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Autism

What is autism?

Autism is a disorder in which a child has problems with communicating and getting along with others. They have unusual or repetitive actions and may have a keen interest in only one subject or activity. For example, they may be obsessed with trains or a particular science fiction movie.

Autism may also be called a pervasive developmental disorder, because a child who has it does not develop normally in several ways.

Boys are more likely to have autism than girls.

What is the cause?

The exact cause of this disorder is not known.

  • The brain makes chemicals that affect thoughts, emotions, and actions. Without the right balance of these chemicals, there may be problems with the way your child thinks, feels, or acts. A child with this disorder may have too little or too much of some of these chemicals.
  • If a woman is infected with a virus, has diabetes, or does not eat a healthy diet while she is pregnant, it increases the risk that the child will develop autism. Exposure to certain chemicals and medicines during pregnancy may also increase the risk. Low oxygen levels from long labor or premature birth may also increase the risk.
  • Autism and similar disorders sometimes run in families. There may be certain genes linked to autism. Having a father older than age 40 may increase a child’s risk.
  • Children with this disorder may have physical changes in their brain. These changes may mean that some parts of the brain are more active or less active than in other children.
  • Children with other brain problems and genetic syndromes such as fragile X syndrome, are sometimes also autistic.

What are the symptoms?

Children with autism may look and act normal for the first few months of life. Over time, your child may become less responsive to you. There are many symptoms, but not all autistic children will have all of these symptoms. They may have some symptoms that are not on this list.

Social Skills

  • Even in the first few months of life, your child may resist being cuddled and may scream to be put down when held. He may withdraw from you, avoid eye contact, and prefer to play alone. He may resist attention or passively accept hugs and cuddling. Your child may avoid waving, making faces, or playing pat-a-cake. He may not look or smile in response to other's smiles. He may ignore others who are upset or in pain.
  • Your child may fail to respond when you call his name, but immediately respond to the television being turned on. You may suspect that your child has a hearing loss.
  • Your child may be slow in learning to interpret what others are thinking and feeling. It is hard for him to see things from someone else’s point of view.

Communication Problems

  • An child with autism usually does not start talking until age 2 or older. He often cannot understand or copy speech or gestures. The rate, pitch, tone, or rhythm of speech is abnormal. Your child may not be able to start a conversation or keep one going. He may use language in unusual ways. He may speak only single words, repeat the same phrase over and over, or echo what he hears.
  • Your child may have trouble carrying on a conversation. He may talk about a favorite subject and not give anyone else a chance to talk. He also doesn't always understand tone of voice or facial expressions, such as a smile, a wink, or a frown.

Sensory problems

  • Children with autism may also have problems with their senses. Many are very sensitive to certain sounds, textures, tastes, and smells. Some children find the feel of clothes touching their skin almost unbearable. Some sounds, such as a vacuum cleaner, a ringing telephone, or a sudden storm will cause these children to cover their ears.
  • Another common problem is some degree of intellectual disability, which used to be called mental retardation. When tested, some areas of ability may be normal, while others may be weak. For example, a child with autism may have good visual skills but not do well on the language tests.

Behavior, activities, and interests

  • Children with autism typically develop strong habits and routines. Your child may get very upset at the slightest change in routine.
  • Your child may be very focused on one subject such as learning all about dinosaurs or trains. Often they have a great interest in numbers, symbols, or science topics.
  • He may walk on tiptoe or flick or twiddle his fingers for long periods. He may repeat movements such as banging his head or rocking. He may have sudden screaming spells or injure himself on purpose.
  • Your child may have trouble learning manual tasks and be hyperactive. Some children develop seizures.

How is it diagnosed?

Your healthcare provider will ask about your child's development at each well child visit. Tell your provider about any concerns you have and any behavior that seems unusual. As a parent or caregiver, you are usually the first to notice unusual behaviors in your child. Do not ignore problems, thinking that your child is just a little slow and will "catch up." Early treatment helps reduce symptoms. It increases your child's ability to grow and learn new skills.

Your child's healthcare provider will examine your child and ask about your child's symptoms and your family history of any medical and mental problems. Your child may have tests such as:

  • Blood tests
  • Hearing tests
  • CT, which uses X-rays and a computer to show detailed pictures of the brain
  • MRI, which uses a strong magnetic field and radio waves to show detailed pictures of the brain
  • EEG, which measures and records the electrical activity in the brain

Because it can be inherited, your healthcare provider may want to screen your other children for symptoms.

If your healthcare provider thinks your child may have autism, he or she will refer you to specialists such as a psychologist, psychiatrist, speech therapist, or neurologist. They can do more testing and advise you about treatment. Your school district may also provide testing services for your child.

How is it treated?

There is no one best treatment for all children with autism. Before you decide on your child's treatment, find out what your options are. Learn as much as you can and make your choice for your child's treatment based on your child's needs. A good treatment program will:

  • Build on your child's interests
  • Offer a predictable schedule
  • Teach tasks as a series of simple steps
  • Actively hold your child's attention in highly structured activities
  • Provide regular evaluation of educational and behavioral goals

Usually children are placed in public schools and the school district provides all needed services. These will include working with a speech therapist, occupational therapist, school psychologist, social worker, school nurse, or aide. You may want to visit public schools in your area to see the type of program they offer to special needs children.

A team of professionals will help evaluate your child and put a plan together. You may also ask your healthcare provider to review the plan. Ask and find out all the services that may be available for your child.

A cognitive behavioral therapist can help your child learn to manage stress, and cut back on obsessive interests and repetitive routines. Other therapies may include art therapy, music therapy or sensory integration, which helps reduce your child's sensitivity to touch or sound. Treatment will also include doing activities at home.

Medicine is often used to treat behavioral problems, anxiety, or other problems. These medicines must be prescribed by a doctor experienced with their use in children with this disorder.

Parents often learn of new or alternative treatments through friends or the media. No diet or dietary supplement has been proven to treat autistic spectrum disorders. Your provider can help you decide if alternative treatments could help or harm your child.

How can I help my child?

  • Your child’s therapist can help you learns ways to work with your child at home. Over time, you may be able to help your child learn how to “read” facial expressions and start to understand other people.
  • Look for your child’s strengths. No one knows what your child may be able to do in time, so don’t set your expectations too low. Encourage your child to try new things.
  • Be specific when you talk to your child. Children with this disorder often do not understand jokes, sarcasm, or sayings such as “cool it.” Know that your child is not being difficult on purpose. He truly cannot always understand. Tell your child in simple steps what you want him to do. It also helps to show your child how to do something rather than just tell him. You may need to show your child the same thing many times. Lots of consistent repetition helps your child learn.
  • Be patient with your child’s communication. He may not be able to put his needs and feelings into words. Watch your child’s body language for signs that he is upset or that something is wrong. Or, if your child is very verbal, realize that he may have memorized things to say, but may not really understand the meaning of the words.
  • Be aware that everyday sights, sounds, smells, tastes and touches may be uncomfortable or distressing for your child. Try to keep from overloading your child, for example by avoiding crowds, noisy stores, or strong smells.
  • Keep a log of what seems to upset your child. Keep track of time of day, places, people, activities, foods, and anything else you notice. If you can see a pattern, you may be able to prevent problems.
  • Join a support group. Support groups can help by sharing common concerns and solutions to problems with other families in the same situation. You can find these services through your healthcare provider, schools, therapy programs, and local and national support organizations.
  • See a mental health professional to help you cope with your stress.
Developed by RelayHealth.
Pediatric Advisor 2013.2 published by RelayHealth.
Last modified: 2013-02-13
Last reviewed: 2012-12-17
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2013 RelayHealth and/or its affiliates. All rights reserved.
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