Autistic Spectrum Disorders and the Family Unit

Autistic Spectrum Disorders and the Family Unit

Autistic Spectrum Disorders are a group of related disorders or developmental disabilities that have been caused by some sort of problem within the brain. The necessity to understand the reasons for autism and the basic underlying pathophysiology has become more severe because the amount of diagnosed cases has increased dramatically in recent years. (White, 2003) Researchers and scientists have not been able to discover, as yet, what, exactly, causes this problem. The affected person may have his basic functioning affected by the Autistic Spectrum Disorder, and it may range form a mild affliction to a severe one. An autistic person may not look different from any of the others around him; the difference in fact is in the behavior and in the way in which he communicates, and interacts and behaves with the others around him. The Autistic Disorder is one of the most commonly known type of Autistic Spectrum Disorder, and the others that come within this bracket are 'pervasive developmental disorder: not otherwise specified', or the PDD-NOS, and the Asperger Syndrome. (Learn the Signs, Act Early: Autism Spectrum Disorders Fact Sheet)

In several cases symptoms of autism would begin during periods of early infancy. But some children would develop autism till a significant deterioration is being observed. (Sandler; Finegold; Bolte; Buchanan; Maxwell; Vaisanen; Nelson; Wexler, 2000) People who are suffering from the many disorders associated with Autistic Spectrum Disorders may exhibit some or all of these symptoms: they will not play 'pretend' games, they will not point out any objects that have caught their interest, the person may not look at the object that another person is pointing at, because it does not interest him at all. The child will not like to be cuddled or touched, and may cuddle only in the few rare times when he wants to, not if others want to. In a phenomenon known as 'echolalia', the autistic child may endlessly and aimlessly repeat the words that have been said to him, and he may also keep on endlessly repeating all his actions over and over again. The autistic child would find it extremely difficult to adapt to changes and he may also display unusual reactions to the senses of smell, taste, and how things look and feel, and sound. (Learn the Signs, Act Early: Autism Spectrum Disorders Fact Sheet) Even though clinical patterns change on the basis of the severity, all children having autism show certain amount of qualitative impairment with regard to reciprocal social interaction, impairment of communication in qualitative terms and constricted, repeated and stereotype characteristics of behaviors, interests and activities. (Committee on Children with Disabilities, 2001)

The importance of this disease was understood only in the middle of the twentieth century though the disease affects as many as on in every five hundred children who are born. This causes a lot of disturbances in the families and miserable lives for the children. It was in 1943 that Dr. Leo Kanner of John Hopkins Hospital studied a group of 11 children and came out with the description of the disease as early infantile autism. At about the same time, a scientist in Germany, Dr. Hans Asperger found out about a milder version of the disease which is now called as Asperger syndrome. The parents are usually the first to notice certain unusual behaviors in their children, and in some children the differences start right from birth -- the child remains unresponsive to others and continue focusing on one item for long periods of time. The symptoms also suddenly appear in children who had been developing normally earlier. It can be the sudden change of an engaging, babbling toddler into a silent, withdrawn, self-abusive, and indifferent to social appeals. There is something seriously wrong and parents are the first to notice the problem correctly while they may not be aware of the reasons for the problem. (Autism Spectrum Disorders: Pervasive Developmental Disorders-http://www.nimh.nih.gov/publicat/autism.cfm)

The defining characteristic of autism is due to a specific disability in the nature and quality relating to the development of social and communicative skills which are being impacted by the particular biological and environmental situations of the individual concerned. It is this disability which differentiates autism from other neurodevelopmental situations like mental retardation, disorders relating to developmental language and particular learning impairments. (Zager, 2005) Now let us look at the definition of autism from the Autism society of America. Autism is a severely affecting lifelong developmental disability that appears during the first three years of life. The occurrence is in approximately fifteen out of ten thousand births and is four times more likely in boys than girls. The disease has been found among all groups with different racial, ethnic and social backgrounds. It is commonly agreed by researchers that there are several causes for autism. The most prevailing symptom was diarrhea, which was found in 17% of the children. (Molloy; Manning-Courtney, 2003) Concern has been made regarding a possible link between measles-mumps-rubella or MMR vaccine and inflammatory bowel disease or IBD and Autism Spectrum Disorder, particularly autism with regression. Further enhanced requests for educational services in relation to ASD have raised concerns regarding possible rise in the prevalence of ASD. (Halsey; Hyman, 2001)

There are some well established causes for autism inclusive of a strong genetic link in matters of tuberous sclerosis, fragile X, and certain other disorders. The opinion that there is a very strong genetic base for the disorder evolves from the fact that children of autistic offspring have higher chances of autism in comparison to the general population. A very strong genetic relation has been significantly attained from studies of autistic children who were born as twins. (White, 2003) Researchers during the latter part of the 1960s and during the early 1970s were doubtful about any significant role in relation to genetic characteristics in the etiology of autism. An understanding that 2% rate of autism in siblings during that time was much high in comparison to the general population, and this showed a possible higher incidence of genetic liability, which brought about the first small-scale twin study relating to autism. The replicated proof in relation to twin and family studies which took place during the 1970s and 1980s showed that both strong elements of genetic influences and that they applied to a phenotype which was very much wider in comparison to the traditional diagnostic group of autism. Medical and chromosomal results also showed influences of genetic heterogeneity. (Rutter, 2000)

Further recent evidence points to the fact that autistic children might show important gastrointestinal symptoms. There is increasing understanding that primary gastrointestinal pathology would contribute to a significant role in the inception and clinical forms of childhood developmental disorders, including autism. (Wakefield; Puleston; Montgomery; Anthony; O'Leary; Murch, 2002) Even though constipation is found in 2% to 5% of children who are healthy, its clinical diagnosis is often problematic to make in cases of children having behavioral disorders. (Afzal; Murch; Thirrupathy; Berger; Fagbemi; Heuschkel, 2003)

Several brain abnormalities have been found in persons having autistic spectrum disorders, but commonalities have been problematic to establish throughout the clinical population. (Akshoomoff; Lord; Lincoln, 2004) Further there have been no studies which have conclusively proved autism to have been caused by psychological environments. The reason for the disease are physical disorders of the brain and the apparent changes induced are disturbances in the levels of physical, social and language skills; abnormal responses to sensations like sight, hearing, touch, pain, balance, smell, taste and the manner of carriage of body; speech and language may be absent or delayed in starting while the capacity to think may be present and abnormal methods of having relations with persons, objects and events. In terms of the disease itself, autism can be present alone or along with other disorders affecting the brain like viral infections, metabolic disturbances and epilepsy. One must be very clear in identifying the disease as wrong diagnosis may lead to wrong and ineffective treatment. When the disease reaches a severe form, the patient may be self-injurious, repetitive, highly unusual and with aggressive behavior. The best form of treatment has been found to be special educational programs with the use of behavioral methods. It should be remembered that autism is treatable and it is important to make early diagnosis and medical intervention. (Autism FAQ - Definition of Autism)

There are other diseases which give symptoms similar to autism, and there have been cases where brain injury has caused symptoms similar to autism. Another disease has been found to be deafness and this has caused some children to exhibit symptoms similar to autism. Thus the hearing capability of children has to be evaluated before blaming their behavior on autism. Another disease is called Galactosemia and this is an inborn defect in carbohydrate metabolism. There is also Heller's disease where the children show normal development till the age of 3 or 4 and then start getting fretfulness, negativism, anxiety, and regression of mental development and slow loss of speech. (Autism FAQ - Similar Conditions)

There is another disease called LKS Landau-Kleffner syndrome which is also called acquired childhood epileptic aphasia. This is a very rare disorder and the patients show normal development and age appropriate language development for the age up to 7 years; then loses receptive language though retains some expressive language; the speech becomes 'telegraphic' with the use of few verbs; the child remains frustrated with the changes that the child observes; the behaviors become autistic; normal or above normal non-verbal scores in IQ; abnormal EEG which would be with or without seizures. Some doctors feel that childhood disintegrative disorder or "late outset" autism may be called Landau- Kleffner Syndrome.

The fifth similar affliction is called PKU "Phenylketonuria." This is a genetic disorder of metabolism and this result in brain damage during the initial years of life if special steps are not taken. The defect in the body system is inadequate production of enzymes to convert amino acid phenylalanine into tyrosine, which is another amino acid. This extra quantity of phenylalanine accumulates in the fluids of the body and gets changed into certain chemicals that damage the human brain. This results in symptoms which are shown in mental retardation as also some symptoms of autism. This deficiency is now being removed through screening of all children immediately after birth so that the children can be given the required diet. The last in the list is Rett's Syndrome and that is a neurological problem occurring only in girls. Here the girls show proper development initially and then stop developing. The symbols are similar to autism. (Autism FAQ - Similar Conditions)

Autism has been well studied and according to authorities the patient must have at least six of the indication as listed below. Of them two have to be from those under group 1 and one each from those under groups 2 and 3. The afflictions listed under group 1 are called impairment in social interaction as demonstrated by deficiencies in using non-verbal behavior like eye-to-eye contacts, facial expressions, body postures and gestures; the next qualities are in failures to develop peer relationships suitable for the age group; lack of spontaneous desire to share enjoyment, interests or achievements with other people; and lack of social or emotional reciprocity. This is manifested through not actively participating in simple social plays or games and instead preferring solitary activities or even involving others only as tools or mechanical aids. (Autism FAQ - Definition of Autism)

The activities under group 2 are about qualitative impairments in communication. This has to be shown by delay in or a total lack of development of spoken language without using of alternative modes like gesture or mimes; even when individuals can speak, they are not able to start or continue conversation with others; in communication to have stereotyped and repetitive language or idiosyncratic language; and lack of varied or spontaneous make believe play or social imitations suitable to the level of the person.

The activities under group 3 are restricted and stereotyped patterns of behavior, interests or activities. This is seen in at least two of the following set of four -- encompassing preoccupation with some stereotyped and restricted patterns of interests that is not normal for the age; an apparent unchanging fixation to some routines or rituals without any function; stereotyped and repetitive use of parts of body like finger flapping or twisting or even other total body movements; and continued interest with parts of objects. The other major indication comes from delays or abnormal functioning of some of the following activities before the age of three -- social interaction; use of language as used in social communication; and symbolic or imaginative play. At the same time, one has to be sure that the disturbances as seen in the person are not better understood to be due to Rett's Disorder or Childhood Disintegrative Disorder. (Autism FAQ - Definition of Autism)

The next question is of determining why autism takes place. There had been ideas earlier that autism was a disease of the psychological part of humans, but today most researchers are convinced that the disease comes from biology. This concept has started from Infantile Autism, a book written in 1965 by Bernard Rimland, and there it has been made clear that parents do not cause children to be autistic. The first of these reasons is that parents who do not fit the autistic parent personality always have autistic children. On the other side, parents seem to be of the type near pathogenic carriers of autistic pathogen end up having normal and non-autistic children. From the side of children, it is seen that siblings of autistic children are generally normal. Another point that is seen is that autistic children are recognized to be unusual in terms of their behavior from the time of their birth. The fifth point to be noted is that the regular ratio of three or four boys for every girl is maintained. (Autism FAQ - Theories and Causes)

The sixth point to be noted is that practically in all cases where one of the twins is afflicted with autism, even the other is afflicted. The symptoms of autism are very similar to symptoms seen in children who are known to have suffered organic brain damage. The total symptoms seen in the case of autism are unique and specific, and are not necessarily duplicated in different autistic children. There are no grades of autism, and that makes it impossible for understanding the disease to have stages in which it occurs. There are further studies taken through MRI and PET scans of the brain of afflicted children and that shows the occurrence of subtle cellular changes in their brains. It is also seen that there are increased incidences of seizures when they reach adolescence and this also is a guide to differences in neurology. (Autism FAQ - Theories and Causes)

The next important question is to find out how the autistic symptoms start in children. The first theory is that of infections from yeast, or from the intolerance of certain food substances. This can be from intolerance to Gluten which can cause what is called "leaky gut syndrome" or to intolerance. These may be leading to the infections passing through the intestine and thus allowing improperly digested peptides to get into the bloodstream. Having entered the bloodstream, it may be possible for some of them to cross the barrier between the brain and blood and this may mimic neurotransmitters and thus finally affecting the sensory input of the individual. There are also theories that this "leaky gut syndrome" happens to individuals due to the lack of beneficial bacteria in their digestive system which help digestion. This apparently results in certain matter entering bloodstream to provoke and unnecessary immune reaction.

Another major theory is that this happens due to Phenol-sulphertransferase or PST deficiency. This means that some individuals who have autism are low on sulfates or enzymes that use the above item, PST, in the form of phenol-sulpho-transferase-P. If this shortage exists then the body system of the individual will not be able to get rid of the amines and phenol compounds after the body has finished using them. If these keep staying on in the body then it may lead to some adverse effects and may even affect the brain. To treat this problem, some dietary restrictions are recommended as also Epsom salt baths. There are also some simple reasons which are suggested like brain injury, constitutional vulnerability, developmental aphasia, deficits in reticular activating system, interplay between psychogenic and neuro-developmental factors with an unfortunate result, structural changes in the cerebrum, genetic reasons, effects of virus, or problems with immunology vaccines or seizures. (Autism FAQ - Theories and Causes)

Important concern has been developed in the lay and medical communities by means of a theory which enhanced measles-mumps-rubella or MMR immunization among young children might be the cause of a likeable marked enhancement in the occurrence of autism. (Dales; Hammer; Smith, 2001) Some studies have also found associations between autism and other factors in the case of the children affected by the disease. It starts with breech deliveries of babies, low Apgar scores of the baby which is the result of a study carried out 15 minutes after the birth of the baby, the birth of the baby taking place before 35 weeks of pregnancy, a history of parents having a psychosis which looks like schizophrenia, etc. Another cause is the history of the parent suffering from similar disorders and that includes psychoses, depression and bipolar disorders. At the same time, while all these theories may not have been tested out, there is not reason to believe that these are the causes for the occurrence of autism. It can also be seen that many babies are born under some of the above conditions, but it is also clear that all of them do not end up as autistic babies. (Possible Autism Causes from Parents, Pregnancy, Birth)

There are also now shifts to theories of going to look at natural explanations for all of our problems, and one of the new theories are based on the understanding that 70% of all our diseases and the process of ageing take place due to Oxidants, which are also known by the name of free radicals. These come from air, water, toxins, chemicals and other factors of modern life. According to their beliefs each cell in the body is being hit 10,000 times a day due to these toxins and thus the functioning of humans are itself a wonder. Combined with this is the fact that children who have autism are poor eaters and very selective about what they eat and thus the children with autism do not get a balanced diet. Thus it is very important for autistic children to be given a proper diet. (The New Sweet Essential Nutrients Glyconutrients) The fundamental quality of scientific research is scientific thinking and when one looks at the question of health in the modern age compared to earlier ages, one has to measure the situation based on some acceptable yardstick which are not judgmental. If one takes life expectancy as a yardstick then the situation of humans and their health have only improved.

At the same time, there have been studies on this disease and pervasive developmental studies have increased according to a study done among preschoolers in Stafford, UK. According to the study the present prevalence was 58.7 per ten thousand with a confidence level of 95% for the incidence of all pervasive disorders, 22 per ten thousand for autistic disorders and 36.7 per ten thousand of the other varieties of disorders. The children did not have medical conditions related to the disorder. Apparently there has been a growth in the disorder from the figures that were found through a similar study 15 years earlier. (Pervasive Developmental Disorders in Preschool Children: Confirmation of High Prevalence)

There are claims from certain sectors that the disease has also been cured. One case is of Kyle Neil, who was born on 19 April, 1998. The child was developing normally with walking at 12 months and speaking 10 words at 15 months. The progress continued till 18 months, but the child became very finicky about food. The child only accepted certain items like chicken nuggets, pizza and milk. He was also seeing about 6 movies a day. In January 2001, the child was about 2 years and 8 months old and was discovered to be autistic. Certain foods were removed from his diet and the situation of the child improved within one year. The foods that were removed were foods containing milk and Gluten. Thus it may be that the child had severe allergies and the removal of the allergy helped the child to recover. The child also may have had yeast intolerance and that was also removed. Yet the child's parents believe that the real cause of help was glyconutrients. (Autistic Child recovery testimony -- sent by Gary Puckett) The objective in treating any disease is to get a cure, and once that is done, all concerned should be happy.