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29 January 2014 Written by  Glenn Ellis

Glenn’s Strategies for Well-Being: Understanding Autism

With a rise in diagnosed cases and a sea of conflicting information, autism is a condition that leaves many parents terrified. Yet affected families have every reason to be hopeful about the future.

 Today, according to the Centers for Disease Control and Prevention, roughly 1 in 88 children are diagnosed with autism spectrum disorders, or ASDs, and it’s four to five times more likely to occur in boys than in girls.

An almost fivefold jump in schoolchildren diagnosed with autism between 1993 and 2003 prompted some authorities and politicians to proclaim that we were in the midst of an “autism epidemic. We also know that some of the increased prevalence is due to changes in the way we diagnose autism. This includes increased recognition of less severely affected individuals.

Experts believe that Autism presents itself during the first three years of a person’s life. The condition is the result of a neurological disorder that has an effect on normal brain function, affecting development of the person’s communication and social interaction skills. Autism has become dramatically more common over time. We can’t pin the increase on a single cause. However, we’ve identified a number of risk factors. Older parents, low birth weight, shorter time between pregnancies and certain gene mutations have all been shown to increase the risk of having a child with autism.

There are three different types of ASDs:

Autistic Disorder (also called “classic” autism):
This is what most people think of when hearing the word “autism.” People with autistic disorder usually have significant language delays, social and communication challenges, and unusual behaviors and interests. Many people with autistic disorder also have intellectual disability.

 Asperger Syndrome: 
People with Asperger syndrome usually have some milder symptoms of autistic disorder. They might have social challenges and unusual behaviors and interests. However, they typically do not have problems with language or intellectual disability.

Pervasive Developmental Disorder: Not Otherwise Specified (PDD-NOS; also called “atypical autism”)
People who meet some of the criteria for autistic disorder or Asperger syndrome, but not all, may be diagnosed with PDD-NOS. People with PDD-NOS usually have fewer and milder symptoms than those with autistic disorder. The symptoms might cause only social and communication challenges.

People with autism or Asperger syndrome may appear to behave unusually. There will generally be a reason for this: it can be an attempt to communicate, or a way of coping with a particular situation.

ASDs begin before the age of 3 and last throughout a person’s life, although symptoms may improve over time. Some children with an ASD show hints of future problems within the first few months of life. In others, symptoms might not show up until 24 months or later. Some children with an ASD seem to develop normally until around 18 to 24 months of age and then they stop gaining new skills, or they lose the skills they once had.

A person with an ASD might

  • Not respond to their name by 12 months
  • Not point at objects to show interest (point at an airplane flying over) by 14 months
  • Not play “pretend” games (pretend to “feed” a doll) by 18 months
  • Avoid eye contact and want to be alone
  • Have trouble understanding other people’s feelings or talking about their own feelings
  • Have delayed speech or language skills
  • Repeat words or phrases over and over (echolalia)
  • Give unrelated answers to questions
  • Get upset by minor changes
  • Have obsessive interests
  • Flap their hands, rock their body, or spin in circles
  • Have unusual reactions to the way things sound, smell, taste, look, or feel

Many people with an autism spectrum disorder (ASD) have difficulty processing everyday sensory information such as sounds, sights and smells. This is usually called having sensory integration difficulties, or sensory sensitivity. It can have a profound effect on a person’s life.

Our central nervous system (brain) processes all the sensory information we receive and helps us to organize, prioritize and understand the information. We then respond through thoughts, feelings, motor responses (behavior) or a combination of these.

We have receptors all over our bodies that pick up sensory information, or ‘stimuli’. Our hands and feet contain the most receptors. Most of the time, we process sensory information automatically, without needing to think about it much. People with sensory integration difficulties – including many people with an ASD – have difficulty processing everyday sensory information. People who struggle to deal with all this information are likely to become stressed or anxious, and possibly feel physical pain. This can result in challenging behavior.

There is no “cure” for ASDs.  Therapies and behavioral interventions are designed to remedy specific symptoms and can bring about substantial improvement.  The ideal treatment plan coordinates therapies and interventions that meet the specific needs of individual children.  Most health care professionals agree that the earlier the intervention, the better.

Educational/behavioral interventions:  Therapists use highly structured and intensive skill-oriented training sessions to help children develop social and language skills, such as Applied Behavioral Analysis.  Family counseling for the parents and siblings of children with an ASD often helps families cope with the particular challenges of living with a child with an ASD.

Medications:  Doctors may prescribe medications for treatment of specific autism-related symptoms, such as anxiety, depression, or obsessive-compulsive disorder.  Antipsychotic medications are used to treat severe behavioral problems.  Seizures can be treated with one or more anticonvulsant drugs.  Medication used to treat people with attention deficit disorder can be used effectively to help decrease impulsivity and hyperactivity.

Other therapies:  There are a number of controversial therapies or interventions available, but few, if any, are supported by scientific studies.  Parents should use caution before adopting any unproven treatments.  Although dietary interventions have been helpful in some children, parents should be careful that their child’s nutritional status is carefully followed.

Nearly 40 percent of preschoolers with autism are getting some kind of complementary or alternative therapy for their condition, with nutritional supplements and special diets being the most common things parents try, a new study shows.

There are no medications currently approved specifically to treat autism spectrum disorders and its core symptoms of social and behavioral problems, according to the U.S. Centers for Disease Control and Prevention. Autism symptoms also include stomach upset and difficulty sleeping, among others.

Recent estimates from CDC’s Autism Developmental Disabilities Monitoring network found that about 1 in 88 children have ASD. This estimate is higher than estimates from the early 1990s. Over the years, some people have had concerns that autism might be linked to the vaccines children receive. One vaccine ingredient that has been studied specifically is thimerosal, previously used as a preservative in many recommended childhood vaccines. However, in 2001 thimerosal was removed or reduced to trace amounts in all childhood vaccines except for one type of influenza vaccine, and thimerosal-free alternatives are available for influenza vaccine. Evidence from several studies examining trends in vaccine use and changes in autism frequency does not support such an association between thimerosal and autism. Furthermore, a scientific review by the Institute of Medicine (IOM) concluded “the evidence favors rejection of a causal relationship between thimerosal–containing vaccines and autism.” The CDC supports the IOM conclusion that there is no relationship between vaccines containing thimerosal and autism rates in children.

One last important point: A person with autism feels love, happiness, sadness and pain just like everyone else. Just because some of them may not express their feelings in the same way others do, does not mean at all that they do not have feelings – THEY DO!

Take good care of yourself and live the best life possible.

The information included in this column is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan. Glenn Ellis, is a Health Advocacy Communications Specialist. He is the author of Which Doctor?, and Information is the Best Medicine. A health columnist and radio commentator who lectures, nationally and internationally on health related topics, Ellis is an active media contributor on Health Equity and Medical Ethics. For more good health information, visit: www.glennellis.com