Causes, Diagnosis and Symptoms of Autism - Essay Example

? Autism Symptoms and Early Signs Autism Symptoms and Early Signs Autistic Spectrum Disorder (ASD) includes “a of neurodevelopment disorders that are characterized by qualitative impairments in the development of social and communication skills, often accompanied by stereotyped and restricted patterns of interests and behavior, with onset of impairment before 3 years of age” (Landa 2008). The definition of ASD is based on the clinical diagnostic criteria mentioned in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition. Autistic Spectrum Disorders include autism, pervasive developmental disorder-not otherwise specified and Asperger’s syndrome. DSM-IV criteria describes the ASDs in children aged 3 years and older however, the emphasis is now given on characterizing the symptoms before three years as developmental abnormalities occur at a very young age and early intervention can also provide a good prognosis for ASD children. ASD leads to impairments in three functional spheres of influence: communication skills, both verbal and non-verbal, socialization and a deficiency of behavioral flexibility, making the child rely on routines. Autism is considered as the most prevalent among the severe developmental disorders. Classic autism was first described by Leo Lanner in 1943 and according to a 2007 report, it is estimated to occur in approximately 1 in 1000 individuals and ASD occurs in 1 in 150 individuals. Prevalence in Canada is estimated to be two per 1000 for autism and six per 1000 for the whole of the ASDs (Bryson et al 2004; Benson & Haith 2009). As mentioned earlier, the developmental abnormalities start manifesting at a very young age even before 3 years of age. Furthermore studies have provided evidence that early intervention can optimize the outcomes for the children affected with autism. Hence, early diagnosis by detecting the early signs and symptoms in the autistic children can aid early intervention and good prognosis. Before proceeding towards the symptoms and early signs of autism, it would be resourceful to overview the etiology of ASD. No singular cause can be pointed out however; the most common and popularly accepted cause is brain abnormalities and genetic etiology. Moreover, it should be made clear over here that autism is not a psychological disorder brought about by poor parenting or childhood years. One important etiological factor is the hereditary origin of autism. Cluster of unstable genes leading to brain abnormalities is also another explanation for the etiology of autism. Some other current theories which are under investigation include toxin ingestion during pregnancy and environmental factors such as viruses (Evans & Daniels 2006). A male predomination is observed at a ratio of four to one. In monozygotic twins there is a high concordance rate around 90%. In children with pre-existing genetic disorders such as Fragile X syndrome, phenylketonuria, tuberous sclerosis, Angleman’s syndrome and Cornelia de Lange syndrome, autistic symptoms can be manifested (Benson & Haith 2009). The overview of ASD etiology exhibits genetic causes and hereditary co-relation as the main factors leading to the developmental abnormalities in the children. The core symptoms that manifest during the first two years of life represent the abnormalities in the social, communicative and cognitive developmental skills of the child. Any abnormality in the normal development of one functional domain also leads to negative outcome on the others as well. The social abnormalities of the autistic child exhibit themselves in categories of attachment, social imitation, joint attention, orientation to social stimuli, face perception, emotion perception and expression and symbolic play. Children with autism exhibit disoriented relationships with their mothers. In autistic children the social behavior of looking at faces develops late at 12 months as compared to normal development at birth. Social behaviors such as following person’s gaze, turning when name called, slowing objects to others, pointing at interesting objects and symbolic play all are certain social behaviors which are delayed significantly or sometimes absent (Mash & Barkely 2003; Dodd 2005). Normally imitation skills develop shortly after birth. However, in autistic children they have poor ability to imitate the movement of others including their body movements and their actions with objects. Even if they are capable of imitating, their approach of imitating is awkward or ill at ease. Impairment in using gaze and gesture as communicating with others to gain their attention is amongst the most earliest and first symptoms of autism. Children with autism also fail to orient with social stimuli as well as non-social stimuli. They are deficient in familiarizing to clapping, smiles, hand gestures or the non-social stimuli such as rattle. Face perception abilities are crucial for a child to develop interpersonal skills. The children with autism have an impaired face perception development and do not have the ability to differentiate between their mother’s face as compared to a stranger’s face. Children with autism also express their emotions in an unusual manner and are most likely to express a negative effect and odd blends of affective expressions. They do not combine smiles to eye contacts and also do not smile in response to their mothers (Mash & Barkely 2003). Children who are later diagnosed with autism also exhibit language and communication abnormalities. Social behavior impairments are precursors to language and communication abnormalities. 50% of children with autism remain mute throughout their lives, however early intervention and diagnosis can reduce the severity of symptoms. Children who do learn to communicate have deviant speech with immediate or delayed verbatim repetition or previously heard words or sentences. Their speech has atypical rhythm, loudness and pronoun reversal is also observed. Children with autism also have a difficulty maintaining conversations due to lack of responsiveness. Autistic children are also characterized by repetitive behaviors and obsessive but these are not categorized as early symptoms of autism during the first year of life. Children with autism often fail to respond to some sounds such as their names being called or they overreact to certain sounds such as the sound of a distant siren. These abnormal responses to sensory stimuli might misguide the parents into believing that their child has hearing impairments. Related symptoms such as self-injurious behaviors, fearful responses to common everyday objects, sleep disturbances, eating disturbances and excessive anxiety are associated symptoms of autism and occur in most of the people with autism along the course of the disorder (Mash & Barkely 2003; Dodd 2005). Early detection of autism requires early on monitoring for the signs of autism in the children. Children should be under the surveillance of the health care professionals and their social, communication and language skill development should be monitored regularly and vigilantly. These signs can be monitored by questioning the parents and trough direct observation. The toddler should be checked for smile in response to the doctor’s smile and the ability to follow the gaze. Engagement in active back-and-forth looking and response to calling the child’s name should also be checked for. To judge the child’s communication and social interaction it is best that the doctor takes time to build the confidence of the child and make him/her comfortable by playing games or engaging in playful activities. Signs of autism should be monitored from 12 or 18 months of age and they become evident during this age duration in most of the cases. Once a child has been established to have autistic signs, it is recommended that certain screening instruments should be used to identify the children at high risk. The Modified Checklist for Autism in Toddlers is designed to be used at two years of age and is completed by parents (Bryson et al 2003). Other screening tools for early detection include Early Screening of Autistic Traits Questionnaire and the First Year Inventory which are used at the beginning of 12-16 months of age (Landa 2008). It has been supported with evidences that early intervention can provide good outcomes for the children with autism. Pre-school children with ASDs have positive responses to intensive management regimes. They can gain an average IQ of 20 points. Similarly, developmental based interventions which are started at an early stage also show improvement in the skills of the children. Applied Behavior Analysis (ABA) is an effectual intervention that helps the children in gaining improvement in their developmental, social and communication impairments. A combination of home-based and center-based intervention has been proved to have a beneficial impact on the development of the 2-year old autistic children (Landa 2008). Consequently, health care professionals and scientists focus on the early detection of the signs and symptoms of autism in the children, as intensive and regular interventional techniques such as ABA and classroom or home based interventions aid the improvement of the various developmental impairments and prevent the child from developing life-long disability and severe developmental abnormality. Autism is the most prevalent among the severely developmental disorders and is characterized by early onset of manifestations. As evident form the clinical trials and data that early intervention and treatment can lead to reduction in the severity of delayed developmental skills and regain of many of the social, language and communication skills of the child. For this purpose, it is crucial that the parents are informed and guided to observe the appearance of autistic symptoms from the time of birth, especially in high risk babies. Health care professionals should also monitor the child for signs of autism through screening instruments, regular health visits and consistent interaction with the parents. References Acquarone, S. (2007). Signs of autism in infants: Recognition and early intervention. London: Karnac. Benson, J B and Haith, M M. (2009). Diseases and disorders in infancy and early childhood. Amsterdam ; Boston ; London : Academic. Bryson, S E, Zwaigenbaum L and Roberts W. (2004).The early detection of autism in clinical practice. Pediatric Child Health. 2004 April; 9(4): 219–221. Dodd, S. (2005). Understanding Autism. Marrickville, N.S.W; New York: Elsevier. Evans, R and Daniels R. (2006). Essential Guide to Autism. SGC Health. Landa, R J. (2008). Diagnosis of autism spectrum disorders in the first 3 years of life. Nature Clinical Practice Neurology (2008) 4, 138-147 Mash, Eric J and Barkley, Russell A. (2003). Child Psychopathology, Second Edition. New York: Gilford Press. Read More