Autism: Putting the Pieces Together
Every year, more than one million young children with unidentified disabilities—including autism—enter school with learning and health issues. These issues put them far behind their peers and have a lasting, negative effect on their ability to meet their full potential.
For children with autism, entering school can be an especially difficult period. Social anxiety, communication skills, and a host of other issues can contribute to an unsuccessful school experience. When autistic kids get the right treatment and therapy before the age of five, they are ready to learn alongside their peers, build lifelong skills, and achieve their dreams.
Today, autism is estimated to affect 1 in 88 children, with the incidence in boys estimated to be 1 in 54. This is why more often than not, you hear people referring to “him” as having autism. Autism Spectrum Disorder (ASD) does not discriminate based on race, ethnicity, or socio-economic status; it can affect anyone. Some doctors believe the increased incidence in autism is due to newer definitions of autism. The term "autism" now includes a wider spectrum of children. For example, a child who is diagnosed with high-functioning autism today may have been thought to simply be odd or strange 30 years ago. An autistic child is not just a statistic; they are an individual who needs a treatment program designed for their specific needs.
There are three general types of ASDs: Autistic Disorder, or “classic” autism, Asperger syndrome, and Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS). Each of the three involves different social and communication problems, but the specific symptoms vary. Think of ASD as an umbrella: it encompasses three main types of autism, but within those three, there are many different manifestations. An estimated 1.5 million Americans have an autism spectrum disorder, but most Americans have no understanding of what it is. Autism is a lifelong developmental disability that affects brain function, emotional development, and social interaction. It affects every facet of daily living, including the ability to communicate, succeed in school, hold a job, maintain friendships, and live independently.
Autistic behaviors may appear as soon as twelve months of age. "We are completely missing the mark on early diagnosis given that autism can be accurately identified at 24 months. This new data reports that the median age of diagnosis is 48 months for Autistic Disorder, 53 months for ASD/PDD and 75 months for Asperger's Disorder," says Patricia Wright, PhD, MPH, National Director of Autism Services, Easter Seals. "We have a lot of work to do in the area of early identification. More than ever, there's an increasing need for funding, services, and support."
Genetic factors seem to have an important link in the occurrence of autism. For example, identical twins are much more likely than fraternal twins or siblings to both have autism. Similarly, language abnormalities are more common in relatives of autistic children. Chromosomal abnormalities and other nervous system (neurological) problems are also more common in families with autism. A number of other possible causes have been suspected but not proven. They include diet, digestive tract changes, mercury poisoning, the body's inability to properly use vitamins, minerals, and vaccine sensitivity.
Since there is no known cure currently available for autism, early detection is critical. Some parents avoid early diagnosis in fear that their child will be labeled as “special needs.” While autism is not curable, it is treatable, especially with early diagnosis. The American Academy of Pediatrics stresses that intervention in children as young as 18 months can dramatically improve lifetime prognosis. With appropriate intervention, many children with autism can grow to be independent adults who contribute to society and have a meaningful quality of life. Without intervention, individuals are far more likely to require lifetime support from their families, the school system, and the government.
Individuals with autism currently face discrimination by health insurance policies that specifically exclude treatment for autism and developmental disabilities. Most states do not mandate coverage for treatment, and most insurance companies deny coverage. This is an outrageous exception to medically necessary health coverage. Would we accept it if other chronic medical conditions like diabetes, cancer, or heart disease were excluded from treatment? The cost of therapy for autism is more than a typical family or individual can afford—up to $50,000 per year. It is reasonable to expect that health insurance premiums will cover necessary services for autistic children. This is a critical issue that needs to be addressed.
An early, intensive, appropriate treatment program will greatly improve the outlook for most young children with autism. Most programs build on the interests of the child in a highly structured schedule of constructive activities. Treatment is most successful when it is geared toward the child's particular needs. An experienced specialist or team should design the program for the individual child. A variety of therapies are available, including:
• Applied behavior analysis (ABA)
• Occupational therapy
• Physical therapy
• Speech-language therapy
Young children diagnosed with autism respond well to one-on-one treatment. This is expensive but results are very promising. They can improve educational performance and assist in developing social skills.
Diet and Autism
There seems to be an obvious connection between diet and autism. This is not to say that diet causes autism, rather modifications to diet can improve how an individual lives with autism. Children with autism appear to respond to gluten-free or casein-free diets. Gluten is found in foods containing wheat, rye, and barley. Casein is found in milk, cheese, and other dairy products. Autism can also be related to food sensitivities and allergies. Identifying and avoiding these foods can also help. The following are tips to keep in mind:
• Use nutritional supplements, including certain vitamins, minerals, amino acids, and essential fatty acids
• Test for food allergies
• Modify diet based on sensitivity
• Treat intestinal bacterial/yeast overgrowth
• Begin heavy-metal detoxification
• Minimize environmental issues
If you are considering these or other dietary changes, talk to both a doctor who specializes in the digestive system (gastroenterologist) and a registered dietitian. You want to be sure that the child is still receiving enough calories and a balanced diet.
There is no medicine that treats the underlying problem of autism. Your child may have behavior modification drugs prescribed to control behavior, however make sure that you discuss the side effects of these with your provider and be cautious of long-term effects these drugs may have.
Although young children with autism may seem to prefer to be by themselves, one of the most important issues is developing friendships with peers. It can take a great deal of time and effort for them to develop the social skills needed to be able to interact successfully with other children, but it is important to start early. In addition, bullying in middle and high school can be a major problem for students with autism, and the development of friendships is one of the best ways to prevent this problem.
Friendships can be encouraged informally by inviting other children to the home to play. In school, recess can be a valuable time for teachers to encourage play with other children. Furthermore, time can be set aside in school for formal “play time” between children with autism and volunteer peers. Typical children usually think that play time is much more fun than regular school, and it can help develop lasting friendships. Children with autism often develop friendships through shared interests, such as computers, school clubs, model airplanes, etc. Encourage activities that the autistic individual can share with others.
It should also be pointed out that the educational, therapy, and biomedical options available today are much better than in past decades, and they will continue to improve in the future. However, it is often up to parents to find those services, determine which are the most appropriate for their child, and ensure that they are properly implemented. Parents are a child’s most powerful advocates and teachers. With the right mix of interventions, most children with autism will be able to improve. As we learn more, children with autism will have a better chance to lead happy and fulfilling lives.
Beware that there are widely publicized treatments for autism that do not have scientific support, and reports of "miracle cures" that do not live up to expectations. If your child has autism, it may be helpful to talk with other parents of children with autism and autism specialists. Follow the progress of research in this area, which is rapidly developing. Autism remains a challenging condition for children and their families, but the outlook today is much better than it was a generation ago. At that time, most people with autism were placed in institutions. Today, with the right therapy, many of the symptoms of autism can be improved, though most people will have some symptoms throughout their lives. Most people with autism are able to live with their families or in the community.
Signs and Symptoms of ASD
The CDC characterizes the signs and symptoms of autism with a list of common behaviors. This is not a definitive list, but can be used as red flags to begin a conversation with your family doctor. They include:
>> Not responding to their name by 12 months old
>> Not pointing at objects to show interest by 14 months
>> Not playing "pretend" games by 18 months, like feeding a doll
>> Avoiding eye contact and wanting to be alone
>> Having trouble understanding other people's feelings or talking about their own feelings
>> Displaying delayed speech and language skills
>> Repeating words or phrases over and over
>> Giving unrelated answers to questions
>> Getting upset by minor changes
>> Having obsessive interests
>> Flapping their hands, rocking their body, or spinning in circles in response to stimuli
>> Having unusual reactions to the way things sound, smell, taste, look, or feel
Courtesy of the CDC
Autism360 provides a new way of listening to the voices of affected individuals, via an analytical system that uses individual input to produce an itemized, structured, and private record of your or your child's medical narrative. Autism360.org
Autism Research Institute is the hub of a worldwide network of parents and professionals concerned with autism to conduct and foster scientific research designed to improve the methods of diagnosing, treating, and preventing autism. Autism.com
Autism Speaks is dedicated to funding global biomedical research into the causes, prevention, treatments, and cure for autism. The goal is to raising public awareness about autism and its effects on individuals, families, and society; and to bringing hope to all who deal with the hardships of this disorder. AutismSpeaks.org
Center for Autism and Integrative Health is a consultative practice which integrates the care of children and adults with neurodevelopmental delays, including Autism Spectrum Disorder and other chronic illnesses. IHeathNow.org
Generation Rescue is an international movement of scientists, physicians, and parent-volunteers researching the causes and treatments for autism and helping more than 20,000 children begin biomedical treatment. GenerationRescue.org
HollyRod Foundation is dedicated to providing compassionate care to those living with Autism and Parkinson’s disease. HollyRod.org
Kartzinel Wellness Center practices what has been termed as Translational Medicine, which defined, is the ability to translate diverse scientific findings into therapeutic protocols for our patients. Kartzinel.com