Autism Treatments and Therapy
What Is Autism?
Autism is a wide range
or spectrum of brain disorders that is usually noticed in young children.
Autism is also referred to as Autism Spectrum Disorder or ASD. Autism decreases
the individual's ability to communicate and relate emotionally to others. This disability
may range from mild to severe. Autism occurs about four to five times more
often in boys than girls.
Is Autism a Disease or a Disorder?
Autism is a disorder,
not a disease. There are many brain disorders that fall into the autism
category such as autistic disorder, childhood disintegrative disorder,
pervasive developmental disorder-not otherwise specified, and Asperger
syndrome.
What Does “Spectrum” Mean?
“Spectrum” in autism
spectrum disorder refers to the wide range of symptoms, skills, and severity of
the disorder. The three most common disorders on the autism spectrum are
autism, Asperger’s syndrome, and pervasive developmental disorder- not
otherwise specified.
Signs of Autism in Toddlers
Autism can develop at
various ages. Some infants may show early signs of autism while others may
develop normally until 15 to 30 months. The Modified Checklist for Autism in
Toddlers, Revised with Follow-Up (M-CHAT-R/F) is a 2 stage screening tool for
parents to assess their child’s risk for autism spectrum disorder. The
M-CHAT-R/F provides a scoring sheet for parents to use after completing the
assessment.
Autism Symptoms
The following are common
symptoms of autism, but non-autistic children may display some of these
behaviors:
·
Rocking, spinning, or
other repeated movements
·
Avoiding physical
contact
·
Avoiding eye contact
·
Rocking, spinning, or
other repeated movements
·
Delayed speech
development
·
Repetitive speaking of
words or short phrases
·
Inability to cope with
small changes in a daily routine
·
Limited or no
interactions with peers
Signs of Autism in Babies
Early warning signs and
symptoms of autism are recognizable. If parents or doctors are able to
diagnosis autism as an infant, treatment can greatly improve a baby’s brain.
Signs of autism usually appear between 12 and 18 months, but parents should
still be on the lookout for common autism symptoms. Early symptoms may be
interpreted as signs of a well-behaved baby because they are quiet,
independent, and undemanding.
Behaviors Associated with Autism in Babies
Signs of Autism in Baby’s Second
Year
As
some autistic children reach age 2, they may regress or lose language skills.
Others may simply have no words by 16 months or no two-word phrases by 2 years
of age. Children may only speak the same words repeatedly or they may repeat
what they hear verbatim. Other signs of autism are organizing toys in certain
ways, as opposed to playing with them. They may also refrain from engaging in
make-believe play or engaging with other children. Two-year-olds with autism
may also be unable to recognize other people’s feelings or facial expressions.
Other Signs of Autism
Other
autism spectrum disorder symptoms are physical problems such as poor
coordination while running or climbing, poor hand control, constipation, and
poor sleeping. Some children develop seizures. Pica, or the tendency to eat
items that are not food, is common in children and adults with autism.
How Is the Brain Affected By
Autism Spectrum Disorder?
Children
affected by autism have an excess of synapses, or connections between brain
cells. This is because there is a shutdown in the normal pruning process that
occurs during brain development. A typical pruning process involves eliminating
about half of cortical synapses by late adolescence. Cortical synapses occur in
the cortex, which is central to thought and processing information from the
senses.
Some
children with autism have larger than normal brains but findings are
inconsistent. MRI scans of some children with autism show abnormal cortical
responses and some show other abnormalities. Future advances in brain studies
may change our understanding of the brain’s role in autism.
Early Screening for Autism
Spectrum Disorder
Because
autism spectrum disorders range from mild to severe, many children are not
diagnosed early. Diagnosing autism may be difficult because there are no
medical tests, such as blood tests, that can diagnose children. Therefore,
treatments may be delayed for years. Autism can sometimes be detected in
children 18 months or younger. Many pediatric doctors can diagnosis children by
age 2.
Developmental
screening for children is an efficient test to tell if they are learning basic
skills when they should. During this exam a doctor might ask the parent some
questions or talk and play with the child to see how he/she learns, speaks,
behaves, and moves. All children should be screened during their 9, 18 and 24
month well-child doctor visits. Older children are often screened if they seem
to fall behind age-related developmental levels.
Autism Diagnosis: Speech Problems
During
developmental screening, a doctor will observe how the baby reacts to the
parent's voice, smile, and other stimuli and may ask a few questions about the
child's reactions. The Communication and Symbolic Behavior Scale may also be
used to evaluate a child’s communication level and help decide if seeking
professional care is necessary. Other tests that determine hearing, speech
development, and behaviors may be completed to help distinguish autism from
other developmental problems.
Autism Diagnosis: Poor Social
Skills
A
major part of the diagnosis of autism is determining social skills. Some
features of many children with autism are their inability to look another
person in the eye, even the eyes of their parents. Children with autism often
focus on objects and do so intently, virtually ignoring other people or other
stimuli for long time periods. If children with autism do communicate, it is
often robot-like without facial expressions or gestures. Ages and Stages
Questionnaires can be helpful in evaluating a child’s communication, gross
motor, fine motor, problem-solving, and personal adaptive skills.
Autism Diagnosis: Evaluation
Although there is no
medical test for autism, a comprehensive diagnostic evaluation can help
diagnosis a child with autism. This evaluation may include looking at the
child’s behavior and development and interviewing parents. Hearing and vision
screenings, genetic testing, and neurological testing may also be involved in a
comprehensive diagnostic evaluation. Most clinicians accept the three criteria
listed below for diagnosis:
·
Impairments in social
interactions
·
Impairments in
communication
·
A restricted and
repetitive range of interests, behaviors, and activities
Asperger's Syndrome
In 2013, The Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
changed how Asperger’s syndrome is classified. Asperger’s syndrome is no longer
a diagnosis on its own, it is now part of the category autism spectrum
disorder. Asperger's syndrome is a “high-functioning” type of autism spectrum
disorder. Symptoms of high-functioning autism may include lack of eye contact,
awkwardness in social situations, missing social cues, or not showing many
emotions. Children may also have normal or superior intelligence but have
difficulty in relating to people and making friends. They also tend to focus on
specialized tasks.
Autism Treatment: Behavior
Programs
Treatment
of autism is available. Behavioral therapy programs are available from several
sources and they are designed to aid people in talking, communicating effectively,
interacting with others, and avoiding negative or antisocial behaviors.
Behavioral therapy uses positive reinforcement, self-help, and social skills
training to improve behavior and communication.
Applied
Behavioral Analysis (ABA) and Treatment and Education of Autistic and Related
Communication Handicapped Children (TEACCH) are treatments available for
children with autism. The Autism Society maintains a website and offers a
toll-free hotline (1-800-3-AUTISM/1-800-328-8476). This resource provides information
and referral services to anyone who requests them.
Autism Treatment: Education
Treatment
involves educating the child with autism spectrum disorder. The Individuals
with Disabilities Education Act (IDEA) authorized states to determine how to
provide educational services to children younger than 3 years of age. The
Education for All Handicapped Children Act of 1975 requires free and
appropriate public education for all children, regardless of the extent and
severity of their handicaps.
Amendments
to the Education of the Handicapped Act of 1986 extended the requirement for
free and appropriate education to children aged 3 to 5 years. Parents are
advised to check with their individual school administrators to determine what
programs best fit their child.
Autism Treatment: Medication
Although
there is no medical treatment for autism, there are treatments for some autism
symptoms. You and your child's pediatrician should discuss medical therapy
before it is administered to be sure the benefits outweigh any risks. The
medical agents commonly used are antipsychotic agents like risperidone or
aripiprazole. Drugs such as methylphenidate, fluoxetine, anti-seizure
medications, and others may help specific symptoms. Close observation is
required to monitor the child's response to any medication.
Autism Treatment: Sensory
Integration
As
previously described, children with autism spectrum disorder may be extremely
sensitive to various sensory stimuli such as sounds, lights, textures, taste,
and odors. Some children may become agitated by touching, hearing, or seeing
specific things such as a bell, blinking lights, touching something cold,
tasting certain foods, or smelling a specific odor like a disinfectant. Some
children can be trained to adapt and thus improve behavior.
Sensory
integration therapy assesses the way an individual’s brain processes sensory
input. A sensory integration-trained occupational or physical therapist will
evaluate the autistic child in order to create a plan that matches sensory
stimulation with physical movement, which can improve how the brain processes
and organizes sensory information.
Autism and Assistive Technology
Technology
has recently given some children with severe autism (patients with autism who
are nonverbal) ways to communicate. Assistive technology is any product, item,
or piece of equipment that is used by a person with a disability to perform
tasks, improve functional capabilities, and become more independent. The
assistive technology may be a computer tablet, a computer, or even a phone app
with programs especially designed to engage children with autism. For students
with severe communication difficulties a device with a speech-generating app or
a speech generating device may be highly effective.
·
Increased speech and/or
language use
·
Improved social
interaction
·
Decreased
self-stimulating and self-injurious behavior
·
Increases ability to
focus
·
Improved sleep and
immune function
·
Increases awareness
Effectiveness of a GFCF
diet for autism lacks scientific evidence to say whether or not this diet can
be helpful.
Unorthodox Autism Treatments
There
is no cure or medication available to treat autism. For this reason many
parents are trying complementary and alternative medicine (CAM) for their
autistic children. However, research on the safety and benefits of these
approaches has been much less studied. Do not start any therapy until it is
discussed with the child's doctor or medical team because some treatments could
be dangerous for your child. In addition to checking with medical personnel,
there are national agencies such as the Autism Society of America that can help
answer your treatment questions.
Around
70% of autistic children suffer from sleep problems, possibly because children
with autism may have a deficiency of melatonin. Low doses of supplemental
melatonin may help children with autism get a better night’s rest. Studies have
shown that melatonin does not have any side effects.
Children
with autism may be suddenly set off by a change in schedule, a noise, or
anything else that irritates them. Relaxation techniques such as deep pressure
massage or weighted clothing may soothe agitation in autistic children during a
meltdown.
What Causes Autism?
Researchers still do not
know exactly what causes autism spectrum disorders. They do know that autism
features abnormalities in brain structure or function. Researchers also suggest
that some toxins or drugs may play a role. For example, valproic acid, thalidomide,
and infection exposure during pregnancy increases autism risk in the infant.
Is Autism Genetic?
Genetics may play a
significant role. Autism occurs more frequently in certain families and in
patients with other genetic problems such as fragile X syndrome, tuberous
sclerosis, congenital syndrome, and untreated phenylketonuria. There is no one
single gene that has been identified as causing autism, but there tends to be a
pattern of autism or related disabilities in many families. Some children may
be born with a susceptibility to autism, but the trigger that causes autism is
unknown
Vaccines Don't Cause Autism
There
is no link between childhood vaccines and autism spectrum disorders. The CDC
completed nine studies which concluded that there is no connection between
thimerosal-containing vaccines and autism. Thimerosal has been removed or
reduced to trace amounts in all childhood vaccines, except for some flu
vaccines
Autism Spectrum Disorder Among
Siblings
Autism
spectrum disorders diagnoses have increased over the years. Researchers have
found that autism runs in families and younger siblings of an autistic sibling
have an 18.7% risk of also having autism. Identical twins have the highest
percentage of autism occurrence, about a 75% chance that both will develop
autism if one twin has autism. As previously mentioned, boys are about four to
five times more likely to develop autism.
Autism Accommodation in School
Children
with autism are given accommodations and assistance in schools. The Individuals
with Disabilities Education Act mandates that all eligible children receive a
free appropriate public education that meets their unique needs. Students with
disabilities are entitled to experience the “least restrictive environment”
(LRE). School districts are required to educate students with disabilities in
regular classrooms with non-disabled peers.
Support
is usually provided to autism students in the form of a specially trained
classroom or one-on-one paraprofessional, adapting curriculum, visual support,
etc. However, parents may feel that a regular classroom environment is not
suitable for their child. In this case, the student may be introduced to the
mainstream environment in small and successful increments and build up to
longer periods of participation.
Special
education services also provide support for students with autism spectrum
disorder by following the Individualized Education Program (IEP). The IEP
explains the student’s needs and how they will be met as well as their
strengths and weaknesses, measurable goals and objectives
Thriving With Autism
Autism spectrum
disorders do not necessarily mean your child cannot lead an independent and
useful life. People with early treatment and mild-to-moderate symptoms can even
graduate from college or graduate schools. Others with below-average abilities
may still be able to do specialized jobs and live independently or in group
homes. The key to autism treatment is early recognition of the signs and
symptoms of autism spectrum disorders in infants and young children. The
following are tips for families with autistic children:
·
Their senses are out of
sync- ordinary sights, sounds, tastes, and touches are perceived differently
·
Give clear, simple
directions
·
They interpret language
literally- idioms, puns, nuances, inferences, metaphors, and sarcasm may not
make sense
·
Be on alert for body
language cues
·
Visual support may help
in daily tasks
·
Help them socially
interact
·
Identify what triggers
their meltdowns
·
Be patient and love them
unconditionally
Reviewed by William C. Shiel Jr., MD, FACP, FACR on Tuesday, July 19, 2016
Autism Signs in Children: What Is Autism Spectrum Disorder?
This tool does not
provide medical advice
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