Diseases & Conditions

Autistic Disorder - Autism


Overview, Causes, & Risk Factors

Autism is a condition that affects development of the brain. Autism severely affects a person's social, mental, emotional, and communications skills.

What is going on in the body?

Autism is the most severe form of the pervasive developmental disorders, which affect a person's ability to interact with others. The hallmark signs of autism are extreme difficulty in responding to social interactions and communicating with others. Autism is most often noticed before the age of 3. It occurs four times more often in boys than in girls. It seems to appear equally among all parts of society. It affects about 5 out of 10,000 people.

Some people who have autism may also have other disorders that affect the brain. These include:

  • epilepsy
  • Down syndrome
  • fragile X syndrome
  • Turner syndrome
  • What are the causes and risks of the condition?

    The causes of autism are not well known. Experts suspect a genetic factor. What is known is that none of the following can cause autism.

  • bad parenting
  • mental illness
  • a child's naughty behavior
  • Psychological factors have also not been found to contribute to autism.

    Some cases of autism have been associated with trauma, disease, or structural abnormalities before or during birth. These include:

  • encephalitis or other serious infections affecting the brain as an infant
  • lack of oxygen during birth
  • the mother having rubella, also called German measles, while she was pregnant
  • untreated phenylketonuria, a problem in the body's ability to handle certain chemicals named phenylketones

  • Symptoms & Signs

    What are the signs and symptoms of the condition?

    A person with autism may have many symptoms. Autism can vary in degree. It can range from mild symptoms to more severe forms with intense symptoms that may affect every part of a person's life.

    All of the symptoms can vary in degree. Not every symptom is seen in each person who has autism. The symptoms include:

  • Difficulty communicating. Spoken language usually develops slowly or not at all. Words are often used in the wrong way. A person with autism may use gestures more than words. He or she may also tend to repeat words or phrases. A person who has autism may have a short attention span.
  • Difficulty in social interaction. A person with autism often has little interest in interacting with others. He or she may not smile in response to others or make eye contact . A person who has autism often spends a lot of time alone and makes little effort to form friendships.
  • Senses that are lessened or more intense. Some persons with autism have little response to any of the five senses. Others may have heightened senses. For example, when an autistic person hears a loud noise, he or she may cover his or her ears for a long time. An infant or child with autism may avoid hugging or any kind of touching.
  • Difficulty in play. A child who has autism may lack interest in playing with others. He or she may not be able to engage in imaginative play.
  • Extremes in behavior. People who have autism may be overactive or extremely passive. They may go from one extreme to the other. Some may show an obsessive interest in a single item, idea, or activity. They may use repeated body movements. Examples are flapping arms, rocking back and forth, or head banging. People who have autism may lack common sense. And they may be aggressive with themselves or others.

  • Diagnosis & Tests

    How is the condition diagnosed?

    A team of healthcare providers should evaluate the person with symptoms of autism. The team may include:

  • a developmental physician
  • a psychologist
  • a neurologist
  • a speech therapist
  • a learning consultant
  • Diagnosis begins with a medical history and physical exam. Further testing is then needed to identify other possible causes of the symptoms. These may include blood tests, cranial CT scans, cranial MRI scans, and electroencephalograms (EEGs).


    Prevention & Expectations

    What can be done to prevent the condition?

    Since the cause of autism is not known, autism cannot be prevented. Early recognition and treatment may decrease the effects of autism.

    What are the long-term effects of the condition?

    Long-term effects of autism depend on how severe the symptoms are. Long-term effects also depend on how soon a person starts treatment. The symptoms of autism may last a lifetime. But it can often be improved with careful intervention and treatment.

    An individual with autism may develop seizure disorders and depression.

    What are the risks to others?

    Autism is not catching. It is not yet clear if some causes of autism are genetic. Genetic counseling may be helpful if a couple has a family history of autism.


    Treatment & Monitoring

    What are the treatments for the condition?

    Treatment for autism first focuses on education. This should be tailored to each person's specific needs and symptoms. Some of the treatments include:

  • audiovisual therapies, which provide structured cues
  • behavioral therapy to help the person deal with his or her environment
  • dietary review
  • "inclusion programs" to help the person adapt to the outside world as much as possible
  • medicines, including antipsychotic medicines
  • music therapy
  • physical therapy
  • speech therapy
  • providing a structured environment for the person
  • Treatment may also include teaching the person how to handle new situations. This can include asking for help, directions, and other needs. An individual with autism often needs guidance in getting jobs and handling the daily work routine.

    The families and friends of people with autism need support as well. The more support they have, the better the adjustment to living with a person with autism. Sometimes the person may need to go to a group home if the family is not able to function and treat the person with autism.

    What are the side effects of the treatments?

    Side effects depend on the treatments used. Behavioral therapy can cause frustration for the person and the family going through it. Medicines may cause stomach upset, rash, irritability, depression, and allergic reactions.

    What happens after treatment for the condition?

    Treatment for autism will usually last a lifetime. A person with a mild form of autism may need to monitor himself or herself for new or worsening symptoms. A person with a more severe form of autism may need assistance with treatment and therapy programs.

    How is the condition monitored?

    Autism needs to be monitored closely. Treatments need to be adjusted over time. Someone with a mild form of autism may improve as he or she matures. An individual with a more severe form of autism may worsen over time and may need adjustments to the treatment program. The person may also have to rely on a caregiver to monitor behavior and help with activities of daily living.


    Attribution

    Author:Eileen McLaughlin, RN, BSN
    Date Written:
    Editor:Crist, Gayle P., MS, BA
    Edit Date:04/20/02
    Reviewer:Lama Rimawi, MD
    Date Reviewed:09/25/01

    Sources

    www.autism-society.org

    Current Pediatric Diagnosis and Treatment, Hathaway, Hay, Groothuis, Paisley, 1993

    Professional Guide to Diseases, Springhouse,1995