Monday, March 12, 2012

Special - autism

When my very young nephew was identified as autistic, his parents were told that he may spend much of his time rocking and staring at the wall. In extreme cases of autism, this is an unfortunate truth. My nephew developed quite differently, however.

The biggest challenge in discussing autism is that the scientific community is not yet in agreement on its definition. Currently the American Psychiatric Association is updating its Diagnostic and Statistical Manual of Mental Disorders for the first time in 17 years, the last edition having occurred around the time my nephew was diagnosed.  When the definition of autism is rewritten by December of 2012,  the identification of the disorder will change accordingly. This will no doubt affect statistics on the prevalence of autism, which now stands at about 1 out of every 110  children, with males being four times more likely to be identified than females. At this point, there is no ability to predict the impact of these changes.

The current definition classes autism as a developmental disorder which appears between birth and the age of three and continues throughout life. The cause is unclear, despite several attempts to link the disorder to vaccines and other causal factors.  Current thinking includes genetic predisposition and the potential impact of various environmental factors. The symptoms include difficulties with social interactions, delayed speech, constant movement, need for routine, hyper-sensitivity to sensory input, abnormal response to pain, challenge in shifting focus, and tendency toward repetitive actions and/or speech patterns (perseveration). Some autistic children will be extremely literal and not able to translate symbolic language such as metaphors.

What is commonly acknowledged is that autism is a spectrum disorder. A child with a spectrum disorder may exhibit the described behaviors connected to the disorder but to varying degrees. It is for this reason that one autistic child may be more socially skillful than another, for example.  My nephew has quite a good sense of humor, even though he sometimes misses teasing jokes that are based on double meanings, and not all children on the spectrum are as able to be purposefully amusing.

Because of the inability to reach complete agreement on the definition of autism, medical professionals may present a variety of diagnoses for the same child. It is not clear as to whether forms of autism mimic attention deficit hyperactivity disorder (ADHD) or whether they are the same condition, for example.  Many children exhibiting the behaviors of autism are treated with medications intended to calm the nervous system, as are children identified with ADHD. The efficacy of treatments for children with autism involves a reasonable amount of experimentation with prescription medications, and this experimentation may go on for years and have side effects that require maintenance.

Take some time to digest this information before the next blog on the autism disorder known as Asperger's syndrome. There are many excellent websites dedicated to information on autism, if you are interested in more details. The site at will link you with many of these sites. 

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