Autism – A Primer

What is autism?
Autism is the most common condition in a group of developmental disorders known as the autism spectrum disorders (ASDs). Autism is characterized by impaired social interaction, problems with verbal and nonverbal communication, and unusual, repetitive, or severely limited activities and interests. Experts estimate that three to six children out of every 1,000 will have autism. Males are four times more likely to have autism than females.

What are common signs of autism?
Three individual behaviors characterize autism. Autistic children have difficulties with social interaction, problems with verbal and nonverbal communication, and repetitive behaviors or obsessive interests. These behaviors can range in impact from mild to disabling.

The trademark feature of autism is impaired social interaction. Parents are usually the first to notice symptoms of autism in their child. As early as infancy, a baby with autism may be unresponsive to people or focus closely on one item, leaving out others for long periods. A child with autism may appear to develop normally and then withdraw and become uninterested in social engagement.

Children with autism may fail to respond to their name and often avoid eye contact with other people. They will 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 correct behavior.

Many children with autism 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. Some speak in a singsong voice about a small range of favorite topics, with little regard for the interests of the person to whom they are speaking.

Many children with autism have a reduced sensitivity to pain, but are abnormally sensitive to sound, touch, or other sensory stimulation. These unusual reactions may add to behavioral symptoms such as a resistance to being cuddled or hugged.

How is autism diagnosed?
Autism varies widely in its severity and symptoms and may go unrecognized, especially in mildly affected children, or when it is masked by more debilitating handicaps. Doctors rely on a core group of behaviors to alert them to the possibility of a diagnosis of autism. These behaviors are:

• 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

Doctors 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; others rely on a combination of parent and doctor observations. If screening instruments indicate the possibility of autism, doctors will ask for a more comprehensive evaluation.

How is autism treated?
There is no cure for autism. Therapies and behavioral interventions are designed to remedy specific symptoms and can bring about significant improvement.

• Educational/behavioral interventions: Therapists use highly structured and intensive skill-oriented training sessions to help children develop social and language skills. Family counseling for the parents and siblings of children with autism often helps families cope with the particular challenges of living with an autistic child.
• Medications: Doctors often prescribe an antidepressant medication to handle symptoms of anxiety, depression, or obsessive-compulsive disorder. Anti-psychotic medications are used to treat severe behavioral problems. Seizures can be treated with one or more of the anticonvulsant drugs. Stimulant drugs, such as those used for children with attention deficit disorder (ADD), are sometimes used effectively to help decrease impulsivity and hyperactivity.
• Other therapies: There are a number of controversial therapies or interventions available for autistic children, but few, if any, are supported by scientific studies. Parents should use caution before adopting any of these treatments.

The ideal treatment plan coordinates therapies and interventions that target the core symptoms of autism: impaired social interaction, problems with verbal and nonverbal communication, and obsessive or repetitive routines and interests. Most professionals agree that the earlier the intervention, the better.