Autism : Symptoms, risk factors and prevention

Autism is a member of the group of pervasive developmental disorders (PDDs), which appear in early childhood, usually before the age of 3. Although symptoms and severity vary, all of these disorders affect a child’s or adult’s ability to communicate and interact with others.

The most common TEDs are:

  • Autism
  • Asperger’s syndrome
  • Rett syndrome
  • Unspecified TEDs (TED-NS)
  • Disintegrative disorders of childhood

Causes of autism

Autism is said to be a developmental disorder whose exact causes are still unknown. Researchers agree that many factors are at the origin of PDD, including genetic and environmental factors , influencing the development of the brain before and after birth.

Several genes are believed to be involved in the onset of autism in a child. These are thought to play a role in fetal brain development. Certain genetic predisposing factors could increase a child’s risk of having autism or PDD.

Environmental factors, such as exposure to toxic substances before or after birth, complications during childbirth or infections before birth, could also be involved. In any case, the education or behavior of parents towards the child is responsible for autism.

In 1998, a British study 1 attributed a link between autism and exposure to certain vaccines, in particular the vaccine against measles, rubella and mumps (MMR in France, MMR in Quebec). However, several studies have subsequently shown that there is no association between vaccination and autism² The main author of the study is now accused of fraud. 

Associated disorders

Many children with autism also suffer from other neurological disorders 6 , such as:

  • Epilepsy (estimated to affect 20 to 25% of children with autism 18 )
  • Mental retardation (estimated to affect up to 30% of children with PDD 19 ).
  • Bourneville tuberous sclerosis (up to 3.8% of children with autism 20 ).
  • Fragile X syndrome (up to 8.1% of children with autism 20 ).

People with autism sometimes have:

  • Problems  sleeping  (falling asleep or staying asleep).
  • Gastrointestinal problems   or allergies.
  • Of  seizures  that begin in childhood or adolescence. These seizures can lead to unconsciousness, convulsions, that is, an uncontrollable shaking of the whole body or unusual movements.
  • Psychiatric disorders such as anxiety  (very present and related to the difficulty in adapting to changes, whether positive or negative), phobias and  depression.
  • Of  cognitive disorders  (disorders of attention, executive function disorders, memory disorders, etc.)

Living with a child suffering from autism brings about many changes in the organization of family life. Parents and siblings have to face this diagnosis and a new organization of  daily life , which is not always very simple. All of this can create a lot of  stress  for the entire household.

Prevalence

About 6 to 7 in 1000 people have PDD in those under 20, or one in 150 children. Autism affects 2 in 1000 children under 20. One third of children with PDD present with mental retardation associate.

Over the past 20 years , the number of cases of autism has increased  dramatically and is now one of the most recognized disabilities in schools. Better diagnostic criteria, the increasingly early identification of children with PDD, as well as the awareness of professionals and the population have undoubtedly contributed to the increase in the prevalence of PDDs all over the world.

Diagnosis of autism

Although signs of autism often appear around the age of 18 months, a clear diagnosis is sometimes not possible until the age of  3 , when delays in language, development and social interactions are over. obvious. The earlier the child is diagnosed, the sooner we can intervene.

To make a diagnosis of PDD, various factors must be observed in the child’s behavior, language skills and social interactions. The diagnosis of PDD is made after a  multidisciplinary investigation . Numerous examinations and tests are necessary.

In North America, the usual screening tool is the  Diagnostic and Statistical Manual of Mental Disorders  (DSM-IV) published by the American Psychiatric Association. In Europe and elsewhere in the world, healthcare professionals generally use the International Classification of Diseases (ICD-10).

Symptoms of autism

Autism (or autistic disorder) is the most well-known pervasive developmental disorder.

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Children with autism typically have problems in three critical areas of development:  social interactions ,  language and communication,  and  behavior . The severity of symptoms varies greatly between children. A child with severe autism demonstrates a complete inability to communicate or interact with others.

Some children show signs of autism at an early age. Others develop normally for the first few months or years, then suddenly withdraw into themselves, become aggressive, or lose the language they have acquired. Although each child has a unique behavior, the most common symptoms in children are:

In terms of social skills 

  • Difficulty making eye contact or understanding facial expressions.
  • Difficulty decoding emotional expressions (knowing if someone is sad) and difficulty interpreting the intentions of others.
  • A difficulty in expressing his emotions, his feelings (it is sometimes difficult for those around him to know if the child is in pain, for example).
  • An absence of response when called by name.
  • A preference to play alone, to withdraw into his world, an inability to make friends of his age.
  • An inability to play symbolic (imaginative, pretend) games.
  • Resistance to hugs or getting caught.

In terms of language and communication

  • The child begins to speak later than 2 years old.
  • The appearance of other developmental delays around 30 months.
  • The loss of words or phrases already acquired.
  • The child does not look at his interlocutor when he is addressing someone.
  • An inability to initiate or maintain a conversation.
  • The child speaks with an abnormal rhythm or tone (a singing or “mechanical” voice).
  • The child can repeat words but does not understand their meaning.

In terms of behavior

  • A tendency to perform  repetitive  movements (called stereotypies) such as rocking, clapping, or spinning.
  • Excessive dependence on particular  routines  or rituals.
  • A  hypersensitivity  or subsensitivity to light, sound, touch, certain textures or insensitivity to pain. This peculiarity could be explained by a disorder of the processing of sensory information.
  • A fascination with certain parts of an object, for example a wheel that turns on a toy.
  • The child is constantly moving.
  • The child does not seek to share his interests with others.
  • Of  temper tantrums , aggressive actions directed against oneself (self-harm) and / or directed to another (hetero aggressiveness).

It is best to see a specialist as soon as possible if your child:

  • Do not babble or twitter by 12 months of age.
  • Does not make gestures to communicate, such as pointing at an object or a picture.
  • Said no words at 16 months old.
  • Don’t say a two-word sentence at 24 months old.
  • Seems to lose his language or already acquired social skills.

People, risk factors and prevention of autism

People at risk

  • Gender: Autism seems to affect boys more frequently   than girls (4 boys for 1 girl).
  • People with parents or  siblings  already affected 3 .
  • People with other developmental disorders, such as Fragile X syndrome or Down syndrome 4 .

Risk factors

To date, no risk factor related to autism has been scientifically established.

Prevention

There is no way to prevent the onset of autism or PDD.

Measures to prevent the consequences of autismTreatments, when started at a young age, can improve children’s language and social skills. However, different treatments are sometimes necessary before determining which combination of therapy is most appropriate for each child.

Medical treatments for autism

Although there is currently no cure for autism, nor a single effective treatment for PDD, a variety of therapies and interventions can reduce symptoms and improve symptoms. learning. Research 7 shows that diagnosis and interventions before school age work better. As the brains of young children are still forming, early intervention gives children a better chance of developing to their full potential and can make a big difference in the lives of many affected children. However, it is never too late to intervene and treatments will be beneficial regardless of the age of those diagnosed.

Because of the continuum of autism, a wide range of supports may be needed. For example, some people need intensive help and constant supervision just to get through the day safely. Others only require special help to communicate or to facilitate their social integration. The ideal treatment plan is a combination of therapies and interventions tailored to each child. These programs and treatments are very numerous and their implementation varies greatly from country to country. Cultural variables (educational means, place of disability, ethical values), economic imperatives and the advancement of knowledge about autism are factors that partly explain these variations in care and the absence of an international consensus. .

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Note: Various types of interventions can be effective in supporting people with autism. The main approaches are explained in this sheet, but it is not an exhaustive list 21 .

Global intervention with behavioral reference

The applied behavior analysis or method Lovaas ABA for Applied Behavior Analysis is one of the best documented therapies to date, called (ABA). Its goal is to structure and reinforce new learning, such as learning to speak, play, interact with others and reduce inappropriate behaviors, such as anger or self-harm. Acquiring these skills eventually allows people with autism to achieve independence. The technique is however expensive and requires intense parental investment over several years. The child should be stimulated 20 to 40 hours per week individually with a professional who has received the necessary training. Often, parents take ABA training to lead the treatment team and hire others to help them deliver treatment.

Global intervention with developmental reference

The TEACCH method ( Treatment and Education of Autistic and Related Communication Handicapped Children ) concerns the treatment and education of children with autism or suffering from communication disabilities. Developed in California in the 1970s, it is based on the principle that the learning environment must be adapted to the autistic child and not the other way around. A lot of visual cues are used, for example, in a classroom, school materials are clearly identified so that students can access them independently.

Interventions focused on socialization

The Floor Time Method or RDI Relationship (Development Intervention Program) is a form of play therapy that takes into account the six stages of emotional development. Social exchange and emotional regulation capacities are stimulated through play. Children must go through these stages to be able to move on to further learning.

The Early Start Denver Model is play- based and can start in children with autism as young as 18 months, at the first sign of it. The method combines individual sessions with a therapist, in a daycare (crèche) and at home. It aims to interest the child in activities and encourage him to communicate with others, especially with his parents.

The management of autism

Children with autism and PDD require medical, paramedical and educational support in addition to educational support. Multidisciplinary support (speech therapy, psychomotor skills, educational support, psychotherapy, occupational therapy) is often offered.

School integration

A team of parents, teachers, psychologists and other specialists who support the child, develop  a personalized school project  (PPS) in France or an  individual education plan  (PÉI) in Canada. This project is useful for guiding the autistic child through his school learning. The child’s parents play a key role in this.

In the long term, the (ideal) goal for each student with PDD is to successfully benefit from   regular schooling . Thanks to early diagnosis and child-friendly care, many of these students become more independent. In France, it is recommended that children be educated in nursery and kindergarten in order to develop their language and social skills. If necessary, the child can be accompanied by a school life assistant (AVS). Over time, the student becomes more  independent  and feels more comfortable in an integrated classroom. For some people, this process can take years. In fact, the pace of progress varies depending on the individual.

During adolescence , some autistic children may experience depression or behavioral problems. Their treatment sometimes needs to be changed in their transition to adulthood. Adults with autism require services and supports, but many are able to work and live independently in an appropriate environment.

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Autism medication and diet

Medication


No medication can cure autism or other ASDs. Some medications can be prescribed to treat the symptoms of the consequences of autism.

Antipsychotics such as Risperidone (Risperdal) or Aripripazole (Abifiy)15 are commonly used in schizophrenia8. In children with PDDs, they can reduce irritability, aggression, self-injury or anger. They can also help control severe behavioural problems.

Antidepressants (Prozac, Zoloft) may be used to control anxiety or depression and sometimes prescribed to reduce repetitive behaviour. Some antidepressants can help control aggression.

Some psychostimulants such as methylphenidates (Ritalin, Concerta), used for attention deficit disorder, are sometimes used successfully in some children with autism to reduce impulsivity or hyperactivity.15 Some children, however, do not respond well to these medications. However, some children do not respond well to treatment and there are side effects to consider.

Diet

People with ASD often have bowel problems or chronic gastrointestinal inflammation. This can cause the body to have difficulty absorbing certain essential nutrients. Some researchers have suggested that the majority of children with ASD also have immune system problems, which means they react differently to viruses, toxins or certain foods.

Several diets have been suggested as possible treatments for autism, such as restriction of food allergens, a diet free of gluten and casein (a milk protein), vitamin supplements such as vitamin B6 and B12, a yeast-free diet, and a diet rich in probiotics. More research is needed to confirm that a specific diet may have a significant effect on the symptoms of autism.

Our doctor’s opinion

Live better with an autistic child

Receiving a diagnosis of autism for your child is far from easy. On the one hand, professionals finally confirm  parents’ suspicions and  concerns about their child’s different behaviors. On the other hand, parents usually go through a whole range of emotions ranging from fear for the well-being of their child to feeling uncertain about their child’s future. However, a clear and early diagnosis allows parents to seek appropriate services for their child.

Many parents feel helpless in the face of the complexity of the psychological, medical and social care offered to their child. The  stress  they will face includes:

  • Find the services needed for effective treatments
  • Face the challenges and conflicts in the education of their child
  • Having to deal with many health professionals and other professional services
  • Find the necessary financial resources
  • Coping with isolation from friends and family social activities
  • Adapt your living environment to the child’s lifestyle
  • Adapt family life and the time invested with other children in the family
  • Help their child to cope with discrimination, bullying and help them build good self-esteem
  • Coping with discouragement and sometimes depression.

The success of cohabitation with an autistic child requires a learning on the part of the parents and the search for the support and the encouragement which they will need during several years for themselves and for their child. Services are available to help families and caregivers of children with autism and other pervasive developmental disorders. Check out the associations and support groups available in your area.

Our doctor’s opinion

“Finding out that your child has autism is not easy. Even if a lot of information is provided by the doctor during this announcement, it often happens that the parents, in shock, do not manage to formulate their questions. Do not hesitate to contact him again to explain all your questions. I remind you that there are no stupid questions. You must benefit from the best possible support during this announcement.

Regarding care, it is essential to have the accompaniment and support of a team of specialists. You will develop with them a scalable (educational, medical, social) project that will best meet the needs (educational, medical, social, etc.) of your child. The exchange between you and all the partners revolving around your child is essential for you to be an actor in this support.

Finally, do not hesitate to contact the associations. They are made up of parents and children who are going through the same things as you. “

Autism : Symptoms, risk factors and prevention
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