Spectrum Of Autistic Disorders

SPECTRUM OF AUTISTIC DISORDERS

Apart from autism, there are four other neuropsychiatric disorders, which are characterized by problems with social interaction, verbal and non-verbal communication, and repetitive behavior of varying degree of severities.  Autism disorder is the first in the list.  As to the etiology, no known etiology can be found in 80% - 90% of cases, a genetic syndrome such as fragile X-syndrome or chromosome 15q duplication is found in 10% - 30% of cases.  There is strong family component.  There has been many claims regarding possible environmental triggering factors especially vaccines and in particular measles, mumps, and rubella.  But so far, no link between the uses of MMR vaccine with autism has been found.

WHAT ARE THE 3 ESSENTIAL FEATURES OF AUTISM?

1. Impaired social interaction (extreme aloneness, failure to make contact)

2. Absent or abnormal speech and language development

3. Narrow range of interest and stereotype or repetitive responses to objects

WHAT BEHAVIORS OF CHILDREN SHOULD AROUSE SUSPICION OF POSSIBLE AUTISM?

1. Avoidance of eye contact during infancy

2. Relating to only part of his body (e.g. the lap) rather than to the whole person.

3. Failure to acquire speech or speech acquisition in an unusual manner (e.g. repeating   another person’s speech)

4. Failure to respond to name when called

5. Spending long period of time in repetitive activities and fascination with movement (e.g. spinning records, dripping water)

6. Failure to look in the same direction when directed by an adult

7. Absence of pointing to show or request something

8. Excessive lining of toy or other objects

9. Limited pretend or symbolic play

WHEN SHOULD SCREENING BE DONE FOR AUTISM?

It is recommended that all children receive autism specific screening at 8- 12    months and whenever there’s a concern for autism. A younger sibling of children who has autism has 10-20 fold increased risk of autism. Problem with pre verbal gestural language and deficit in social skill is present in most children by 18 months of age.  The 23 Autism M-CHAT (modified version of checklist for autism in toddler) is probably the most commonly use screening questionnaire. Positive result, warrant referral to more detailed testing.

DOES EARLY INTERVENTION AND/OR THERAPY IMPROVE THE OUTCOME IN CHILDREN WITH AUTISM?

In general, early diagnosis and involvement of therapies on children with autism does appear to improve outcomes such as decreased need for social education in later years and an increase in the chance for independence as an adult.  Certain subsets of children with autism such as those with no co-existing cognitive deficits will fare better.  Additionally, early recognition and intervention may assist families in understanding and coping with potentially challenging medical co morbidities and social and behavioral issues.  When autism is suspected the child should be referred to specialist in this field, also, referred to speech and language pathologist to get therapy started as soon as possible.  All autism needs audiology evaluation because of their language disorder.

Dr. Hossein Sardarizadeh
Specialist Pediatrician
Armada Medical Centre

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