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Autism

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Author - Dr. Sharmila Samaranayake ( MBBS - Colombo, DCH )

Author 2 - Psychiatrist Dr.Wije via Director

Institution - Health Education Bureau – Sri Lanka.

Introduction

Autism is a disorder that affects the way a person communicates with other people. It is most likely a group of similar disorders with various degrees of severity. Most patients with autism also have a learning disability. So they need specialist care and education.

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Cause

The cause is not known. There are various theories, and various factors and genes may be involved. Although there was an argument that the MMR vaccine has a link to a child developing autism, there is no evidence that this is true.

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How common is it?

Autism is uncommon, but it seems to have become more common in recent years. Boys are 3 times more likely than girls to have autism. The most common age for diagnosis was between 3-4 years. According to various research autism will now occur in about 2-3 per 1000 children.

A recent study done in a semi urban community in Sri Lanka, screening 18 – 24 month old children for autism found out that 1 per 93 that is 1.07% in 18 – 24 month age group was diagnosed with autism.

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Symptoms and signs

Symptoms start in the first 3 years of life. In most patients it usually develops from birth. Following spectrum of symptoms are more common in children with autism.

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Social difficulties

The child may :

  • Seem to be 'stuck up' and aloof
  • Have little or no interest in others around him/her
  • Have no real friends and prefers to stay alone.
  • Not understand other people's emotions.

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Problems with language and communication

Speech usually develops later than usual. When it does, the language may develop wrongly.

  • They find it difficult to express themselves
  • Cannot understand others’ gestures, facial expressions or tone of voice or commands
  • Repeat same words over and over again and repeat what you say back to you
  • Say odd things which doesn’t suit the situation or make new words of their own

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Poor imagination

Imaginative play is limited in children with autism. They tend to do the games and activities that they learn over and over again. E.g. looking at hands, turning wheels, rubbing surfaces etc. Usually these games are those which a younger child would normally play.

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Unusual behaviours

Anger and temper tantrums occur if routines are disturbed. Children with autism often hurt themselves when they are angry by banging their head. Sometimes they do this to get attention.

  • Odd mannerisms such as hand-flapping or other odd movements which are useless
  • Actions are repeated over and over again

Most children with autism have a low IQ. Around 7 in 10 have an IQ level below 70 which is low enough to be classed as 'learning difficulty'. (The average IQ of the normal population is 100.) But some have normal, or even high, intelligence.

Complications - These symptoms are very confusing to parents and they can get frustrated. Autistic children can get injured especially when they go into a temper tantrum. There is no 'cure' for autism.

Management - Autism once diagnosed needs special psychiatric care. They need special education to help with language and communication skills. Behavior therapy to promote good behaviors and to reduce bad behaviors is needed.

There is no specific medication for autism. Sometimes drugs may be used to control aggressiveness or outbursts of excitement.

There is no 'cure' for autism. The aim should be to maximize the potential of each child as they grow into adults.

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What is the outlook (prognosis)?

Autism continues for life. Since the severity can vary, it is difficult to predict the outcome for each child. Even without treatment, sometimes there is improvement in the teenage years and some become more sociable. Some adults with autism manage to work and get by with minimal support. Many need more support and live at home with family. A placement in a residential home may be needed when older.

Prevention and Promotion - Since a cause for developing autism is not identified yet there is no preventive method. But parents’ role is to help the child with autism to reach their maximum potential.

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Still pictures

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Interactive pictures

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References

Patient UK  article on Autism, Nelson’s text book of paediatrics.

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Links

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Last update on : 2011-03-23 15:21:39