Currently, the causes of autism are unclear. According to some theories, its appearance would be due to genetic and / or environmental factors.
The symptoms and signs of autism are very numerous and can vary greatly from patient to patient. Generally, the first manifestations of autism appear at an early age or during early childhood.
Diagnosis requires the involvement of a team of professionals and includes several tests and evaluative examinations.
Currently, autism is an incurable condition.
However, there are supportive treatments that can effectively limit various symptoms of the disease.
Their presence has effects on the emotional-behavioral sphere, on learning abilities, on memory, etc.
EPIDEMIOLOGY
According to some Anglo-Saxon research, in the United Kingdom, autism affects one in every hundred individuals, with a greater prevalence in the male population.
LATEST INDICATIONS OF DSM-V
The DSM, or Diagnostic and Statistical Manual of Mental Disorders, is a collection of all the peculiar characteristics of known mental and psychological diseases, including the respective criteria required for diagnosis.
In the "latest edition of the DSM (V edition), written in 2013, the term" autism "includes, in addition to" autism defined as poc ", other various problems of neurodevelopment, including: Asperger's syndrome, the disintegrative disorder of "childhood and pervasive developmental disorder.
The inclusion of these problems under the heading "autism" is explained by the fact that, according to psychiatrists, they are in effect subforms of autism.
This vision is definitely recent, since, up to the penultimate edition (DSM-IV), disorders such as Asperger's syndrome or childhood disintegrative disorder represented pathological entities in their own right.
MEANING OF DISEASE OF THE AUTISTIC SPECTRUM
Psychiatrists and psychologists often use the term "autism spectrum disease" to define autism.
The word "spectrum" refers to the wide range of symptoms and signs that autism can cause, and their considerable variability in severity.
At the present time, it is impossible to affirm the existence of a link between certain genes of the human genome and autism: in fact, no scientific evidence has shown with absolute certainty a genetic correlation between some genetic alterations (mutations) and the presence of any form of autism.
ENVIRONMENTAL FACTORS: THE HYPOTHESIS
Premise: an environmental factor is any circumstance, event or habit that can affect the life of an individual, to a certain extent.
According to the hypotheses of doctors and researchers, the environmental factors that could affect the presence of autism are:
- Premature birth. A birth is premature when it takes place at least three weeks before the fortieth and final week of pregnancy.
- The mother's intake of alcohol or certain medications (such as sodium valproate) during pregnancy.
- The massive exposure of the mother to very polluted environments.
- Maternal infections, contracted by the mother during pregnancy.
- The advanced age of the parents at the moment of conception.
Currently, the scientific evidence on this is still insufficient. This is why several experiments are underway, the aim of which is to demonstrate the effective connection between the aforementioned points and the condition of autism.
MALE INDIVIDUALS ARE PARTICULARLY AT RISK
As stated, autistic people are usually male.
According to some statistical research, the male: female ratio with autism is 4: 1.
Hence, the tendency of the male population to suffer from autism is 4 times higher than the female population.
MYTHS TO BE DISSOLVED
At one time, there were hypotheses that autism could derive from or had some connection with:
- Vaccination against measles, mumps and rubella (MMR vaccine).
- Exposure to thiomersal (or thimerosal), a vaccine preservative, also used in the preparation of: disinfectants for ophthalmological use, immunoglobulins, anti-poison serums, tattoo ink.
Over the past 10-15 years, several researches have shown that there is no link between the two aforementioned circumstances and autism.
Recently, several teams of scientists have debunked the myth that gluten and casein support the condition of autism and their elimination in the diet represents a therapeutic remedy. of a set of words or phrases.
In reality, however, their hearing abilities are almost always perfectly normal.
Some of these problems - including, for example, delayed language development or a preference for playing alone - can already be found in preschool age.
BEHAVIORAL SPHERE
The classic abnormal behaviors of an autistic child include:
- Perform repetitive movements, such as rocking back and forth or clapping your hands.
- Use the toys in different ways than their real purposes.
- To strongly depend on certain habits, so much so that a possible upheaval of the latter represents a real drama.
- Feeling strong attraction or marked repulsion towards foods, depending on their color or preparation.
- The tendency to smell toys, objects and people, for inexplicable reasons.
- Having very few interests, but manic. It is very common for autistic subjects to develop a particular attraction to certain activities or objects and to devote most of their daily time to them.
- Demonstrate a particular sensitivity to bright lights, certain sounds or physical contact (even when it is not painful).
- Being in constant motion.
IQ
Among people with autism, there are some with a lower than average IQ and poor learning skills, others with "normal intelligence, and still others - but this is a real minority - with specific skills in the field of mathematics or" art.
MOTOR SKILLS
Many people with autism show coordination problems and awkward movements.
SYMPTOMS IN ADULT AGE
In adulthood, the problems of a person with autism can improve - in some cases even clearly - or remain unchanged, if not even get worse.
WHEN TO SEE THE DOCTOR?
In the opinion of doctors, parents should have their child undergo specialist checks if:
- At the age of 6 months, does not smile or denotes any sign of joy / cheerfulness.
- At the age of 9 months, does not emit sounds and does not show particular facial expressions.
- At the age of 12 months, does not vocalize.
- At the age of 14 months, does not perform any return gesture, does not point, does not stretch, etc.
- At the age of 16 months, does not speak.
- At the age of 24 months, does not pronounce two-word sentences.
ASSOCIATED DISORDERS AND PATHOLOGIES
For reasons still unclear, autism is often associated with other diseases, including: some learning disorder (dyslexia, dyscalculia, etc.), attention deficit hyperactivity disorder (ADHD), Tourette's syndrome, "epilepsy," anxiety, dyspraxia, obsessive-compulsive disorder, depression, bipolar disorder, sleep disorders and tuberous sclerosis.
pediatricians and experts in speech problems - and provides a series of analyzes and evaluative tests.For a correct diagnosis of autism, it is also very important to consult the Diagnostic and Statistical Manual of Mental Disorders (DSM) and to compare the criteria reported therein and what has been observed with the various analyzes and evaluative tests.
At present, there is no specific diagnostic test for autism. This, for obvious reasons, makes it more difficult to determine whether an individual is autistic or not.
For most patients, the age of diagnosis is school (6-8 years).
A diagnosis of autism in adult individuals is very rare.
ANALYSIS AND EVALUATION TEST
Typically, analysis and assessment tests include:
- A physical examination, which serves to establish the exact nature of the symptoms. For example, a child who does not respond to their name may have an undiagnosed hearing disorder. With the physical examination, doctors clarify this and other similar aspects.
- An analysis of the genetic profile, to clarify if the individual under examination suffers from any genetic disease, among those previously reported (fragile X syndrome, Rett syndrome, etc.).
- A specialist test that evaluates social interaction, communication skills and behavior.
For this type of evaluation, the comparison between what was observed by the test taker and what was observed by parents and school teachers up to that moment is very important. - A specialist test that establishes language development.
- A neurological exam, for mental health assessment.
- A questionnaire, addressed to parents, which serves to clarify whether, in the family, there are (or have been) relatives with similar disorders to the individual under examination.
IMPORTANCE OF ACCURATE DIAGNOSIS
Accurately establishing the characteristics of autism on a case-by-case basis is very important, as it allows the specialist staff who are treating a particular patient to plan the most appropriate therapy.
pediatrician, a mental illness specialist, a learning disorder expert, a speech therapist and an occupational therapy expert.
SOME EXAMPLES OF TREATMENTS
The support treatments provided include:
- Cognitive-behavioral therapy. It is a form of psychotherapy, which aims to teach the patient how to recognize and master problematic (or inactive) behaviors.
Undergoing cognitive-behavioral therapy, an autistic patient should reduce their behavioral problems (for example, limit their manias or repetitive gestures) and learn new communication skills. - Educational interventions. They consist of planned activities, the purpose of which is to improve specific skills / abilities.
In the case of autism, educational interventions aim to improve communication skills, social skills and behavior. - Family therapy. It is a form of psychotherapy that affects the patient's entire family.
Briefly, it is based on the concept that parents, siblings and other close relatives play a decisive role in supporting their loved one during the therapeutic path foreseen for him.
To get good results from family therapy, it is good for the family to learn the characteristics of the disease and how to best help those affected.
Some tips for parents with an autistic child:
- Always use the child's name when addressing him.
- Make use of simple language.
- Speak slowly and articulate the words well. It may be useful to interpose pauses between one word and another.
- Accompany what is said with simple gestures.
- Give the child the right time to process what has been said.
ARE THERE ANY MEDICINES?
Despite the numerous scientific researches on the subject, at the present time there is no specific drug against autism.
However, it should be noted that, in some situations, doctors and psychotherapists use drugs to control certain symptoms or particular associated pathologies.
Possible medicines used in autism include: melatonin for sleep disorders, antidepressants (serotonin reuptake inhibitors) for depression, anticonvulsants for epilepsy, methylphenidate for ADHD and antipsychotics for "anxiety or" excessive aggression.
Remember that the aforementioned drugs can only be taken on prescription, as they can also have serious side effects on the person who uses them.
For further information: Medicines for the Treatment of Autism
SUPPORT FOR ADULTS
Adult individuals with autism can rely on the same supportive treatments provided for young autistic individuals and on a range of specific aids, which support them, for example, in finding a job or becoming independent.
