An autistic child walked into the room clinging to his father’s trouser and vehemently refused to be separated from it throughout the consultation despite being wooed with toys and candy.
Another child came into the room and could not sit still; he crawled under the tables, horse-rode every chair and plucked at the sleeves of the staff present. Interestingly, medical students attempted to play with him but he cried as soon as he was picked up and ignored anyone who spoke to him. His game was simple; big adult person, be still and let me pluck your sleeves. We were not very different from furniture for that child.
One of the first things a doctor would explain to the parent of a child being evaluated for autism spectrum disorder is its core components. An autistic child usually has impairment in communication, reciprocal social interaction and restricted behaviours and interests. The two scenarios above describe children with impaired reciprocal social interaction and restricted interests. The second child may have been more active but that child had absolutely no interests in doing anything else but his own organized play program. Autistic children may have problems communicating in terms of language, speech and cognition. It is for these reasons that a child may then be evaluated for autism spectrum disorder (ASD)
ASDs are a part of a category of disorders known as Pervasive developmental disorders. The three disorders in the Autism spectrum are;
- Autistic disorder
- Asperger syndrome
- Pervasive developmental disorder- not otherwise specified (PDD-NOS)
Autistic disorder is the diagnosis for a child with all three core components of ASD before the age of three years. Pervasive developmental disorder - not otherwise specified means a child has all three core components of autism, however, does not meet the criteria for the other Pervasive developmental disorders (which are specific).
Another important thing to explain to parents is the variability of how the disorder presents. This is essentially why it is called a “spectrum”. It is the variability in the presentation of the core symptoms that determines which part of the spectrum a child belongs to. For instance, Isaac Newton who was a genius and one of the most intelligent scientists in the history of mankind, did not like to speak to other people, had very few friends, was almost only interested in his scientific work, lectured an empty classroom when no one turned up for lectures and was known to have conducted an examination for absent students in an empty classroom. There is a high probability that he had one of the disorders on the autism spectrum. This disorder is known as Asperger’s syndrome. Here language and cognitive development are not significantly delayed but there are problems with social interaction and repetitive, obsessive behaviour. Guess which other genius is suspected to have had Asperger’s syndrome? Albert Einstein. Even within the spectrum, forms are very mild and some are severe.
What causes Autism?
There is no known cause for autism spectrum disorders. Research does not support the claims that measles, mumps and rubella vaccine can cause autism. There is some hereditary component to the disorder; siblings of an autistic child have higher odds of being autistic. A mother who had rubella or cytomegalovirus infection while pregnant could have a child with ASD. ASD is four times more common in boys than in girls.
What are the symptoms seen in Autistic children and what is the way forward?
The descriptions parents of autistic children give to their children’s behaviour are varied: too restless, in his/her own world, very shy, mute, uncooperative, aggressive, are some examples.
Their concerns are whether their children can be cured of autism and go on to have a normal life (the cognitive delay is often of primary concern). Although there is currently no cure for autism, early speech and behavioural therapy have been shown to be the most effective in improving the child’s functioning. A lot of children have been rehabilitated to have far less disruptive behaviour this way.
This therapy is available at developmental clinics and at some schools with therapists. Drugs when used help to treat aggressive and injurious behaviour. The stigma associated with ASD has actually been on the decline as more people know about it than in times past, this is also the reason for the increase in the number of children being diagnosed all over the world.
Does your child have these symptoms? He/she will benefit from neurodevelopmental assessment by a child development doctor. The earlier this is done, the more effective any therapy undertaken will be.
Article By: Ikechukwu Amaechina