What is Autism?
Autism is a lifelong disorder that emerges in the first year or two of life. It consists of disturbances in the following areas:
- Developmental rates and the sequence of motor, social-adaptive and cognitive skills.
- Reaction towards sensory inputs – hyper and hypo sensitivity in audition, vision, tactile stimulation, motor, olfactory and taste, including self-stimulatory behaviours.
- Speech and Language, cognition, and nonverbal communication, including mutism, echolalia, and difficulty with abstract terms.
- Capacity to appropriately relate to people, events and objects, including lack of social behaviours, affection and appropriate play.
Autism is normally the common name for Autism Spectrum Disorder (ASD). ASD is the collective term for individuals affected in the aforementioned areas. Due to the diverse symptoms the word spectrum is used. Another term often heard is Pervasive Developmental Disorder ( PDD). This refers to the milder form of Autism while ASD is the more severe form. PDD – NOS refers to Pervasive Developmental Disorder – Nothing Otherwise Specified which again is a mild form of this developmental disorder. Autism is found in males four times more frequently than in females and affects 1 in 500 children.
In general, the age of detection of ASD varies with severity and developmental delays, especially in communication and social interaction. Usually this disorder is identified after 18 months of age. Research shows that infants with ASD have been described as either lethargic, preferring solitude and making few demands , or highly irritable, with sleeping problems and screaming and crying, including more frequent tantruming, repetitive movements and ritualistic play, extreme reactions to certain stimuli, joint attention and communication difficulties including a lack of gestures and lack of pretend and social play.
What are the symptoms of Autism?
Since autism is a developmental disorder its behavioural manifestations vary with age ability. Its core features, present in different forms, at all stages of development and at all levels of ability, are:
- Social interaction
- Imagination/Repetitive Restricted Behaviours and Interests.
Deficit in communication involving delay in language development is one of the core features of Autism Spectrum Disorder. Although the pattern of communication and language development is quite variable across individuals with autism, early life symptoms in communication are commonly seen during the child’s second year of life.
The variance in expressive/spoken language features seen across Autism ranges from no productive expressive language to verbal fluency. Some studies reveal that approximately 80-90% of autistic children develop some functional speech by the age of 9 years.
Predictors of language development
Lots of longitudinal research in autistic children from 2 years of age till 9 years has revealed certain predictors of spoken language development. They are as under –
- Non verbal cognitive abilities
- Joint attention
- Communication scores on formal tests
This gets to show that children who at the age of 2 have better nonverbal cognitive abilities, joint attention skills will grow up to have better spoken language skills.
Type and degree of language deficit may vary over time in autism. Some verbal children with ASD show similar levels to typically developing children in language areas like vocabulary development and grammar. Some children who show signs of early language delays might ‘catch up’ over time. Some autistic verbal children also show similarities to ‘specific language impairment’ another group of language disorders.
What causes Autism?
In the past, Autism has been linked to the presence of emotional, physical, environmental and health related deficiencies. It was believed that ‘cold mothers’ who failed to provide a healthy nurturing and emotionally sound environment to their toddlers caused ASD. But sufficient research has suggested that the main factor that causes Autism is Biological preponderance.
Approximately 65 % of individuals with ASD have abnormal brain patterns. The incidence of autism is higher when accompanied by prenatal complications, Fraglie X syndrome , Ritt syndrome and a family history of autism.
ASD is often accompanied by mental retardation and seizures.
High levels of serotonin in the brain. Serotonin is a neurotransmitter and natural opiate.
Abnormal development of celrebellum ( part of the brain that regulates sensations)
Multi focal disorders of the brain
Impairment of neural subcortical structures
Impairment in cortical development
Genetic link .Research is still on. It is opined that there might be several genes involved which express autism.
Social- Environmental Factors
Early studies indicated that parents who didn’t interact appropriately with their children caused autism. But no basis has been found for this conclusion.
Children with ASD have problems in processing information and analysing it.
When attending they fixate on one aspect, often some irrelevant minor details.
Difficulties in discrimination.
All these issues precipitate the language deficit symptoms including inability to identify the relevant contextual information, echolalia and poor social skills
What are the treatment options for children with Autism?
Treatment or intervention of Autism is a very extensive comprehensive program which involves a host of professionals and the child’s family. The following are some important pivots in the intervention of children with Autsim Spectrum Disorder
Speech Language Therapy: Important for developing the necessary communication and speech skills in children with Autism
Various behavioural therapies like Relationship Development Intervention (RDI), Applied Behaviour Analysis (ABA), Discrete Trial Teaching (DTT), PRT (Pivotal Response Treatment), Verbal Behaviour are all tried and tested ways to improve the child’s communication, cognitive and social skills. Such therapies are provided by certified therapists and also by some Psychologists.
Occupational Therapy and Sensory Integration