Whenever I encounter the word “autism,” whether in conversation, or seeing it in an article, or hearing it in a public service announcement on the radio, I probably have the same reaction that most people have who are unfamiliar with the condition—What is it exactly? How can it be treated? Can a person with autism still lead a productive and happy life?
These questions are especially important to a surprisingly large group of people, a group that seems to be growing since the 1990s. The incidence of autism was, for many years, about 5 in 10,000 births; now it is about 60 in 10,000, though it’s possible that the higher number may be the result of a broader definition of the condition. The Centers for Disease Control estimates that 1 in 88 children is diagnosed with some form of autism. Curiously, autism occurs in boys about four times as often as in girls.
In any case, autism—autism spectrum disorder (ASD)—is very real. It is a severe developmental disorder that begins at birth or within the first three years of life. Autism affects the brain’s normal development of social and communication skills. It is not immediately obvious in many cases, because most autistic children are perfectly normal in appearance. But they exhibit puzzling and disturbing behaviors which are very different than those of typical children.
Early indicators of autism include no babbling or pointing by age 1 and/or no single words spoken by 16 months or no two-word phrases by age 2. The most common and noticeable sign of autism is impaired social interaction. This can include being withdrawn, not responding to their own name, not making friends, not entering into kids’ games, lack of eye contact, treating others as objects, preferring to be alone, and lack of empathy. Another sign is problem with communication. It’s common for an autistic child to have problems with social conversation, have slow (or not any) language development, or use gestures instead of words to communicate. Children with autism may not react well to changes in routine (In fact, they may fly into an uncontrollable rage). Repeated body movements (such as constant rocking or self-abusive head-banging), and unusual attachments to objects are more signs of autism. Autistic people may become easily startled, or not affected at all, by loud noises, may have a heightened or low response to pain, and may have other sensitivities, such as those involving sight, touch, smell, or taste. Autism may manifest itself in intense temper tantrums, aggressive behavior to others (or self), short attention span, narrow range of interests, overactive or very passive behaviors, or getting stuck on a single topic or task.
Researchers aren’t entirely certain what causes autism, but they think that possibly both genetics and environment may play roles. Studies have found irregularities in the brain, causing the inability of various sections of the brain to effectively communicate with other parts of the brain. One question that is often asked, when addressing the possible causes of autism, is whether or not common vaccines are a cause. There are no studies indicating that childhood vaccines cause autism.
How is autism treated? Does it eventually go away as the person grows into adolescence and adulthood? Can it be managed well enough to enable the autistic person to live a “normal” productive life? I asked Kim Armitage, a pediatric occupational therapist at TOTS Therapy and Wellness Center in Midland. She stressed that early detection and treatment are of utmost importance. If a child is diagnosed with autism very early, then therapy can be much more effective because the nervous system is still developing; it’s still changeable, and with that the nervous system can be “taught” new behaviors. Since autism varies greatly in degree and nature, treatment has to be tailored specifically for the individual. Most treatment involves a behavior analysis and modification program, and it can also include medications, occupational therapy, speech-language therapy, and physical therapy. Ms. Armitage also mentioned the need to remember that the child with autism is a child, not a disease. She says that the best therapy is that which focuses on the child’s strengths and builds on them, not the weaknesses. In addition to early diagnosis and treatment, the other key to successful management of the disorder seems to be the degree of autism in the individual. Many high-level autistics can perform well in conventional classrooms and go on to lead productive lives. For example, Dr. Temple Grandin is a professor at a major university and world-renowned designer of livestock handling systems-—and is autistic. She also lectures all over the world, enlightening her audiences about autism.
The biggest challenge to people with autism and their families is social interaction—everyday life. This becomes even more important as the child grows toward adolescence and adulthood, because teen peers can be quite cruel. Autism never goes away; it is not outgrown. But the simple act of going out to dinner can be a harrowing, embarrassing experience for a family with an autistic child. Sometimes the smallest, most unexpected thing can trigger an almost uncontrollable outburst, and the parents try to deal with it in front of “the whole world.” And the general public just sees what they think is a misbehaving child with bad parents who’ve never disciplined him. The public is not very forgiving. So simple things—like getting a haircut, going shopping, going to a movie—become things that many families with an autistic child just can’t do.
The previous paragraph is the most important one in this article. If you see a family with an out-of-control child at the mall or the grocery store, give the parents some slack. Don’t automatically assume that they’re bad parents who let their kids run wild. They may be working as hard as they can to try to raise an autistic child to become a normal, functioning adult. And this may be the best they can do.