Autism, know more

What is autism?

Autism is a developmental disorder that usually appears in the first three years of life and compromise the communication skills and social interaction.

In May of 2013 was released the fifth edition of the diagnostic and Statistical Manual of mental disorders (DSM-V), which brought some major changes, including new diagnoses and changes of names of diseases and conditions that already existed.

In this manual, as well as Autism, Asperger's syndrome, was incorporated into a newmedical term and englobador, called the autism spectrum disorder (ASD). With thisnew definition, Asperger syndrome is now considered a mild form of autism. That way, patients are diagnosed only in degrees of commitment, so the diagnosis is more complete.

Autism spectrum disorder is defined by the presence of persistent Deficits in social communication and social interaction in multiple contexts, currently or by a previous history ", according to the DSM-V.

Causes

The causes of autism are still unknown, but research in the area is increasingly intense. Probably a combination of factors that lead to autism. It is known that genetics and external agents play a key role in the causes of the disorder. According to the American Medical Association, the chances of a child developing autism because of genetic inheritance is 50%, with the other half of the cases may correspond to exogenous factors, such as the authoring environment.

Anyway, many genes appear to be involved in the causes of autism. Some make children more susceptible to the disorder, others affect brain development and the communication between neurons. Others, still, determine the severity of symptoms.

As for external factors that may contribute to the emergence of the disorder are air pollution, complications during pregnancy, infections caused by viruses, changes in the digestive tract, mercury contamination and sensitivity to vaccines.

Autism and vaccines

And speaking of them, still believes that some vaccines may cause autism in children. Parents can ask the doctor or nurse to wait or even refuse the application of the vaccine. However, it is important to consider the risks of not vaccinating your child.

Some people believe that a small amount of mercury (thimerosal), which is a common preservative in multidose vial, vaccines cause autism or ADHD. However, the research does not indicate that this risk is real.

The American Academy of Pediatrics and The Institute of Medicine of the United States agree that no vaccine or component of it is responsible for the number of children who are currently diagnosed with autism. They concluded that the benefits of the vaccine are greater than the risks.

All routine childhood vaccines are available in single-dose in ways that was not added mercury.

How many children have autism?

The exact number of children with autism is unknown. A report published by the Centers for disease control and prevention (CDC) of the United States suggests that autism and its related disorders are much more common than you think. It is unclear whether this is due to an increase in the rate of the disease or the greatest ability todiagnose the problem.

Autism affects four to five times more boys than girls. Family income, education and lifestyle seem to influence the risk of autism.

Some doctors believe that the higher incidence of autism is due to new definitionsof the disorder. The term "Autism" now includes a broader spectrum of children. For example, nowadays, a child diagnosed with high-functioning Autism could be simply regarded as shy or with learning difficulties for 30 years.

Other disorders of development like include:

Rett syndrome: very different from autism, only occurs in females

Childhood disintegrative disorder: rare disease in which a child acquires skills and then forgets everything before 10 years of age

Pervasive development disorder: not specified, also called atypical autism.

Risk factors

Some factors are considered at risk for developing autism. Check out:

Gender: boys are four to five times more likely to develop autism than girls

Family history: families who have already had some Member with autism are at greater risk of having another later. Similarly, it is common for some parents that have generated some autistic son present problems of communication and social interaction themselves

Other disorders: children with some specific health problems tend to have greater risk of developing autism than other children. Epilepsy and tuberous sclerosis are among these disorders

Age of parents: the more advanced the age of the parents, the more chances of a child developing autism until three years ago.

Symptoms of Autism

The majority of parents of children with autism suspects that something is wrong before the child turns 18 months old and seek help before she reaches 2 years. Children with autism typically have difficulties in:

Play make-believe

Social interactions

Verbal and non-verbal communication

Some children with autism appear normal before a year or two, but suddenly "regress" and lose language and social skills they have acquired earlier. This type of autism is called regressive autism.

A person with autism can:

Have sight, hearing, touch, smell or taste overly sensitive (for example, they can refuse to wear clothes "that itch" and become distressed if they are forced to usálas)

Have an abnormal emotional change when there is a change in routine

Do repetitive body movements

Demonstrate abnormal attachment to objects.

The symptoms of autism can range from moderate to severe.

The problems of communication in autism may include:

Can't start or maintain a social conversation

Communicate with gestures instead of words

Develop the language slowly or not develop it

Do not adjust the vision to look at objects that other people are looking

Don't refer to yourself properly (for example, say "you want water" when the kid wants to say "I want water")

Does not point to call people's attention to objects (happens in the first 14 monthsof life)

Repeat words or memorized passages, as commercial

Use nonsensical rhymes

There are several symptoms that may indicate autism, and not always the child will display all of them. Among the groups of symptoms that can affect a person with autism are:

Social interaction

Don't make friends

Does not participate in interactive games

Is withdrawn

May not respond to eye contact and smiles or avoid eye contact

You can treat people as if they were objects

Prefers to be alone rather than accompanied

Shows lack of empathy

Response to sensory information

Not scared of loud noises

Has the sight, hearing, touch, smell or taste buds enlarged or diminished

You can find normal noises painful and cover your ears with your hands

Can avoid physical contact to be very stimulating or overwhelming

Rubs surfaces, put your mouth on the objects or the lick

Seems to have an increase or decrease in response to pain

Jokes

Don't imitate the actions of others

Prefers solitary or ritualistic pranks

Do not pretend play or imagination

Behaviors

Intense tantrums

Gets stuck on a single subject or task (perseverance)

Low attention span

Few interests

Is hyperactive or very passive

Aggressive behavior with others or you

Intense need of repetition

Makes repetitive body movements

Seeking medical help

Children, in General, give the early signs of autism in the first year of life. If you notice any signs of disorder in your child, talk to a doctor. He may recommend specific tests. The behaviors of the child alert are:

Don't respond with a smile or expression of happiness at six months

Don't mimic sounds or facial expressions to nine months

Don't mumble to 12 months

Do not gesticulate to 12 months

Don't say a Word to 16 months

Not to say phrases composed of at least two words to 24 months

Lose social skills and communication at any age.

In medical consultation

It is likely that a pediatrician can make the diagnosis of autism, analyzing the symptoms. However, you may be referred to a specialized center in which multidisciplinary team evaluates the child.

As queries are usually brief and there's a lot of information and questions to cover, it's a good idea to be well prepared. Here is some information to aid in the diagnosis more quickly:

Write down any symptoms you are experiencing, including those that may seem unrelated to the reason for which you scheduled the query

Write down the important personal information, including any major tensions or recent life changes

Make a list of all the medicines, as well as any vitamins or supplements that you are taking

Take a family member or friend along. Sometimes it can be hard to remember all the information provided during the consultation. Someone accompanying you might remember something you lost or forgot.

What to expect from the doctor?

Doctors often do a lot of questions. It is important to be prepared to answer them.Check out some examples of issues that may be raised by a specialist:

What specific behavior have led you to seek medical help for your child?

When the first symptoms started?

These atypical behavior are frequent or occasional?

What your son's favorite habits?

Your child interacts with family and other children?

His family has a history of autism or some other brain disorder?

Diagnosis of Autism

The doctor will look for signs of delay in the development of the child. If the main symptoms of autism, he forwards the child in question to a specialist, who can make amore accurate diagnosis. Generally, it's done before three years of age, since the signs of the disorder usually appear early.

For diagnosis, the doctor uses the criteria of the diagnostic and Statistical Manual ofmental disorders, American Psychiatric Association. According to him, the child maybe diagnosed with autism perform at least six of the classic symptoms of the disorder.

Exams

All children need routine development tests with the pediatrician. Further testing may be required if the doctor or parents are worried. For autism, this should be doneespecially if a child does not attain language benchmarks.

These children can do a hearing evaluation, blood lead testing and screening test for autism, as the checklist for autism in toddlers (CHAT) or the Autism screening questionnaire.

A doctor experienced in the diagnosis and treatment of autism is usually necessary to make the diagnosis. As there is no biological test for autism, the diagnosis is oftenbased on very specific criteria.

An evaluation of autism typically includes a complete physical and neurological examination. May also include any specific tool, such as:

For autism diagnostic interview-revised (ADIR)

Autism diagnostic observation program (ADOS)

Grading scale of autism in children (CARS)

Autism rating scale of Gilliam

Screening test for invasive developmental disorders.

Children with autism or suspected autism typically undergo genetic tests in search of abnormalities in the chromosomes.

Autism includes a wide spectrum of symptoms. Therefore, a single assessment and fast cannot indicate the real skills of the child. Ideally, a team of different specialists evaluate the child with autism is suspected. They can evaluate: communication, language, motor skills, speech, school success and thinking skills.

Living/Prognosis

Autism remains a difficult disorder to children and their families, but the perspectiveis much better than a generation ago. At that time, most people with autism was hospitalized in institutions.

Today, with the right treatment, many of the symptoms of autism can improve, even though some people remain with some symptoms throughout their lives. Most people with autism can live with their families or in society.

The Outlook depends on the severity of autism and the level of treatment that the person receives. Seek help from other families who have relatives with autism and by professionals who give the necessary support to the relatives is also an interesting alternative.

Possible complications

Autism can be associated with other disorders that affect the brain, such as fragile X syndrome, tuberous sclerosis and intellectual deficit. Some people with autism may also develop seizures.

The stress of dealing with autism can lead to social and emotional complications for family and caregivers, as well as for the person with autism. Therefore, psychologicalfor both a, and the other is essential.

Treating autism

There is no cure for autism, but a program of early, intensive and appropriate treatment greatly improves the prospect of young children with the disorder. Most programs will enhance the interests of the child with a highly structured schedule of constructive activities. The visuals are generally useful.

The main goal of treatment is to maximize the social and communicative skills of the child by means of reducing the symptoms of autism and support for developmentand learning.

But the form of treatment that has more success is what is targeted to the specific needs of the child. An expert or an experienced team should develop the program for each child. There are several therapies for autism available, including:

Occupational therapy

Physical therapy

Speech/language therapy

There are several programs to address social problems of communication and behavior that are related to autism. Some of these programs focus on reducing behavioural problems and learning new skills. Others seek to teach children how to act in certain social situations and how to communicate properly. One such program is the ABA, stands for applied Behavior Analysis, widely used in young children with some disturbance within the autism spectrum. The ABA uses a single learning approach thatstrengthens the practice of various skills. The goal is for the child the normal functioning of the development. ABA programs are normally made in the House of the child under the supervision of a behavioral psychologist.

Other program quite applicant as alternative treatment is the TEACCH (treatment and education of autistic and related Communication Deficits children), that uses other Visual AIDS that help the child to work independently and to organize and structure your environment.

The TEACCH tries to improve the skills and adaptability of a child, at the same time that takes the problems associated with autism spectrum disorders in. Unlike the ABA programs, TEACCH programs do not expect children to achieve normal development with treatment.

Medicines

There are no drugs able to treat the main symptoms of autism, but often are usedmedications to treat behavioral or emotional problems that patients with autism, such as aggression, anxiety, attention problems, extreme compulsions that the child cannot control, hyperactivity, impulsivity, irritability, mood swings, outbursts, difficulty sleeping and fits of anger.

Diet

Not all experts agree that changes in diet make a difference, not all research on this method showed positive results, but if you are considering these or other dietary changes as a means of treatment for your child, we recommend that a conversation with a gastroenterologist (specialist in the digestive system) and a nutritionist.

Some children with autism appear to respond to a gluten-free diet or no casein. Gluten is found in foods that contain wheat, rye and barley. Casein is found in milk, cheese and other dairy products.

Other approaches

There are many advertised treatments for autism that have no scientific basis and stories of "miracle cures" that do not meet the expectations. If your child has autism, it can be helpful to talk with other parents of autistic children and autism specialists.Follow the progress of research in the area, which is developing rapidly.

An example of these early treatments are the infusions of SECRETIN. There was a lot of excitement with this method of treatment in the past. Now, after many researches in several laboratories, it is possible that SECRETIN don't do no effect to children with autism. However, the research continues.

Medicines for autism

The medications for the treatment of autism are:

Neuleptil

Only a doctor can tell you what the medication right for your case, as well as the correct dosage and duration of treatment. Always follow strictly the guidelines of your doctor and NEVER self-medicate. Do not discontinue use of the medication without consulting a doctor before and, if you take it more than once or in quantities much greater than the prescribed, follow the instructions on the package leaflet.

Prevention

There is no one correct formula to prevent autism, but recent studies show that therole of genetic inheritance in the development of the disorder is not as great as previously thought. Genes play 50% of the chances of a child having autism. In other words, in at least half the cases there's not much you can do against human genetics.But the other 50% correspond to external factors, very

Reviewed by Dr. Evelyn Vinocur, a psychiatrist and a master's degree in Neuropsychiatry at Universidade Federal Fluminense (UFF) and cognitive behavioural psychotherapist, specializing in Mental Health of children and adolescents by the Santa Casa de Misericordia of Rio de Janeiro (SCMRJ) and Universidade do Estado do Rio de Janeiro (UERJ). Associate member of the Brazilian Association of Psychiatry (CRM-RJ: 303,514)

DSM-V, the American Psychiatric Association diagnostic and Statistical Manual of Mental Disorders 4th ed. Edit. Medical Arts

The World Health Organization (who)

Journal of the American Medical Association (JAMA)