Autism affects approximately 1 in every 88 children and is 5 times more common in boys than in girls. Autism is the most common developmental disorder within a group of Autism Spectrum Disorders which include Asperger Syndrome, and Pervasive Developmental Disorder.
Children will usually be brought to the attention of the pediatrician by a parent who may sense that their child may not be developing appropriately. Most children will show symptoms before the age of three. Children who are autistic tend to have trouble with social interaction, difficulty communicating verbally and nonverbally, and usually display repetitive or obsessive behaviors. Symptoms can present as early as infancy. Babies may be unresponsive to caregivers and may focus on one thing for prolonged periods of time. Older children may avoid eye contact in social situations and resist changes in routine. Other behaviors include rocking, head banging, biting and difficulty playing or interacting with other children. They may also be very sensitive to sound or touch which might explain why affected children resist being hugged or cuddled. Parents should ask for help from their pediatrician if the following developmental milestones are not met:
- Not respond to his or her name by 12 months
- Not point at objects to show interest by 14 months
- Not play “pretend” games by 18 months
A person with ASD might:
- Avoid eye contact
- Have delayed speech and language skills
- Repeat words or phrases over and over
- Get upset by minor changes
- Flap his or her hands, rock his or her body
Unfortunately, there is not one specific diagnostic test for autism. Pediatricians will usually conduct developmental screening tests at 9, 18 and 24 months of age during regular physical exams. There are also screening tests specifically for autism. Tests most commonly used by pediatricians are the Modified Checklist for Autism in Toddlers (MCHAT) done at 18 months and the Autism Screening Questionnaire for children over the age of four. There are many other illnesses which may resemble autism and should be ruled out before final diagnosis is made. Thus, your pediatrician may ask for the help of other specialists including the psychiatrist, neurologist, developmental pediatrician, speech pathologist, audiologist and occupational and/or physical therapists.
The cause of autism is unknown. Autism occurs as the result of a neurological abnormality, the cause of which is unknown. It is likely that a combination of immunologic, genetic, environmental and metabolic factors result in the development of autism. The risk of having a second child with autism is 2-18% and in an identical twin the risk is 36-95%.
When the diagnosis of autism is made, the treatment plan has to be individualized. There is no one cure for autism. Treatment should involve a multidisciplinary team approach. There are medications, mineral and vitamin supplements, behavioral therapies and dietary interventions which can be found in the literature. However, any new treatment plan should be discussed with your pediatrician to avoid any potential harmful side effects. An important aspect of treatment is also the involvement of support groups to assist parents and children with navigating the often stressful aspects of autism.
If you have any concern that your child may be showing signs of autism or developmental delay, do not hesitate to make an appointment with your pediatrician. The potential for a better outcome is greater when the diagnosis is made as early as possible.