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Infantile autism develops before 30 months of age and is characterized by impaired verbal and non-verbal communication, imaginative activity, and social interaction.

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Autism is a condition in which children are unable to develop normal relationships with others. It is diagnosed by the presence of characteristic disturbances in development.

About 4 of every 10,000 children are autistic, and 2 per 10,000 have some form of pervasive developmental disorder (PDD). PDD means that some, but not all, symptoms of autism are present.

Autism is a lifelong disease that ranges in severity from mild cases in which the autistic person can live independently, to severe forms in which the patient requires social support and medical supervision throughout his or her life.

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Causes and Risk Factors

There are physical bases for autism's development including genetic, infectious, and traumatic factors. Viral infection during the first trimester of pregnancy, rubella being one of the best studied culprits, is a suspected cause of autism.

Autism affects males four times more often than females, and there is a genetic basis for the disease.

Contrary to previous notions, autism is not induced by parents.

Two types of onset are reported. In one, the patient appears to have symptoms from the first months of life. In the second, an apparently normal course of development occurs until age 18 to 24 months, when the symptoms become manifested.

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The symptoms vary greatly but follow a general pattern. Not all symptoms are present in all autistic children.

Autistic infants may act relatively normal during their first few months of life before becoming less responsive to their parents and other stimuli. They may have difficulty with feeding or toilet training; may not smile in recognition of their parents' faces, and may put up resistance to being cuddled.

As they enter toddlerhood, it becomes increasingly apparent that these children have a world of their own. They do not play with other children or toys in the normal manner, rather they remain aloof and prefer to play alone.

Verbal and nonverbal communication skills, such as speech and facial expressions, develop peculiarly. Symptoms range from mutism to prolonged use of echoing or stilted language. When language is present, it is often concrete, unimaginative, and immature.

Another symptom of autism is an extreme resistance to change of any kind. Autistic children tend to want to maintain established behavior patterns and a set environment. They develop rituals in play, oppose change (such as moving furniture), and may become obsessed with one particular topic.

Other behavioral abnormalities that may be present are: staring at hands or flapping arms and hands, walking on tiptoe, rocking, tantrums, strange postures, unpredictable behavior and hyperactivity.

An autistic child has poor judgment and is therefore always at risk for danger. For instance, an autistic child may run into a busy street without any sign of fear.

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Properly diagnosing autism is very important, since confusion may result from inappropriate and ineffective treatment.

Deafness is often the first suspected diagnosis, since autistic children may not respond normally to sounds.

The children's appearance and muscle coordination are normal.

Occasionally, an autistic child has an outstanding skill, such as an incredible rote memory or musical ability. Such children may be referred to as "autistic savants."

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Appropriate early intervention is important. Once the diagnosis has been made, the parents, physicians, and specialists should discuss what is best for the child. In most cases, parents are encouraged to take care of the child at home.

Special education classes are available for autistic children. Structured, behaviorally-based programs, geared to the patient's developmental level have shown some promise.

Most behavioral treatment programs include:

  • clear instructions to the child

  • prompting to perform specific behaviors

  • immediate praise and rewards for performing those behaviors

  • a gradual increase in the complexity of reinforced behaviors

  • definite distinctions of when and when not to perform the learned behaviors

Parents should be educated in behavioral techniques so they can participate in all aspects of the child's care and treatment. The more specialized instruction and behavior therapy the child receives, the more likely it is that the condition will improve.

Medication is only administered to treat specific symptoms such as seizures, hyperactivity, extreme mood changes, or self-injurious behaviors.

The autistic child requires much of the parents' attention, often affecting the other children in the family. Counseling and support may be helpful for the parents.

The outlook for each child depends on his or her intelligence and language ability. Some people with autism become independent adults. A majority can be taught to live in community-based homes, although they may require supervision throughout adulthood.

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Questions to Ask Your Doctor

When will the symptoms appear?

What type of symptoms will there be?

What if the child just likes to be left alone as opposed to being autistic?

What type of test is given to diagnose autism?

Where is testing done?

How accurate is the test?

Is the autism mild or severe?

Will the child be able to attend public school if they have mild autism?

Is there a cure?

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