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| Volume 1, Issue 17 | JULY 2004 |
| Inside This Issue | |||||
| 1 | Autism | ||||
| 2 | Updates and Announcements | ||||
Medical Information Fact Sheet
Autism is a complex biological disorder that generally affects a person throughout their lifetime. This disorder begins in early childhood, usually before age three and affects many crucial areas of development. Autism causes problems with verbal and nonverbal communication, social interactions with others including both physical and verbal interactions, and routines or repetitive behaviors. Children with autism frequently repeat words or actions over and over, obsessively follow routines or schedules for their actions, or have very specific ways of arranging their belongings. Autism has a wide variety of characteristics ranging in intensity from mild to severe. One child with autism does not behave like another child with the same diagnosis. Children and adolescents with autism typically exhibit some of these common characteristics listed above.
Background:
Autism is the most common of a group of conditions called pervasive developmental disorders (PDDs) or more often referred as the autism spectrum disorders (ASDs). ASDs involve delays in many areas of childhood development. The conditions that are included in this ASD are Autistic disorder, Asperger disorder, Childhood disintegrative disorder (CDD), Rett syndrome, and Pervasive Developmental Disorder Not Otherwise Specified (PDDNOS) or atypical autism. Children with any of these ASD demonstrate deficits in social interaction, verbal and nonverbal communication, and repetitive behaviors. Each child will display communication, social, and behavioral patterns that are individual but fit into the overall diagnosis of ASD. Children with ASD do not follow the typical patterns of child development. In some children, hints of future problems may be apparent from birth. Most often though, the problems with communication and social skills become more noticeable as the child lags further behind other children the same age. Recent studies show though that at least 20% of children with autism experience a “regression”, as reported by their parents. This means that children had a mostly normal development, but then had a loss of social or communication skills.
Current figures and statistics show that autism occurs in all racial, ethnic, and social groups. These figures also show that boys are three to four times more likely to be affected by autism than girls. Studies estimate that as many as 12 in every 10,000 children have autism or a related condition. In addition, if a family has one child with autism, there is a 5% to 10% chance that the family will have another child with autism. In contrast, if a family does not have a child with autism, there is only a 0.1% to 0.2 % chance that the family will have a child with autism.
The first signs of autism are usually noticed by age 3. In most cases, the symptoms of autism are measurable by certain screening tools at 18 months of age. However, parents and experts in autism treatment can usually detect symptoms before this time. In general, a formal diagnosis of autism can be made when a child is two, but it is usually made when the child is between two and three, when he or she has a noticeable delay in developing language skills.
Researchers are unsure about what causes autism. Several studies suggest that autism might be caused by a combination of biological or environmental factors, or both, including viral exposure before birth, a problem with the immune system, or genetics. Many recently published studies have examined the possible connection between autism and the measles, mumps, and rubella (MMR) vaccine. At this time, though, there is no data that suggests that any part of this vaccine or any combination of vaccines causes autism.
There is also no proof that any material used to make or preserve vaccines plays a role in causing autism. Studies of families and twins suggest a genetic basis for the disorder. Other studies have found the brains of individuals with autism may function differently from those that are considered “normal”. Research suggests that an abnormal slowing down of the brain development before birth may cause autism. Studies also are looking at how autism-related problems in brain development may affect behavior later in childhood. Lastly, chemicals in the brain also may play a role in autism. As a normal brain develops the level of serotonin, a chemical found in the brain, declines. In some children with autism, however, serotonin levels do not decline. Researchers are investigating whether this happens only to children with autism or whether other factors are involved.
Doctors should do a “developmental screening” at every well-baby and well-child visit, through the pre-school years. In this screening, the doctor asks questions related to normal development that allows him or her to measure a specific child’s development. If the doctor finds that a child either has definite signs of autism, or has a high number of “red flags” that may suggest autism, he or she will send the child to a specialist in child development or another health care professional, so the child can be tested for autism. The specialist will rule out other disorders and use tests specific to autism. Then he or she will decide whether a formal diagnosis of autism, ASD, or another disorder is appropriate. Some behaviors that signal a need for a doctor to immediately evaluate a child for autism include the following:
· The child does not babble or coo by 12 months of age.
· The child does not gesture (point, wave, grasp, etc.) by 12 months of age
· The child does not say single words by 16 months of age.
· The child does not say two word phrases on his or her own by 24 months of age.
· The child has any loss of any language or social skill at any age.
To date, there is no cure for autism. However, there are a number of treatments that can help people with autism and their family’s lead more normal lives. Individualized, intense interventions that begin as early as possible give people with autism their best chance for progress. Doctors suggest starting these treatments before a child is two-and-a-half or three to get the best and most lasting results.
In some cases, treatment can help people with autism function at normal or near-normal levels. It is important to match your child’s needs and potential with treatments or strategies that are likely to be effective in moving him or her closer to normal functioning. Most professionals agree that individuals with autism respond well to highly structured, specialized education programs, designed to meet the individual’s needs.
Many families of children and adults with autism are finding new hope from a variety of treatments for autism. Some treatments include Individualized Education Programs (IEPs), Comprehensive treatment programs, Applied behavior analysis (ABA), Positive behavioral interventions and support (PBS), and medications. There are many treatment options and combinations of treatments. A trained professional will help develop a program of treatment options that will be best suited for the child with autism.
Lastly, it is important that parents or other caregivers with autistic children talk with their health care providers about their concerns, get accurate information from libraries, hot lines, or other sources, ask questions about treatments and services, talk to other families in the community who have autistic children, and find family network organizations. There are resources and services available to all that have or may have an autistic child.
References
Autism Society of America (2002, July 5). Common Characteristics of Autism. Retrieved on July 7, 2004 from the World Wide Web:
http://www.autism-society.org/site/pageserver?pagename=autismcharacteristics.
National Institute of Child Health and Human Development (2004, May 5). Autism Facts. Retrieved on July7, 2004 from the World Wide Web: http://www.nichd.nih.gov/publications/pubs/autism/facts/sub1.htm.
National Institute on Deafness and Other Communication Disorders (2003, January 2). Autism and Communication. Retrieved on July 12, 2004 from the World Wide Web: http://www.nichd.nih.gov/health/voice/autism.asp.
National Institute of Mental Health (2004, April 1). Autism Spectrum Disorders (Pervasive Developmental Disorders). Retrieved on July 12, 2004 from the World Wide Web: http://www.nimh.nih.gov/publicat/autism.cfm?output=print.
National Mental Health Information Center (2001, December 15). Children’s Mental Health Facts Children and Adolescents with Autism. Retrieved on July 12, 2004 from the World Wide Web: http://www.mentalhealth.samhsa.gov/_scripts?printpage.aspx.
HCPCFC PROGRAM UPDATES and ANNOUNCEMENTS!!!
We would like to congratulate Kristen Thompson and Nicole Boyd on their promotions to PHN III.
Congratulations!!!!
Also we would like to extend a welcome to
Michelle Haynes
as the Interim Assistant Nurse Manger!
Editor: Kristen Thompson, PHN, and Nicole Boyd, PHN
Contributors: Michelle Haynes, PHN, MBA, Interim Assistant Nurse Manager and Judy Earp, MHA, Director of Public Health Nursing.
