April is Autism awareness month, although there is a push to rename it Autism education and acceptance month. This is probably the biggest issue I see with this and many disorders, how do we acknowledge, accept and embrace individuals who may not act or look the way you do. You start with an understanding of the condition, even if it is a simple understanding. You don’t need to know the science or anatomy behind conditions, just a simple understanding of what to look for and how to react.
As physicians we are taught, not only how to make the diagnosis but more importantly how to interact with both the patient and the family. We don’t expect the general public to have that knowledge but we do appreciate when people understand some conditions and can make the day of the individual and their family a bit easier. The child with autism is not ignoring you and is not being rude by not looking at you when spoken to, that is a part of the condition. Accept it and communicate as well as you can knowing this is part of the autism spectrum symptoms. How we act as adults shows a lot of our knowledge or ignorance towards conditions.
So do we need to discuss the symptoms on the spectrum of autism, it may help you as individual understand and accept the actions of an individual with autism. As infants we learn many social skills including, looking at faces, smiling, even as simple as turning to the sound of a voice or your name being called. Autistic infants and children often will not respond to a voice or their name, they may seek their parents more than others and often they won’t participate in social interactions they are more content playing on their own. Understanding those simple aspects are important. So your interaction with the child will be different, accept it, do not try to change them, understand that this is part of who they are. Don’t try to lecture their parents, accept it.
Children with autism have difficulty with communication, their vocabulary is not as advanced as child of a similar age. This is not a lifelong issue and early identification of these infants allows for early intervention. This intervention allows the child with autism to learn ways to communicate and expands their vocabulary be it at a different rate than others. Remember this is a spectrum and in fact the spectrum is so wide that at one end there is the child who shows just minor or slight delays in language and communication skills, for these patients it is important for teachers as well as peers to understand the spectrum. Peers can be very mean at some ages, as parents, educating your children about Autism, Down’s , Cerebral Palsy the list goes on, and how to interact with these children of the same age will make them outstanding kids and adults in the future. Teach them but be a role model as well. Thank the individual with Down’s who bags your groceries, don’t ignore them. Tell them they did a great job, read their name tag and say Thanks, you will feel the reward as much as they do.
Time to get off the soap box and discuss some issues. So how common is autism spectrum? Estimates are that 1 in 68 children fall somewhere on the spectrum of Autism. There are others who place this number lower as we know there are many cases that are not diagnosed. Many ask why the rate is so much higher than in the past? Is it environmental? No it is more about awareness, early diagnosis and early intervention. We have discussed it many times and there is no association with vaccines and autism. In fact all of the national autism societies promote full vaccination for all children.
So what causes autism, we are not sure. We know there are some genetic components but this is not the only factor but we have not identified environmental factor. Research is being done in early diagnosis , cause, treatment and cure.
We discussed some of the symptoms but here are a few more.
1. Social Challenges- inability to socially interact with large groups, may not look you in the face, and are more comfortable being alone
2. Emotional outbursts- some with autism have emotional outburst that are not expected, they may be affection or anger
3. Communication difficulties- we discussed slow or minimal language development and that these individuals may do better with nonverbal tools, photos, I pads etc.
4. Body language is not to be interpreted as it may be for others-
5. Repetitive behaviors- this is common and can be disruptive to people so it is very important that we understand this may occur and accept it. They may hand flap, they may rock in place, they may wiggle their fingers in front of their face
6. Autistic induvial may also have a preoccupation or almost obsession on a variety of things. It may be as simple as how does a refrigerator work or it may be a science topic, in other words it could be anything
If you have concerns about autism bring them up with your physician. They can schedule screening tests and enrollment in early intervention. Many adults actually fall on the spectrum and have never been diagnosed. For these individuals the diagnosis is important as well, as it can help explain social interactions and workplace interactions. So even if you have a concern as an adult seek help as it will make your life better. The diagnosis actually is relieving to many adults as it shines a light of explanation on struggles they may have had thru life.
It is important to know that autism is a true spectrum, yes there are some individuals who have lower IQ’s , however there are others who have above average intelligence. Mozart was thought to be autistic, as was Einstein, Thomas Jefferson and Dan Aykroyd. The spectrum is wide and the diagnosis in no means limits what an individual will do in life. Many of you may remember the movie Rain Man with Tom Cruise and Dustin Hoffman. Where Dustin Hoffman is an autistic brother of Cruise.
So the main messages are pretty clear. If you have a child that you are concerned about, discuss it with your pediatrician and seek testing and early intervention. If you are an adult and have had issues that concern you may be autistic see your doctor and discuss it. Most importantly when you interact with an individual who falls on the spectrum, know what to look for and what to expect.