What is Autism?

Autism is a nervous developmental disorder seen in early childhood and characterized by severe impairment in social interaction, impairment in communication and repetitive type of behavior.

The origin of autism is genetic and the occurrence is prevalent in the siblings. The onset of the condition occurs before the age of three. Males are more affected than females. Autism may be associated with tuberous sclerosis and fragile X syndrome.

Impairment in social interaction includes inadequate use of non-verbal behaviour such as facial expressions and posture, failure to develop appropriate social relationships, lack of sharing interests and lack of emotional reciprocity. The patient fails to develop normal social behavior like appropriate smiling or eye contact.

Communication impairment includes delay or lack in development of spoken language, impairment in initiating conversation and repetitive usage of language. There is no alternative mode of communication also.

Repetitive pattern of behavior includes abnormal pre-occupation, inflexibility to non-functional activities, repetitive manners and pre-occupation with inanimate objects. Such activities may include repetitive hand flapping and continuous performance of some rituals.

The symptom severity and the intelligence quotient (IQ) may vary widely in the patients.

The condition may worsen in certain conditions like pregnancy, labour, delivery or maternal rubella.

Diagnosis

The diagnosis of autism needs to get differentiated from other similar conditions like schizophrenia, mutism, language disorder and mental retardation. There are other very similar disorders also including Asperger’s disorder (autistic disorder without language delay), Rett’s disorder (female disease of impairment of language and coordination seen after 5 months of age) and Childhood disintegrative disorder (developmental regression seen after 2 years of age).

Developmental history, psychological and intellectual testing, language assessment along with EEG can confirm the diagnosis. Autistic children have higher incidence of epilepsy and this increases with age.

Treatment Plan

The affected children are treated with special education plan and behavioral management skills. Counseling and family support hold an important place in the treatment regime. Medications may also be prescribed symptomatically.

Constant monitoring is crucial by the caregivers. Intellectual and language testing should be repeated after every two years in the childhood.

Prognosis

Prognosis is usually not very favourable. The affected child may behave just 20-25% above the functional capacity of a mentally retarded level. If the communication development occurs before 5 years of age, the prognosis can be treated as favourable.