November 3, 2006

The Best Wealth is Your Health

Autism: know the signs, act early

By Dr. Meena Sathappan
Special to the Times

Autism is not a disease. It is a developmental disorder of brain function. It affects about 2 to10 out of every 10,000 people, depending on the diagnostic criteria used. Males have a higher incidence, about four times more than females. Autism has been found all over the world, irrespective of racial or social backgrounds.

Autism is classified as one of the pervasive developmental disorders. This is due to the fact that it varies widely in severity and can go unrecognized -- especially in mildly affected people or those with multiple handicaps. Additionally, autistic people have a normal life expectancy.

The severity of autism varies from person to person. Most severe cases are marked by extremely repetitive, unusual, self -injurious, and aggressive behavior. In its mildest form, autism resembles a personality disorder associated with a perceived learning disability.

People with classical autism show three types of symptoms - impaired social interaction, problems with verbal and non-verbal communication and imagination, and unusually or severely limited activities or interests.

Common signs of autism in children
Symptoms usually appear within the child’s first three years and continue throughout life. Though there is no cure, early detection and proper management helps in ensuring relatively normal development and the reduction of undesirable behaviors. Some of the common signs in children are:

Impaired social interaction – failure to respond to their names and often avoid looking at other people. These children have difficulty interpreting tone of voice or facial expressions and do not respond to others.

Other signs include:

Not playing “pretend” games – like pretending to “feed” a doll

Not pointing at objects to show interest –like at a flying airplane

Not looking at objects when another person points at them

Having trouble relating to others or not having an interest in other people at all

Avoiding eye contact and preferring to be alone

Having trouble understanding other people’s feelings or talking about their own feelings

Repetitive movements – engage in repetitive movements such as rocking and hair twirling, or injuring themselves through biting or head banging.

Other signs include:

Repeating or echoing words that are said to them

Repeating actions over and over again

Having trouble adapting when a routine changes

Delayed speech – start later than other children. Referring to themselves as “I” or “me.” Some children speak in a singsong voice about a few topics and don’t necessarily care if the other person is interested. Since hearing problems can be confused with autism, children with delayed speech development should always have their hearing checked. Children sometimes have impaired hearing in addition to autism.

Abnormal responses to sound or touch – many children show reduced sensitivity to pain. On the other hand, they may be extraordinarily sensitive to other sensations. Some children have unusual sensitivities leading to behavioral symptoms such as a dislike to being hugged or cuddled. They may also have unusual reactions to the way things smell, taste, look, feel, or sound.

Children with some symptoms of autism, but not enough to be diagnosed with the classical form of the disorder, are often diagnosed with pervasive developmental disorder – not otherwise specified (PDD-NOS). A small percentage of people with autism are called savants. These people have limited but extraordinary skills in areas like music, mathematics, drawing or visualization.

What causes Autism?
There is no single cause. Researchers believe several genes, as well as environmental factors such as viruses or chemicals, contribute to the disorder. There is strong evidence that autism occurs when brain development is affected during early fetal development. For reasons that are still not clear, about 20 to 30 percent of people with autism also develop epilepsy by the time they reach adulthood.

Recent studies strongly suggest that genetics plays a big role in autism. It is estimated that, in families with one autistic child, the risk of having a second autistic child is approximately five percent, or one in 20, which is greater than the risk for the general population.

How can Autism be treated?
Though there are no cures for autism at present, therapies or interventions can help correct specific symptoms in each individual. Some of them are educational/behavioral and medical interventions. Though they don’t cure, they bring about substantial improvement in autism.

Educational / Behavioral Interventions – consists of highly structured and often intensive skill oriented training that is tailored to the individual child. Therapists work with children to help improve their social or language skills. Since children learn rapidly when they are young, it is important that such therapies begin as early as possible. Recent evidence suggests that intervention has a good chance of favorably influencing brain development.

Medication – Doctors may prescribe drugs to reduce self-injurious behavior, or other troublesome symptoms of autism, as well as other associated conditions such as epilepsy or attention disorders.

If you or your Doctor think there could be a problem, ask for a referral to see a developmental pediatrician or other specialist. You can also contact the National Dissemination Center for Children with Disabilities ( www.nichcy.org) to know of available resources.

Simply put, the sooner you begin the intervention, the better are your chances of helping your child reach his or her full potential. Act early and make a difference!

Source: Centers for Disease Control (www.cdc.com) & Child Development Institute (www.childdevelopmentinfo.com)

Dr. Meena Sathappan is a board-certified Pediatrician who lives and practices in Evergreen. She is available for questions and consultation at Aasha Pediatrics, 2060 Aborn Road, # 230, San Jose, CA 95121 (corner of Aborn Road and Capitol Expressway). You can call her at 408-274-9099, or e-mail her at msathappan@gmail.com. Website: www.aashapediatrics.com.