|
There
are separate labels for different points on the Autism
spectrum. At the least affected end, you may find
labels such as "Asperger's Syndrome", "High
Functioning Autism" and "Pervasive Developmental
Disorder - Not Otherwise Specified". At the
other end of the spectrum you may find labels such
as "Autism", "Classic Autism" and "Kanner
Autism".
Characteristic behaviour in
Autism Spectrum Disorder
The following descriptions give a guide to many of
the behaviours observed in children, teenagers and
adults with an Autism Spectrum Disorder. It is important
to remember that everyone is different and very few
children or adults will show all of these characteristics.
The three lists below based on an article "What
Is Autism?" written by Dr. Di Boswell and Ms.
Helen Baker, is reproduced from the Autism Victoria
web site and shows a typical progression from childhood
into adulthood.
Preschool Years
Food problems. The child can be resistant to solid
foods or may not accept a variety of foods in their
diet.
Unusual responses to other people. A child may show
no desire to be cuddled, have a strong preference
for familiar people and may appear to treat people
as objects rather than a source of comfort.
The
child tends not to look directly at other people
in a social way. This is sometimes referred to as
a lack of eye contact.
There may be constant crying or there may be an unusual
absence of crying.
The child often has marked repetitive movements,
such as hand-shaking or flapping, prolonged rocking
or spinning of objects.
Many children develop an obsessive interest in certain
toys or objects whilst ignoring other things.
The child may have extreme resistance to change in
routines and/or their environment.
The child may appear to avoid social situations,
preferring to be alone.
There is limited development of play activities,
particularly imaginative play.
The child may have sleeping problems.
There may be an absence of speech, or unusual speech
patterns such as repeating words and phrases (echolalia),
failure to use 'I', 'me', and 'you', or reversal
of these pronouns.
There are often difficulties with toilet training.
The child generally does not point to or share observations
or experiences with others.
The child may be extremely distressed by certain
noises and/or busy public places such as shopping
centres.
There is no evidence of disability in the child's
physical appearance - many children with an Autism
Spectrum Disorder are very attractive in appearance.
Primary School
Years
Parents may notice that much of the distressing behaviour of the preschool years
decreases.
There can be a period of relative calm and adjustment, but resistance to the
demands of others remains.
There can be an increase in social interest; they better tolerate playing beside
other children and may begin to show attachments to certain people (often adults
or younger children).
Echolalia speech, if present, decreases and spontaneous speech emerges. About
half of the children who are non-verbal in the preschool years will acquire some
speech.
School behaviour problems can occur, often because the child finds it difficult
to make social judgments about other children.
Ritualistic and compulsive behaviour patterns are very common.
Hyperactivity and a poor attention span are often observed, usually because the
child has trouble understanding instructions from the teacher and classroom 'rules'
The child's difficulty in understanding other people and interpreting what is
going on around them leads to significant levels of anxiety.
Many children will show a lack of motivation or desire
to please others.
These children have difficulty transferring skills
learned in one setting to another setting, e.g.,
school to home.
Adolescence to Adulthood
The behaviour disturbance and mood imbalance so typical of teenagers seems to
be exaggerated for those with an Autism Spectrum Disorder. It may start a little
later, and continue into late teens and early twenties but eventually there is
a resumption of calmer behaviour.
A few adolescents show marked improvement in their behaviour and skills and some
may show serious behaviour regression - but all survive adolescence!
Sexual development and interest varies with physical
development but in general is delayed.
The commencement of menstruation and sexual
drive are usually tolerated calmly but exhibitionism and masturbation are sometimes
problems. This behaviour can usually be redirected using behaviour modification
techniques. The video Autism The Teen Years addresses this issue very well.
The presence of a disability seems to become more obvious in the physical appearance
of the older person, especially if they also have an intellectual disability.
Epilepsy or seizures may develop in a number of adolescents
with an Autism Spectrum Disorder
Increased levels of anxiety and the development
of depressive symptoms often occur and carers need to be alert to this and seek
professional help. Medication may be prescribed to help 'take the edge' off their
anxiety levels
If they have received specialist intervention, adults with an Autism Spectrum
Disorder are able to partly overcome their difficulties but continue to require
sensitive and sustained support, usually from their families.
Diagnosis of Autism (DSM-IV)
It requires considerable experience and training to become competent at making
a diagnosis.
(1) Qualitative impairment in social interaction, as manifested by at
least two of the following:
1. Marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye
gaze, facial expression, body postures, and gestures to regulate social interaction
2.Failure to develop peer relationships appropriate to developmental level
3.Lack of spontaneous seeking to share enjoyment, interests, or achievements
with other people (e.g., by a lack of showing, bringing, or pointing out objects
of interest)
4.Lack of social or emotional reciprocity
(2) Qualitative impairments in communication as manifested by at least
one of the following:
1.Delay in, or total lack of, the development of spoken language (not accompanied
by an attempt to compensate through alternative modes of communication such as
gesture or mime)
2.In individuals with adequate speech, marked impairment in the ability to initiate
or sustain a conversation with others.
3.Stereotyped and repetitive use of language or idiosyncratic language
4.Lack of varied, spontaneous make-believe play or social imitative play appropriate
to developmental level
(3) restricted repetitive and stereotyped patterns of behavior, interests,
and activities, as manifested by at least one of the following:
1.Encompassing preoccupation with one or more stereotyped and restricted
patterns of interest that is abnormal either in intensity or focus
2.Apparently inflexible adherence to specific, nonfunctional routines or rituals
3.Stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping
or twisting, or complex whole-body movements)
4.Persistent preoccupation with parts of objects
Delays or abnormal functioning in at least one of the following areas, with onset
prior to age three. The disturbance is not better accounted for by Retts disorder
or childhood disintegrative disorder.
1.social interaction,
2.language as used in social communication, or
symbolic or imaginative play.
More Symptons / Signs commonly seen in the child with Austism
1. Bothered by touch and physical contact,
2. Hypersensitive to stimuli. e.g. noise, light, touch, smells
3. Fussy eater, eating a restricted range of foods
4. Bothered by the texture of foods, preferring smoother texture-free foods
5. Will smell objects and food
6. Easily put off by slightly different smells and tastes in their favourite
food
7. Easily frustrated and frequent tantrums that have no apparent reason
8. Bags or dark circles under the eyes
9. Dry skin, eczema
10. White spots on fingernails
11.Tics, obsessiveness and compulsive repetitive behaviours
12. frequent colds, flu, ear, nose and throat infections and other ailments suggestive
of impaired immunity.
13. Gut problems characterized by loose stools/constipation,bloating,excessive
wind,lower abdominal discomfort,tenderness/ pain.
14. Poor muscle tone
15. Failure to thrive
16. Echolalia (repeating words or phrases)
17. Pica (eating non-foods, e.g. paper or dirt)
Causes
Although we do not know exactly what causes Autism, here is a list of things
which seem to play a part. A recent study has demonstrated a link between autism
and the Engrailed 2 (EN2) gene, which may contribute to up to 40% of autism cases
in the general population. EN2 is involved in normal neural development. The
study provides further genetic evidence that EN2 might act as an ASD susceptibility
locus, and they suggest that a risk allele that perturbs the spatial/temporal
expression of EN2 could significantly alter normal brain development."
(Am. J. Hum. Genet., 77:851-868, November 2005)
The Genetic code may have flaws. While there is a genetic component to Autism,
genetics alone cannot explain the recent rise in Autism in industrialised nations.
The cell membrane that protects each cell is less than optimum, leaving it vulnerable.
There is much support in animal and human studies that a reduced intake in Omega
3 fatty acids results in impaired cell membranes and Neurodevelopmental disorders.
Antigens (foreign toxic matter, heavy metals, viruses and bacteria) attack vulnerable
cells and damage them, resulting in cells that cannot carry out their function
normally. Antigens can damage or change the genetic code in the cell, and when
the cell reproduces itself it does so with the changed code leading to dysfunction
in future cells. There is emerging evidence that a dysfunctional methylation
system may result in abnormal genetic expression leading to dysfunctional cells.
Vit. B12, folate, B6 and Magnesium play a central role in regulating Methylation.
Abnormal methylation can damage metallothionein protein which regulate zinc/copper
ratios and other metals in cell membranes. Impaired cellular structures can result
in multi-systemic disorders, affecting gastrointestinal, Immune, endocrine and
central nervous system. The delicate balance between beneficial and detrimental
bacteria in the gut can be upset by antibiotics, food preservatives and other
environmental toxic additives, leading to a condition known as intestinal dysbiosis.
Opportunistic bacteria in the gastrointestinal tract may irritate a vulnerable
gut wall resulting in irritable bowel syndrome, leaky gut and food sensitivities.
Some bacteria can produce amines. When these bacteria are overgrown, they can
produce large amounts of amines. Amines are known to have receptors in the same
areas in the brain as neurotransmitter receptors. This can result in a scrambling
of brain signals by amines.
Treatment
The child with Austism will need to see a peadiatrician, child psychiatrist,
educational spychologist, speech and language therapist and enlist in a programme
to teach them coping skills in society. It is important to choose a programme
that encourages the child to think for themselves while giving structure, caring
and respect. Programmes that train the child to copy / mimmick, do not help the
child to cope with life when out of site of the trainer! A few training models
are listed below:
 TEACCH program
SCERT model
The hanen program
LEAP The
Son-Rise program
|
