The term autism was first coined in 1940 however, awareness has increased in the recent years. Autism Spectrum Disorder (ASD) is a fairly common condition affecting almost 1 in 42 boys and 1 in 189 girls. It encompasses a number of clinical entities with varying degrees of difficulties in communication, social interaction as well as repetitive behaviours. The manifestations can range from mild to severe. Some individuals may excel in math or music or art but may be socially inept (Sheldon from the TV show – The Big Bang Theory, is an example). It is believed that Albert Einstein and Amadeus Mozart may have had ASD. Each affected child is unique in his or her presentation of symptoms. Behavioural and intellectual challenges may affect the quality of life to varying degrees. Hence, treatment must be tailored to each patient’s individual needs.
The developmental profiles of children vary but there are some behaviours or delays in certain milestones that should encourage you to speak to your healthcare provider about further evaluation for autism. Those most common include — the child not making appropriate eye contact or making unusual finger movements near the eyes; the child does not babble by 12 months of age or smile by 6 months. Instead of normal speech, the child continues to speak in jargon and keeps repeating words that do not make sense. Sometimes the speech that has developed begins to regress. There is a checklist available —MCHAT (modified checklist for Autism in Toddlers ) that caregivers can download and go through with their physicians to determine the need for further evaluation by a Developmental Behavioural Paediatrician.
It is believed that although the developmental process that leads to autism may commence before birth, the most obvious clinical manifestations are usually not evident until 12-18 months after birth. Some infants develop normally and then begin to regress where they lose their previously acquired skills. Several years ago a small study raised concerns about the link between the MMR (Measles, Mumps and Rubella) vaccine. The study has now been discredited and since then several large studies have found no link between autism and vaccinations. The unfortunate sequel to this study has been that, it wrongly created a paranoia for vaccinations followed by a decrease in vaccinations given to the general population. This has led to outbreaks of measles and other vaccine preventable diseases resulting in significant morbidity and jeopardizing the safety of the whole community.
Treatment is usually addressed by a multidisciplinary team with input from the occupational therapist, speech language pathologist, physical therapist, behaviour consultant and developmental paediatrician. The prognosis varies depending upon a number of factors: the age at which the intervention was initiated, the severity of the symptoms and the availability of support systems. Some improve with age and intervention, whereas others continue to be a challenge. Some of the high functioning individuals with ASD may be able to compensate for their lack of social skills and find a career that may unmask their genius and make this a better world! Where would we be without Albert Einstein, Amadeus Mozart, Sir Isaac Newton, Dan Aykroyd, Andy Warhol and Michelangelo?