Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Medical Author: David Perlstein, MD FAAP
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR
It is commonplace to have a family member or close friend with a child
diagnosed with one of the autism spectrum disorders (ASDs, including
autistic
disorder, Asperger disorder,
pervasive developmental disorder). These are a set
of neurodevelopmental disabilities affecting young children and adults, which
are currently not considered "curable". The goals of management include
minimizing the symptoms and maximizing both independent function and quality of
life. These are not uncommon disorders. Their prevalence has been estimated as
approximately 6.5 per 1000 children, or 1 in every 150 children. Many believe
that there is an "Autism Epidemic." However, as with many diseases and
disorders, there are many reasons for this high prevalence.
Fortunately, significant media coverage and increased research have resulted
in a better educated public and more vigilant healthcare practitioners. It is
clear that early diagnosis and intervention are associated with better outcomes.
The American Academy of Pediatrics (AAP) published an updated guide
for the "Management of Children with Autism Spectrum Disorders." In this publication, both background
information and management choices are reviewed. In addition the AAP's approved
"Surveillance and Screening Algorithm: Autism Spectrum Disorders (ASDs)" is
introduced. Currently this translates into the following: All children should be
screened for autism at 18 months and again at 2 years of age, and at any time a
parent raises a concern about autism spectrum disorders (even if they have no signs of developmental
delay). Although many health care practitioners were already screening, the
process has been formalized and I expect that even more children will be
referred, resulting in earlier diagnosis and intervention.
Autism is characterized by impaired development in social interaction, communication, and behavior.
The degree of autism varies from mild to severe.
Severely afflicted patients can appear to have a profound intellectual disability.
Research tends to continue to refute the idea that immunizations cause
autism.
The cause of autism is unknown.
The optimal treatment of autism involves an educational or vocational
program that is suited to the developmental level of the child or adult,
respectively.
It is important for the unique medical and mental-health needs of
people with autism to be addressed in order to optimized both their life
expectancy and quality of life.
What is autism?
Autism is a developmental disorder that is characterized by impaired
development in communication, social interaction, and behavior. Autism afflicts
one out of every 100 to 166 children and it affects the lives of many children
and their families. It tends to affect about five boys to every one girl. Autism is classified as a pervasive developmental disorder (PDD), a category of disorders that is often described interchangeably with the broad spectrum of developmental disorders affecting young children and adults called 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. Some of the past confusion about the disorder has been resolved.
What are the symptoms and signs 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:
Individuals 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, persons with this disorder are capable of showing
affection, demonstrating affection bonding with their mothers or other
caregivers. However, the ways in which individuals
with autism 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.
Epilepsy is a brain disorder in which the person has seizures. There are two kinds of seizures, focal and generalized. There are many causes of epilepsy. Treatment of epilepsy (seizures) depends upon the cause and type of seizures experienced.
Learning disabilities can cause an individual to have trouble learning and using skills such as reading, listening, writing, reading, speaking, reasoning, and performing mathematics. There is no cure for learning disabilities. Parents and teachers working together to properly diagnose learning disabilities can properly plan a course of education. For some, medication may be appropriate as complimentary treatment.
Fragile X syndrome is the most common inherited form of mental retardation. It's caused by a mutation on the X chromosome. People with Fragile X syndrome suffer from physical, social, emotional, speech, language, sensory, intelligence, and learning impairments. There is no definitive treatment for Fragile X, though there are ways to minimize the symptoms.
Learn about mitochondrial disease, genetic disease in which include a group of neuromuscular diseases that are caused by damage to the mitochondria Common mitochondrial myopathies include Kearns–Sayre syndrome, myoclonus epilepsy, and mitochondrial encephalomyopathy. Symptoms of mitochondrial disease include heart failure, exercise intolerance, dementia, muscle weakness, movement disorders, deafness, blindness, stroke-like episodes, and more. There is no specific treatment for mitochondrial disease.
Pervasive development disorders (PPDs) are conditions involving developmental delays in children. There are five types of PDDs: autism, Asperger's syndrome, childhood disintegrative disorder, Rett's syndrome, and pervasive development disorders not otherwise specified (PDDNOS).
Asperger's syndrome (AS, Asperger syndrome, Asperger disorder) is an autism spectrum disorder. Asperger's syndrome is characterized by a degree of impairment in language and communication skills, and repetitive or restrictive thoughts or behaviors. The most common symptom of Asperger's syndrome is the obsessive interest in a single object or topic. Other conditions that may co-exist with Asperger's syndrome include: ADHD, tic disorders, depression, anxiety disorders, and OCD. Diagnosis of Asperger's syndrome is complicated, and treatment is generally directed toward minimizing the symptoms of the syndrome and behavioral and educational interventions.
Seizures are divided into two categories: generalized and partial. Generalized seizures are produced by electrical impulses from throughout the brain, while partial seizures are produced by electrical impulses in a small part of the brain. Seizure symptoms include unconsciousness, convulsions, and muscle rigidity.
Good parenting helps foster empathy, honesty, self-reliance, self-control, kindness, cooperation, and cheerfulness, says Steinberg, a distinguished professor of psychology at Temple University in Philadelphia. It also promotes intellectual curiosity, motivation, and desire to achieve. It helps protect children from developing anxiety, depression, eating disorders, antisocial behavior, and alcohol and drug abuse.
Landau-Kleffner syndrome (LKS, infantile acquired aphasia, acquired epileptic aphasia, or aphasia with convulsive disorder), a childhood disorder that occurs between the ages of 3 and 7, is characterized by the sudden loss of speech, epileptic seizures, depression, hyperactivity, and aggressiveness.
Children with auditory processing disorders often do not recognize subtle differences between sounds in words, even though the sounds themselves are loud and clear. Symptoms of auditory processing disorder include low academic performance, behavior problems, language difficulty, difficulty reading, and trouble paying attention. Treatment may involve auditory trainers, environmental modifications, auditory memory enhancement, and auditory integration training.
Children's health is focused on the well-being of children from conception through adolescence. There are many aspects of children's health, including growth and development, illnesses, injuries, behavior, mental illness, family health and community health.
Face blindness (prosopagnosia) is a condition that causes the inability to recognize faces. Face blindness may be caused by stroke, traumatic brain injury, or certain neurodegenerative diseases. Treatment involves helping the patient develop compensatory strategies.
Autism spectrum disorders (ASDs) are developmental disorders that do not appear to be linked to vaccines. More people than ever are being diagnosed with an ASD, including adults. Children with autism may receive special education services. A child with an ASD may or may not have a mitochondrial disease.
Few experiences match the drama of a convulsive seizure. A person having a severe seizure may cry out, fall to the floor
unconscious, twitch or move uncontrollably, drool, or even lose bladder control. Within minutes, the attack is over, and the person regains consciousness but is exhausted and dazed. This is the image most people have when they hear the word epilepsy. However, this type of seizure -- a
generalized tonic-clonic seizure -- is only one kind of epilepsy. There are many other kinds, each with a different set of symptoms.
Epilepsy was one of the first brain disorders to be described. It was mentioned in ancient Babylon more than 3,000 years ago. The strange behavior caused by some seizures has contributed through the ages to many superstitions and prejudices. The word epilepsy is derived from the Greek word for "attack." People once thought that those with epilepsy were being visited by demons or gods. However, in 400 B.C., the early...
