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Autism

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Autism is a neuronal disorder in which the patients portray improper social interactions and communication. It ties the patient to limited and repetitive behavior the disorganization of neuronal components within the brain. The disorganization of the neuronal connections such as synapses leads to three possible disorders that fall under the Autism Spectrum; Asperger’s Syndrome, Pervasive Developmental Disorder and Autism itself. The actual details of the disorganization of neuronal connections are not known. The social skills of the child are significant in diagnosing the disorder. Linguistic proficiency and behavior are also crucial markers in the diagnostic process. Management of the disorder aims at reducing the insufficiencies and distress that result from the disease. Psychosocial means of treatments like family support and special education are the ones that enable their functional independence. Creative therapies, special diets, acupuncture, chelation therapies and other sensory-based diets are also fundamental in the management of autism.

Pathophysiology of Autism

Neuronal Anomalies

The configuration of cells within the brain of children suffering from autism is improper leading to the impairment of its functioning. The frontal lobe, temporal lobe and the cerebellum both exhibit these anomalies. In childhood, the amygdala and the hippocampus hypertrophy are enlarged. The density of neurons within the prefrontal cortex of autistic children is higher than that in normal children. Post-mortem autopsies reveal that the cingulated and fusiform gyri has fewer than normal gamma-aminobutyric acid-B receptors. The cingulate gyrus is crucial in social relations, cognitions and emotions. The fusiform gyrus functions in face evaluations and noticing facial expressions. (Frith, 1989)

Metabolic anomalies

Imbalances in some neurotransmitters and hormones also lead to behavioral disorders such as autism. Serotonin and some other neuro-peptides like anti-diuretic hormone and oxytocin cause disorders in relational behaviors if their proportions are imbalanced.
Serum biotinidase that enables metabolism (use and recycling) of biotin is essential in maintaining the behavioral functions of an individual. Insufficiency of this enzyme leads to change in relational behavior resulting in autistic manifestations.
The decreased composition of the blood of autistic children with the complement protein C4B leads to increased immune vulnerability.

Signs and symptoms

The areas mainly affected in children with autism are social interaction, language and behavior. Some of the signs of autism may appear in early infancy or they may appear later in life; months or years after birth. The signs of autism are not universal to every affected child, many affected children are showing various signs. In severe cases, the children have marked or complete impairment in communication and social interactions. Each child show unique behaviors and the common signs (in social skills) include; inability to respond to their names when called, poor eye contact when interacting with others. In their general interactions, they do not encourage holding and cuddling, seems not to hear what you say sometimes when addressing them, prefer being alone even when playing, do not seek for help or ask for something and do not seem to be aware of others feelings. (Howlin, Patricia & Anna Moorf, 1997)

In language, the child may have delayed speech development or be unable to speak completely. The child does not seem to understand simple questions and cannot follow simple instructions. The child may utter words and phrases (which he knows) repeatedly but does not know how to use them to make a coherent and understandable statement. In addition, they are profoundly affected in conversation, being unable to neither start nor maintain one. In their speech, their tone or rhythm is abnormal; they may use a singsong tone or a robot-like speech. Finally, they cannot maintain eye contact when making a request and they may lose previously acquired ability to say words or sentences. (Kim, 2000) (Rutter, 1978)

Behaviorally, the children perform repeated movements like rocking, spinning or hand flapping. With time, they develop specific rituals which, when slightly changed, makes them very upset. They are very restless, always in constant motion. Sometimes they may take a special interest in certain details of an object but cannot get the ‘big picture of the subject’. They display unusual behavior, like being oblivious to pain but very sensitive to light, sound and touch. Interestingly, they may show unusual food preferences, like eating only a few foods or craving things that are not food; like chalk. In their creative activities, they cannot engage in imitative or make-believe plays. They are not fearful of performing activities that may cause self-harm, such as head banging.

Most children with autism acquire knowledge or skills slowly and some have signs of lower than normal intelligence. In some cases, children with autism may show exceptional ability in a specific area, for example music. For those with least severe problems may lead normal or near normal lives.

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Management

Autism is incurable hence many parents seek out alternative and complementary therapies. The main resources for treatment are families and educational system. For instance, some parents choose to supplement educational and medical intervention with art therapy focused on reducing the child’s sensitivity to touch and sound. Taking shifts (among family members) to look after the child with autism to prevent burnout since it can be an around the clock job. Also, seeking out other families with children having same impairment can offer support, since they can exchange advice on how to care for the children. This can as well help them to form support groups for parents and children with autism. Families of children with autism should take time to learn about the disorder, to counter the many myths and misconceptions about the disease. This can help them to appreciate the children and understand their attempts to communicate.

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