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.
Since autism was first added to the psychiatric literature about fifty years ago,
there have been numerous studies and theories about its causes. Researchers still
have not reached agreement regarding its specific causes. First, it must be
recognized that autism is a set of a wide variety of symptoms and may have many
causes. This concept is not unusual in medicine. For instance, the set of
symptoms that we perceive of as a "cold" can be caused by literally hundreds of
different viruses, bacteria, and even our own immune system.
Although some remain convinced that certain vaccines, vaccine preservatives
or medications taken to treat side effects of vaccines that may cause autism,
conventional wisdom continues to agree that immunizations do not cause autism.
Autism is thought to be a biologically-based disorder. In the past, some researchers had
suggested that autism was the result of poor attachment skills on the part of
the mother. This belief has caused a great deal of unnecessary pain and guilt on
the part of the parents of children with autism, when in fact, the inability of the
individual with autism to interact appropriately is one of the key symptoms of
this developmental disorder.
In support of a biological theory of autism,
several known neurological disorders are associated with autistic features.
Autism is one of the symptoms of these disorders. These conditions include:
some of the
inborn errors of metabolism (biochemical defects).
Autism, in short, seems to be
the end result or "final common pathway" of numerous disorders that affect brain
development. Also, brain studies have demonstrated that persons with autism tend
to have a number of abnormalities in brain size. In general, however, when clinicians make the diagnosis of autism,
they are excluding the known causes of autistic behaviors. However, as the
knowledge of conditions that cause autism advances, fewer and fewer cases will
likely be thought of as being "pure" autism and more individuals will be identified as
having autism due to specific causes.
There is a strong association between autism and
seizures. This association
works in two ways: First, many patients (20% to 30%) with autism develop
seizures. Second, patients with seizures, which are probably due to other
causes, may develop autistic-like behaviors. One special and often misunderstood
association between autism and seizures is the
Landau-Kleffner Syndrome. This
syndrome is also known as acquired epileptic aphasia. Some children with
epilepsy develop a sudden loss of language skills--especially receptive language
(the ability to understand). Many often also develop the symptoms of autism.
These children often, but not always, have a characteristic pattern of
electrical brain activity seen on EEG (electroencephalogram) during deep sleep
called electrographic status epilepticus during sleep (ESES). The usual age of
onset of language loss or regression is around four years of age, which makes the
Landau-Kleffner syndrome distinguishable from autism on these grounds, in that
autism usually is first exhibited in younger children. However, in recent years,
some children (very, very few) who did not exhibit overt (observable) seizures
were found to have Landau-Kleffner syndrome.
The importance of these findings is
that, although rare, the Landau-Kleffner syndrome can resolve spontaneously and
in some cases can be treatable with prednisone, a steroid medication related to
cortisone. This association between the Landau-Kleffner syndrome and autism has
led many clinicians and families to search for the typical EEG pattern (ESES) in
individuals with autism. This unusual EEG pattern is seen only in deep sleep, which
usually requires prolonged recordings of up to 12 hours. Many, many children and adults
with this disorder will display some abnormalities on their sleep EEG, but
probably very few have true Landau-Kleffner syndrome that will respond to
treatment.
It must also be noted that prednisone, in the very high doses used to
treat Landau-Kleffner syndrome, almost invariably produces side effects, which
may include weight gain, high blood pressure, diabetes, growth failure, stomach
ulcers, irritability, destruction of the hip joint, and susceptibility to
infectious disease (suppressed immune system). While most of these side effects
are reversible, some of the complications of high dose prednisone therapy can be
irreversible and even fatal.
Other treatments ranging from common anticonvulsant
therapy to surgery have been proposed and are being tried for Landau-Kleffner
syndrome. It is difficult to evaluate the true effects of any treatment for
Landau-Kleffner syndrome due to the high rate of spontaneous resolution of
symptoms (remission).
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.
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.
Asperger syndrome (AS, Asperger's syndrome) is an autism spectrum disorder. Asperger 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 syndrome is the obsessive interest in a single object or topic. Other conditions that may co-exist with Asperger syndrome include: ADHD, tic disorders, depression, anxiety disorders, and OCD. Diagnosis of Asperger syndrome is complicated, and treatment is generally directed toward minimizing the symptoms of the syndrome and behavioral and educational interventions.
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).
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.
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.
Neurology RSS
Healthy Living Tips
This site complies with the