Autism Spectrum Disorders

Severely impaired development of normal communication and social skills

  • Usually develop before the age of 3
  • More common in boys
  • Sometimes run in families
  • Lifestyle is not a significant factor

Autism was first identified in 1943 and is now estimated to affect about 1 in 100 children in the UK. There are varying forms of autism known as autism spectrum disorders, and affected children have a wide range of symptoms. In general, there is a failure to develop language and communication skills, inability to form social relationships, and a marked need to follow routines. These disorders are more common in boys.

At least 2 in 3 autistic children have generalized learning disabilities. Rarely, affected children have normal or above-average intelligence, a form of autism known as Asperger’s syndrome. Autism spectrum disorders are possibly caused by abnormalities of the brain. The disorders sometimes run in families, which suggests that genetic factors may be involved. In a very small proportion of autistic children, a specific genetic abnormality is identified as a cause of their condition, such as fragile X syndrome.

What are the symptoms?

Some autistic children show symptoms from birth, such as arching the back to avoid physical contact. In infancy, a child with autism may bang his or her head against the side of the cot. Other children may appear normal until they are about 12–18 months old, when the following symptoms become apparent:

  • Failure to develop normal speech.

  • Absence of normal facial expression and body language.

  • Lack of eye contact.

  • Tendency to spend time alone.

  • Lack of imaginative play.

  • Repetitive behaviour, such as rocking and hand flapping.

  • Obsession with specific objects or particular routines.

  • Severe learning difficulties.

Rarely, an autistic child has an exceptional skill, such as a particular aptitude for technical drawing, mathematics, or playing a musical instrument. Some affected children develop epilepsy. Children who have Asperger’s syndrome may develop normal speech and language but have difficulty communicating with other people. These children are also rigid in their behaviour and cannot tolerate changes in routine.

Are there complications?

Autism spectrum disorders often have a devastating effect on family life. Bringing up an autistic child can be stressful, especially when the child is unable to show normal responsiveness and affection. Parents may find it difficult to take the child to public places because of his or her unusual or difficult behaviour. Other children in the family may feel neglected because an autistic sibling needs so much attention. A child with autism may also be at risk of self-harm.

What might be done?

Autism spectrum disorders are often first identified by parents who notice that their child’s behaviour is different from that of other children in the same age group. The doctor will usually refer the child to a child development specialist or child psychiatrist. There are no specific tests to confirm the diagnosis. However, when a genetic disorder such as fragile X syndrome is suspected, blood tests may be performed to look for the genetic abnormality.

There is no cure for autism spectrum disorders. Treatment normally focuses on education designed to maximize a child’s potential. Language and speech therapy can improve communication skills. Behaviour therapy can help to replace abnormal behaviours with more appropriate ones, and occupational therapy can improve physical skills. A highly structured daily routine is usually recommended.

What is the prognosis?

Most children with autism spectrum disorders cannot lead independent lives and require long-term care. Some people with Asperger’s syndrome achieve academic success, although they may always have poor social skills.

From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.

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