Autism

Autism is one of a group of developmental problems called autism spectrum disorders (ASD) that appear in early childhood, usually before age three. Though symptoms and severity vary, all autism disorders affect a child’s ability to communicate, interact, and be successful in peer and family relationships.

The number of children diagnosed with autism in the U. S. continues to rise, according to a new report released by the Centers for Disease Control and Prevention. The latest estimate is that 1 in 88 American children have some form of autism spectrum disorder. It isn’t clear whether this is due to better diagnosis and reporting, a real increase in the number of cases, or both.

While there is no cure for autism, intensive, early treatment can make a big difference in the lives of many children with the disorder.

SYMPTOMS
Children with autism generally have problems in three important areas of development–social interaction, language, and behavior. There are some common autism symptoms:

SOCIAL SKILLS
• Doesn’t respond to name
• Has poor eye contact
• Appears not to hear you sometimes
• Resists cuddling or holding
• Prefers playing alone
• Easily overwhelmed in group situations
• Has difficulty with transitions

LANGUAGE
• Doesn’t point to objects or express wants or desires
• Expressive language delay
• Loses previously acquired ability to speak words or sentences
• Doesn’t make eye contact when asking for something
• Uses an abnormal tone of voice
• Can’t initiate a conversation or keep one going
• Conversations are frequently “off topic”

BEHAVIOR
• Performs repetitive movements such as rocking, spinning, or hand-flapping
• Becomes disturbed at any change in routines
• Moves constantly
• May be unusually sensitive to light, sound, and touch
• May be fascinated by parts of an object


WHEN TO SEE A DOCTOR
Children with autism generally show some signs of delayed development by 18 months. Your doctor may recommend further developmental tests if your child:
• Doesn’t babble or coo by 12 months
• Doesn’t gesture–such as point or wave–by 12 months
• Doesn’t say single words by 16 months
• Doesn’t say two-word phrases by 24 months
• Loses previously acquired language or social skills at any age
• Doesn’t respond to name when called
• Has poor eye contact

CAUSES
Autism has no single, known cause. Given the complexity of the disease and the range of autistic disorders, there are likely many causes, including:
• Genetic problems. A number of genes appear to be involved in autism. Some may make a child more susceptible to the disorder; others affect brain development or the way brain cells communicate. Still others may determine the severity of the symptoms.
• Environmental factors. Researchers are exploring whether viral infections, heavy metal exposure, and air pollutants may play a role in triggering autism.

No link between vaccines and autism
There has been controversy about a possible link between autism and certain childhood vaccines, particularly the measles-mumps-rubella (MMR) vaccine. No reliable study either in the U.S. or Europe has shown a link between autism and the MMR vaccination. It is important to vaccinate your children against serious diseases, such as whooping couth (pertussis), measles and mumps.

Risk Factors
Autism affects children of all races and nationalities, but certain factors can increase a child’s risk, including:
• Your child’s sex: Boys are three to four times more likely to develop autism than girls.
• Family history: Families who have one child with autism face an increased risk of having another child with the disorder.
• Parental age: Having a father age 40 or older may increase a child’s risk of autism.

Diagnosis
Your pediatrician will look for signs of developmental delays at regular checkups. If your child shows some signs of autism, you may be referred to a specialist in treating children with autism who can perform a formal evaluation.
Your doctor can help identify resources in your area that may help your child. Next week’s article will provide information on choosing suitable educational programs and community resources to aid you cope with the challenges of raising an autistic child.


Dr. Martin Luloff is a pediatrician with Dartmouth-Hitchcock Putnam Physicians and provides care for patients in Southwestern Vermont Medical Center's pediatrics department. To schedule an appointment with Dr. Luloff, call (802) 447-3930. Learn more about how SVMC and Dartmouth-Hitchcock are working together for a healthier community and visit www.svhealthcare.org. “Health Matters” is a weekly column meant to educate readers about their personal health, public matters and public policy as it affects health care.