Autism is a pervasive developmental disorder defined by behavioral problems that include social disability, communication impairment, repetitive behaviors, and restricted interests. It is a brain disorder that impairs social interaction and communication, thus causing restricted and repetitive behavior, all starting before a child is three years old.
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It is hereditary in origin, although its genetics are complex and it is unclear which genes are responsible. However other factors play a big role in causing the disorder eg. childhood vaccines even though this is a controversial cause and it lacks convincing scientific evidence. Advanced paternal and maternal age during conception is also another major cause.
Events around the time of birth have a significant association as they may lead to poor uterine blood flow, poor fetal oxygenation, infection, and head trauma from prolonged pressure-all of which may cause irreparable damage to the brain resulting in abnormal development.
The use of certain drugs in pregnancy especially during critical periods of fetal brain development or after conception may be enough to cause autism (Autism Spectrum Disorders-ASDs) as can pre and post-natal exposure to certain viral and bacterial infections. Children who are exposed to environmental toxins or even alcohol during gestation have an increased risk of getting ASDs and other developmental disorders.
The question of the effects of the measles-mumps-rubella-(MMR) vaccine and any mercury-containing vaccines have been raised in association with ASDs. However, studies have not yet proven this to be true.
The condition affects many parts of the brain. Unfortunately how it comes to affect these parts of the brain is poorly understood. Signs are often noticed within the first two years of the child’s life and this follows a steady course without relapse.
It does not have an individual set of symptoms but rather a pattern of symptoms. The impairments are noticeable in areas like social interaction, communication, and restricted interests, and repetitive behaviors.
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As far as social impairment is concerned, people with autism show less or no attention to the immediate society unless it concerns them e.g. responding to only their name. They smile and look at others less often.
Children with autism often do not appear to seek connectedness. They are content to be alone and ignore their parent’s bid for attention. They seldom make eye contact or try to get others’ attention using gestures or vocalization.
These children have delayed onset of babbling-past nine months-and may begin to say words but then stop speaking, often between 15 and 24 months. The play patterns of children with ASDs are often repetitive and lack creativity or imitation. Typical examples include endlessly spinning the wheels of toy cars instead of ‘driving’ them, or arranging and re-arranging crayons instead of using them to color pictures. Other examples include the resistance to change(e.g. insisting that the furniture should be arranged in a certain specific way and should not be changed), the performance of activities the same way each time, preoccupation with a single television program, and many more behaviors that tend to lead the child into doing things repetitively.
It should however be noted that autistic children do not prefer to be alone. They do not choose to be alone. It is only because making friends and creating relationships for them proves very difficult.
On the part of communication, most children with this condition do not develop enough natural speech to meet the expected communication skills that they are to attain at a certain age. Just as mentioned before cases of delayed babbling, unusual gestures, diminished responsiveness, and desynchronization of vocal patterns with the caregiver are usually very eminent.
As the children grow, they find it very difficult to even make requests, share experiences, or even make up a discourse out of their own words. They tend to copy the interlocutor’s words (echolalia)
Cases of unusual responses to sensory stimuli have been reported to be some of the symptoms experienced by children suffering from this condition. There is no sufficient evidence though proving the claim that sensory symptoms differentiate autism from other developmental disorders.
Sleep problems are also known to be common in children with developmental disabilities, autism being one of these. There has been evidence given on this issue. It asserts that children with autism experience more sleeping problems than those with other developmental disorders. These problems are manifested through difficulty in falling asleep after going to bed, frequent nocturnal awakenings, and early morning awakenings. Dominick et al say that about two-thirds of children suffering from this condition have a history of lack of sleep.
Some of the chromosomal abnormalities associated with autism are deletion, duplication, and inversion. Hereditability is also another big cause of autism. It is said to stand for almost 90% of the causes.
Other causes are environmental factors, which however are yet to be proven to be true causes of autism. These factors are still under research and include; infectious disease, heavy metals, solvents, diesel exhaust, PCBs, phthalates, and phenols used in plastic products, pesticides, brominated flame retardants, alcohol, smoking, illicit drugs, and vaccines.
The way autism ends up affecting the victim has not yet been well understood. Its mechanism can however be divide into two areas; that’s the pathophysiology of brain structures and processes associated with autism and neuropsychological linkages between brainstrucures and behaviors.
In the case of pathophysiology, autism is believed to result from the developmental factors that affect the functioning of the brain. The developmental factors that are said to be the causes of autism affect all or part of the brain, hindering the normal functioning of the brain system. The alteration of the brain system usually occurs immediately after conception.
Neuroanatomical studies and the associations with teratogens strongly suggest that autism’s mechanism includes alteration of brain development soon after conception. This localized anomaly appears to start a cascade of pathological events in the brain that are significantly influenced by environmental factors. Although many major structures of the human brain have been implicated, almost all postmortem studies have been of individuals who also had mental retardation, making it difficult to conclude.
Brain weight and volume and head circumference tend to be greater in autistic children. The cellular and molecular bases of pathological early overgrowth are not known, nor is it known whether the overgrown neural systems cause autism’s characteristic signs.
In neuropsychological linkages, two major categories of cognitive theories have been proposed about the links between autistic brains and behavior.
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The first category focuses on deficits in social cognition. Hyper-systemizing hypothesizes that autistic individuals can develop internal rules of operation to handle internal events—but are less effective at empathizing by handling events generated by other agents.
The second category focuses on nonsocial or general processing. Executive dysfunction hypothesizes that autistic behavior results in part from deficits in flexibility, planning, and other forms of executive function. A strength of the theory is predicting stereotyped behavior and narrow interests; a weakness is that executive function deficits are not found in young autistic children.
Unlike many conditions, diagnosis of autism is based on behavior, not cause or mechanism. Two commonly used diagnostic instruments include Autism Diagnostic Interview-(ADI-R) which is a semi-structured parent interview and Autism Diagnostic Observation Schedule which uses interaction with the child.
A preliminary investigation is usually performed-this is carried out by taking developmental history and physically examining the child. If warranted, diagnosis and evaluations are conducted with the help of specialists.
Early identification is ASDs important to enhance the outcomes and achieve functional speech by the age of five years. Treatment is geared towards maximizing functional independence and quality of life, alleviating family distress, facilitating development and learning, promoting socialization, reducing maladaptive behavior, and supporting families with relevant information.
Educational interventions, including behavioral strategies and therapies, are the cornerstone of managing ASDs.These interventions address communication, social, daily living, play and leisure skills, academic achievement, and maladaptive behaviors.
Medical care can be used to prevent acute illnesses and manage sleep dysfunction, as well as mental conditions and other associated problems such as seizures, abdominal pain, vomiting, diarrhea, or constipation, common in ASDs.
No treatment has been established to be best. Most treatments are tailored towards the child’s needs-administered according to the behavior and symptoms elicited by the child. It should also be noted that treatment is very important at early stages because it helps lessen associated deficits and family distress and increase the quality of life and functional independence.
Consistent special education programs and behavior therapy as early as detection of the condition is highly advisable to help these children acquire self-care, social, and job skills.
In conclusion, it is important to take note of the fact that autism has no cure. What is observable though in victims who undergo the discussed treatments is a reduction in these behaviors.Even though core difficulties remain symptoms become less severe in later childhood. It is however unfortunate that most children end up lacking meaningful relationships, and future employment opportunities. Early observation and treatment are therefore highly stressed.
Newschaffer CJ, Croen LA, Daniels J et al. (2007). “The epidemiology of autism spectrum disorders”. Annu Rev Public Health 28: 235–58.
Myers SM, Johnson CP, Council on Children with Disabilities (2007). “Management of children with autism spectrum disorders”. Pediatrics 120 (5): 1162–82. PMID 17967921. Lay summary – AAP (2007-10-29).
Freitag CM (2007). “The genetics of autistic disorders and its clinical relevance: a review of the literature”. Mol Psychiatry 12 (1): 2–22.
Arndt TL, Stodgell CJ, Rodier PM (2005). “The teratology of autism”. Int J Dev Neurosci 23 (2–3): 189–99.