in their ability to relate to and understand others. Puberty and emerging sexuality may be more difficult for teens who have autism than for others this age. Teens are at an increased risk for developing problems related to depression, anxiety, and epilepsy.
Some adults with autism are able to work and live on their own. The degree to which an adult with autism can lead an independent life is related to intelligence and ability to communicate. At least 33% are able to achieve at least partial independence.footnote 2
Some adults with autism need a lot of assistance, especially those with low intelligence who are unable to speak. Part- or full-time supervision can be provided by residential treatment programs. At the other end of the spectrum, adults with high-functioning autism are often successful in their professions and able to live independently, although they typically continue to have some difficulties relating to other people. These individuals usually have average to above-average intelligence.
Many people with autism have symptoms similar to attention deficit hyperactivity disorder (ADHD). But these symptoms, especially problems with social relationships, are more severe for people with autism.
About 10% of people with autism have some form of savant skills—special limited gifts such as memorizing lists, calculating calendar dates, drawing, or musical ability.footnote 1
Many people with autism have unusual sensory perceptions. For example, they may describe a light touch as painful and deep pressure as providing a calming feeling. Others may not feel pain at all. Some people with autism have strong food likes and dislikes and unusual preoccupations.
Sleep problems occur in about 40% to 70% of people with autism.footnote 3
Almost half of children with autism spectrum disorders have a tendency to "wander off" from a caregiver, or "elope." For many caregivers of children with autism, elopement is one of the most stressful behaviours with which they must learn to cope. Studies show that functional assessment-based behavioural interventions, such as applied behavioural analysis, are effective in reducing the frequency of elopement.
Autism is one of several types of autism spectrum disorders (ASDs), once known as pervasive developmental disorders (PDDs). It is not unusual for autism to be confused with other ASDs, such as Asperger's syndrome, or to have overlapping symptoms. A similar condition is called unspecified neurodevelopmental disorder. This condition occurs when children display similar behaviours but do not meet the criteria for autism. Also, other conditions with similar symptoms may also have similarities to or occur with autism.
Autism is often identified during regularly scheduled routine checkups. Early diagnosis and treatment can help the child reach his or her full potential.
When a developmental delay is recognized in a child, further testing can help a doctor find out whether the problem is related to autism, another autism spectrum disorder (ASD), or a condition with similar symptoms, such as language delays or avoidant personality disorder. If your primary care provider does not have specific training or experience in developmental problems, he or she may refer your child to a specialist—such as a developmental pediatrician, a psychiatrist, a speech therapist, a psychologist, or a child psychiatrist—for the additional testing.
Other lab tests may be done under specific circumstances. These tests include:
All doctors who see infants and children for routine checkups should watch for early signs of developmental disorders. Developmental screening tools, such as the Ages and Stages Questionnaire or the Modified Checklist for Autism in Toddlers (M-CHAT), can help assess behaviour.
If a doctor discovers the following obvious signs of developmental delays, the child should immediately be evaluated:footnote 5
If there are no obvious signs of developmental delays or any unusual indications from the screening tests, most infants and children do not need further evaluation until the next regular visit.
But children who have a sibling with autism should continue to be closely monitored, because they are at increased risk for autism and other developmental problems.
When socialization, learning, or behaviour problems develop in a person at any time or at any age, he or she should also be evaluated.
Early diagnosis and treatment helps young children with autism develop to their full potential. The primary goal of treatment is to improve the overall ability of the child to function.
Symptoms and behaviours of autism can combine in many ways and vary in severity. Also, individual symptoms and behaviours often change over time. For these reasons, treatment strategies are tailored to individual needs and available family resources. But in general children with autism respond best to highly structured and specialized treatment. A program that addresses helping parents and improving communication, social, behavioural, adaptive, and learning aspects of a child's life will be most successful.
Experts, including the Canadian Paediatric Society and the American Academy of Pediatrics (AAP), recommend the following strategies for helping a child to improve overall function and reach his or her potential:footnote 6, footnote 7
Many people with autism have sleep problems. These are usually treated by staying on a routine, including a set bedtime and time to get up. Your doctor may try medicines as a last resort.
Stories about alternative therapies, such as secretin and auditory integration training, have circulated in the media and other information sources. When you are thinking about any type of treatment, find out about the source of the information and about whether the studies are scientifically sound. Accounts of individual success are not sufficient evidence to support using a treatment. Look for large, controlled studies to validate claims.
Experts have not yet identified a way to prevent autism. Public concern over stories linking autism and childhood vaccines has persisted. But numerous studies have failed to show any evidence of a link between autism and the measles-mumps-rubella (MMR) vaccine.footnote 8 If you avoid having your children immunized, you put them and others in your community at risk for developing serious diseases, which can cause serious harm or even death.
Having a child with autism requires taking a proactive approach to learning about the condition and its treatment while working closely with others involved in your child's care. You also need to take care of yourself so that you are able to face the many challenges of having a child with autism.
Ask your doctor or contact autism groups to find training about autism and how to manage symptoms. Parent and family education can reduce family stress and improve a child's functioning. Understanding the condition and knowing what to expect is an important part of helping your child develop independence.footnote 7
Become informed about your child's educational rights. There may be federal, provincial, and local laws or policies to aid children who have autism. Find out what services are available in your area.
Learning about autism will also help prepare you for when your child reaches adulthood. Some adults with autism can live by themselves, work, and be as independent as other people their age. Others need continued support.
Close communication with others involved in your child's education and care will help all concerned. The best treatment for children with autism is a team approach and a consistent, structured program. Everyone involved needs to work together to set goals for:
Work closely with the health professionals involved in your child's care. It is important that they take time to listen to your concerns and are willing to work with you.
Learn ways to handle the normal range of emotions, fears, and concerns that go along with raising a child who has autism. The daily and long-term challenges put you and your other children at an increased risk for depression or stress-related illnesses. The way you handle these issues influences other family members.
CitationsVolkmar FR, et al. (2009). Pervasive developmental disorders. In BJ Sadock, VA Sadock, eds., Kaplan and Sadock's Comprehensive Textbook of Psychiatry, 9th ed., vol. 2, pp. 3540–3559. Philadelphia: Lippincott Williams and Williams.American Psychiatric Association (2013). Neurodevelopmental disorders. In Diagnostic and Statistical Manual of Mental Disorders, 5th ed., pp. 31–86. Washington, DC: American Psychiatric Association.Zachor DA (2006). Autism. In FD Burg et al., eds., Current Pediatric Therapy, 18th ed., pp. 1219–1226. Philadelphia: Saunders Elsevier. American Psychiatric Association (2013). Neurodevelopmental disorders. In Diagnostic and Statistical Manual of Mental Disorders, 5th ed., pp. 31–86. Washington, DC: American Psychiatric Association.Johnson CP, et al. (2007, reaffirmed 2010). American Academy of Pediatrics clinical report: Identification and evaluation of children with autism spectrum disorders. Pediatrics, 120(5): 1183–1215.Canadian Paediatric Society (2004). Early intervention for children with autism (CPS Position Statement PP 2004-02). Paediatrics and Child Health, 9(4): 267–270.Myers SM, et al. (2007, reaffirmed 2010). American Academy of Pediatrics clinical report: Management of children with autism spectrum disorders. Pediatrics, 120(5): 1162–1182.Taylor LE, et al. (2014). Vaccines are not associated with autism: An evidence-based meta-analysis of case-control and cohort studies. Vaccines, 32(29): 3623–3629.Other Works ConsultedAnderson C, et al. (2012). Occurrence and family impact of elopement in children with autism spectrum disorders. Pediatrics, 130(5): 870–877.Council on Children With Disabilities, Section on Developmental Behavioral Pediatrics, Bright Futures Steering Committee and Medical Home Initiatives for Children With Special Needs Project Advisory Committee (2006, reaffirmed 2010). Identifying infants and young children with developmental disorders in the medical home: An algorithm for developmental surveillance and screening. Pediatrics, 118(1): 405–420. [Erratum in Pediatrics, 118(4): 1808–1809.]Dumont-Mathieu T, Fein D (2005). Screening for autism in young children: The Modified Checklist for Autism in Toddlers (M-CHAT) and other measures. Mental Retardation and Developmental Disabilities Research Reviews, 11(3): 253–262.Johnson CP, et al. (2007, reaffirmed 2010). American Academy of Pediatrics clinical report: Identification and evaluation of children with autism spectrum disorders. Pediatrics, 120(5): 1183–1215.Parr J (2010). Autism, search date May 2009. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.Volkmar FR, et al. (2009). Autism and autism spectrum disorders: Diagnostic issues for the coming decade. Journal of Child Psychology and Psychiatry, 50: 108–115.Williams K, et al. (2010). Selective serotonin reuptake inhibitors (SSRIs) for autism spectrum disorders (ASD) (Review). Cochrane Database of Systematic Reviews (9).Wong V, et al. (2004). A modified screening tool for autism (Checklist for Autism in Toddlers [CHAT-23]) for Chinese children. Pediatrics, 114(2): 166–176.
Current as ofSeptember 11, 2018
Author: Healthwise StaffMedical Review: John Pope MD - PediatricsBrian D. O'Brien MD - Internal MedicineKathleen Romito MD - Family MedicineElizabeth T. Russo MD - Internal MedicineAdam Husney MD - Family MedicineE. Gregory Thompson MD - Internal MedicineFred Volkmar MD - Child and Adolescent PsychiatryLouis Pellegrino MD - Developmental Pediatrics
Current as of: September 11, 2018
Author: Healthwise Staff
Medical Review:John Pope MD - Pediatrics & Brian D. O'Brien MD - Internal Medicine & Kathleen Romito MD - Family Medicine & Elizabeth T. Russo MD - Internal Medicine & Adam Husney MD - Family Medicine & E. Gregory Thompson MD - Internal Medicine & Fred Volkmar MD - Child and Adolescent Psychiatry & Louis Pellegrino MD - Developmental Pediatrics
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