Autism: Questions & Answers

There are many baffling expressions used to describe the numerous psychological conditions and behaviors which are officially diagnosed as Autism Spectrum Disorder (ASD). Autism is a Pervasive Development Disorder (PDD) that begins at birth or within the first two-and-a-half years of life. Most children with autism, usually, are perfectly normal in their physical appearance. However, they spend their free time occupying themselves with confusing behaviors which are noticeably different from those of typical children their age, and cane be very upsetting to those around them. Many of these behaviors include repetitive actions such as hand-flapping, head banging and other potentially injurious behaviors.

What is Autism?

Our understanding of the Autism Spectrum Disorder (ASD) has advanced rapidly in recent years. ASD’s are a family of neurodevelopmental conditions characterized by unusual patterns in social interaction, communication, and range of interests and activities. While this profile is generally applicable for the entire ASD population, much variation actually exists. No two individuals exhibit the exact same symptoms and as such ASD is a heterogeneous disorder.

Autism is called an invisible disability because you can not tell if a person has autism simply by looking at him. Instead, you have to examine the person’s behaviors. If you think that you or someone you love may be autistic, you’ll probably have noticed certain symptoms. Perhaps you’ve observed a lack of eye contact, difficulty with social relationships, speech delays, or odd physical behaviors such as rocking, finger flicking or toe walking. These are the “red flags” that suggest something might be wrong — and that something might be autism.

Autism cannot be diagnosed with a medical test, screening. Diagnosis involves interviews, observation and evaluations. A precise diagnosis must be based on observation of the individual’s communication, behavior, and developmental levels. However, because many of the behaviors associated with autism are common with other disorders, a variety of medical tests may be planned to rule out or identify other possible causes of the symptoms being exhibited as well parental interview.

Autism diagnosis is based on clinical observation and testing by a professional using one or more standardized tests. Professionals most likely to diagnose autism are psychologists, psychiatrists, developmental pediatricians, and school psychologists. Some of the screenings and tests which may be used in the diagnostic process are: CARS (Childhood Autism Rating Scale), Autism Diagnostic Checklist Form E-2, CHAT (Checklist for Autism in Toddlers), M-CHAT (Modified Checklist for Autism in Toddlers), Pervasive Developmental Disorders Screening Test -2, ADOS (Autism Diagnostic Observation Scale), and ADI-R (Autism Diagnostic Interview – Revised).

There are five disorders under the PDD umbrella which include Autism, Aspergers, Rhett’s Syndrome, Childhood Disintegrative Disorder, and PDD-NOS (not otherwise specified).

What Causes Autism?

While there is no known distinctive cause of autism, there is increasing evidence that autism most likely has a number of causes or etiological factions that contribute to its manifestations. There is some indication of a genetic influence in autism. There is a greater likelihood that identical twins will have autism than fraternal twins. In the case of identical twins, there is a 100% overlap in genes; whereas in fraternal twins, there is a 50% overlap in genes, the same overlap as in non-twin siblings.

Currently, a great deal of research has focused on locating the ‘autism gene; however, many researchers speculate that in the end, a hundred or more genes will likely be associated with the heterogeneity of autism. There is also evidence that the genetic link to autism may be a weakened or compromised immune system. Other research has shown that depression and/or dyslexia are quite common in one or both sides of the family when autism is present.

There is also evidence that a virus can cause autism. There is an increased risk in having an autistic child after exposure to rubella during the first trimester of the pregnancy. In addition, there is also a mounting fear by parents that viruses linked to vaccinations, such as the measles component of the MMR vaccine and the pertussis component of the DPT shot may cause autism. However, there is no known research that supports this assumption and recently the MMR vaccine theory has come under extreme criticism.

There is increasing alarm that toxins and pollution in the environment can also lead to autism. There is a high prevalence of autism in some parts of California, various areas in Queens and Staten Island, as well as certain parts of New Jersey. Several agencies are now attempting to uncover the reasons for the high percentage of autism in this community, which may be related to environmental conditions.

Canadian researchers have become the first to identify specific behavioral signs in infants as young as 12 months that can predict, with incredible accuracy, whether a child will develop autism.

The preliminary findings, published recently in the International Journal of Developmental Neuroscience, were taken from an ongoing study of 200 Canadian infants, the largest study of its kind in the world. The infants, many of whom have been followed from birth to 24 months, are younger siblings of children who have been diagnosed with autism.

Studies show that families with one autistic child have a roughly five to10 percent chance of a second child being diagnosed with autism, a rate of recurrence about 50 times higher than the general population.

Dr. Lonnie Zwaigenbaum, a developmental pediatrician with the Oxford Centre and McMaster Children’s Hospital and a lead investigator for the Canadian study, the Canada – U.S. Baby Sibs Research Consortium is supported by the National Alliance for Autism Research (NAAR) and the National Institute of Child Health and Human Development (NICHD) in the U.S. It is widely regarded as one the most exciting developments in autism research today. Dr. Zwaigenbaum was also a noted speaker at the Icare4autism Conference in Jerusalem this past July co-sponsored by Shema Kolainu-Hear Our Voices.

“This is a groundbreaking work that is pushing the frontier of what we know about the biological nature of autism, and why it emerges so early in life,” says Dr. Zwaigenbaum. “Our hope is that it will lead to the development of new and earlier treatments that could make a huge difference for these children.”

While autism is difficult enough to detect in young children, it can be even more complex to diagnose in older children especially when the child appears very intelligent and can speak.

According to Lorna Wing, an internationally recognized researcher, children on the spectrum: “share a triad of impaired social interaction, communication, and imagination, associated with a rigid, repetitive pattern of behavior …The triad can be recognized at all levels of intelligence and can occur alone or together with any otherphysical or psychological disorder.” Wing, L.(1996) Autistic Spectrum Disorder. British Medical Journal,312

There is also the challenging distinctiveness of ‘high-functioning autism’ or Asperger’s Syndrome, which includes:

Social Deficits: Even though they may be very intellectual, they are socially immature and have great problems and usually little interest in making friends. This presents particular problems for school age children who are often the victims of bullying.

Perseverating: many children become expert in certain topics in which they accumulate comprehensive information that they repeat excessively. They do not fully comprehend the notion of taking turns and are insensitive to the needs of other people they are in conversation with.

Is There A Cure For Autism?

There is no known cure for autism. However, autism can be treated and those with autism can learn to communicate and to share in family life. Most parents try a variety of interventions to find what is effective with their child. Research has shown that Applied Behavioral Analysis (ABA) can be very successful with people with ASD, ideally at as early an age as possible.

Some people who appear classically autistic as young children are able to overcome their symptoms and become high functioning, usually as a result of their needs being met through an effective early intervention program. Research has shown that the functional ability of most people tends to improve with age. However, if they are not taught communication skills, frustration can lead to severe behavior problems.

Will People with ASD ever be Able to Live Independently?

• Many people with autism do flourish and go on to hold responsible jobs and live independently. Others have the intellectual abilities to be employed but are held back by their inability to adapt socially to the stresses of everyday life.

• The focus of every intervention program for the person with autism should be to work on helping them adapt to living in society. Their quality of life and ability to function is far more important than how they do on an I.Q. test.

Autism doesn’t have to be a life sentence; it is an illness that can be treated and offers much hope for parents and caretakers if they take the necessary steps early on to combat it. By becoming more aware of the options open to you one can do much in alleviating many of the problems children with autism will face later in life.

We can establish a mutual connection and relationship with each child, which is the stage for all education and growth.