AUTISM

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Autism.

P.K.Ghatak.MD

No. 63.



Autism literally means self-absorption. A Swedish psychologist, Paul Eugen Bleuler coined the term in 1910.

Autism is found to have many variable symptoms and sometimes the conditions can go on and is correctly identified in adult life. This led to a change in name, now autism is called Autism Spectrum Disorder, ASD.

 The ASD is considered as a Neurodevelopmental disorder. ASD presents behavioral and social issues, and some others consider the ASD as a discipline problem.

The newborns can recognize the voice of their mother at birth; some even say the recognition of mother's voice begins in the womb. By the time the children are 2 to 3 months old, the children turn their heads to their mothers, and the facial expression of the child expresses happiness and makes eye contact with his mother. It is natural, that the mother detects lack of personal connection and apathy of the child and begins searching for an answer and soon the autism diagnosis is made. If this is missed, the kindergarten teachers are almost surely able to detect the condition. If not, the next opportunity will be in primary school. If the diagnosis is wrongly made as a discipline problem, compulsive obsessive disorder or schizophrenia then the condition may go on to adult life.

Due to expansion of the diagnostic criteria and new research includes adults, more and adults are now diagnosed with Adult Autism. In 1990, 900 adults were diagnosed and in 2021, 2.5 million were diagnoses with ASD worldwide.

In recent years, 4 subtypes of ASD are proposed based on the genetic patterns and traits. The X chromosome may have protective function and accounts for fewer autism in the female children. Presently over 230 genes are linked with autism.


These are known about the cause of ASD.

1, A neurodevelopmental disorder.

2, Cause is speculative and mostly unknown.

3, Combination of several genetic and non-genetic factors may be operative.


The main symptoms of Autism Spectrum Disorder: 

 The child does not respond when called by his name, lack of eye contact and social interaction. And finds difficulty in adapting to a new environment. Some of them exhibit rocking body movements and repeat certain words or phrases. Some are fixed to certain objects and have a fixed way to perform most tasks.

Prior to the name change, the following ASD subtypes were known:

1, Asperger's syndrome. 2, Kanner's syndrome. 3, Rett syndrome. 4, Pervasive Developmental Disorder. 5, Childhood Disintegrative Disorder.

Of these 5 subtypes, Asperger's syndrome is very well known. The children with this disorder are very intelligent, hypersensitive to sensory stimuli and highly anxious individuals and their interest is confined to a narrow field. They are handicapped in social interactions and communications. They display repetitive behaviors and utter words or phrases spontaneously over and over. A minority of then utter offensive words or phrases, this condition is Coprolalia.

The incidence of ASD in the USA is 3.2 % in children under 8 yrs old.

A new mother is devastated when she learns her newborn has ASD. Besides shattered happiness, the financial burden is heavy for the family and also for the community in finding funds for providing special education and other forms of assistance for the child.

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Footnote:

Besides Asperger's syndrome, a brief description of four remaining syndrome is given here. Kenner syndrome is characterized by a socially isolated child, often non- verbal and follows a particular routine daily. Rett syndrome is very rare, girls are affected mostly, after a normal motor and social developments for 6 months, gradually regress motor skill and muscle functions and finally fails to maintain breathing and swallowing. Pervasive developmental disorder is marked by delayed development of skilled motor functions and speech. Childhood disintegrative disorder is better known by Heller's syndrome is marked by regression of all previously learned skills.

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