Autism is a pervasive developmental disorder that affects brain function. It is no longer considered a psychological condition or a psychiatric illness. Autism-ASD, is a severe and early developmental disorder of the child appearing before the age of 3 years. It is characterized by isolation, disruption of social interactions, language disorders, non-verbal communication and stereotyped activities with restricted interests. Three cumulative elements thus characterize autism:
- Communication disorder
- Disruption of social relations
- Behavioral disorders.
Autism is a developmental disorder of neurobiological origin diagnosed on the basis of characteristics of behavior and development. The notion of spectrum of autistic disorders includes both well-characterized clinical pictures and more atypical pictures. On one hand, we may see variability of symptoms in their severity or on the age of their appearance, and on the other hand we see the association with other disorders (retarded intellectual development, epilepsy for example). The manifestations of autism can vary from child to child and to the same child over time.
Characteristics of Autism
Autism is characterized primarily by poor social interaction. Parents are usually the first to detect the symptoms of autism in their child. In the infant stage, a baby with autism may not react to others, or concentrate carefully in one place for very long time.
An autistic child may seem to develop a sense of retreat and become indifferent to any social contact. Many children with autism have reduced sensitivity to pain, but are abnormally sensitive to sensations such as sound, touch, or other sensory stimulation. These unusual sensitivities may result in behavioral symptoms such as resistance to being cuddled or taken in the arms.
The autism spectrum is broad and heterogeneous, but many of these traits are common to children with autism or autistic disorders.
- Unconscious of the existence of the feelings of others.
- Often behaves as if no one is present.
- Does not respond when called, seems not to listen when talked to them, seems to have no emotions, avoids eye contact, does not respond to signs or affection.
- Does not have or has difficulty interacting with others
- Little or no interest in participating in the games or is unable to do so, remains alone without participating or carries out activities with a ritual character, does not react most of the time to the feelings and emotions of others.
- They need stability and a ritual to reassure. They often have trouble accepting change, even the smallest change can cause great fits of anxiety, for example if an object has been changed from one place to another. If the colors of the walls have changed. If the clock is placed differently.
- Difficulty using both verbal and non-verbal language to understand and communicate with others.
- Difficulties in understanding and using language, gestures and facial expressions correctly (ex: laughs when scolded, jumps when situations excites them.
- Excitement, anger, self-mutilation, aggressiveness, cries and tears appear in case of frustration. Sometimes they are inconsolable when they get into their fit of anger.
- Stereotyped Body Movements. Makes unusual and repetitive movements preventing them from concentrating enough on their activities (waving their hands, clapping their fingers, clapping their hands, rocking, making faces). These behaviors, which are difficult to restrict without targeted action, keep repeating as long as adapted behavior does not replace them.
Autism is no longer considered a psychological condition, it corresponds to a true neuro-developmental pathology linked to anomalies of the development of the central nervous system.
Autism often goes unnoticed in early childhood, it is usually with entering society (nursery, school, daycare) that the manifestations are obvious, by the difficulties of social interaction, problems of verbal and non-verbal communication, and repetitive behavior or restricted, even obsessive, interests. These behaviors have repercussions that range from mild to severe.
Autism occurs during the first 36 months of life. Sometimes signs are present almost immediately, from the first months of life, but sometimes these signs appear after a longer period or months of apparently normal development.
Autism is considered to last a lifetime, it interferes with development and learning of all kinds.
The heterogeneity of development is characteristic of autism and PDD, that is, certain areas of development get greatly affected than others. Special cognitive skills are also frequently found in people with autism. The clinical tables presented by people with autism or PDD are therefore very variable. Autistic disorders can be isolated, or associated with other anomalies, disorders or diseases.
It should be noted that there is no objective means (no blood tests, radiographic etc) to diagnose autism. The very important complementary examinations to be carried out are aimed at finding the frequent associated disorders.
In all cases, the diagnosis is clinical, based on the observation of the classic tripod:
- Qualitative alteration of social interactions
- Qualitative changes in communication
- Restricted, repetitive and stereotyped character of behavior, interests and activities
Causes of Autism
To date, no single cause has been found to autism and it is likely that several different causes can lead to the development of the signs of autism.
Current research strongly suggests that there are neurological and genetic bases. The idea that autism originates in disorders of the parent-child relationship is completely false.
The risk of autism does not depend on the social or educational level of the family or on ethnic origin. Research into the causes of autism calls for different scientific specializations and varied approaches.
Here is a brief overview of the main research trends:
The neuropsychological approach
It seeks to understand the cognitive functioning of people with autism.
- A deficit in executive functions, which means, the set of mental capacities that allow a person to manage his or her behavior, initiate an action, plan and organize it, be flexible in dealing with a task.
- A “central coherence weakness” – Central coherence is the function that makes it possible to put information in its context, to extract the significant information from all the information received, and to prioritize them. People with autism would prefer the treatment of detail to the loss of the whole. They would preferentially treat the perceptual aspects of the environment because of a lesser ability to access its meaning.
- A deficit of the “theory of mind” – This is the ability of an individual to attribute mental states to oneself and to others. This ability allows for example to interpret or predict the behaviors of others from the desires, beliefs or intentions that can be conveyed to the other. It allows to represent the social situations, to lie, to anticipate the consequences of an action. This difficulty would explain the disorders of socialization, communication and imagination.
The Study of the Peculiarities in the Treatment of Perceptions
According to experts the basic shortfall of autism would be a treatment of perception. Autistic people would preferentially treat perceptions in their elemental properties, especially in the visual and auditory domains. Other experts propose a shortage in the processing of complex information.
The neurobiological data
This research is based on the study of the morphology of the brain. The study of its functioning with new imaging techniques, and biological measurements.
These studies reveal differences in the morphology of the brain of people with autism. Differences in their developmental kinetics, abnormalities in information processing followed by abnormalities in the activation of different areas, and cerebral circuits with significant biological abnormalities.
The intervention of genetic factors among the causes of autism is now recognized. This would be a complex multi-genic transmission. Many genes have been detected from the study of differences between affected subjects, related subjects or healthy subjects. Currently only abnormalities on the genes q21-35 and chromosome 17q have been replicated significantly. The neuroligin genes, SHANK neurexin, also appear to be involved, affecting synaptic function by dysregulation of protein synthesis.
The perceptual, sensory and motor peculiarities of autistic persons would lead to disturbances in the constitution of the mind, in particular concerning the constitution of the image of the body. These difficulties would lead to an emotional overflow itself responsible for added difficulties in the development and organization of sensory perceptions and cognition.
Current psychoanalytic research is based on elements of concordance that have emerged in recent years between the data provided by neurosciences, the work of developmental psychology and the theories developed from the observation of babies, patients and empathic observations collected in treatments.
Cure For Autism
To date, there is no treatment capable of curing autism, and it is very difficult not to lose oneself before the multiplicity of care offered to meet the difficulties of autistic people. Currently, only one treatment is validated, compared to another in the management of autistic individuals.
There is however agreement on the following points:
- It is commonly recommended that the care of people with autism rests on three main components, the relative share of which must be adapted according to the characteristics of each person and his / her evolution. The three components are:
- Educational – independence of the subject
- Pedagogy – learning capability of the subject
- Therapeutic – mental and physical health of the subject
- The interest of early care is recognized. You should know, however, that a person with autism can continue to progress all his life, including in adulthood.
- The care must be sufficiently intensive.
- It must be individualized, that is to say adapted to the particularities of each person and regularly re-evaluated according to the evolution.
- So there is no cure of autism but different methods that may be more appropriate for some people, for certain difficulties, or at certain times of the development of the autistic person. Methods that are flexible, open, coordinating with several other methods of care are preferred. Common sense rules are also important (beware of techniques that exclude others or are too expensive).
- The use of medication may be indicated. It should be noted that pharmacological treatments are always symptomatic, that is to say they are aimed at reducing certain symptoms (such as agitation, anxiety, stereotypies or invasive rituals, sleep disorders etc) without treating the cause of autism. In general, these treatments are not devoid of side effects. These medications can make it possible to relieve an embarrassing symptom or to calm a period of crisis, but they can have an indirect impact on learning, communication or socialization.
- Always pay close attention to the physical health of the autistic person, whose somatic problems can be overshadowed by autistic symptomatology including communication and behavioral disorders.
Autism interferes in learning of all kinds and leads to a very heterogeneous development. Most symptoms, however, improve with time. The prediction depends on the existence and the importance of an associated mental retardation, the presence of epilepsy, the appearance of language before 6 years. An aggravation during puberty is frequent, which can last one to two years, with return to the previous state
In short, the symptoms varies from one autistic person to another. Some of them remain largely handicapped all their lives and do not have access to language, while others will arrive at a relatively good personal self-sufficiency. The overwhelming majority of people with autism require lifelong support.
Whether people with autism make much or little progress, they remain foreigners in our social world. Even the most advanced, those who seem the most independent, always run the risk of behaving in a strange and inadequate way. Each individual needs a sympathetic, compassionate and experienced person to advise and support him / her. Parents play this role as long as they can, but it is necessary for others to fulfill this role as a friend, advocate or guardian when no family member can. Autistic people find themselves isolated and solitary without deserving or desiring it. It is up to us to live, work with / for them, to be responsible for trying to ensure that support and reception structures are there, when they need them, and that there are provisions to assist and protect them.
For more information on autism visit autismhub.co.uk