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MONDAY, April 28 (HealthScoutNews) -- The signs often show up
early in a baby's life: He doesn't babble or coo like other infants.
Later, he may fail to gesture, point or make eye contact.
As time passes, the child may have difficulty learning to talk
or, frequently, not talk at all, even as he approaches his second
birthday.
When these symptoms prevail, the diagnosis could be autism -- a
complex brain disorder that can keep its victims locked in a
private, silent world painfully disconnected from those who love
them. In its most severe form, it can totally inhibit a child's
ability to communicate, respond to his surroundings or develop the
emotional connections necessary to form the most basic of
relationships with others.
"When a child is finally diagnosed as autistic, most parents say
they knew something was wrong, sometimes beginning shortly after
birth," says Dr. Richard I. Perry, a child and adolescent
psychiatrist at Bellevue/New York University Medical Center.
Unfortunately, parents don't always get the medical validation
they need. And that's something experts hope to change with
education campaigns, like National Autism Awareness Month, which
concludes Wednesday.
"One of the biggest problems with this disorder is that parents
can have a very hard time persuading pediatricians and other
professionals that there is something wrong with their kids beyond a
normal slow development," Perry says.
There's a popular myth -- one of several surrounding autism --
that you can't diagnose this disease until a child is well into
childhood, he says.
In reality, the signs are evident as early as 18 months of age,
or sometimes even sooner, Perry says.
Another popular myth holds that because there's no specific
treatment and no cure for autism, parents should be in no rush to
get a diagnosis.
While as recently as 10 or 15 years ago that may have been true,
experts say today studies show specific behavioral therapies can
have a powerful impact on the course of autism. And the sooner they
begin, the more difference they can make in a child's life.
"Generally, for a portion of the population, behavior
intervention can help many individuals to learn, and lead a more
regular and less-dependent life. And the earlier it begins, the
better," says Andy Shih, director of research and programs at the
National Alliance for Autism Research.
Other treatments, including antidepressants, can sometimes help
as well. Again, the earlier the diagnosis is made, the better, Perry
says.
The National Institutes of Health estimates that some 400,000
Americans are diagnosed with autism. And males are diagnosed about
four times more often than females.
However, a recent report by the California Department of
Developmental Services puts the number much higher -- up to 1.5
million.
That figure has led to what some say is the creation of still
another myth about autism -- namely, that rates are increasing and
at an alarming pace. According to Shih, however, there are no
concrete facts to support this conclusion.
"Officially, the jury is still out as to whether or not we are
seeing a true increase. But what is more certain is that there's
definitely more kids being diagnosed," Shih says. This may be due,
in part, to changes in the clinical definition of autism, which now
includes some children who were previously diagnosed with mental
retardation, he says.
This recognition has helped to break down still another popular
myth about autism -- that it is a form of mental retardation. While
some experts once held this to be true, doctors today know this is
not the case.
"In children with mental retardation, there is a fixed level of
intelligence, usually earmarked by a low IQ. But there is also an
enormous capacity to love and to interact with others," Perry says.
In autistic children, he says, the IQ can vary dramatically from
low to extremely high, but there is always a serious void in terms
of social interaction that you don't see in mental retardation.
While no one is sure why autism occurs, Shih says some of the
newest theories focus on the brain's rapid growth shortly after
birth.
Every child comes into the world with a kind of "wild flower
garden" of electrical connections growing inside their brain, Shih
says. As the weeks and months pass by, environmental cues help to
prune down the brain's wildly expanding connections, allowing only
those needed most -- for example, those governing language and
hearing skills -- to develop and grow strong. As they do,
communication skills and emotional development begins, as babies
learn to talk and interact with others.
But in autistic children, says Shih, the brain's "garden" doesn't
undergo this natural "pruning" process. Instead, all the synapses
and connections continue to grow unchecked. The end result: the
child's brain circuitry is bombarded with so many conflicting
messages, through so many pathways, it can't make solid connections
to any of them, Shih says.
"Instead, they remain locked in a very private world," he says.
Although myths also abound as to the cause of autism, no one
really knows why this disorder occurs. Shih, however, believes the
strongest evidence to date can be found in the gene pool, which, he
says, is the only place where links to the complete spectrum of
autistic behaviors can be found.
"It is really only when you look to the genetic level that you
see the common denominators that universally almost every child with
autism shares," says Shih.
It hasn't been determined if environmental factors exacerbate
genetic tendencies. Researchers continue to explore possible links
to diet, stress during pregnancy, as well as the role of childhood
vaccines during the first few years of life.
Regardless of any environmental connections that may one day be
ruled in or out, Shih and Perry believe that a better understanding
of the genetic underpinnings of autism will ultimately lead to
better treatments and, possibly, a cure.
Until that time, they say, awareness and education are a parent's
best allies -- two factors that can make that critical early
diagnosis possible.
According to the National
Alliance for Autism Research, parents can look for the following
warning signs of autistic behavior:
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Has not babbled or
cooed by 1 year;
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Has not gestured,
pointed or waved by 1 year;
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Has not spoken a
single word by 16 months;
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Has not spoken a
two-word phrase by 2 years of age;
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Experiences any
loss of any language skills at any age.
Parents should talk to
their health-care provider about an autism evaluation if they notice
any significant behavioral changes in their child, including:
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Does not respond to
his or her name;
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Can't tell or
describe what he or she wants;
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Experiences any
language delays;
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Doesn't follow
directions at all;
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Appears at times to
have a hearing impairment;
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Doesn't know how to
play with toys;
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Has poor eye
contact;
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Appears to be in
his or her own world;
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Does not smile
socially.
More information
To learn more about autism, visit the
National Alliance for Autism Research,
The Autism Society of America and
The
National Library of Medicine.
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