MedicineNet.com
  MedicineNet home Picture Slideshows Diseases and conditions Symptoms and signs Procedures and tests Medications Health and Living Health news and views MedTerms medical dictionary  
Font Size
A
A
A


Autism

Revising Medical Author: Roxanne Dryden-Edwards, MD
Revising Medical Editor: William C. Shiel, Jr., MD, FACP, FACR

Patient to Patient

Autism Awareness: Interview with Nancy D. Wiseman

Reviewed by William C. Shiel Jr., MD, FACP, FACR

Lear the Early Red Flags and Warning Signs of AutismCould It Be Autism? A Parent's Guide to the First Signs and Next Steps
MedicineNet interviews author and mother of an autistic child, Nancy Wiseman

MedicineNet asks: Why are symptoms of autism sometimes evident at an early age, while at other times, the symptoms develop at age 2?

Nancy: Often parents will miss the earliest signs, like lack of joint attention, gestures, or social reciprocity (the cornerstone of healthy development). Instead, they notice that their child is delayed in language or that they are not responding to their name when called. This is why it is so important that parents and professionals learn the critical, yet often overlooked, milestones for social, emotional, and communication development. Even before you see warning signs, it's imperative that parents chronicle the milestones and share them with their pediatrician.

At 4 months, is your child…

  • Following and reacting to bright colors, movement, and objects?
  • Turning toward sound?
  • Showing an interest in watching people's faces?
  • Smiling back when you smile?

When my daughter's first words came in, I counted the number of words because my pediatrician asked me at every well visit how many words she had. I didn't know that the quality of words was more important than the quantity. At two, my daughter had only four words and they were not meaningful words. Some were words that she echoed after hearing me speak them.


Patient to Patient

What is autism?

Autism is a developmental disorder that is characterized by impaired development in communication, social interaction, and behavior. Autism is classified as a Pervasive Developmental Disorder (PDD), which is part of a broad spectrum of developmental disorders affecting young children and adults--the Autistic Spectrum Disorders (ASD). The range of these disorders varies from severely impaired individuals with autism to other individuals who have abnormalities of social interaction but normal intelligence--Asperger's syndrome. The ways in which autism is exhibited can differ greatly. Additionally, autism can be found in association with other disorders such as mental retardation and certain medical conditions. The degree of autism can range from mild to severe. Mildly affected individuals may appear very close to normal. Severely afflicted individuals may have an extreme intellectual disability and unable to function in almost any setting.

In the past, autism has been confused with childhood schizophrenia or childhood psychosis, and may have been misunderstood as schizotypal personality disorder in some adults. As additional research information about autism becomes available, the scope and definition of the condition continues to become more refined. Much of the past confusion about the disorder has been resolved.

What are the symptoms of autism?

The current Diagnosis and Statistical Manual of Mental Disorders–Fourth Edition, Treatment Revision (DSM–IV–TR) identifies three features that are associated with autism:

  • impairment in social interaction,
  • communication, and
  • behavior.

Impairment in social interaction

First, patients with autism fail to develop normal personal interactions in virtually every setting. This means that affected persons fail to form the normal social contacts that are such an important part of human development. This impairment may be so severe that it even affects the bonding between a mother and an infant. It is important to note that, contrary to popular belief, many, if not most, autistic persons are capable of showing affection and do demonstrate affection and do bond with their mothers or other caregivers. However, the ways in which autistic individuals demonstrate affection and bonding may differ greatly from the ways in which others do so. Their limited socialization may erroneously lead parents and pediatricians away from considering the diagnosis of autism. As the child develops, interaction with others continues to be abnormal. Affected behaviors can include eye contact, facial expressions, and body postures. There is usually an inability to develop normal peer and sibling relationships and the child often seems isolated. There may be little or no joy or interest in normal age-appropriate activities. Affected children or adults do not seek out peers for play or other social interactions. In severe cases, they may not even be aware of the presence of other individuals.

Communication

Communication is usually severely impaired in autistic persons. What the individual understands (receptive language) as well as what is actually spoken by the individual (expressive language) is significantly delayed or nonexistent. Deficits in language comprehension include the inability to understand simple directions, questions, or commands. There may be an absence of dramatic or pretend play and these children may not be able to engage in simple age-appropriate childhood games such as Simon Says or Hide-and-Go-Seek. Adults may continue to engage in playing with games that are for young children.

Autistic individuals who do speak may be unable to initiate or participate in a two-way conversation (reciprocal). Frequently the way in which an autistic person speaks is perceived as unusual. Their speech may seem to lack the normal emotion and sound flat or monotonous. The sentences are often very immature: "want water" instead of "I want some water please." Those with autism often repeat words or phrases that are spoken to them. For example, you might say "look at the airplane!" and the child or adult may respond "at airplane," without any knowledge of what was said. This repetition is known as echolalia. Memorization and recitation of songs, stories, commercials, or even entire scripts is not uncommon. While many feel this is a sign of intelligence, the autistic person usually does not appear to understand any of the content in his or her speech. For more, please read the Autism and Communication article.

Autistic persons often exhibit a variety of repetitive, abnormal behaviors. There may also be a hypersensitivity to sensory input through vision, hearing, or touch (tactile). As a result, there may be an extreme intolerance to loud noises or crowds, visual stimulation, or things that are felt. Birthday parties and other celebrations can be disastrous for some of these individuals. Tags on clothing may be perceived as painful. Sticky fingers, playing with modeling clay, eating birthday cake or other foods, or walking barefoot across the grass can be unbearable. On the other hand, there may be an underdeveloped (hyposensitivity) response to the same type of stimulation. This individual may use abnormal means to experience visual, auditory, or tactile (touch) input. This person may head bang, scratch until blood is drawn, scream instead of speaking in a normal tone, or bring everything into close visual range. He or she might also touch an object, image or other people thoroughly just to experience the sensory input.

Autistic children and adults are often tied to routine and many everyday tasks may be ritualistic. Something as simple as a bath may only be accomplished after the precise amount of water is in the tub, the temperature is exact, the same soap is in its assigned spot and even the same towel is in the same place. Any break in the routine can provoke a severe reaction in the individual and place a tremendous strain on the adult trying to work with them.

There may also be non-purposeful repetition of actions or behaviors. Persistent rocking, teeth grinding, hair or finger twirling, hand flapping and walking on tiptoe are not uncommon. Frequently, there is a preoccupation with a very limited interest or a specific plaything. A child or adult may continually play with only one type of toy. The child may line up all the dolls or cars and the adult line up their clothes or toiletries, for example, and repeatedly and systematically perform the same action on each one. Any attempt to disrupt the person may result in extreme reactions on the part of the autistic individual, including tantrums or direct physical attack. Objects that spin, open and close, or perform some other action can hold an extreme fascination. If left alone, an autistic person may sit for hours turning off and on a light switch, twirling a spinning toy, or stacking nesting objects. Some individuals can also have an inappropriate bonding to specific objects and become hysterical without that piece of string, paper clip, or wad of paper.



Next: What causes autism? »


Printer-Friendly Format  |  Email to a Friend


space Related health and medical articles From the Doctors at MedicineNet.com MedicineNet Doctors recommend space
space
MedicineNet Doctors Recommend
  • Epilepsy (Seizure Disorder) - Learn about epilepsy, or seizure disorder. Causes include head injury, trauma, prenatal injury, poisoning, medications, stroke, heart attacks, alcoholism, infection, and more. Symptoms, diagnosis, and treatment information is included in the information. Source:Government
  • Measles - Learn measles (rubeola) causes, signs and symptoms (rash, fever, Koplik spots), transmission facts and disease prevention (measles, mumps and rubella vaccination). Source:MedicineNet
  • Fragile X Syndrome - Read about Fragile X syndrome (FXS or Martin-Bell syndrome) causes, signs, symptoms, and treatments. Learn the facts about the most common inherited form of mental retardation. Source:Government
  • Read 168 more Autism related articles ...
Latest Medical News
space

Women's Health

Find out what women really need.




Topics Related to Autism

Autism
RSS FeedSpecialty RSS       Add to My Yahoo! What is this?

Early Diagnosis of AutismEarly Diagnosis of Autism
The sooner a child with autism is diagnosed, the sooner intervention can start. See more WebMD Videos »








Adult Skin Problems Slideshow




Health categories:

News & Views | Diseases & Conditions | Symptoms & Signs | Procedures & Tests | Medications | Health & Living | Medical Dictionary

Popular health centers:

Allergies | Arthritis | Cancer | Diabetes | Digestion | Healthy Kids | Heart | Men's Health | Mental Health | Women's Health | More...

Publications:

ePublications (PDFs) | XML News via RSS | Audio Podcasts | Email Newsletters

MedicineNet.com:

About Us | Privacy Policy | Search Help | Site Map | WebMD® | Medscape® | eMedicine® | eMedicineHealth® | RxList®

HON Code We comply with the HONcode standard for health trust worthy information:
verify here.

©1996-2008 MedicineNet, Inc. All rights reserved. Notices and Legal Disclaimer.
MedicineNet does not provide medical advice, diagnosis or treatment. See additional information.