AUTISM


Definition: The term “autism” refers to a group of neurodevelopmental disorders called autism spectrum disorders (ASDs). These disorders are characterized by significant impairment in social interaction, communication, and behavior. ASDs vary in severity and include Asperger syndrome and pervasive developmental disorder-not otherwise specified, which are milder forms, and classic autism or autistic disorder, which is the most severe form.

Causation: The disorder is believed to develop due to certain genetic defects that hinder early brain development. Research has shown a hereditary component, and environmental triggers probably influence the severity of the disorder. Boys are more frequently affected than girls. Although contributory factors have been identified, the exact cause of autism remains elusive.

Clinical features and diagnosis: The diagnosis of the disorder is established on the basis of certain tell-tale clinical features and developmental anomalies. The characteristic clinical features of autism are generally recognized between 2 and 3 years of age. Evidence now indicates that the lack of social interaction and repetitive behavior may be present since early infancy. On the other hand, some children may develop normally for a few months and subsequently show regressive behavior and social withdrawal. Affected children show no interest in social interaction; they may have poor eye contact with others, show no interest in pointing to interesting things, fail to develop peer relationships, and may not respond to being called by name. Autistic children may not engage in imaginative or pretend plays, and they may be more focused on specific parts (e.g., wheels) rather than the entire toy (e.g., car). They are commonly interested in stacking or lining things and may be overly attached to certain objects and routines. They have difficulty in communicating with others using language and in expressing themselves; they may say the same words over and over again and may have peculiar speech patterns, e.g., a sing-song way of speaking. Some children may never learn to speak. Many affected children show repetitive behavior such as rocking, spinning, or twirling, while some may show self-abusive behavior like head banging and biting. In severe cases, the child may have convulsions.

Management: The management of the condition involves various forms of behavioral, family, and speech therapy; medications may be required for the treatment of associated conditions such as convulsions and/or anxiety disorders. The treatment goal is mainly to achieve independence, promoting socialization, and improving the overall quality of life of the patients.