• Knowledgebase: Behavioral, Developmental, and Emotional Problems

    Questions about behavioral and emotional problems, Autism, developmental delays.

    23. Autism - Top

    Alternative Names
    autistic disorder; infant autism

    Definition
    A condition occurring in young children before the age of 3 years characterized by unresponsiveness to human contact, deficits in language development, and bizarre responses to environmental stimuli.

    Causes, Incidence and Risk Factors
    The cause of autism is unknown but it may include psychological, physiological, and sociological factors. The autistic child is unresponsive to other people, communicates poorly, and may seem to be repulsed by physical contact. Parental behavior towards autistic children may seem distant and unaffectionate. This type of response from parents may be a reaction to the disorder rather than a cause of autism. The disorder has been associated with maternal rubella infection, phenylketonuria (an inherited disorder of metabolism), tuberous sclerosis (an inherited disease of the nervous system and skin), lack of oxygen at birth, encephalitis, and infantile spasms.


    Symptoms
    unresponsiveness to people
    lack of attachment to parents or caretakers
    rigid or flaccid muscle tone while being held
    little or no interest in human contact
    lack of attachment to parents or caretakers
    language impairment
    impaired speech or language onset in childhood
    meaningless repetition of words or phrases
    bizarre or repetitive behavior patterns such as uncontrollable head banging, screaming fits, arm flapping
    self-destructive behavior
    very distressed by minor changes in the environment
    overreaction or underreaction to sensory stimulus
    delayed mental and social skills
    Signs And Tests
    Appearance of symptoms before age 3 is a sign of the disorder. The Denver Developmental Screening Test (DDST) shows delayed development, especially of language and social skills. IQ test scores may be low because of lack of cooperation rather than lack of intelligence.


    Treatment
    Treatment of this disorder is very difficult and prolonged. Parents, teachers, and therapists work together in coordinated efforts to encourage social adjustment and speech development in the child. Positive reinforcement techniques such as offering food for appropriate behavior or language responses have been successful in promoting skills. Treatment may be in an institution, specialized school, day-care setting, or in the home. Family members may need counseling because they often feel guilty or inadequate.

    Expectations (Prognosis)
    Some children with autism may function below normal intellectual levels, while others may do well in school but have severe social impairments. Success in individual cases seems to be best with early recognition and intervention. Some children never do speak.

    Complications
    inability to care for self
    inadequate social skills
    self harm
    Calling Your Health Care Provider
    Call for an appointment with your health care provider if a child is non-responsive to people or the environment, a child has odd or peculiar speech, or a child exhibits behavior that may lead to self harm.


    Prevention
    Because the cause is unknown, prevention may not be possible.


    Support Groups
    The stress of illness can often be helped by joining a support group where members share common experiences and problems. See autism - support group.



    The information provided herein should not be used for diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions.

    - Updated: March 5, 2001

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    • James L Horwitz, MD

    David C. Thomas, MD

    Barbara Lindberg, PNP