Introduction/Definition
Autism is one of the pervasive developmental disorders characterized by difficulty with social interactions, impairment in communication, both verbal and nonverbal and a pattern of repetitive with a restricted pattern of movement. (Chiu 2011). Also, together with these aforementioned characteristics, autistic patients, they also have difficulties using language, relating with other individuals and also, properly interpreting and responding to the external world around them. Although the disorder begins in childhood, a diagnosis of autism is not made until the child is aged 3 years. However, the child would have been showing some symptoms of autism between the ages of 12-18 months. (Dryden-Edwards & Stoppler 2012)
Presentation
The usual presenting complaint is usually delayed in using language in preschool years. although this might not be the case if the child has a form of autism called higher function autism in which the prominent symptoms are behavioral problems at ages 4-5 years and social problems coming into the picture later. Autism persists throughout lifetime. (Chiu 2011)
Symptoms and Signs
Symptoms of autism that begin in early life include lack of attention. A child with autism would not make eye contact with a parent; the patient would also not smile when smiled to. The patient could also have other medical conditions like epilepsy, cerebral palsy, fragile x syndrome, tuberous sclerosis or congenital rubella among other medical conditions. The patients are also known to suffer from intellectual disability. They are known to have mental retardation. And of course, there is a history of deficiency in language development, social integration and social interaction. Autistic individuals also have stereotyped behaviors such as flapping of the hand and self-injurious behavior. (Dryden-Edwards & Stoppler 2012)
Owing to its characteristic as a spectrum disorder, autism presents with a wide range of symptoms, severity and clinical features. (Brasic 2012) The manifestation of the disorder differs from one individual to another. Affected individuals who show only mild symptoms of the disorder learn to live independent lives later in future while those manifesting severe symptoms of the disorder require lifelong supervision and care. Autism affects all races, socioeconomic and ethnic groups. 3-4 times more boys than girls are affected. As many as 2 million Americans have one form of autism. There is no cure for autism. (Brasic 2012)
Pathophysiology
Autism is a manifestation of neurologic abnormality. A strong link has been established in autistic children the exact cause, however, is not known. Researchers suspect that there are a number of genes that manifest synergistically to increase the risk of a child having autism. A monozygotic twin is said to have a 30% risk of having autism. The risk is also higher is first degree relatives of patients that have autism. Factors such as immunologic, environmental and metabolic factors have been implicated. 10% of autistic children are also said to have other underlying medical conditions. Like fragile X syndrome, a generic disorder, phenylketonuria, a metabolic disorder, brain developmental abnormalities, like macrocephaly, microcephaly and cerebral dysgenesis. (Brasic 2012)
Management
Management of the disorder begins with a proper evaluation of the patient to differentiate between autism and other pervasive developmental disorders. The treatment is individualized to each patient, because of the wide range of presentation patterns. (Dryden-Edwards & Stoppler 2012).The treatment is tailored along the line of behavioral, psychological and educational components. It is advised that the treatment is started in early childhood as soon as the diagnosis is confirmed because it has been shown that early commencement of treatment portends a better prognosis for the patient. Also, patients with high functioning autism - those that have mild symptoms, usually fare better than those with severe symptoms. (Brasic 2012)
References
J R Brasic (2012). Autism Treatment and management. Medscape Reference. Accessed on 22nd February 2012 from http://emedicine.medscape.com/article/912781-treatment
R Dryden-Edwards & M C Stoppler (2012). Autism. Emedicine health. Accessed on 22nd February 2012 from http://www.emedicinehealth.com/autism/article_em.htm
S Chiu (2011). Pervasive Developmental Disorder. Medsape Reference. C Paraki (Ed). Accessed on 22nd February 2012 from http://emedicine.medscape.com/article/914683-overview
