Autism Disease

BASICS

DESCRIPTION

Autism is a pervasive developmental disorder of early childhood characterized by severe impairment in:

Effective social skills
Absent or impaired language development
Repetitive and/or stereotyped activities and interests, especially inanimate objects
System(s) affected: Nervous
Genetics: High concordance in monozygotic twins, increased prevalence in siblings
Incidence/Prevalence in USA: 3-5 per 10,000 school age children
Predominant age: Onset prior to age 3, but generally abnormal development is apparent well before
Predominant sex: Male > Female (5:1)

SIGNS AND SYMPTOMS

Impairment in social interaction:
- Inadequate or lack of use of multiple non-verbal behaviors, such as postures and facial expression
- Failure to develop appropriate peer relationships
- Lack of sharing interests and achievements
- Lack of social and/or emotional reciprocity
Communication impairment:
- Delay or lack of development of spoken language without accompanying alternative modes of communication
- Impairment in initiating and sustaining conversation
- Idiosyncratic language with stereotyped or repetitive usage
- Lack of developmentally appropriate play, especially imitative
Repetitive and stereotyped patterns of behavior:
- Abnormal preoccupations either in intensity or focus
- Inflexibility to non-functional activities
- Stereotyped or repetitive motor mannerisms
- Stereotyped or repetitive motor mannerisms

CAUSES

Unknown

RISK FACTORS

Associated with increased risks during pregnancy, labor and delivery. Maternal rubella.

DIAGNOSIS

LABORATORY

N/A (other than to rule-out associated conditions)

Drugs that may alter lab results: N/A
Disorders that may alter lab results: N/A

PATHOLOGICAL FINDINGS

N/A

SPECIAL TESTS

Psychological testing using early childhood instruments, such as the Bailey or using non-verbal instruments, such as the Leiter
Intellectual level needs to be established and monitored, as it is one of the best measures of prognosis
EEG to rule-out brain damage and associated conditions. Autistic children have a markedly higher incidence of epilepsy which increases with age.

IMAGING

Could be useful in ruling out associated conditions

DIAGNOSTIC PROCEDURES

Developmental history
Psychiatric examination
Psychological testing
Comprehensive language assessment

TREATMENT

APPROPRIATE HEALTH CARE

Comprehensive structured educational programming of a sustained and intensive design

GENERAL MEASURES

Parent support groups and respite programs

SURGICAL MEASURES

N/A

ACTIVITY

As tolerated by the child

DIET

No special diet

PATIENT EDUCATION

The Autism Society of America, 8601 Georgia Ave., Suite 503, Silver Spring, MD 20910; 301-565-0433
Atwood T, Wing L. Asperger's Syndrome: A Guide for Parents and Professionals, Jessica Kingsley Publisher, 1997
Siegel B. The world of the autistic child: understanding and treating autistic spectrum disorders. Oxford, England, Oxford University Press

FOLLOW UP

PREVENTION/AVOIDANCE

None known

POSSIBLE COMPLICATIONS

Increasing incidents of seizure disorders

EXPECTED COURSE AND PROGNOSIS

Prognosis is closely related to initial intellectual abilities with only 20% functioning above the mentally retarded level
Communicative language development before age five is also associated with a better outcome
The general expected course is for a life-long need of supervised structured care. Only 1-2% become independent.

MISCELLANEOUS

ASSOCIATED CONDITIONS

Mental retardation
Attention deficit/hyperactivity disorder
Phenylketonuria, tuberous sclerosis, and fragile X syndrome

AGE-RELATED FACTORS

Pediatric: Onset seen only in children under three
Geriatric: N/A
Others: N/A

PREGNANCY

Increased risk of autism in complications of pregnancy, labor and delivery

OTHER NOTES

Refer also to Asperger's syndrome

ABBREVIATIONS

N/A

Clinical Investigations

ROLE OF HOMOEOPATHY

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