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Autism

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Autism Spectrum Disorders also known as Pervasive Developmental Disorders first came on the scene in the middle of the twentieth century. In 1943 Dr. Leo Kanner studied a group of 11 children and introduced the disorder. It's first name was Infantile Autism. A year later Dr. Hans Asperger described a milder form of the disorder that became known as Asperger syndrome. The autism spectrum disorders can be reliably detected by the age of 3 years and in some cases as early as 18 months. Studies suggest that many children eventually may be accurately identified by the age of 1 year. The two disorders are today listed in the Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR (fourth edition, text revision). The two that will be the focus of this paper are Autism and Asperger.

Autism

Autism is not a disease, but a developmental disorder of brain function. People with classical autism show three types of symptoms: impaired social interaction, problems with verbal and nonverbal communication and imagination and unusual or severely limited activities and interest. Although there is no cure, appropriate management may foster relatively normal development and reduce undesirable behaviors. People with autism have normal life expectancy. Autism affects two to ten of every 10,000 people, depending on diagnostic criteria used. Autism strikes males about four times as often as females, and has been found throughout the world in people of all racial and social backgrounds. Autism varies a great deal in severity. The most sever cases are marked by extremely repetitive, unusual, self-injurious and aggressive behavior. The mildest form of autism resemble a personality disorder associated with a perceived learning disability.

Common Signs

The main feature of autism is impaired social interaction. Children with autism may fail to respond to their names and often avoid looking at other people. They often have difficulty interpreting tone of voice or facial expression. They also don't respond to others' emotion or watch other people's faces. They appear unaware of other's feelings toward them and of negative impact of their behavior on other people. Many children with autism engage in repetitive movements such as rocking and hair twirling or in self-injurious behavior such as biting or head banging. I have witnessed this while on my job. I saw a student who was very upset for an unknown reason. The way he chose to deal with his anger was to head butt a tree. He got a running start, with his head down and ran straight toward a tree and butt it full force. He did not seem to feel the pain. He ran into the tree several times. Children of autism also tend to start speaking later than other children and may refer to themselves by name instead of "I" or "me." Some speak in song voice or a light airy voice about topics of interest to them with little regard of interest to the person to whom they are speaking.

Diagnosis

Some doctors use the term "emotionally disturbed" to describe people with autism. Because it varies widely in its severity and symptoms, autism may go unrecognized, especially in mildly affected individuals or in those with multiple handicaps. Researchers have developed several sets of diagnostic criteria for autism. Some frequently used are:

Absence or impairment of imaginative and social play

Impaired ability to make friends with peers

Impaired ability to initiate or sustain a conversation with others

Stereotype, repetitive , or unusual use of language

Restricted patterns of interest that are abnormal in intensity or focus

Apparently inflexible adherence to specific routines or rituals

Preoccupation with parts of objects

Since hearing problems can be confused with autism, children with delayed speech development should always have their hearing checked. My child did not start to speak at the appropriate time so she was thought to have autism. Later years my child, who is a very smart child, told me she remembers the test that were given. I asked her why didn't she talk and her response was I just didn't feel like talking. I didn't want to talk to those people. I just wanted to talk to my sister and my teddy bear. Children sometimes have impaired hearing in addition to autism. About half of the people with autism score below 50 on IQ test, 20 percent score between 50 and 70, and 30percent score higher than 70percent. A small percent of people with autism are savants. These people have limited but extraordinary skills in areas like math, music, drawing, or visualization.

Causes

There is no single cause. Researchers believe several genes, as well as environmental factors such as viruses or chemicals, contribute to the disorder. There is also a belief that childhood vaccinations may contribute to autism. The MMR vaccine has been thought to be linked to speech loss. The DTP vaccine is also thought to be linked with autism. Information on these studies can be found on the web site Autism Today www.autismtoday.com/articles. Studies of people with autism have found abnormalities in several regions of the brain, including the cerebellum, amygdale, hippocampus, septum, and maxillary bodies. Other studies suggest that people with autism have abnormalities of serotonin or in other signaling molecule in the brain. These studies are preliminary and require further study. There was an earlier study that parental practices were responsible for autism. They have now been disproved. In a minority of cases, disorders such as fragile X syndrome, tuberous sclerosis, untreated phenylketonuria (PKU), and congenital rubella cause autistic behavior. Other disorders , including Tourette syndrome , learning disabilities, and ADD, often occur with autism but do not cause it. For reasons unknown about 20 to 30 percent of people with autism also develop epilepsy by the time they reach adulthood.

Genetics

Recent studies strongly suggest that some people have a genetic predisposition to autism. Scientist estimate that, in families with one autistic child, the risk of having a second child with the disorder is approximately five percent, or one in twenty, which is greater than the risk for clues about which gene contribute to this increase in susceptibility. In some cases, parents and other relatives of an autistic person show mild social, communicative, or repetitive behaviors that allow them

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