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Autism in Children & Adolescents
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General Facts:

  1. Although ASD varies significantly in character and severity, it occurs in all ethnic and socioeconomic groups and affects every age group.
  2. Experts estimate that three to six children out of every 1,000 will have ASD.
  3. Males are four times more likely to have ASD than females.
  4. Children with ASD appear to have a higher than normal risk for certain co-occuring conditions, including Fragile X syndrome (which causes mental retardation), tuberous sclerosis (in which tumors grow in the brain), epileptic seizures, Toureette syndrome, learning disabilites, and attention deficit disorder.
  5. About 20 - 30% of children with ASD develop epilepsy by the time they reach adulthood.
  6. While people with schizophrenia may show ASD-like symptoms, their symptoms usually do not appear until much later on in life, usually in the late teens & early adulthood.
  7. For many children, symptoms improve with treatment and age.
  8. Children whose language skills regress early in life--before age 3--appear to have a higher than normal risk of developing epilepsy or seizure-like brain activity.
  9. During adolescence, some children with ASD may become depressed or experience behavioral problems, and their treatment may need some modification as they transition to adulthood.
  10. People with ASD usually continue to need services and support as they get older, but many are able to work successfully and live independently or within a supportive environment.

What is Autism?:

Autism Spectrum Disorder (ASD) is a range of complex neurodevelopment disorders, characterized by social impairments, communication difficulties, and restricted, repetitive, and stereotyped patterns of behavior. Autistic disorder, somtimes called autism or classical ASD, is the most severe form of ASD, while other conditions along the spectrum include a milder form known as Asperger syndrome, the rare condition called Rett syndrome, and childhood disintegrative disorder and pervasive developmental disorder not otherwise specified (usually referred to as PDD-NOS).

Common Signs of ASD:

  1. Impaired social interaction
  2. Failing to respond to their name & often avoiding eye contact
  3. Difficulty interpreting what others are thinking or feeling, because they cannot understand social cues, such as tone of voice or facial expressions
  4. Retitive movements, such as rocking and twirling
  5. Self-abusive behavior, such as biting or head-banging
  6. Begin speaking later than other children, and may refer to themselves by name instead of "I" or "me"
  7. Speaking in a sing-song voice about a narrow range of favorite topics, with little regard for the interests of the person to whom they are speaking
  8. Inability to play interactively with other children

Early Indicators:

  1. No babbling or pointing by age 1
  2. No single words by 16 months or two-word phrases by age 2
  3. No response to name
  4. Loss of language or social skills
  5. Poor eye contact
  6. Excessive lining up of toys or objects
  7. No smiling or social responsiveness

Later Indicators:

  1. Impaired ability to make friends with peers
  2. Impaired ability to initiate or sustain a conversation with others
  3. Absence or impairement of imaginative and social play
  4. Stereotyped, repetitive, or unusual use of language
  5. Restricted patterns of interest that are abnormal in intensity or focus
  6. Preoccupation with certain objects or subjects
  7. Inflexible adherence to specific routines or rituals

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What Causes Autism?:

Scientists aren't certain about what causes ASD, but it's likely that both genetics and environment play a role. Researchers have identified a number of genes associated with the disorder. Studies of people with ASD have found irregularities in several regions of the brain. Other studies suggest that people with ASD have abnormal levels of serotonin or other neurotransmitters in the brain. THese abnormalities suggest that ASD could result from the disruption of normal brain development early in fetal development caused by defects in genes that control brain growth and that regulate how brain cells communitcate with each other, possibly due to the influence of environmental factors on gene function. While these findings are intriguing, they are preliminary and require further study. The theory that parental practices are responsible for ASD has long been disproved.

Twin and family studies strongly suggest that some people have a genetic predisposition to autism. Identical twin studies show that if one twin is affected, there is a 90% chance that the other twin will be affected. There are a number of studies in progress to determine the specific genetic factors associated with the development of ASD. In families with one child with ASD, the risk of having a second child with the disorder is approximately 5%, or 1 in 20. This is greater than the risk for the general population. Researchers are looking for clues about which genes contribute to this increased susceptibility. In some cases, parents and other relatives of a child with ASD show mild impairments in social and communicative skills or engage in repetitive behaviors. Evidence also suggests that some emotional disorders, such as manic depression, occur more frequently than average in the families of people with ASD.

Treatment:

There is no cure for ASD. Therapies and behavioral interventions are designed to remedy specific symptoms and can bring about substantial improvement. The ideal treatment plan coordinates therapies and interventions that meet the specific needs of individual children. Most health care professionals agree that the earlier intervention the better.

Educational/behavioral interventions: Therapists use highly structured and intensive skill-oriented training sessions to help children develop social and language skills, such as Applied Behavioral Analysis. Family counseling for the parents and siblings of children with ASD often helps families cope with the particular challenges of living with a child with ASD.

Medications: Doctors may prescribe medications for treatment of specific ASD-related symptoms, such as anxiety, depression, or obsessive-compulsive disorder. Antipsychotic medications are used to treat severe behavioral problems. Seizures can be treated with one or more anticonvulsant drugs. Medication used to treat people with attention deficit disorder can be used effectively to help decrease impulsivity and hyperactivity.

Other therapies: There are a number of controversial therapies or interventions available for people with ASD, but few, if any, are supported by scientific studies. Parents should use caution before adopting any unproven treatments. Although dietary interventions have been helpful in some children, parents should be careful that their child's nutritional status is carefully followed.

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