1:0 What is Autism ?
Autistic disorder almost always develops before the age of threee and is characterized by impaired verbal and non-verbal communication, social interaction, some form of repetitive and restricted stereotyped interest, ritual, or other behaviour. Autistic children show abnormal responses to sensations. Any one or more of these senses may be affected. All these difficulties manifest themselves in behaviours, i.e., abnormal ways of relating to people, objects and events in the environment.
Autism is also known as a ‘spectrum disorder’, because the severity of symptoms ranges from a mild learning and social disability to a severe impairment, with multiple problems and highly unusual behaviour. The disorder may occur alone, or with accompanying problems such as mental retardation or seizures. Autism is not a rare disorder, being the third most common development disorder. Typically, about 20 in a population of 10,000 people will be autistic or have autistic symptoms.
2:0 Causes of Autisam:
There are physical bases for autism’s development including genetic, infectious, and traumatic factors. Viral infection including rubella during the first trimester of pregnancy, have been studied as possible causes of autism. Children with Fragile X Syndrome or tuberous sclerosis have higher rates of autism than the general population.
Autism affects males four times more than females, and there is a genetic basis for the disease.
Contrary to previous notions, autism is not caused by upbringing.
3:0 Symptoms of Autism:
The symptoms vary greatly but follow a general pattern. Not all symptoms are present in all autistic children.
Autistic infants may act relatively normal during their first few months of life before becoming less responsive to their parents and other stimuli. They may have difficulty with feeding or toilet training; may not smile in recognition of their parents’ faces, and may put up resistance to being cuddled.
As they enter toddlerhood, it becomes increasingly apparent that these children have a world of their own. They do not play with other children or toys in the normal manner; rather they remain aloof and prefer to play alone. Parents often mention that their child is so undemanding that he or she is “too good”.
Verbal and nonverbal communication skills, such as speech and facial expressions, develop peculiarly. Symptoms range from mute to prolonged use of echoing or stilted language. When language is present, it is often concrete, unimaginative, and immature.
Another symptom of autism is an extreme resistance to change of any kind. Autistic children tend to maintain established behaviour patterns and a set environment. They develop rituals in play, oppose change (such as moving furniture), and may become obsessed with one particular topic.
Other behavioural abnormalities that may be present are: staring at hands or flapping arms and hands, walking on tiptoe, rocking, tantrums, strange postures, unpredictable behaviour and hyperactivity.
An autistic child has poor judgement and is therefore always at risk for danger. For instance, an autistic child may run into a busy street without any sign of fear.
4:0 Treatment for Autism:
There is no cure for autism. Therapies and behavioural interventions are designed to remedy specific symptoms and can bring about substantial improvement. 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.
· Educational/behavioural 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.
Most behavioural treatment programmes include:
1. clear instructions to the child.
2. prompting to perform specific behaviours.
3. immediate praise and rewards for performing those behaviours.
4. a gradual increase in the complexity of reinforced behaviours.
5. definite distinctions of when and when not to perform the learned behavious.
Parents should be educated in behavioural techniques so they can participate in all aspects of the child’s care and treatment. The more specialized instruction and behaviour therapy the child receives, the more likely it is that the condition will improve.
· 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 behavioural 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, 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 are supported by scientific studies.
5:0
· What is a person with autism like ?
A child with high functioning autism may have a normal or high I.Q., be able to attend a regular school and hold a job later in life. However, this person may have difficulty expressing himself and may not know how to mix with other people. Moderately, and more seriously affected children with autism will vary tremendously. Some autistic children do not ever develop speech, while others may develop speech but still have difficulty using language to communicate. Often, there is an unusual speech pattern, such as echoing whatever is said to them, repeating a word over and over, reversing “you” and “I” when asking for something and speaking only to express needs, rather than emotions.
A child with autism looks just like any other child, but has distinctive behaviour pattern. A child who is autistic may enjoy rocking or spinning either himself or other objects, and may be happy to repeat the same activity for a long period of time. At other times, the child may move very quickly from one activity to another, and may appear to be hyperactive. Many autistic children have sensitivity to certain sounds or touch, and at other times, may appear not to hear anything at all. Autistic children may have very limited pretend play; they may not play appropriately with toys or may prefer to play with objects which are not toys. Autistic children may be able to do some things, like sing songs or recite rhymes very well, but may not be able to do things requiring social skills very well.
* How is autism diagnosed ?
There are no medical or genetic tests that can detect autism. These can only rule out other conditions. A diagnosis of autism requires a sensitive and experienced doctor to observe the child very carefully, ask the parents about the development of the child, and then objectively follow internationally recognized criteria for diagnosis. Onset may occur at birth, or a child may have a period of normal development followed by a deterioration of verbal and social skills around 1 ½ - 2 ½ years. Where onset is at birth, the disorder can be detected as early as a year. Autism may occur alongside conditions such as mental retardation and hyperactivity, but the autistic traits in the person are typically what require attention.
· Can autism be prevented ?
Autistic children can make significant progress if the intervention is appropriate and consistent. Early intervention, before the child is five, is especially crucial to the child’s progress. This is why an early and accurate diagnosis is so important. Autistic children grow to become autistic adults, and there is a particular need for meaningful outlets for social interaction and employment where possible.
· How is Autism different from Mental Retardation ?
When a person has M R there is a more or less even impairment in skills in all areas of development. Therefore, if an M R child of 8 years has a mental age of 5 then all his skills would be roughly around 5 years (i.e., motor, communication, social, self-help, cognition, etc.). In Autism, there is an uneven skill development – in fact this is the hallmark of autism. In some areas the child may show age-appropriate skills; in some the skills may be below the development level; and then again there are people with autism who possess exceptional skills. i.e. beyond their age level.
· Can the Child ever live an independent life ?
Autism is a spectrum disorder. Currently, there is no reliable objective measure of how severe the Autism is in an individual child. Children with autism have potential for building up their skills and they can be helped if they receive early, well-focused intervention. Depending on the child’s individual skill profile and the appropriateness and intensity of intervention he or she receives, children with autism can lead relatively independent lives.
· What are the chances of her going to a regular school ?
There are a number of autistic children who have integrated into regular schools. The chances depend on several factors. The most important is “What is the skill profile, how early diagnosis was received, and thereafter the kind of early intervention provided ?” Most children with Autism have different learning styles from regular children and therefore teaching styles also need to be different. In some schools this is not understood and therefore children with autism face difficulties, after Grades 4 or Grade 5 many have to drop.
· When and will the child ever speak ?
A large number of autistic children do not use speech. It is very difficult to say when and whether the child will ever speak. It is confirmed that there is no difficulty in their physical abilities that stops them from speaking. Some children who might have spoken as infants and then lost their speech may or may not get their speech back. Currently, it is unknown why some children develop speech and others do not. Experience with children with autism has shown that if the environment is accepting, and people are aware of the kind of speech they themselves need to use with the child, it can produce positive results.
* Can speech therapy help:
Speech therapy can help some children. It is absolutely essential for the speech therapist to understand autism and also the individual child. Otherwise, the conventional methods of speech therapy help children with autism very little, because as stated above, the inability to speak is not a physical problem. However, every child with autism can benefit from interventions that emphasize communication.
· Why is an autistic child hyperactive ?
Hyperactivity can have a medical reason. However, most children with autism are restless because of an impairment of their imaginative and social skills. They cannot play with their toys and other children meaningfully and find it very difficult to occupy themselves. Often they eat a lot to keep themselves occupied. Hyperactivity can be reduced as the children are taught new skills and ways to keep themselves occupied.
· What are the chances of having the 2nd autistic child :
About 10% of the cases of autism can be accounted for genetically. If there is one child with autism in the family, risks of having another child with autism is much higher than in the general population. So far, there is no reliable test to detect autism in the fetus.
· Why does a child with autism keep playing with his fingers/rocking himself back and forth/spinning around ?
Children with autism respond to sensations abnormally. They often have a condition known as sensory dysfunction. One theory is that these unusual mannerisms like flapping and rocking are natural responses or methods of coping with sensory difficulties. These behaviours may help them to relax.
· Are people with autism also mentally challenged ?
It is very difficult for people with autism to take an IQ test, because they may have certain skills but are not able to use them or exhibit them in a test. About 50% people with autism are also mentally challenged, just the way that people with cerebral palsy or Down’s Syndrome can have mental retardation. Autism can occur in association with other difficulties like cerebral palsy, dyslexia, down’s syndrome, visual impairment and seizure disorder.
· If a child has autism and mental retardation, which needs more attention ?
If a person with autism also has mental retardation, his training will need to primarily address his autism. This is because autism is a condition that affects all aspects of a person’s behaviour and development. Our goal is to help the person become integrated into society and so it is important to focus on the development of social, communicative and adaptive skills. However, for a child with cerebral palsy, for instance, in addition to the above, occupational therapy may also have to be provided. Similarly, for a child who has seizure disorder or any other medical condition, appropriate treatment also is required.
Autistic disorder almost always develops before the age of threee and is characterized by impaired verbal and non-verbal communication, social interaction, some form of repetitive and restricted stereotyped interest, ritual, or other behaviour. Autistic children show abnormal responses to sensations. Any one or more of these senses may be affected. All these difficulties manifest themselves in behaviours, i.e., abnormal ways of relating to people, objects and events in the environment.
Autism is also known as a ‘spectrum disorder’, because the severity of symptoms ranges from a mild learning and social disability to a severe impairment, with multiple problems and highly unusual behaviour. The disorder may occur alone, or with accompanying problems such as mental retardation or seizures. Autism is not a rare disorder, being the third most common development disorder. Typically, about 20 in a population of 10,000 people will be autistic or have autistic symptoms.
2:0 Causes of Autisam:
There are physical bases for autism’s development including genetic, infectious, and traumatic factors. Viral infection including rubella during the first trimester of pregnancy, have been studied as possible causes of autism. Children with Fragile X Syndrome or tuberous sclerosis have higher rates of autism than the general population.
Autism affects males four times more than females, and there is a genetic basis for the disease.
Contrary to previous notions, autism is not caused by upbringing.
3:0 Symptoms of Autism:
The symptoms vary greatly but follow a general pattern. Not all symptoms are present in all autistic children.
Autistic infants may act relatively normal during their first few months of life before becoming less responsive to their parents and other stimuli. They may have difficulty with feeding or toilet training; may not smile in recognition of their parents’ faces, and may put up resistance to being cuddled.
As they enter toddlerhood, it becomes increasingly apparent that these children have a world of their own. They do not play with other children or toys in the normal manner; rather they remain aloof and prefer to play alone. Parents often mention that their child is so undemanding that he or she is “too good”.
Verbal and nonverbal communication skills, such as speech and facial expressions, develop peculiarly. Symptoms range from mute to prolonged use of echoing or stilted language. When language is present, it is often concrete, unimaginative, and immature.
Another symptom of autism is an extreme resistance to change of any kind. Autistic children tend to maintain established behaviour patterns and a set environment. They develop rituals in play, oppose change (such as moving furniture), and may become obsessed with one particular topic.
Other behavioural abnormalities that may be present are: staring at hands or flapping arms and hands, walking on tiptoe, rocking, tantrums, strange postures, unpredictable behaviour and hyperactivity.
An autistic child has poor judgement and is therefore always at risk for danger. For instance, an autistic child may run into a busy street without any sign of fear.
4:0 Treatment for Autism:
There is no cure for autism. Therapies and behavioural interventions are designed to remedy specific symptoms and can bring about substantial improvement. 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.
· Educational/behavioural 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.
Most behavioural treatment programmes include:
1. clear instructions to the child.
2. prompting to perform specific behaviours.
3. immediate praise and rewards for performing those behaviours.
4. a gradual increase in the complexity of reinforced behaviours.
5. definite distinctions of when and when not to perform the learned behavious.
Parents should be educated in behavioural techniques so they can participate in all aspects of the child’s care and treatment. The more specialized instruction and behaviour therapy the child receives, the more likely it is that the condition will improve.
· 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 behavioural 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, 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 are supported by scientific studies.
5:0
· What is a person with autism like ?
A child with high functioning autism may have a normal or high I.Q., be able to attend a regular school and hold a job later in life. However, this person may have difficulty expressing himself and may not know how to mix with other people. Moderately, and more seriously affected children with autism will vary tremendously. Some autistic children do not ever develop speech, while others may develop speech but still have difficulty using language to communicate. Often, there is an unusual speech pattern, such as echoing whatever is said to them, repeating a word over and over, reversing “you” and “I” when asking for something and speaking only to express needs, rather than emotions.
A child with autism looks just like any other child, but has distinctive behaviour pattern. A child who is autistic may enjoy rocking or spinning either himself or other objects, and may be happy to repeat the same activity for a long period of time. At other times, the child may move very quickly from one activity to another, and may appear to be hyperactive. Many autistic children have sensitivity to certain sounds or touch, and at other times, may appear not to hear anything at all. Autistic children may have very limited pretend play; they may not play appropriately with toys or may prefer to play with objects which are not toys. Autistic children may be able to do some things, like sing songs or recite rhymes very well, but may not be able to do things requiring social skills very well.
* How is autism diagnosed ?
There are no medical or genetic tests that can detect autism. These can only rule out other conditions. A diagnosis of autism requires a sensitive and experienced doctor to observe the child very carefully, ask the parents about the development of the child, and then objectively follow internationally recognized criteria for diagnosis. Onset may occur at birth, or a child may have a period of normal development followed by a deterioration of verbal and social skills around 1 ½ - 2 ½ years. Where onset is at birth, the disorder can be detected as early as a year. Autism may occur alongside conditions such as mental retardation and hyperactivity, but the autistic traits in the person are typically what require attention.
· Can autism be prevented ?
Autistic children can make significant progress if the intervention is appropriate and consistent. Early intervention, before the child is five, is especially crucial to the child’s progress. This is why an early and accurate diagnosis is so important. Autistic children grow to become autistic adults, and there is a particular need for meaningful outlets for social interaction and employment where possible.
· How is Autism different from Mental Retardation ?
When a person has M R there is a more or less even impairment in skills in all areas of development. Therefore, if an M R child of 8 years has a mental age of 5 then all his skills would be roughly around 5 years (i.e., motor, communication, social, self-help, cognition, etc.). In Autism, there is an uneven skill development – in fact this is the hallmark of autism. In some areas the child may show age-appropriate skills; in some the skills may be below the development level; and then again there are people with autism who possess exceptional skills. i.e. beyond their age level.
· Can the Child ever live an independent life ?
Autism is a spectrum disorder. Currently, there is no reliable objective measure of how severe the Autism is in an individual child. Children with autism have potential for building up their skills and they can be helped if they receive early, well-focused intervention. Depending on the child’s individual skill profile and the appropriateness and intensity of intervention he or she receives, children with autism can lead relatively independent lives.
· What are the chances of her going to a regular school ?
There are a number of autistic children who have integrated into regular schools. The chances depend on several factors. The most important is “What is the skill profile, how early diagnosis was received, and thereafter the kind of early intervention provided ?” Most children with Autism have different learning styles from regular children and therefore teaching styles also need to be different. In some schools this is not understood and therefore children with autism face difficulties, after Grades 4 or Grade 5 many have to drop.
· When and will the child ever speak ?
A large number of autistic children do not use speech. It is very difficult to say when and whether the child will ever speak. It is confirmed that there is no difficulty in their physical abilities that stops them from speaking. Some children who might have spoken as infants and then lost their speech may or may not get their speech back. Currently, it is unknown why some children develop speech and others do not. Experience with children with autism has shown that if the environment is accepting, and people are aware of the kind of speech they themselves need to use with the child, it can produce positive results.
* Can speech therapy help:
Speech therapy can help some children. It is absolutely essential for the speech therapist to understand autism and also the individual child. Otherwise, the conventional methods of speech therapy help children with autism very little, because as stated above, the inability to speak is not a physical problem. However, every child with autism can benefit from interventions that emphasize communication.
· Why is an autistic child hyperactive ?
Hyperactivity can have a medical reason. However, most children with autism are restless because of an impairment of their imaginative and social skills. They cannot play with their toys and other children meaningfully and find it very difficult to occupy themselves. Often they eat a lot to keep themselves occupied. Hyperactivity can be reduced as the children are taught new skills and ways to keep themselves occupied.
· What are the chances of having the 2nd autistic child :
About 10% of the cases of autism can be accounted for genetically. If there is one child with autism in the family, risks of having another child with autism is much higher than in the general population. So far, there is no reliable test to detect autism in the fetus.
· Why does a child with autism keep playing with his fingers/rocking himself back and forth/spinning around ?
Children with autism respond to sensations abnormally. They often have a condition known as sensory dysfunction. One theory is that these unusual mannerisms like flapping and rocking are natural responses or methods of coping with sensory difficulties. These behaviours may help them to relax.
· Are people with autism also mentally challenged ?
It is very difficult for people with autism to take an IQ test, because they may have certain skills but are not able to use them or exhibit them in a test. About 50% people with autism are also mentally challenged, just the way that people with cerebral palsy or Down’s Syndrome can have mental retardation. Autism can occur in association with other difficulties like cerebral palsy, dyslexia, down’s syndrome, visual impairment and seizure disorder.
· If a child has autism and mental retardation, which needs more attention ?
If a person with autism also has mental retardation, his training will need to primarily address his autism. This is because autism is a condition that affects all aspects of a person’s behaviour and development. Our goal is to help the person become integrated into society and so it is important to focus on the development of social, communicative and adaptive skills. However, for a child with cerebral palsy, for instance, in addition to the above, occupational therapy may also have to be provided. Similarly, for a child who has seizure disorder or any other medical condition, appropriate treatment also is required.
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