Autism

Autism is a complex developmental disorder that appears in the first 3 years of life, although it is sometimes diagnosed much later. It affects the brain's normal development of social and communication skills.

Common features of autism include impaired social interactions, impaired verbal and nonverbal communication, problems processing information from the senses, and restricted and repetitive patterns of behavior.

The symptoms may vary from moderate to severe. Two related, milder conditions are Asperger syndrome and "pervasive development disorder not otherwise specified" (PDD-NOS).

Most parents of autistic children suspect that something is wrong by the time the child is 18 months old and seek help by the time the child is 2. Children with autism typically have difficulties in verbal and nonverbal communication, social interactions, and pretend play. In some, aggression -- toward others or self -- may be present.

Some children with autism appear normal before age 1 or 2 and then suddenly "regress" and lose language or social skills they had previously gained. This is called the regressive type of autism.

People with autism may perform repeated body movements, show unusual attachments to objects or have unusual distress when routines are changed. Individuals may also experience sensitivities in the senses of sight, hearing, touch, smell, or taste. Such children, for example, will refuse to wear "itchy" clothes and become unduly distressed if forced because of the sensitivity of their skin. Some combination of the following areas may be affected in varying degrees.

Communication:

• Lack of pointing to direct others' attention to objects (occurs in the first 14 months of life)
• Does not adjust gaze to look at objects that others are looking at
• Cannot start or sustain a social conversation
• Develops language slowly or not at all
• Repeats words or memorized passages, such as commercials
• Does not refer to self correctly (for example, says "you want water" when the child means "I want water")
• Uses nonsense rhyming
• Communicates with gestures instead of words

Social interaction:

• Shows a lack of empathy
• Does not make friends
• Is withdrawn
• Prefers to spend time alone, rather than with others
• May not respond to eye contact or smiles
• May actually avoid eye contact
• May treat others as if they are objects
• Does not play interactive games

Response to sensory information:

• Has heightened or low senses of sight, hearing, touch, smell, or taste
• Seems to have a heightened or low response to pain
• May withdraw from physical contact because it is overstimulating or overwhelming
• Does not startle at loud noises
• May find normal noises painful and hold hands over ears
• Rubs surfaces, mouths or licks objects

Play:

• Shows little pretend or imaginative play
• Doesn't imitate the actions of others
• Prefers solitary or ritualistic play

Behaviors:

• Has a short attention span
• Uses repetitive body movements
• Shows a strong need for sameness
• "Acts up" with intense tantrums
• Has very narrow interests
• Demonstrates perseveration (gets stuck on a single topic or task)
• Shows aggression to others or self
• Is overactive or very passive