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February 9, 2012

Understanding Autism

by Cristina González

According the Centers for Disease Control and Prevention, 1 in 100 children have autism spectrum disorder, a developmental disorder that affects a child’s social and communication skills. But new proposed changes in the definition of autism would greatly reduce the rate at which the disorder is diagnosed. Here’s what autism is, how you can spot symptoms in your child’s early years, and what you can do to treat it.

A vacant stare. A relentless obsession. A stunning aptitude. These are all signs and symptoms of autism, a developmental disorder that affects 3 million individuals in the United States every year. And Latinos aren’t immune: In 2001 white children had autism rates 90 percent higher than Latino children, but by 2005, the rates were the same. But now, the American Psychiatric Association (APA) is reviewing the definition of autism and narrowing it. The APA is completing work on the fifth edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM), the standard reference for mental disorders, and the revised definition would exclude about three quarters of those now diagnosed with milder forms of autism. While the guidelines are still being debated and the changes won’t go into affect until 2013, it’s still important to understand what autism is, for the health of your child and family.
 
What is autism?
Autism is the general term for a spectrum of developmental disorders that most often affect children in their first three years of life. (The disorders currently include milder forms like Asperger’s syndrome and “pervasive developmental disorder, not otherwise specified”—but these would be disqualified in the new definitions.) In general, the disorders cause delays in the brain’s normal development of social and communication skills. Children with an autistic condition usually have difficulties communicating, interacting socially and controlling repetitive behaviors.  
 
What causes autism?
Autism is a biological condition linked to abnormal chemistry in the brain. While the exact cause is unknown, researchers have found a combination of factors that can lead to the disorder. First, genes may play a part. Studies have shown that chromosomal abnormalities and other nervous system (neurological) problems are more common in families with autism. Secondly, there may be some evidence (yet no proof) that environmental factors like diet and the body’s inability to process vitamins and minerals may be linked to the condition. 
 
Can vaccines cause autism?
There has been speculation in the past about a possible link between autism and vaccines. Some believe that the small amount of mercury that is a common preservative in vaccines causes autism or attention deficit hyperactivity disorder (ADHD). However, no studies have shown this to be true. In fact, the American Academy of Pediatrics, and The Institute of Medicine (IOM) have stated “no vaccine or component of any vaccine is responsible for the number of children who are currently being diagnosed with autism” and that the “benefits of vaccines outweigh the risks.”
 
What are the symptoms of autism?
Children with autism typically show difficulties in four common areas. First, communication. They may communicate with gestures instead of words, fail to adjust their gaze and fail to develop language. Second, social interaction. Children may fail to make friends, refuse to play interactive games, treat others as if they were objects and show a lack of empathy. Next, children may have trouble responding to sensory information. For example, they may not startle at a loud noise; they may have heightened senses; or they may withdraw from physical contact. Finally, children may have trouble with play. They will fail to imitate the actions of other people, prefer to play alone, and show little aptitude for pretend play. 
 
Under the current criteria, a person can qualify for a diagnosis by exhibiting six or more of 12 behaviors; under the new proposed definition, the person would have to exhibit three deficits in social interaction and communication and at least two repetitive behaviors. This means that though these are general symptoms that may point toward autism, children and adults would have to meet a much narrower criteria to be officially diagnosed. 
 
When should a child be tested for autism?
All children develop differently, but if a child fails to meet milestones, parents should seek out further testing. Children should be babbling and gesturing by 12 months, saying single words by 16 months and saying two-word spontaneous phrases by 24 months. A routine test might include a hearing evaluation, blood lead test, and screening test for autism. Since there is no single biological test for autism, the diagnosis is often based solely on the very specific criteria in the DSM.
 
What is the treatment for autism?
No two treatments are alike, but in general they include medications, occupational therapy, physical therapy and speech language therapy. Some children with autism seem to respond to changes in their diet, in particularly, a gluten-free or casein-free diet. 
 
What should I do if I think my child has autism?
Document your child’s developmental milestones and continue to keep regularly scheduled pediatric check-ups. If you think your child is exhibiting symptoms of autism, talk to your doctor about the next steps, especially before changing your child’s diet or routine. Children with autism can go on to lead integrated lives, with little or no side effects from autism.
 
To learn more about autism, click here

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