Autism

I

Introduction

Autism, disorder that affects the social, emotional, and behavioral development of children. Autism is marked by serious difficulties in interacting and communicating with other people. Other symptoms may include constantly repeating certain actions or behaviors, or having intense interests restricted to only particular things or topics. Symptoms of autism usually appear before the age of three and can last the rest of a person’s lifetime. Autism is at least four times more common in boys than in girls.

The term autism comes from Greek auto, meaning “self,” and refers to an abnormal withdrawal from the world outside oneself. The American psychiatrist Leo Kanner first described the disorder in 1943. Autism was originally thought to be a form of schizophrenia, but it has been recognized since the 1960s as a distinct developmental disorder that is not a psychosis. Modern researchers now identify a wide “spectrum” of autism symptoms that may occur in different combinations or with different severities in children.

The causes of autism remain a major area of research and of controversy. Studies indicate that autism is often associated with abnormalities in the functioning of the brain and that the disorder may have a genetic basis in most cases.

Raising a child with autism can present special challenges for a family. There is no cure for autism but some treatments and therapies can lessen the symptoms. Some persons with autism may need special care throughout their lives while others may learn to function independently in society.

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II

Prevalence

The number of children diagnosed with autism has increased since the 1990s. Until the mid-1990s, autism was estimated to occur in 1 in 3,000 children. More recent estimates suggest that autism occurs in approximately 1 in 500 children, and that 1 in 150 children may be on the “autism spectrum” with one or more symptoms. An estimated 560,000 children in the United States may have autism spectrum disorders.

Possible reasons why more cases of autism are being reported include dramatically improved and standardized methods for diagnosing autism, along with increased awareness of autism, first among the medical community and then in the media. Children and adults with less severe symptoms are more likely to be diagnosed with autism today than they were 15 years ago.

On the other hand, some researchers believe that the greater number of autism diagnoses represents a true increase in the incidence of the disorder and points to some environmental factor that may have changed over the same period of time. Although no scientific data currently support a connection with autism, possible environmental factors proposed include toxic chemicals, vaccines, pollutants, food products, and prenatal exposure to certain drugs or infectious agents.

A still unexplained feature of autism is the much higher incidence of the disorder in boys, about four times as frequent as in girls. Girls with autism, however, tend to show more severe symptoms and mental impairment.

III

Symptoms

The diagnosis of autism—officially called “autistic disorder” (AD)—is based upon the American Psychiatric Association’s definition of three symptoms areas: (1) social difficulties, (2) communication difficulties, and (3) restrictive interests or repetitive behaviors. Symptoms from all three of these areas must be present before the age of three to make a diagnosis of autism. Most children with autism show developmental delays from the infant or toddler period. In some cases, however, children with autism suffer a regression, or loss of skills, after a period of normal development.

A

Social Difficulties

Symptoms of social difficulty are usually the first signs of autism. Normally an infant should respond to others with a social smile within the second or third month of life. Lack of such a smile during this period is often the earliest indication of autism. Infants who are later diagnosed with autism also make poor eye contact and do not imitate caregiver sounds or gestures.

Children with autism typically do not share their enjoyment with others. For example, toddlers with autism may smile or laugh in response to a noisy toy, but they will not bring this toy to the caregiver. Another early sign of problems in social communication is a lack of gestures, including pointing. As they get older, children with autism often fail to develop typical friendships or even typical relationships with siblings or parents. They may also seem unaware of the feelings of other people or fail to comfort a person who is upset.

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