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Autism

Autism Spectrum Disorders

Challenge of Studying the Brain, ASD expained, Newborn Brain Development, Causes of Autism, Scientific Research, Types of Autism, Vaccines, When to See A Doctor, ASD Treatment and more.

Introduction

The human brain is the most complex organism, even in today’s world of extremely advanced computers. Neurologists and scientists in human development have been studying the brain for hundreds of years, but we can safely put to side the work of physicians before the 1980s, no matter how celebrated, since they lacked access to current day devices that facilitate observation and analysis of this unbelievably intricate organism.

Whatever little we have learned about the brain− the process of its development from the day a child is born, and its progressive growth into adulthood− has clarified a few of the myriad issues of its development under normal conditions.

The yawning gap between the understanding of how genetics and environmental factors affected its development has narrowed somewhat. In a wider perspective, it has been seen that genes inherited from parents definitely shape the development process, governing how our predilections are expressed. At the same time, our experiences, mostly the outcome of how we interact with others, have a major effect on how these very predispositions are expressed.

Recent research has revealed that many abilities considered to be imbued at birth are, in fact, a function of the integration of a series of experiences brought forward with heredity. Both these factors govern the optimal development of that staggering masterpiece of design, the human brain. Why then does the brain malfunction, in certain cases from birth itself? We hear that some people are autistic; what is autism?

Challenge of Studying the Brain

Before we define anything related to the brain, it is essential to understand why the brain has apparently not been studied as exhaustively as other human organs. In order to study any organ, it is often required to distort or destroy a part of it and record what the outcome is, as is done with laboratory born and bred mice and rabbits. This is indirectly possible with every organ a human being has, in that progressive degradation can be monitored over time, as can recoveries post treatment, without damaging the person.

Hearts can be removed and examined while their owners are on a ventilator. A deceased person’s healthy organs can be removed and used to replace defective organs in others, with prior permission. But the brain cannot be fully studied, except in participatory exercises, nor can it be removed, since it governs itself and its innermost recesses cannot be reached, unlike the other organs of the human body.

Invasive techniques, like positioning electrodes in the brain, or disabling a part of this organ to observe and evaluate end effects on behavior may be used with non-human species, but ethical reasons forbid extensive experimentation with humans. But then, human beings are the sole subjects who can provide a rational response to multifarious verbal instructions.

The only recourse left is to use low output non-invasive techniques like electroencephalogram (EEG) recordings or functional neuroimaging on humans vis-á-vis non-humans.

Source

Important topics, like language, cannot be studied at all, other than in humans. It is possible that human and non-human studies complement each other: Individual brain cells can only be studied in non-humans; complex cognitive tasks can only be studied in humans.

Tissue samples for biopsy for suspected brain tumors are a separate issue. Today’s gauntlet for neuroscience is the combination of these two sources of information, which, when put together, yield a comprehensive functional insight of the human brain.

The Make-up of The Human Brain (need correction here)

The brain is the most powerful organ in the body, yet weighs only around 1.5 kg (3.3 lb). Its texture is that of a firm jelly. Its volume is close to 1130 cubic centimetres (cm3) in women and 1260 cm3 in men, though variations can be substantial. Neurological differences in volume between the genders do not correlate with IQ or cognitive performance. The main components of human brain are neurons, glial cells and blood vessels. The neurons number about 86 billion, with an almost equal number of cells called glia.

The brain has 3 main parts:

  • The cerebrum, which, along with its cortex fills up most of the skull. It controls memory, deduction, thought processes, feeling and movement.
  • The cerebellum, which lies beneath the cerebrum, at the rear of the head. It looks after balance and overall coordination.
  • The brain stem, which lies under the cerebrum and ahead of the cerebellum. It joins the brain and the spinal cord and controls life-related functions like breathing, pulse rate, blood pressure and digestion (ibid).   

The human head is rather small, but the size of the brain fitted inside is large. The cerebral cortex, a layer of neural tissue that covers most of the brain, is folded in such a manner that it increases the surface area of the brain fitted in the space available. This folding pattern is common between individuals, with small variations. The cortex is split into four lobes, the frontal lobe, parietal lobe, temporal lobe, and occipital lobe respectively.

The human brain is prone to both damage and disease. It is protected by the skull with its thick bones and cerebrospinal fluid, and segregated from the bloodstream by the blood–brain barrier. The most common type of physical damage is head injuries caused by a blow to the head, a stroke, or poisoning by neurotoxins. A blow to the head causes contusions and concussion.

The most common and least serious type of traumatic brain injury is called a concussion. CDC statistics show as many as 3.8 million sports, recreation and accident-related concussions occur each year in the U.S.

A concussion is most often caused by a sudden direct blow or bump to the head. The brain is cushioned by spinal fluid and encased in the protective shell of the skull. When you sustain a concussion, the impact can jolt your brain. Your brain then doesn’t function normally. If you’ve suffered a concussion, vision may be disturbed, you may lose equilibrium and fall. In short, the brain is confused. If the after effects last longer than one day, it is called Post Trauma Stress Disorder (PTSD). Concussions often occur in young children because their heads are disproportionately large compared to the rest of their body. As kids enter adolescence, they experience rapid height and weight gain, factors that make them more prone to accidents than adults. According to the National Dissemination Center for Children with Disabilities, 1 million children each year suffer concussions. More than 30, 000 incur long-term disabilities as a result of the traumatic brain injury. Source: http://www.webmd.com

Strokes

The cells that make up the brain survive on the oxygen and nutrients brought to it in the blood pumped from the heart. If this supply is denied to the cells or reduced, they first suffer damage and then die. Such a condition is called a stroke.

A stroke may thus be caused by a blockage in an artery (ischemic stroke) or by a leak in blood vessel or even a burst (hemorrhagic stroke). People often experience a short term interruption of blood coursing through their brain (transient ischemic attack, or TIA).

Ischemic Stroke

Almost 85% of strokes suffered are ischemic strokes. An ischemic strokes takes place when the arteries from your heart to your brain narrow down or get blocked, resulting in a major reduction of blood flow (ischemia). The most common ischemic strokes include:

  • Thrombotic stroke. A thrombus is a blood clot that is formed in one of the many arteries that provide blood to your brain. If this thrombus leads to a stroke−as it certainly will− you would have undergone a thrombotic stroke. The clot is exactly the same as those that cause a myocardial infarction or heart attack and is caused by the same reasons, i.e., fat deposit (plaque) in arteries that narrow it and reduce blood flow (atherosclerosis) or by other specific artery conditions.
  • Embolic stroke. An embolus is a loose blood clot travelling through arteries and when it gets lodged in an artery in the brain, it causes a stroke. The lodging of an embolus is called an embolism and if this happens in an artery in the brain, it is called a pulmonary embolism.

Hemorrhagic Stroke

If a blood vessel in your brain ruptures, leaks or bursts, you will suffer a hemorrhagic stroke. Brain hemorrhages may be caused by one of many conditions that affect your blood vessels, like hypertension (high blood pressure) and aneurysms, weak spots caused by thinning of the walls of a blood vessel. A brain hemorrhage is labeled according to precisely where it occurs in the brain. Bleeding anywhere inside the skull is called an intracranial hemorrhage. Bleeding within the brain itself is known as an intracerebral hemorrhage. Bleeding can also occur between the covering of the brain and the brain tissue itself, called a subarachnoid hemorrhage.

Transient Ischemic Attack (TIA)

A transient ischemic attack (TIA), or a mini stroke is a short period of time when you exhibit symptoms similar to those in a stroke. The TIA is caused by a short term decrease in blood supply to a part of your brain and could last less than five minutes. A TIA doesn’t leave lasting symptoms because the blockage is temporary. You must seek emergency care even if your symptoms seem to clear up. If you’ve had a TIA, it means there’s likely a partially blocked or narrowed artery leading to your brain, or a clot source in the heart. A TIA should be construed as a serious warning that a major stroke is round the corner.

None of the above cause Autism Spectrum Disorders.

So what is Autism Spectrum Disorder (ASD)?

Autism Spectrum Disorder is a serious neurological disorder in a child’s development that restricts or even prevents its ability to communicate and interact with others.

Earlier, five disorders were classified under a blanket category officially termed Pervasive Developmental Disorders, or PDD. These five disorders were:

  • Autism
  • Asperger’s syndrome
  • Rett syndrome
  • Childhood disintegrative disorder
  • Pervasive Developmental Disorder Not Otherwise Specified (PDDNOS)

ASD is now defined by the American Psychiatric Association’s Diagnosis and Statistical Manual of Mental Disorders (DSM-5) as a single disorder that includes disorders that were previously considered separate — autism, Asperger’s syndrome, childhood disintegrative disorder and pervasive developmental disorder not otherwise specified. Rett syndrome has been left out. Asperger’s syndrome was to be removed this year from this spectrum or range.

Though overall birth rate is on the decline, the number of children afflicted by autism spectrum disorder is on the rise. This could be due to improved detection technology, facilitating better detection and reporting, or a genuine increase in the disease, or both. 25 years ago, the stated rate was pegged at 2-6 per 1, 000. Today, it is 1 in 88. Even though there is no known allopathic cure for autism spectrum disorder, focused early treatment could make a serious positive difference in the day to day lives of many unfortunate children.

Symptoms of Autism

As mentioned earlier, autism spectrum disorder affects how a child perceives and socializes with others, causing problems in crucial areas of development — social interaction, communication and behavior. ASD can manifest itself at any stage of childhood. Some children exhibit symptoms soon after birth. Others could grow normally for the first couple of months, even years of life, but then, out of nowhere, start displaying symptoms such as becoming withdrawn or cantankerous or lose the ability to use already demonstrated language skills.

Each child is different from another, and, with ASD, may show individual behavior patterns at varying levels of severity. The level of severity is decided by others, on the basis of cognitive impairment, reduction of social communications, classic restrictive behavior repetition along with effects of such disabilities. The Mayo Clinic has done a lot of work in this field.

The standard symptoms are (ibid):

A: Social Communication and Interaction

  • Fails to respond to his or her name or appears not to hear you at times
  • Resists cuddling and holding and seems to prefer playing alone — retreats into his or her own world
  • Has poor eye contact and lacks facial expression
  • Doesn’t speak or has delayed speech, or may lose previous ability to say words or sentences
  • Can’t start a conversation or keep one going, or may only start a conversation to make requests or label items
  • Speaks with an abnormal tone or rhythm — may use a singsong voice or robot-like speech
  • May repeat words or phrases verbatim, but doesn’t understand how to use them
  • Doesn’t appear to understand simple questions or directions
  • Doesn’t express emotions or feelings and appears unaware of others’ feelings
  • Doesn’t point at or bring objects to share interest
  • Inappropriately approaches a social interaction by being passive, aggressive or disruptive

B: Patterns of Behavior

  • Performs repetitive movements, such as rocking, spinning or hand-flapping, or may perform activities that could cause harm, such as head-banging
  • Develops specific routines or rituals and becomes disturbed at the slightest change
  • Moves constantly
  • May be uncooperative or resistant to change
  • Has problems with coordination or has odd movement patterns, such as clumsiness or walking on toes, and has odd, stiff or exaggerated body language
  • May be fascinated by details of an object, such as the spinning wheels of a toy car, but doesn’t understand the "big picture" of the subject
  • May be unusually sensitive to light, sound and touch, and yet oblivious to pain
  • Does not engage in imitative or make-believe play
  • May become fixated on an object or activity with abnormal intensity or focus
  • May have odd food preferences, such as eating only a few foods, or eating only foods with a certain texture

Most children afflicted by ASD are slow learners, with IQ below par. Others with ASD are normal or better than par in the IQ department — they pick up things quickly, but fall foul when it comes to communication and application of what they seem to know in routine life and adapting to social situations.

A minor percentage of children with ASD are savants — they display extraordinary skills in a defined arena, such as abstract math, number crunching or music. There is no fairy tale ending here. Some may grow up and become social, exhibiting rational behavior. Those with the least problems as kids could well lead close to normal lives. But most will, unfortunately, remain aggressive and regressive.

How The Newborn Brain Develops

The basic matter of a brain is a nerve cell, the neuron. Interestingly, when kids are born, they already have almost all the neurons they will require in their life-span, totaling more than 85 billion. Yes, some neurons do develop well after birth, in adulthood; the neurons kids are born with are those they will utilize as they grow, from childhood to adulthood.

While still a fetus, neurons are created and join up into an infantile brain. As neurons move, they begin to respond to chemical signals. This is a unique bottom up process, with migration from the less developed segments of the brain to the more elaborate. The first areas of the brain that must develop in totality are the areas called the brainstem and the midbrain, because these areas govern all bodily functions needed to live, called the autonomic functions. At birth, these portions of the nervous system have to be and, indeed, are well developed because they will be required instantaneously after delivery, whereas the higher zones, like emotions, thought processes, etc., are still at a primitive stage.

Immediately after birth, a new born baby has many new things to do to live, like breathe, eat, sleep, see, hear, smell, make noise, feel sensations, etc. It has to be ready to react at T0, as delivery reaches its final phase. The 85 billion neurons help them do just that. The newborns’ brains are on the go from moment T1, when they are exposed to the atmosphere as they move down, head first in normal deliveries, to the exit of the birth canal. With the passage of time, the brain cells will have much development work at hand.

Most of brain growth and subsequent development starts to take place soon after birth, especially in the higher brain regions involved as just explained. Each region knows and manages the functions that will be assigned to it using a complex progression, mainly using chemical messengers, also known as the vital force (such as neurotransmitters and hormones) to help forward information to other sections of both the brain and the body.

Brain development, manifested as learning, is actually a micro-electric process of grouping neurons, at times a trial and error procedure.

When required, a new neuron will be created; existing neurons will be strengthened by reinforcement, and misplaced neurons will be isolated from the connection highway, to be restored to its correct place at the appropriate moment.

This connection is called a synapse, a structure that allows a neuron to transmit an electrical or chemical message to another cell. Synapses reorganize the floating structure of a brain under formation by creating pathways connecting the required parts of the brain that govern all that we do—from breathing and sleeping to thinking and feeling, all set like a sprinter on his starting blocks at T0 and activated at T1. This is how the brain develops after birth, because at birth, only the critical synapses have been formed, those vital for living outside the comfort of the womb.

The synaptic growth rate after birth is astronomical, to govern bodily functions other than heart rate, breathing, eating, and sleeping. Virtually every occurrence is a new experience for extremely young children, and synapses react thereto by multiplying in response. At its zenith, a healthy kid’s cerebral cortex may generate up to two million synapses per second. By the time a child reaches an age of 3, its brain could well have close to 1012 (1, 000 trillion) synapses, way in excess of the amount they might ever need. The brain itself decides which synapses it will need and these synapses are retained and strengthened; many others are gradually weeded out.

This pruning of synapses is a perfectly normal process of child development. In fact, as the children reach the adolescence stage, close to 50 percent of their synapses would have been disposed of, retaining only those they will need to live out their lives. Brain development is a continuous procedure and will carry on throughout their lives. In other words, the brain continues to learn, memorize, and adapt to changed circumstances (ibid).

The brain is self adaptive. It adopts another new and important process in its development, viz, myelination. Myelin is a white fatty tissue encapsulating fully grown brain cells in a sheath, to ensure unambiguous transmission between synapses. This is why young children take time to process information; their brain cells are deficient in the myelin needed for rapid, unambiguous transmission of nerve impulses. Myelination starts in the areas of the brain stem and cortex, which are the main areas for the growth of motor and sensory response, before migrating to the higher-order zones that have developed by now to manage thought processes, memories, and emotions. Moreover, the tempo of growth of myelination is affected by the experiences the child undergoes, continuing into adolescence.

By the time a baby is three years old, its brain would have reached close to 90 percent of the size it will carry through into adulthood. Strangely, the brain is an excellent example of Newton’s laws: The more the stimulation each region of the brain receives, the more the activity incited in that region. It is this stimulation that provides the baseline for education.

Plasticity—The Influence of Environment

Plasticity is, in effect, a researcher’s term for brain elasticity. It describes the ability of the brain to adapt to changed circumstances as a response to continuous stimulation. The degree of plasticity depends on what stage the development process is in and the specific brain system affected. For example, the lower segment of the brain, which we know controls primary yet essential functions like breathing and pulse rate, is more rigid than the higher level of functioning cortex, which regulates thoughts and feelings. Cortex plasticity reduces with age, although plasticity remains, but to a lesser degree. It is this plasticity of the brain that permits us to learn progressively into adulthood and thereafter (ibid).

The continuous adaptation of a brain still developing is the outcome of a combination of genetics and experience. Our brains get us ready to anticipate specific experiences by creating the synapses needed to react to those experiences. For instance, our brains are trained to respond to speech; when infants hear speech, their neural systems responsible to react to speech/language are stimulated to function as organized. The more infants are exposed to speech, the better their language-related synapses become. If such an exposure does not take place, the synapses developed in expectation could be discarded, i.e., "use it or lose it." It is via these intertwined procedures of forming, strengthening and abandoning synapses that our brains readapt to changing environment.

The capability to adapt to changing environment forms part of normal development. For instance, kids growing up in freezing Iceland, on farms, or in large groups quickly learn how to adapt to those environments. That said, all children require stimulation and sustenance to stay healthy. If these are deficient—if a child’s custodians are indifferent or antagonistic—that child’s development of the brain could be damaged. Since the brain becomes accustomed to that environment, it will get used to a negative environment as easily as it would to a positive one. Even so, a slightly underformed brain, which would become normal in a positive environment in time, is at a risk of autism (ibid).

It is believed that there are windows of time for developing certain abilities, i.e., when specific components of the brain are most vulnerable to exacting experiences. Animals artificially blinded in their sensitive period when they develop vision might lose the ability to see, even if the artificial blinding device is removed at a later stage. Such an experiment cannot be carried out on a human being.

Why such an experiment cannot be done on humans needs no explanation. It is infinitely more complicated to assess periods of human sensitivity. But then, if certain synapses are not frequently activated, they may be abandoned, and the associated abilities diminished. For instance, babies have a genetic predilection to bond strongly with their primary caretakers. But if this caregiver is indifferent or hostile, the attachment procedure is impaired and the infant’s ability to shape any meaningful relationships during his or her life could be destroyed.

Even so, the plasticity of the child’s brain often permits them to recover to normal despite missing gainful experiences. Recovery of missed experiences become more difficult in the later stages in life, but hope should never be lost. This is particularly true in the case of young children deprived of specific stimuli, resulting in improper pruning of synapses pertinent to those stimuli and the ensuing deprivation of neuronal pathways. All the same, normal children have the resilience to bounce back from impaired progress past the developmental stage, to learn and regulate each step in concordance with the capability of their brains to build an efficient synaptic network.

The organizing scaffold for kids’ development is based on re-creation of memories. If repetitive experiences fortify a specific neuronal pathway, that pathway first becomes encoded, eventually becoming a memory. For instance, tiny tots quickly learn to put one foot in front of the other to walk, words to convey their sentiments, a smile is usually reciprocated. At a point in time, these evolve from processes to memories using a pathway created to facilitate a smooth and effective transmission of information. Creating memories is essential in adapting to our environment. Our brains try to fathom our world and regulate interactions with our world to enhance productive survival and growth. If the initial environment is offensive or negligent, our brains might generate memories of such negative experiences that could color our impression of our world throughout our existence adversely (ibid).
Babies are known to be born with the ability of implicit memory, meaning that they perceive the prevailing environment and can recall it in subconscious ways. They recognize their mother’s voice from some subconscious memory. Such implicit memories could well have a noteworthy impact on a kid’s attachment relationships later in life. Very young children who have been maltreated or suffered other ordeals may not be able to access memories for their adverse experiences. These implicit memories can have serious deleterious repercussions in the form of flashbacks, nightmares and other unmanageable reactions.

What Causes Autism Spectrum Disorder?

The number of ASD cases diagnosed has been rising at a steady pace over the past decade.

At the turn of the millennium it was 2-6 in 1, 000, increasing to 1 in 110 and currently estimated at 1 in 88.

We know that ASD is a mental condition in which children struggle with social interaction and communication, usually coupled with a narrow range of interests and a proclivity for a fixed routine.

One of the leading questions psychiatrists specializing in child psychiatry are regularly asked is, "What causes autism?" Unfortunately, the candid answer is that so far, nobody really knows. The individual asking the question very likely has a reason behind it and he is left dissatisfied. Thus the answer moves into the sphere of generalization, with a blanket reply that it is possibly due to a wide variety of factors, the important causes being ‘genetic’ and ‘environmental’ influences. If the reason is not known, the answer must remain general.

The causes of ASD can be described in two ways:

  • Primary ASD (also known as idiopathic ASD) – where no underlying factors can be identified to explain why ASD has developed.
  • Secondary ASD – where an underlying medical condition or environmental factor thought to increase the risk of ASD is identified.

About 90% of cases of ASD are primary, and about 10% are secondary.

Factors Thought to Increase the Risk of Developing ASD

Factors thought to increase the risk of developing ASD, known as ‘risk factors’, can usually be divided into five main categories (ibid):

  • Genetic factors – certain genetic mutations may make a child more likely to develop ASD.
  • Environmental factors – during pregnancy, a child may be exposed to certain environmental factors that could increase the risk of developing ASD.
  • Psychological factors – people with ASD may think in certain ways that tend to heighten their symptoms.
  • Neurological factors –problems with the development of the brain and nervous system may contribute to the symptoms of ASD. Pruning is inefficient, leading to a block in storage space.
  • Other health conditions.

Note the use of the word ‘may’.

The media is perhaps spreading wrong information, given the current thrust of recent reports that claim to have evidence of yet another "risk factor" to autism. The scope of links found vary from air pollution to maternal antibodies, leaving the father blameless; gluten sensitivity, genetic mutations and a folic acid deficiency have all been touted as probable causes of this disorder. This naturally begs the question: why is it almost impossibly difficult for doctors and scientists to isolate the cause for this serious condition, especially because it seems to be waxing large.

What the general public must know is that there is no "typical" autistic person. ASD encompasses such a wide and sundry group of patients with multiple combinations of exhibited symptoms and an equally wide diversity in functional severity that diagnosis has remained general. This has some doctors now saying, "When you have seen one person with autism, you have seen one person with autism." It also helps to explain why the term spectrum in ASD has become a better method of discussing this woeful condition. This is antithetic to the perspective of the American Psychiatric Association’s Diagnosis and Statistical Manual of Mental Disorders.

There is no definitive CAT/PET or brain MRI scans for ASD. It is believed that some innovative technologies are in the research studies/ being developed phase to pinpoint the malaise earlier. That said, diagnosis of ASD in clinical practice is still based on child behavior, along with observations about his psychomotor response and brain processing, i.e., how he thinks, relates, communicates and responds. Child behavior devolves from diverse causes. For the moment, consider a child who can’t walk. There could be any number of reasons why that child can’t walk — some obvious, some more complex to determine. It could be a painful toe, a broken ankle, some infection, a pulled muscle or a predicament with the child’s nervous system. Diagnose that child simply on behavior (the child is unable to walk) and we may end up with a conclusion of "immobility spectrum disorder." Figuring out immobility is far easier than comprehending ASD, a "brain disorder." After all, there are less than 100 bony joints plus muscles in our leg, with the nerves employed by the muscular system hardly as complex as the 100 billion neurons, and trillions of synapses in the brain (ibid).  

So what are we left with? Innumerable variations in brain development, the enduring combination of environmental exposures or genetic disturbances that could lead to ASD, with detrimental concomitant effects on social communication, language and behavior. Autism is best seen as a spectrum, a brood of "autisms." If indeed so, news about yet another link to or cause of ASD should not surprise us. This challenge, in itself, is not unique. We regularly diagnose so many other brain disarrays, like attention deficit hyperactivity disorder (ADHD), depression, bipolar disorder and virtually every other mental imbalance on the basis of clinical appraisal — patient history, family observation, the patient himself when communicative, teachers, other dependable sources, as well as comprehensive examination of the patient. To complicate matters, other conditions have been observed to exist alongside ASD, like ADHD, which is thought to be present in a third of children with autism.

Scientific Research

So far, we have believed that ASD is genetically biased. Now, scientists stress the fact that escalating cases of autism can’t be elucidated only by genetic change, as our genes are just not changing as rapidly. Thus far, large-scale genetic research can explain only about 20 percent of ASD cases. We also know that there is more than one gene responsible. Who knows, there could well be several hundred genes interrelating to bring about ASD. Autism genetic research is increasingly relying on experts in computing and statistics to be able to separate and decipher the "signal" to "noise" ratio, to determine what is actually noteworthy in larger genetic research.

Progress has been made in understanding ASD and ADHD. Researchers are developing specialized eye-tracking technologies aimed at diagnosing ASD earlier than ever before (and early detection and intervention are crucial to long-term functioning in youth affected by this condition). By detecting subtle changes in eye gaze, researchers have been able to identify ASD in children as young as 18 months of age. These eye tracking technologies, however, remain experimental and are not currently in routine clinical use. However, the FDA has just approved the Neuropsychiatric EEG-Based Assessment Aid (NEBA) system as an aid to making a diagnosis of ADHD. This NEBA system measures different formats of brain waves, thereby enhancing ADHD diagnosis accuracy when conducted alongside clinical appraisal. With luck, similar technologies might be approved for analyzing ASD in the years ahead permitting us to build more specific interventions to cater for the multifarious "autisms." Till such time as the cause for ASD is established, we will perforce have to stay with generalization.

Types of Autism

Two of the five listed types of Autism have been/will be removed from that list of five. These are:

  • Rett Syndrome: Primarily affecting females, Rett syndrome is an autism spectrum disorder. Its symptoms begin after a period of normal development that lasts between 6 and 18 months, after which the child’s mental and social development regresses. Scientists have discovered that a mutation in the sequence of a single gene can cause Rett syndrome. This discovery may also lead to methods of screening for the disorder.
  • Asperger syndrome: Asperger syndrome, a form of autism, is mostly a ‘hidden disability’. This means that you can’t tell that someone has the condition from their outward appearance. People with the condition have difficulties in three main areas. They are:
  • social communication
  • social interaction
  • social imagination

All autistic patients have these three disabilities as well. People with Asperger syndrome have fewer problems with speaking and are often of average, or above average, intelligence. They do not usually have the accompanying learning disabilities associated with autism, but they may have specific learning difficulties. These may include dyslexia and dyspraxia or other conditions such as attention deficit hyperactivity disorder (ADHD) and epilepsy. With the right support and encouragement, people with Asperger syndrome can lead full and independent lives (ibid).

As of now, there is no ‘cure’ or specialized treatment for Asperger syndrome. Children with Asperger syndrome will grow into adults with Asperger syndrome. However, as general understanding of the debility improves and medical services continue to develop, afflicted people will have excellent opportunities to reach their potential to the full. 

Is ASD Caused by Vaccines?

There are two schools of thought, one believing that the Measles Mumps Rubella (MMR) vaccine was causing stomach disorders in some children and autism in others. The counter to this is that if MMR was the cause of Autism, then the number of victims should have been in the hundreds of millions, not in the 1 in 88 category.

MMR Causes Autism

At the outset, it is worth remembering that it’s worth remembering that the exact same people who own the free world’s drug companies also own America’s news outlets. Finding unbiased information has been and will still be difficult.

In 1996, Dr. Andrew Wakefield of Austin, Texas noticed the link between stomach disorders and autism, and taking his research one step further, the link between stomach disorders, autism and the Measles Mumps Rubella (MMR) vaccine. His research was published in 1998, and the good doctor became the hit man of a world-wide smear campaign by drug corporations, governments and media companies, losing his license to legally practice medicine. He became a best-selling author instead.

But in recent months, courts, governments and vaccine manufacturers have quietly conceded the fact that the Measles Mumps Rubella (MMR) vaccine most likely does cause autism and stomach diseases. Pharmaceutical companies have paid out massive monetary awards, totaling in the millions, to the victims in an attempt to compensate them for damages and to buy their silence. The news that vaccines cause autism has now spread across the US despite a coordinated media black-out.

In December 2012, two landmark decisions were announced that confirmed Dr. Wakefield’s original concern that there was a link between the MMR vaccine, autism and stomach disorders. The news went unreported, but independent outlets like The Liberty Beacon finally published the pathbreaking news. The news was published online, “In a recently published vaccine court ruling, (December 13, 2012) hundreds of thousands of dollars were awarded to Ryan Mojabi, whose parents described how MMR vaccinations caused a “severe and debilitating injury to his brain, diagnosed as Autism Spectrum Disorder (‘ASD’).

The Liberty Beacon described the second court ruling that month, as well as similar previous verdicts, “The government suffered a second major defeat when young Emily Moller from Houston won compensation following vaccine-related brain injury that, once again, involved MMR and resulted in autism. The cases follow similar successful petitions in the Italian and US courts (including Hannah Poling, Bailey Banks, Misty Hyatt, Kienan Freeman, Valentino Bocca, and Julia Grimes) in which the governments conceded or the court ruled that vaccines had caused brain injury. In turn, this injury led to an ASD diagnosis. MMR vaccine was the common denominator in these cases.”

The ant-vaccine groups say that thimerosal, a preservative used in vaccines, is toxic to the central nervous system and responsible for an alarming rise in rates of autism among children in the United States and around the world. Since the world has slowly become aware of the dangers of the MMR vaccine, parents around the globe have refused to get their children vaccinated. Further investigations revealed the callous attitude and antipathy of the manufacturers and governments alike.

The Counter Argument to the MMR Causes of Autism

One of the key pillars of the “vaccines cause autism” argument is that with the increase in the number of childhood vaccines on the schedule over the years, autism prevalence has increased, as well. The immune system doesn’t count the number of shots. It counts what’s in those shots, the molecules known as antigens, which trigger the immune response. And the number of antigens children encounter by way of today’s vaccine schedule is thousands fewer than it once was.

Now that key pillar has been eroded. A study published in the Journal of Pediatrics on 06 March 2013 added up the antigen number in the vaccines administered to 1008 children, 25% with autism, and found no correlation whatsover between autism and increasing antigen number through completion of the vaccine schedule up to age 2. The study was funded by the US Centers for Disease Control and Prevention.

These children were born from 1994 to 1999, during a time when a single DTP shot could contain more than 3000 of the molecules that fire up the immune system. Today’s vaccine-related antigen exposure is considerably less. The authors say: “Thus, even though the routine childhood schedule in 2012 contains several more vaccines than the schedule in the late 1990s, the maximum number of antigens to which a child could be exposed by age 2 years was 315 in 2012 …”

From 3000 in a single shot to 315 total today.

Researchers also examined both autistic disorder and autism associated with regression. In neither case did they find a link to increasing vaccine-related antigen exposure through infancy. Their work had some limitations. For example, not all antigens are created equal. Some have more immune triggering areas on them than others. The study did not incorporate the relative intensity of the immune response to each antigen. Yet, the authors note that the 314 antigens infants encounter via vaccines in their first two years of life is a drop in an ocean of antigen exposures: Beginning at birth, an infant is exposed to hundreds of viruses and other antigens, and it has been estimated that an infant theoretically could respond to thousands of vaccines at once.

The major argument is that if the MMR vaccine was indeed the culprit, then there should have been millions of more children/youths afflicted with ASD. "There is no evidence whatsoever linking the development of autism to childhood vaccines, " The Guardian of May 20, 2014, reported. A new study involving more than a million children found no evidence of a link between childhood vaccines and autism or autism spectrum disorder. Researchers pooled the results of studies that have assessed the relationship between vaccine administration and the subsequent development of autism spectrum disorder. No significant associations were found between vaccinations and the development of the condition. The researchers included five cohort studies involving 1, 256, 407 children, and five case-control studies involving 9, 920 children.

Many respected medical institutions have scrutinized the evidence from the United States and abroad, and have come to the conclusion that there is no link between autism and exposure to thimerosal. What’s more, the preservative has been removed from most childhood vaccines in the United States and the storage system changed at greater cost to manufacturers.

When to See A Doctor

The symptoms listed earlier should alarm parents. It is essential for a child’s future that it be checked for ASD and preventive treatment started, if only to limit the malaise.
This is a guide to what your child should be doing at 11/2-2 years of age:

  • Shows interest in his / her siblings or peers
  • Brings you items to show you
  • Follows your gaze to locate an object when you point
  • Engages in “pretend play” (e.g. feeding a doll or making a toy dog bark)
  • Uses many spontaneous single words and some-two word phrases

Some of the following may be early indicators of ASD. It has been observed that no single symptom necessarily signals autism – generally, a child would exhibit several indicators from the list below:

Behaviour

  • Has inexplicable tantrums
  • Has unusual interests or attachments
  • Has unusual motor movements such as flapping hands or spinning
  • Has extreme difficulty coping with change

Sensory

  • Afraid of some everyday sounds
  • Uses peripheral vision to look at objects
  • Fascination with moving objects
  • High tolerance of temperature and pain

Communication

  • Not responding to his/her name by 12 months
  • Not pointing or waving by 12 months
  • Loss of words previously used
  • Speech absent at 18 months
  • No spontaneous phrases by 24 months

Play

  • Prefers to play alone
  • Very limited social play (e.g. “Peek-a-boo”)
  • Play is limited to certain toys
  • Plays with objects in unusual ways such as repetitive spinning or lining up

Early diagnosis and intervention are very important for children with ASD. The USA caters for such children under the Individuals with Disabilities Education Act (IDEA). Children with ASD may be eligible for early intervention services (birth to 3) and an educational program that has been designed appropriate to their individual needs. Apart from pure academics, special education programs for students with ASD (ages 3 to 22) have also been made with its focus on improving communication, social, academic, behavioral, and daily living skills. Idiopathic problems that obstruct learning are left to professionals particularly knowledgeable about ASD to develop and implement a syllabus for both home and school.

The classroom should be so structured that training programs are consistent and logical. It has been noted that students with ASD learn best and without confusion when information is presented audio-visually. Interaction with understanding nondisabled peers is significant, as these students become models of language, social, and behavioral skills. Since consistency and continuity are critical for children with ASD, parents should be part of the overall development plan for their child, so that school activities and experiences are carried into the home and community. It is possible that children undergoing such programs coordinated with specialized adult support services will grow to live, work, and participate fully in their communities.

Tips for Teachers

  • Learn more about ASD (ibid).
  • Check out research on effective instructional interventions and behavior.
  • Ensure directions are given step-by-step, verbally, visually, and by providing any support or prompts, as needed by the student. Be as explicit as possible in your instructions and feedback to the student.
  • Find out what the student’s strengths and interests are and emphasize them. Give positive feedback and lots of opportunities for practice.
  • Build opportunities for the student to have social/collaborative interactions throughout the regular school day.
  • If behavior becomes an issue, call in the experts (including parents) to understand the behavior pattern and develop a unified, positive approach to resolving them.
  • Have consistent routines and schedules.
  • Reward students for each small success.
  • Work alongside the student’s parents to implement the educational plan devised.

Tips for Parents

  • Learn about ASD. The more you learn, the better you can help your child (ibid).
  • Interact with your child in ways most likely to adduce positive response.
  • Know what may trigger a breakdown for your child and minimize them. The earliest years are the toughest, but it does get better!
  • Learn from professionals and other parents how to meet your child’s special needs.
  • Stick to structured, consistent schedules and routines.
  • Behavior, communication, and social skills are areas of concern for a child with ASD. Maintaining a loving and structured approach in caring for your child helps greatly.
  • Learn about assistive technology that can help your child, from simple picture boards to sophisticated communication devices, consistent with age.
  • Work with professionals in early intervention. Include related services, supplementary aids and services and a positive behavioral support plan, if needed.
  • Be patient, and stay optimistic. Your child, like every child, has a whole lifetime to learn and grow. 

ASD Treatment

There is no medication that can cure ASD or treat the core symptoms, though there is medication that can aid some people afflicted with ASD function better. Treatment already exists for inability to focus, hyperactivity, depression, seizures, etc. These can be used as advised by a specialist in ASD. Medications may affect different children differently, which is why it is important to work with a professional who is a specialist in ASD. Watch for negative side effects. At the same time, remember your child has to undergo routine medical checks along with all other kids.

Many types of treatments are available, under the following categories:

  • Behavior and Communication Approaches
  • Dietary Approaches
  • Medication
  • Complementary and Alternative Medicine

Behavior And Communication Approaches to aid children afflicted by ASD are those that provide structure, direction, and organization for the child in addition to family participation. A noteworthy approach for treating people with ASD is Applied Behavior Analysis (ABA), which is widely accepted by specialists and used both in schools and clinics. ABA is a variation of Different Strokes, encouraging positive behavior while disparaging negative behavior to progress a skill set. The child’s development is tracked and plotted.

Dietary Approach

Some dietary approaches have been built up by known therapists, but lack scientific support desired for extensive recommendation. An unproven treatment might help one child, but may not help another. Grandma’s potions will not work here.

Medication

As already stated, medication may help control hyperactivity, inability to focus, depression, or seizures. The U.S. Food and Drug Administration has approved the use of antipsychotic drugs (like risperidone and aripripazole in the USA) to treat, at stipulated ages, children with ASD who suffer from violent tantrums, aggression, and even injure themselves.

Complementary and Alternative Treatments

At times, parents and doctors use treatments normally not recommended by a pediatrician to assuage ASD. Such treatments are called complementary / alternative treatments (CAM). They might include chelation (removal of heavy metals from the body), biologicals (e.g., secretin), or body-based systems (like deep pressure). Some might go in for Homeopathy, Acupuncture, etc.

Organizations That may be of Assistance

Achieve Beyond

Association for Science in Autism Treatment

Autism Treatment Center

AUTCOM – The Autism National Committee

Autism Research Institute

Geneva Centre for Autism

Southwest Autism Research and Resource Center (SARRC)

Autism Consortium

Autism Ontario

Autism Society

Autistica – Funding Pioneering Autism Research

Center for Autism and Related Disorders

The Dan Marino Foundation

Autism Center – University of Washington – Seattle, Tacoma

The Daniel Jordan Fiddle Foundation – A National Autism Organization: Granting a Future to Adolescents and Adults

Families for Early Autism Treatment

Doug Flutie Jr. Foundation for Autism

National Fragile X Foundation

Jenny McCarthy’ Autism Organization

The Golden Fund for Autism

Hollyrod Foundation

Illinois Center for Autism

IMHRO (One Mind Institute) – Global Innovation for Brain Health

Lakeside Center for Autism

The Mifne Swiss House

NARPAA | National Association of Residential Providers for Adults with Autism

National Autism Association | Help and Hope for Families Affected by Autism

New England Center for Children

Organization for Autism Research

Rocky Mountain Autism Center – Colorado

South Carolina Autism Society

Talk About Curing Autism (TACA)

The Color of Autism Foundation African American Support

The Help Group

Train 4 Autism

References

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