Kathmandu

Autism is a severely incapacitating lifelong developmental disorder that typically occurs in the first three years of life. It causes impairment or disturbance in three main areas: social skills, communicative (verbal as well as non-verbal) skills and production of repetitive and restricted behaviors. Autistic individuals may show abnormal responses to sensations. Any one or more of the senses may be affected. All these difficulties manifest themselves in behaviours i.e. abnormal ways of relating to people, objects and events in the environment.

Autism is known as a “spectrum disorder”, because the severity of symptoms ranges from a mild learning and social disability to a severe impairment, with multiple problems and highly unusual behavior. The disorder may occur alone, or with accompanying problems such as mental retardation or seizures. Autism is not a rare disorder, being the third most common developmental disorder, more common than Down’s Syndrome. Typically, about 20 in a population of 10,000 people will be autistic or have autistic symptoms. Eighty per cent of those affected by autism are boys.

A child with high functioning autism may have a normal or high IQ, be able to attend a regular school and hold a job later in life. However, this person may have difficulty expressing himself and may not know how to mix with other people. Moderately and severely affected children with autism will vary tremendously. Some autistic children do not ever develop speech, while others may develop speech but still have difficulty using language to communicate. Often, there is an unusual speech pattern, such as echoing whatever is said to them, repeating a word over and over, reversing “you” and “I” when asking for something and speaking only to express needs, rather than emotions.

How can you diagnose autism?

There are no medical or genetic tests that can detect autism. These can only rule out other conditions. A diagnosis of autism requires a sensitive and experienced doctor to observe the child very carefully, ask the parents about the development of the child, and then objectively follow internationally recognised criteria for diagnosis. Onset may occur at birth, or a child may have a period of normal development followed by a deterioration of verbal and social skills around 1 1/2-2 1/2 years. Where onset is at birth, the disorder can be detected as early as a year. Autism may occur alongside conditions such as mental retardation and hyperactivity, but the autistic traits in the person are typically what require attention.

What causes autism?

Current research indicates that anything that can produce structural or functional damage to the central nervous system can also produce the condition of autism. We know that certain viruses and known genetic conditions are associated with autism. In addition, there are families that have more than one child with autism. At present, it is believed that about 10 per cent of all cases can be accounted for genetically. Autism is not caused by an unhappy home environment, both parents working, mental stress during the pregnancy, poor handling by the mother, an emotional trauma, or other psychological factors. You cannot cause a child to become autistic.

Can it be prevented, cured or treated?

At present, there is no cure for autism. The only consistently effective treatment for autism is a structured training programme; therefore, a combination of a good school and parent training is the best known treatment. Autistic children can make significant progress if the intervention is appropriate and consistent. Early intervention, before the child is five, is especially crucial to the child’s progress. This is why an early and accurate diagnosis is so important. Autistic children grow to become autistic adults, and there is a particular need for meaningful outlets for social interaction and employment where possible.

Are people with autism also mentally retarded?

It is very difficult for people with autism to take an IQ test because they may have certain skills but are not able to use them or exhibit them in a test. About 50 per cent of people with autism are also mentally retarded. Autism can occur in association with other difficulties like cerebral palsy, dyslexia, Down’s syndrome, visual impairment and seizure.

(The article is jointly

contributed by Martin Moen Furre, Lars Espolin Johnson, Rune Laugsand and John

Ivar Sandvik)