As a parent, you may have come across the term "autism" or "ASD". This condition is difficult to understand, as it varies from person to person, but to get a general idea, here's some basic information to help you spot early signs and symptoms in your child:
What is autism Autism spectrum disorder (ASD) is a developmental disability caused by differences in the brain that manifests symptoms in areas regarding a person’s behavior, social relationships, language, and, sometimes, intelligence. It’s a “spectrum disorder” because the condition can range from mild to very severe, says the U.S. National Institute of Mental Health (NIH).
According to the American Academy of Pediatrics, autism affects 1 in 68 children, with boys five times more likely to be diagnosed with the condition than girls. In the Philippines, it ranks behind cerebral palsy as the second most frequently diagnosed developmental disorder, according to the Autism Society of the Philippines as reported by Business Mirror.
It used to be that several conditions like Asperger syndrome, autistic disorder and pervasive developmental disorder not otherwise specified (PDD-NOS) were diagnosesd separately from autism. Now, they’re all called and diagnosed with ASD.
Persons with ASD behave, communicate, interact and learn differently from most people. One notable trait of people diagnosed with autism is their inclination towards repetitive behavior and interests. But because autism has such a wide spectrum, there can be great differences between persons diagnosed with it. “The learning, thinking, and problem-solving abilities of people with ASD can range from gifted to severely challenged. Some people with ASD need a lot of help in their daily lives; others need less,” says the U.S. Centers for Disease Control and Prevention (CDC).
The cause of autism is still unclear, though experts think it’s a genetic condition that develops during early pregnancy and is caused by multiple factors which include genetics, parents’ age, and environmental toxins, among others. Children with certain conditions (like Rett syndrome and tuberous sclerosis) are also more likely to have it. The American Academy of Pediatrics (APA), the CDC, and a number of large studies have all found and state that there is no evidence to show that vaccines cause autism.
Does your child have it? Signs and symptoms of ASD usually show up by the time the child is 2 or 3 years old. Some babies with autism seem to develop normally until around this age when they stop gaining new skills or lose the ones they already have.
“Studies have shown that one-third to half of parents of children with an ASD noticed a problem before their child’s first birthday, and nearly 80 to 90 percent saw problems by 24 months of age,” says the CDC. The APA recommends all children be screened for autism on their 18-month and 24-month checkup.
As with most developmental conditions, early detection is crucial. “You will not lose anything with early consultation with professionals,” says Dr. Lourdes C. Sumpaico-Tanchanco, a developmental-behavioral pediatrician at The Medical City, and faculty member of the Ateneo School of Medicine and Public Health. “Early intervention gives you the opportunity to improve your child’s later outcome.”
Signs and symptoms As already mentioned, autism is different for every child. Though autism does have typical red flags, the combination of symptoms (evident in a child’s social skills, ability to communicate, behavior and intelligence) and its severity can vary greatly.
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The symptoms below, as listed by the CDC and APA, need not be all present to indicate ASD.
Red flags In toddlers
Does not respond to their name by 12 months old
Does not point at objects (like an airplane in the sky) by 14 months old
Does not play pretend games (like pretending to feed a doll) by 18 months old
Avoids eye contact
Has trouble understanding other people’s feelings or talking about their own feelings
Has delayed speech and language skills
Repeats words over and over again
Easily upset by minor changes
Has obsessive interests
Flaps his hands, rocks his body or spins in circles
Reacts unusually to the way things sound, smell, taste, look or feel
Social skills “Social issues are one of the most common symptoms in all of the types of ASD,” says the CDC, and they can cause serious problems in a child’s life. Again, these vary a lot. Some children with ASD might not be interested in other people at all. Others might want friends, but don't know how to develop friendships stemming from a difficulty understanding feelings and personal space boundaries.
Most children with autism have a hard time with sharing and taking turns. Many are sensitive to being touched and do not like being held or cuddled. Other signs include: having flat or inappropriate facial expressions, refusing to be comforted by others when distressed, and preferring to keep interests to oneself.
Communication Some children with ASD can communicate very well. Some talk very little or not at all. Others only begin talking later in childhood. Persons with autism may also have difficulty understanding language or participating in conversation.
Many children who do speak usually go through a stage where they repeat things they hear. If you ask a child with autism a question, for example, he might respond by saying the question back.
Children with autism might also have a difficulty with gestures, facial expressions, body language, and tone of voice. They might not sense excitement when a person apeaks in a high-pitched voice, or realize that an upward-curving mouth -- a smile -- means a person is happy. They might also have trouble using these tones themselves, which is probably why some talk in a flat or robot-like voice.
Behavior People with autism usually thrive on routines and have difficulty with change. “A change in the normal pattern of the day—like a stop on the way home from school—can be very upsetting to people with ASD. They might ‘lose control’ and have a ‘melt down’ or tantrum, especially if in a strange place,” says the CDC.
A child with autism might also spend a lot of time engaging in repetitive motions. He might often rock from side to side, flap his hands, walk on his toes or spin around in circles. Other behavioral symptoms include:
Playing with toys the same way every time
Playing with parts of toys instead of the whole toy (e.g., spinning the wheels of a toy truck)
Lining up toys or other objects
Being seemingly unable to feel pain
Being very sensitive, or not sensitive at all to smells, sounds, lights, textures, and touch
Unusual use of vision or gaze—looks at objects from unusual angle
Treatment ASD has no cure, but treatment can greatly improve the outcome of the condition as the child grows older. Treatment and intervention is based on the child’s individuality. “All interventions will rely on diagnoses and assessment results,” explains Dr. Edilberto I. Dizon, a pediatrician, SPED diagnostician, and counselor at Child Find Therapy Center. He is also a professor in the College of Education at the University of the Philippines in Diliman, Quezon City.
“The assessment results can tell us what the child can and cannot do. Based on that, we’ll be able to design a program which will help determine where to put the child, what to teach him, and how to teach him. Without assessment results, we will not know how to tackle it because each child is unique,” he adds.
Treatment can involve special education, behavioral therapy, social skills training, speech and language therapy, and physical therapy. Medication is sometimes prescribed to help with symptoms that may come with autism like anxiety, depression and hyperactivity.
“Parents who first hear of the diagnosis of autism often grieve over the ‘loss’ of their child,” says Dr. Tanchanco. She and Dr. Dizon both highly encourage and recommend building and finding a support system. Ask all the members of the household to participate in carrying out interventions and treatment. Talking to other parents who also have children with autism will help a lot. Avoid those who only vent and complain, and find other parents who are positive and uplifting. Reach them through organizations like the Autism Society of the Philippines.