Key Signs of Autism

Tuesday, April 01, 2003

April is National Autism Awareness month and the ideal time to revisit the signs and symptoms of autism as well as new research with regard to potential causes.

Autism is a broad term for a group of brain disorders that interfere with a child’s ability to communicate and interact in a typical fashion with others, including close family members. The condition seems to be more prevalent today but this is largely attributed to earlier and better diagnosis. Approximately 1 in 88 children are diagnosed with an autism spectrum disorder (ASD) before they're eight years old. Autism is more common in boys than in girls (1 in 54 boys are identified with the disorder, compared to 1 in 252 girls).

Physicians now prefer to talk about autistic spectrum disorder (ASD) which better represents the wide range of severity in the symptoms of autism in any given child.

All autistic children have two things in common: difficulties with how they develop and use language, and differences in social behavior. Common symptoms include delays in the development of language, loss of previously acquired language between 12 and 18 months of age, decrease in eye contact, repetitive behaviors (called “stereotypies”), and abnormal patterns of play and pretending.

Children sometime seem not to hear or understand what is being said to them and often there are other behaviors such as desire for sameness, only liking certain foods or clothes, and temper tantrums. Contrary to popular belief, most autistic children are quite affectionate, but usually only with certain people and on their own terms. Autistic children often use gestural language to communicate but most will not actually point their own finger at what they want.

Autistic symptoms are usually apparent by 18 months of age. Any parent with concerns about their child’s language should discuss this with their pediatrician. Children should clearly use actual words to communicate their wants and needs by 18 months and should use short sentences by the age of 2.

The only proven therapy for autism is a structured behavioral approach and aggressive speech and language therapy from an early age.

The best known form of structured treatment is known as applied behavioral analysis. The first step is a diagnosis and the second step is the carving out of a treatment plan individualized to each child. Sometimes medicine is helpful for treatment of symptoms of autism, but behavioral and language interventions are the most vital. Many children will also benefit from adjunctive treatments such as occupational therapy, and work with sensory integration dysfunction.

There continues to be controversy with regard to the cause of autism.There is increasing evidence that autism is, in fact, an abnormality of the formation of the brain from early in pregnancy. Genetics play a role in the development of autism as well and that the most popular theories of cause, vaccinations and mercury are being scientifically rejected in the peer reviewed medical literature.

Information published in 2009 examined the issue of immunizations and concluded that there was strong evidence against the hypothesis that vaccination causes autism. Also, the scientific consensus is that there is no evidence of a causal relationship between vaccinations and autism. In this month’s major journal of pediatrics, leading experts in autism reviewed the link between thimerosal, mercury and autism and concluded that on the basis of the evidence it was improbable that thimerosal and autism are linked.

Progress made by a child with autism is related to many factors including intelligence and progression of language. Many children do very well and every family should express concerns about their child if they have them, pursue treatment, and maintain optimism for the ultimate outcome.

Lalania K. Schexnayder, MD, PhDDr. Lalania Schexnayder
Specializing in Pediatric Neurology