The ability of parents to suspect that their baby may have autism is
very critical to early diagnosis and intervention. This article is aimed
at getting parents to the point where they are able to ask: Is this
autism or what? How early this question is answered in a child's life,
goes a long way to determine whether he/she will live a dependent or
independent life. A high index of suspicion is so important because
having had previous normal children does not exclude the possibility of
having an autistic baby.
The risk of having autism is highest
(90%) for a concordant twin of a known autistic kid. Other siblings have
only 35% risk of being diagnosed with autism. Autism usually presents
enough symptoms and signs for accurate diagnosis by the age of two. As
such many federal and state government programs for supporting autistic
children require that it is diagnosed before his/her second birth day
for them to qualify.
In response to the growth of autism as a
source of disability in the US, Congress passed the Children's Health
Act in 2000, mandating several activities that included the
establishment of a new autism research network. This legislation led to
the birth of five NIH institutes charged with the responsibility of
researching into the causes, diagnosis, early detection, prevention and
treatment of autism.
Yet a CDC autism survey in 2009 showed that 1
in 110 US kids was at risk of developing autism, with boys being four
to five times more likely to be affected than girls. A significant
number of high-functioning autistic kids diagnosed in 2000 are now in
their early twenties and need vocational employments as people with
liability. There are many federal, state and county programs currently
available to assist higher functioning autistic adults with independent
living, job procurement, community inclusion, speech therapy and mental
health care.
Since 2000 a lot has been learned about autism
neurobiology, diagnosis, intervention genetics, and services. The number
of autism support resources have also grown dramatically. One key
knowledge that has emerged from the various research efforts is that
autism is a broad spectrum disorder including several members of a group
of disorder known as pervasive developmental disorders (PDDs).
Autism
is therefore presently classified in the Diagnostic and Statistical
Manual of Mental Disorders, 4th Edition. (DSMV--IV-TR) as Autism
Spectrum Disorder (ASD). The DSMV-IV describes ASD as a group of five
pervasive brain. disorders (AD, AS, PDD-NOS, RD, and PCDD) which
variably impair a child's ability to communicate, socialize, behave
normally. and reason at age-appropriate levels. AD is the classic autism
disorder. AS is Asperger's Syndrome. PDD-NOS is Pervasive Developmental
disorders Not Otherwise Specified. RS IS Rett Syndrome while CDD is
Childhood Disintegrative Disorder.
The classic ASD is a
neuro-psychiatric developmental disorder affecting the brain in such a
way that an individual's communication, socialization, behavioral,
cognitive (reasoning) abilities are compromised to various extents. It
is the extent to which these adaptive skills are compromised that
differentiates one PDD from the other. It also accounts for the spectral
nature of autism. In severe ASD the IQ is substantially reduced adding
the fourth component, cognitive (reasoning) impairment to the picture.
This
same compromise accounts for the highly variable levels of disability
observed among individuals diagnosed with ASD. Some autism patients are
so minimally affected as in Rett disorder that they live independently
without supervision. Others are so severely affected, as in classic ASD,
that they need 24/7 residential care, as well as assistance with
activities of daily living (ADL).
The rest of the PDDs then fit in
at various levels between these two extremes. How ASD selectively
targets and alters the areas of the brain responsible for emotions,
speech, behavior and reasoning is still being actively researched. These
target areas include the limbic system (amygdala and nucleus
accombens), and the ventromedial prefrontal cortex and the frontal lobe.
The
understanding of how these areas have been genetically altered by other
disorders affecting them, coupled with observations in traumatic or
surgical lobotomy, have both provided some insight into the possible
risk factors for autism. What is known so far is that ASD is triggered
by multiple and random gene alterations (frame shift mutation or gene
duplication, or deletion), on chromosomes 15 and 16. Gene deletion or
duplication leads to a frame shift mutation, which in turn leads to the
production of a neutral protein, a destructive protein, or an enhancing
protein in the target areas of the brain.
