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Autism; a Child’s Prison, a Parent’s Torture


Autism; a Child’s Prison, a Parent’s Torture

Abstract:

“He seems very antisocial” “He doesn`t enjoy playing with the rest of the kid his age” “He is definitely an introvert” “She seems oddly obsessed with highways and she always seems to be combing her hair!” The whispers seem to fill the room!

Later, however, a doctor diagnoses the child with autism.

 

What is autism?

The “classic” form of autism was first described by Dr. Leo Kanner. These children were different from normally-developing children from birth.
Autism is a complex developmental disorder that has the following three defining core features:

 

  1. Problems with social interactions.
  2. Impaired verbal and nonverbal communication.
  3. A pattern of repetitive behavior with narrow, restricted interests.


Autistic disorder, sometimes called autism or classical ASD, is the most severe form of ASD. While other conditions along the spectrum include a milder form known as Asperger syndrome, the rare condition called Rett syndrome, and Childhood Disintegrative Disorder and Pervasive Developmental Disorder not otherwise specified (usually referred to as PDD-NOS).


Scary numbers:

  • The most recent studies show that of children born in 1998, 9 out of every 1000 have an autism spectrum disorder, corresponding to an average of 1 out of every 110 children.
  • As many as 1.5 million people in the U.S. may have some form of autism.
  • Autism affects all races, ethnic groups, and socioeconomic levels.
  • Boys are 3-4 times more likely than girls to have autism.
  • It can be summarized that between 1 in 500 (2/1,000) to 1 in 166 children (6/1,000) have autism.
  • A study conducted by the Centers for Disease Control and Prevention found the rate of autism for children ages 3 to 10 years to be 3.4 per 1,000 children, which is lower than the rate for mental retardation; but higher than the rates for cerebral palsy, hearing loss  and vision impairment found in the same study.


Causes:

Scientists aren’t certain about what causes ASD, but it’s likely that it is related to many different factors.

 

  1. Researchers have identified a number of genes associated with the disorder (there is probably no single gene or genetic defect responsible for autism).  
  2. Studies suggest that people with ASD have abnormal levels of serotonin or other neurotransmitters in the brain, suggesting that ASD could result from the disruption of normal brain development early in fetal development caused by defects in genes that control brain growth and that regulate how brain cells communicate with each other, possibly due to the influence of environmental factors on gene function.  While these findings are intriguing, they are preliminary and require further study.  
  3. Post mortem studies and recently developed imaging techniques have helped to identify some of the major brain areas implicated in Autism. The areas include the cerebellum, cerebral cortex, and temporal lobe (particularly the Amygdala). The disorder may result from the failure of various parts of the brain to work together.
  4. In some children, autism is linked to an underlying medical condition. Examples include metabolic disorders, congenital infections, genetic disorders, developmental brain abnormalities, and neurologic disorders acquired after. These medical disorders alone do not cause autism as most children with these conditions do not have autism.
  5. Environmental factors and exposures may interact with genetic factors to cause an increased risk of autism in some families.
  6. Many different theories that have been proposed about what causes autism are no longer accepted; one of which is the theory that emotional trauma at any age (especially bad parenting) was to blame.

 

The Vaccine Debate:

A huge debate erupted on February 1998 when Dr.Andrew Wakefield published a paper in “The Lancet” stating that the MMR vaccine was to blame in 8 out of 12 cases  of autism that attended his clinic at the London Royal Free Hospital, and that the symptoms came into view days after the vaccine. The team also claimed to have discovered a new inflammatory bowel disease underlying the children’s conditions (ileal-lymphoid nodular hyperplasia).
Crucially, the onset of this acquired form of regressive autism is accompanied by other visible and associated physical manifestations of problems. These include bright red ears and dark rings under the eyes after certain foods, acute gluten and casein intolerances, prolonged hyperactivity, night sweating and loss of temperature control, and chronically poor sleep patterns.
The UK Department of Health viewed the timing of these symptoms after the MMR vaccination as a coincidence; stating that autism was realized around this time because this is a time when child development is most rapid, and therefore any failure most noticeable, suggesting that autism was always there and that the full blown picture was only the result of a “delayed action genetic bomb”.
Parents of the affected children, on the other hand, reply that it is highly unlikely that previous problems would have been missed, especially at a time where children receive constant devoted attention and close scrutiny regarding their development.
 Research reported by Dr. Jeff Bradstreet to the US Institute of Medicine on 9th February
2004 found that, when the cerebrospinal fluid of 28 regressive-autistic children was
analyzed, measles virus was found in 19 of the 28 cases. When 37 non-autistic control group children were analyzed, only one child was found to have measles virus. All 65 of these children had received MMR, and none had any recorded history of wild measles infection.
The final word on this fueling debate came in a paper called: “Debunking the Link Between Autism and Immunization” by Nick Miller, published on February 4th 2010.This paper clearly stated that since most of the anti-vaccination believers were convinced that the main criminal was mercury-based ingredient thimerasol, how come no one managed to realize that when thimerasol was removed from vaccines, autism rates went up!! “And gradually it became clear that the original study was a furphy, as more and more follow-ups failed to duplicate the original findings. Science was satisfied. The link was disproven. The caravan should have moved on.”
The longest medical misconduct inquiry ever conducted by the General Medical Council has now come to an end, and they confirmed more than 30 charges against Wakefield.

 

The Role of Inheritance:

Identical twin studies show that if one twin is affected, there is a 90 percent chance the other twin will be affected
In families with one child with ASD, the risk of having a second child with the disorder is approximately 5 percent, or one in 20.  This is greater than the risk for the general population.  
In some cases, parents and other relatives of a child with ASD show mild impairments in social and communicative skills or engage in repetitive behaviors.
Evidence also suggests that some emotional disorders, such as manic depression, occur more frequently than average in the families of people with ASD.


Symptoms and signs:

 

Impaired reciprocal social interaction:

 

  1. Poor use of body language and nonverbal communication, such as eye contact, facial expressions, and gestures;
  2. Lack of awareness of feelings of others and the expression of emotions, such as pleasure (laughing) or distress (crying), for reasons not apparent to others;
  3. Remaining aloof, preferring to be alone;
  4. Difficulty interacting with other people and failure to make peer friendships;
  5. May not want to cuddle or be cuddled;
  6. Lack of or abnormal social play;
  7. Not responding to verbal cues (acting as if deaf).


Impaired communication:

 

  1. Delay in, or the total lack of, the development of spoken language or speech
  2. If speech is developed, it is abnormal in content and quality;
  3. Difficulty expressing needs and wants, verbally and/or nonverbally;
  4. Repeating words or phrases back when spoken to (known as echolalia);
  5. Inability to initiate or sustain conversation;
  6. Absent or poorly developed imaginary play.

 

Restricted repertoire of interests, behaviors, and activities:

 

  1. Insisting on following routines and sameness, resisting change;
  2. Ritualistic or compulsive behaviors;
  3. Sustained odd play;
  4. Repetitive body movements (hand flapping, rocking) and/or abnormal posture (toe walking);
  5. Preoccupation with parts of objects or a fascination with repetitive movement (spinning wheels, turning on and off lights);
  6. Narrow, restricted interests (dates/calendars, numbers, weather, movie credits).


Children with ASD appear to have a higher than normal risk for certain co-occurring conditions, including Fragile X syndrome (which causes mental retardation), tuberous sclerosis (in which tumors grow on the brain), epileptic seizures (  20 - 30 % of children with ASD develop epilepsy by the time they reach adulthood), Tourette syndrome, learning disabilities, and attention deficit disorder.   While people with schizophrenia may show some autistic-like behavior, their symptoms usually do not appear until the late teens or early adulthood.  Most people with schizophrenia also have hallucinations and delusions, which are not found in autism.


When Should the Alarm Bell Ring?

 

Very early indicators that require evaluation by an expert include:

 

  • No babbling or pointing by age 1
  • No single words by 16 months or two-word phrases by age 2
  • No response to name
  • Loss of language or social skills
  • Poor eye contact
  • Excessive lining up of toys or objects
  • No smiling or social responsiveness.


Later indicators include:

 

  • Impaired ability to make friends with peers
  • Impaired ability to initiate or sustain a conversation with others
  • Absence or impairment of imaginative and social play
  • Stereotyped, repetitive, or unusual use of language
  • Restricted patterns of interest that are abnormal in intensity or focus
  • Preoccupation with certain objects or subjects
  • Inflexible adherence to specific routines or rituals.


If even one of these statements is true of a child, parents should resist the temptation to "just wait and see." Problems of this type may signal some type of disability, even if it is not autism.


Diagnosis:

There is no lab test or X-ray that can confirm the diagnosis of autism. The diagnosis of autism is based on clinical judgment regarding observations of the individual's behavior. A comprehensive evaluation requires a multidisciplinary team, including a psychologist, neurologist, psychiatrist, speech therapist, and other professionals who diagnose children with ASD.


The comprehensive evaluation of a child with autism might include: obtaining complete medical and family history;  physical exam; formal audiology evaluation; selected medical/lab tests on an individual basis (for example, lead levels, genetic tests, metabolic tests, brain MRI, electroencephalogram [EEG]); speech, language, and communication assessment; cognitive and behavioral assessments (focus on social skills and relationships, problem behaviors, motivation and reinforcement, sensory functioning, and self-regulation); and  academic assessment (educational functioning, learning style).


Treatment:

There is no cure for ASD.  A generation ago, most children with autism were institutionalized. This is no longer the case and most children with this disorder live with their families.


The improving understanding of autism has shown that, regardless of the severity of the condition, appropriate treatment and education can eventually help many children with autism to be integrated into their community.


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.  The following specific programs have been developed for persons with autism:


TEACCH is a program developed in North Carolina. The underlying principle is that the environment should be adapted for the person with autism, not the other way around. This program focuses less on changing specific behaviors and more on providing the child with the skills needed to understand his or her environment and communicate his or her needs.


Floor time is an approach that helps the child with autism progress on the natural developmental ladder.


Social stories is an approach that uses stories to teach children social skills. This helps the child develop an understanding of the appropriate or expected response to the situation. The stories are tailored to the individual and often include music and illustrations.


 Family counseling for the parents and siblings of children with ASD often helps families cope with the particular challenges of living with a child with ASD.


Medications:  Doctors may prescribe medications for treatment of specific ASD-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 is a number of controversial therapies or interventions available for people with ASD, 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.


New research in the field of autism:

  • On March 30th 2007, the University of Nottingham conducted a study revealing that autistic children are able to interpret the mental status of others by looking at their eyes, a finding that contradicts what was previously believed. The results were published in a study called “The Eyes Have It – Autism Research Yields Surprising Results” by Dr.Askush Vidvarthi.
  • “Behavioral signs of autism become evident between the ages of 6 – 12 months” claimed a study supervised by the UC Davis MIND Institute on February 2010. The study was conducted over a period of 5 years counting every incidence of babbling, smiling and eye contact until the child was 3, finding that by the time the children were 1 year old (not 6 months as most of the studies report) most of the symptoms and signs of autism were present, emerging gradually during the second part of the first year of life.
  • Phoebe Caldwell, who has received the Times/Sternberg Active Life Award for her pioneering treatments, mentioned in a paper titled: “How to communicate with autistic children” published May 4th 2010; that using the concept of intensive interaction introduced by Geraint Ephraim in the 1980s can help in communicating with autistic children. The paper claims that “using body language to communicate promotes eye contact, the desire to move closer and increased social responsiveness”.
  • On July 19th 2010, Richard Alleyne cited the results of a study published on the Proceeding of the National Academy Of Sciences, claiming that autism could be detected in the voices of the children using a device called LENA (Language Environment Analysis), by recording a whole day’s speech and feeding the results to a special computer program that compares the results to that of children known to be autistic. This method has 86% accuracy.
  • A huge leap in detecting and diagnosing autism took place when researchers at Harvard University's McLean Hospital and the University of Utah claimed they have developed the best biologically based test for autism to date, according to a paper published on December 2nd 2010. The test is a brain scan that measures the deviations in brain circuitry that can detect the condition with almost 100% accuracy.  

 

Conclusions:

Autistic children appear to be locked up in a world of their own, impenetrable to others; thereby rendering help extremely difficult to give and receive.


Science graced us with various means to cope with the condition, to help these children live as normal a life as possible. But the key to being able to use this knowledge remains early detection.


Not enough emphasis could be placed on early observation and diagnosis in order to gain the maximum benefit from all therapies available.


We should learn to love these children for who they are, rather than spending time exchanging blames about what caused them to be like this in the first place.

 


اضغط هنا للقراءة باللغة العربية


Source :

“Test for autism is most promising yet, claims study”, by Richard Alleyne 2nd December 2010
“Autism detected in voice of children”, By Richard Alleyne 19 July 2010.
“Behavioural signs of autism become evident between the ages of 6 and 12 months”, by Dr.Sanjukta Acharva, February 16th  2010.
“How to communicate with Autistic children” by Phoebe Caldwell, may 4th 2010.
“The eyes have it—Autism research yields surprising results”, by Dr.Ankush Vidvarthi, March 30th 2010.
“Debunking the link between autism and vaccination” by Nick Miller, February 4th 2010.
Autism fact sheet, National Institute of Neurological Science and Stroke. www.ninds.nih.gov/disorders/autism
The Brain briefings, May 2006 by Stephen Heinemenn, David Van Essen and Carol A. Barnes.
“Autism Overview” (www.emedicinehealth.com/autism)   by Roxanne Dryden-Edwards, MD.
“MMR Vaccine, Thimerosal and Regressive or Late Onset Autism (“Autistic Enterocolitis”) A Review of the Evidence for a Link between Vaccination and Regressive Autism”, David Thrower, June 2005.






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