Understanding and Preventing Autism

Autism is a behavioral and social interaction disorder due to abnormal brain nerve development. This condition causes sufferers to have difficulty communicating, socializing, and learning. Autism is also called autism spectrum disorder (ASD). The term spectrum itself refers to the symptoms and severity of this disease which vary from sufferer to sufferer.

Disorders included in ASD are Asperger’s syndrome, pervasive developmental disorder (PPD-NOS), autistic disorder, and childhood disintegrative disorder (Heller syndrome). This condition is often associated with savant syndrome. Based on data collected by WHO, autism occurs in 1 in 160 children worldwide. Meanwhile, in Indonesia, until now there has been no definite data regarding the number of autism sufferers.

Causes and Symptoms of Autism

The cause of autism is not yet known for certain. However, there are several factors that can increase a person’s risk of developing autism, namely:

• Having certain genetic or chromosomal disorders, such as fragile X syndrome and tuberous sclerosis.
• Having a family history of autism.
• Being born prematurely.
• Being born to parents who are over 40.
• Being born to a mother who consumed alcohol or certain medications, especially epilepsy medications, during pregnancy.

It is important to note that administering the measles vaccine, including the MR and MMR vaccines, does not cause autism in children. In fact, administering the vaccine can help children avoid infections, such as measles, mumps, or rubella.

Symptoms of autism often appear at the age of 2 years. In some cases, symptoms of autism appear at the age of less than 1 year, or only appear in adulthood. People with autism generally experience obstacles in carrying out daily activities with varying symptoms and levels of severity. Here are some symptoms that usually appear in people with autism:

Communication and Social Interaction Disorders
Some children with autism have difficulty interacting with others. These symptoms are usually seen when they are 8 or 10 months old. Some children may also be good at talking, but this ability can be lost as they get older.
Symptoms of autism related to communication and social interaction disorders are:

• Does not respond when called even though hearing is normal.
• Never expresses emotions and is insensitive to the feelings of others.
• Cannot start or continue a conversation, even when only asking for something.
• Often repeats words (echolalia), including latah, but does not understand their proper use.
• Often avoids eye contact and shows little facial expression.
• Has an unusual tone of voice, such as a flat robot.
• Prefers to be alone, as if in his own world.
• Does not understand simple questions or instructions.
• Reluctant to share, talk, or play with others.
• Avoids or refuses physical contact with others.

Behavioral Pattern Disorder
People with autism have patterns of behavior, activities, or interests that appear unusual, limited, and repetitive.
Some symptoms associated with this behavioral pattern disorder are:

• Sensitive to light, touch, or sound, but does not respond to pain.
• Always the same activity pattern, or becomes upset if there is a change.
• Abnormalities in posture or movement patterns, such as always walking on tiptoes.
• Repetitive or repetitive movements, such as waving the hands or rocking the body back and forth.
• The type of food chosen tends to be the same, for example foods with a certain texture.

In addition to the above symptoms, autism sufferers also often experience other conditions, such as:

• ADHD.
• Epilepsy.
• Tourette syndrome.
• Obsessive compulsive disorder (OCD).
• Anxiety disorders.
• Bipolar disorder.
• Depression.

The sooner autism is treated, the more effective the treatment will be. Therefore, see a doctor if your child shows the symptoms of autism mentioned above. Autism can generally be detected early in a child’s development.
Immediately see a doctor if your child shows the following symptoms:

• Having limited ability to speak or interact.
• Does not respond happily or smile by 6 months.
• Does not imitate sounds or facial expressions by 9 months.
• Does not babble by 12 months.
• Does not make gestures, such as waving or pointing, by 14 months.
• Does not say a single word by 16 months.

To diagnose autism, the doctor will ask the patient and his/her family about their complaints and the patient’s family medical history.
The doctor can confirm the diagnosis of autism in patients who have the following criteria:

• Deficient communication and social interaction, including social and emotional responses, body language in interactions, and the ability to build and maintain relationships.
• Restricted patterns of behavior, activities, or interests, such as behavior or speech that shows the same routine, overreaction, or vice versa.
• Symptoms appear in the early developmental period and become more apparent over time.
• Symptoms interfere with work, social activities, and other areas of life.
• The symptoms experienced are not caused by another developmental disorder.

Autism cannot be cured. However, there are several therapy options that can be done to develop the patient’s abilities, including:

Behavioral and Communication Therapy
This therapy aims to provide a number of lessons to patients that include basic daily skills, both verbal and nonverbal, namely:

• Applied behavior analysis (ABA)
  Applied behavior analysis therapy helps patients behave positively in all situations. This therapy also helps patients develop communication skills and leave behind negative behaviors.
• Developmental, individual differences, relationship-based approach (DIR)
  DIR, commonly called floortime, aims to develop emotional relationships between patients and their families.
• Occupational therapy
  Occupational therapy aims to encourage patients to live independently, by teaching basic skills, such as dressing, eating, bathing, and interacting with others.
• Speech therapy
  Speech therapy helps patients learn to develop communication skills.
• Treatment and education of autistic and related communication-handicapped children (TEACCH)
  This therapy uses visual cues, such as pictures, that show the steps in doing something. TEACCH will help patients understand how to do everyday activities, such as changing clothes.
• The picture exchange communication system (PECS)
  This therapy also uses visual cues like TEACCH. However, PECS uses symbols, to help patients communicate and learn to ask questions.

Family Therapy
Family therapy aims to help parents and families to help patients to be active. Families will learn how to interact with patients so they can teach them how to communicate and behave.

Medicines
Doctors may prescribe the following medications to control symptoms:

• Antipsychotic medications, such as risperidone to treat behavioral problems.
• Anticonvulsant medicines, to treat seizures.
• Antidepressants, to relieve depression.
• Melatonin, to treat sleep disorders.

Patients also need to consume a balanced nutritious diet. This is because the consumption of gluten and dairy products is thought to worsen autism symptoms. However, there is no evidence that prohibiting these products is beneficial for people with autism.

Untreated autism can lead to the following complications:

• Sensitive and angry at bright lights and loud noises, or unable to respond to heat, cold, or pain.
• Seizures in people with autism with epilepsy, because epilepsy is common in people with autism.
• Digestive problems.
• Sleep disturbances.

Symptoms in autism sufferers related to impaired social interaction and activity can also have an impact on their quality of life.
Sufferers can experience problems such as:

• Inability to live independently.
• Mental disorders, such as stress, depression, anxiety, mood disorders, and impulsive behavior.
• Inability to follow lessons.
• Inability to form social relationships.

Because the cause is unknown, autism is difficult to prevent. However, doctors may recommend that pregnant women take the following steps to reduce the risk of their child being born with autism:

• Living a healthy lifestyle, for example by undergoing regular pregnancy check-ups, consuming a balanced nutritious diet, and exercising regularly.
• Avoiding alcohol consumption during pregnancy.
• Avoiding exposure to pollution and hazardous chemicals.
• Consulting a doctor if you need to take certain medications during pregnancy.
• Making sure you have been vaccinated before becoming pregnant, especially the rubella vaccine.
• Undergoing examinations and following your doctor’s advice if you are sick, especially if you are diagnosed with celiac disease or phenylketonuria (PKU).