Autism

Autism is a neurodevelopmental disorder characterized by impaired social interaction, verbal and non-verbal communication, and restricted and repetitive behavior. Parents usually notice signs in the first two years of their child's life.^[2] These signs often develop gradually, though some children with autism reach their developmental milestones at a normal pace and then regress.^[3] Thediagnostic criteria require that symptoms become apparent in early childhood, typically before age three.^[4]

While autism is highly heritable, researchers suspect both environmental and genetic factors as causes.^[5] In rare cases, autism is strongly associated with agents that cause birth defects.^[6] Controversies surround other proposed environmental causes;^[7] for example, the vaccine hypotheses have been disproven. Autism affects information processing in the brain by altering how nerve cellsand their synapses connect and organize; how this occurs is not well understood.^[8] In the DSM V it is one of three recognized disorders in the autism spectrum (ASDs), the other two being Asperger syndrome, which lacks delays in cognitive development and language, and pervasive developmental disorder, not otherwise specified (commonly abbreviated as PDD-NOS), which is diagnosed when the full set of criteria for autism or Asperger syndrome are not met.^[9]

Early speech or behavioral interventions can help children with autism gain self-care, social, and communication skills.^[2] Although there is no known cure,^[2] there have been reported cases of children who recovered.^[10] Not many children with autism live independently after reaching adulthood, though some become successful.^[11] An autistic culture has developed, with some individuals seeking a cure and others believing autism should be accepted as a difference and not treated as a disorder.^[12]

Globally, autism is estimated to affect 21.7 million people as of 2013.^[13] As of 2010, the number of people affected is estimated at about 1–2 per 1,000 worldwide. It occurs four to five times more often in boys than girls. About 1.5% of children in the United States (one in 68) are diagnosed with ASD as of 2014, a 30% increase from one in 88 in 2012.^[14][15][16] The rate of autism among adults aged 18 years and over in the United Kingdom is 1.1%.^[17] The number of people diagnosed has been increasing dramatically since the 1980s, partly due to changes in diagnostic practice and government-subsidized financial incentives for named diagnoses;^[16] the question of whether actual rates have increased is unresolved.^[18]

Characteristics

Autism spectrum disorder video

Autism is a highly variable neurodevelopmental disorder^[19] that first appears during infancy or childhood, and generally follows a steady course without remission.^[20] People with autism may be severely impaired in some respects but normal, or even superior, in others.^[21]Overt symptoms gradually begin after the age of six months, become established by age two or three years,^[22] and tend to continue through adulthood, although often in more muted form.^[23] It is distinguished not by a single symptom, but by a characteristic triad of symptoms: impairments in social interaction; impairments in communication; and restricted interests and repetitive behavior. Other aspects, such as atypical eating, are also common but are not essential for diagnosis.^[24] Autism's individual symptoms occur in the general population and appear not to associate highly, without a sharp line separating pathologically severe from common traits.^[25]

Social development

Social deficits distinguish autism and the related autism spectrum disorders (ASD; see Classification) from other developmental disorders.^[23] People with autism have social impairments and often lack the intuition about others that many people take for granted. Noted autistic Temple Grandin described her inability to understand the social communication of neurotypicals, or people with normal neural development, as leaving her feeling "like an anthropologist on Mars".^[26]

Unusual social development becomes apparent early in childhood. Autistic infants show less attention to social stimuli, smile and look at others less often, and respond less to their own name. Autistic toddlers differ more strikingly from social norms; for example, they have less eye contact and turn-taking, and do not have the ability to use simple movements to express themselves, such as pointing at things.^[27] Three- to five-year-old children with autism are less likely to exhibit social understanding, approach others spontaneously, imitate and respond to emotions, communicate nonverbally, and take turns with others. However, they do form attachments to their primary caregivers.^[28] Most children with autism display moderately less attachment security than neurotypical children, although this difference disappears in children with higher mental development or less severe ASD.^[29] Older children and adults with ASD perform worse on tests of face and emotion recognition^[30] although this may be partly due to a lower ability to define a person's own emotions.^[31]

Children with high-functioning autism suffer from more intense and frequent loneliness compared to non-autistic peers, despite the common belief that children with autism prefer to be alone. Making and maintaining friendships often proves to be difficult for those with autism. For them, the quality of friendships, not the number of friends, predicts how lonely they feel. Functional friendships, such as those resulting in invitations to parties, may affect the quality of life more deeply.^[32]

There are many anecdotal reports, but few systematic studies, of aggression and violence in individuals with ASD. The limited data suggest that, in children with intellectual disability, autism is associated with aggression, destruction of property, and tantrums.^[33]

Communication

About a third to a half of individuals with autism do not develop enough natural speech to meet their daily communication needs.^[34] Differences in communication may be present from the first year of life, and may include delayed onset of babbling, unusual gestures, diminished responsiveness, and vocal patterns that are not synchronized with the caregiver. In the second and third years, children with autism have less frequent and less diverse babbling, consonants, words, and word combinations; their gestures are less often integrated with words. Children with autism are less likely to make requests or share experiences, and are more likely to simply repeat others' words (echolalia)^[35][36] orreverse pronouns.^[37] Joint attention seems to be necessary for functional speech, and deficits in joint attention seem to distinguish infants with ASD:^[9] for example, they may look at a pointing hand instead of the pointed-at object,^[27][36] and they consistently fail to point at objects in order to comment on or share an experience.^[9] Children with autism may have difficulty with imaginative play and with developing symbols into language.^[35][36]

In a pair of studies, high-functioning children with autism aged 8–15 performed equally well as, and adults better than, individually matched controls at basic language tasks involving vocabulary and spelling. Both autistic groups performed worse than controls at complex language tasks such as figurative language, comprehension and inference. As people are often sized up initially from their basic language skills, these studies suggest that people speaking to autistic individuals are more likely to overestimate what their audience comprehends.^[38]

Iatrogenic Advocates: Modern Guardians of "The Mentally Ill"

At all levels of society, including business, academics, organizations and families, those in positions of relative social power seem to believe they have the right to speak on behalf of those who have less of it. Everywhere we look, those at the top of conventional power hierarchies are freely appropriating the voices of those lower on the totem pole. They are speaking to and for our needs. They are deciding what is good for us and our families. They are deciding what policies and positions are necessary, good and right for all sorts of us without ever having to be troubled to talk people of our sort. They are deciding, literally, the directions and fate of organizations in which hundreds, thousands, even millions of us have invested our efforts, trust or lives without one wit of socially enforceable obligation to even give a rip. 

It's no different in the mental health arena.  A few short days ago, the House of Representatives voted to create Two Americas - one for the diagnosed and one for the presumably 'normal.'  They did so with the almost unequivocal blessing of the mental health organizations who are supposed to protect the rights and interests those of us who have been psychiatrically labelled. 

Yep, our closest allies and biggest benefactors freely traded away our humanity in return for trinket programs and/ or a pass on being slated for organizational extinction by vindictive political interests. In the final analysis, they were ok with the fact that the people they represent - and say they serve - will now be targeted and singled out for heightened screening, supervision, oversight and control compared to other Americans.  In fact, for the most part, they are now going around waiving flags of success and bragging about the great deals they negotiated on our behalf.  

In some ways, none of this is all that new.  From the beginning of our nation, there have been two sets of laws, two sets of rights for American citizens, depending on which category you fall into. The moment you get a diagnosis, you fall into the latter category.  You can be stripped of rights to liberty, person and property without the normal due process protections afforded every other American citizen.  Equally egregious, the only basis for this is that some mental health professional, somewhere, has at some time in your life given you a mental health label.  Instant second class citizenship.  Instant life sentence to a lesser personhood.  

Post-diagnosis, somebody who thinks you're not behaving only has to know of the label and invoke it.  From that moment on, for all practical purposes, you are are assumed crazy until proven sane.  The onus falls on you.  Only those Americans who manage to stay diagnosis-free get to retain their full legal status to full protection under the law.

The injustice of this is obvious to all who care to look.  Many are rightly shaking their heads, wondering how we got to this place - how all of this happened and why, in modern times, does it keep getting even worse?  

Part of the problem lies in the structure of so-called charitable or public interest organizations and their relationship to causes they purport to represent.  In this regard, the world of mental health is no different than others.  Nonprofits spring up all the time for all sorts of causes.  The variety that purport to speak for 'The Mentally Ill' are a dime a dozen.  We are a lucrative cause, and a ready-made source of healthcare and philanthropic funding.  Numerous so-called advocacy and public interest organizations make a living from our issues. They say they are working for us - that they represent us and our best interests.

On the whole, however, these organizations are self-serving and out of touch.  While some may be well-intentioned, in practice, they are a recipe for de facto fraud and self-dealing.  They are not run by or for those of us they claim to serve.  They are not accountable to us, to our values, our vision or to the outcomes we want to achieve.  They make little, if any, meaningful effort to reach out to us, engage us, ask what we want or what would make our lives better.  To the contrary, their agenda is determined by founders, board members, funders, liability concerns, lawyers and insurance companies, government regulations - everybody but us.  If fact, they consider it our responsibility to seek them out if we want to have a voice with them on our own issues.  

In a word, they are using us. They are appropriating our pain, our victimization, the fact of our second class citizen status.  And then, with a subtle slip of the hand they are converting our issues -and all the resources and goodwill that go with them - to advance their own priorities and agendas. They are making decisions about us, without us - often without ever having met us - and calling it for our benefit.  They are shamelessly, unabashedly bragging about how much good they have done for us - and how grateful we and everyone else should be for what they do - even while stepping in front of us on the podium and substituting their own voices for ours.  Even while stealing the very seats at the table that should be rightly ours and then afterwards sweeping the floor of crumbs that we would happily make a meal of. 

What morally legitimate paradigm would operate this way?  It’s like:  You hear a rumor that Joe Peer needs help. So you write up a grant, get Uncle Sam to fund it, do what you feel like doing, collect a paycheck every week and then tell everybody what a sad case Joe Peer is and how much he loves what you are doing for him.  Uncle Sam keeps the paychecks coming.  No one knows you’ve never even met Joe Peer. 

This is self-promotion, self-dealing, a blatant breach of trust.  It has nothing to do with advocacy or the public good.  It has everything to do with the vulnerability - the powerlessness and the susceptibility to being taking advantage of - of the populations these organizations claim to be protecting.

Guardianship by any other name...

These are the new mental health guardians.  Make no mistake about it:  If you have a diagnosis, you have a guardian.  In fact, you have many of them.  They are appointed, not on an personal private level, but for our people as a whole.

It's not that we appoint them or that some court or elected official does.  Nope, they actually appoint themselves.  They pull together enough money, resources and legal know how.  Then they create a mission statement, vision, and by-laws.  They submit papers to the IRS and, presto!, done deal.  Now, there is another nonprofit that gets to speak for us, claim seats at the table on our behalf, and solicit funds and public goodwill intended for our benefit.

This is how you get to be a designated guardian of other people's causes - and other people's futures - in the United States of America today.  It is hard to conceive of any way of doing business that would do less in the way of supporting a people's legitimate quest for self-determination.

Indeed, the vast majority of these organizations - and those who direct and run them - are not members of the actual groups they claim to represent.  They may be close to us.  They may be educated or have a lot of book learning.  They may have good hearts and good will.  But they have not walked in our shoes or seen life from our eyes. And, because of that, few and far between are those who really understand.  

Iatrogenic leadership...

But lack of understanding is the least of our concerns.  The impact of these organizations is far from neutral - it is often downright damaging.  By and large, they replicate, rather than challenge, the status quo, along with the harmful dominant culture assumptions that maintain it.  They impoverish our people and our cause by draining away resources that rightly should belong to us.  They give the illusion that our voices are present and that our interests have been represented.  In a word, they are causing, intensifying, perpetuating the same disenfranchisement, disconnection, discrimination and marginalization they are funded to repair.

Ironically, insidiously, this re-enacts the essential trauma and oppression that our people have experienced at the hands of psychiatry since its inception. The essential dynamic is one wherein a few designated 'experts' who 'know' are allowed to substitute their judgment for what is in our 'best interests.'  As with psychiatry, such attitudes thrive in a climate of discrimination.

We live in a dominant culture that takes it for granted that those in some roles (guardians, experts, managers) ‘know’ better than others (diagnosed, unschooled, employees) what is ‘good’ for them. This conventional practice of classifying people into hierarchical categories of social worth is a huge part of the problem.  It reifies the construct of social unworthiness, and validates the relative social privilege of the so-called worthy.   The effect is to amplify the voice, legitimacy and power that privileged roles already have, while effecting political and social death for the sorry-lotted rest of us. This perpetuates - rather than alleviates- the oppression of those who are so ‘labeled’.

Indeed, the very social characteristics that qualify some people as ‘the ones who know best’ --things like family standing, position in society, employment roles and academic credentials -- are the very factors that get used and abused by those with more social standing to devoice and disempower those of us with less of it.  Such distinctions arguably are what created the social structures that oppress so many of us in the first place.

Not surprisingly then, these structures historically have been part of the problem, not the solution for our people.  While the people, positions and organizations that make them up may vary over time, in essential form, they preceded our oppression and were embedded in the existing social fabric that allowed it to materialize.  They may have even motivated, engineered or actively supported the institutional expediencies that stripped us of our rights. At the very least, they perpetuate our continued vulnerability to labeling and marginalization across demographics.

Do You Have Authority to Exercise Authority? 

The Universal Declaration of Human Rights makes clear that authority for governance derives from the governed. (Art. 21.3) Similarly, the Convention on the Rights of Persons With Disabilities expressly rejects a ‘guardianship’ approach to governance. (Art. 12).  Thus, would-be leaders may not simply substitute their judgment for that of the constituency they claim to serve.  Rather, they may only represent individuals who have requested their assistance.  Moreover, the scope of their authority is to ascertain and support the 'rights, will and preferences' (Art. 12) of those they endeavor to assist.

By all appearances, the organizational guardians of mental health fail dismally with regard to these standards (as does our government).  So let’s be clear here.  From the point of view of the world community, the decisions being made on behalf of 'The Mentally Ill' in America are morally null and void.  In a nutshell:

We didn’t ask you. You don’t know us.  You make your living catering to a system that oppresses us. You are abusing your power and calling it ‘help’. If don’t see how that’s happening or your part in it, you’ve just proven the point. 

ACUTE STRESS DISORDER

Acute Stress Disorder Symptoms

Acute Stress Disorder is characterized by the development of severe anxiety, dissociative, and other symptoms that occurs within one month after exposure to an extreme traumatic stressor (e.g., witnessing  a death or serious accident). As a response to the traumatic event, the individual develops dissociative symptoms. Individuals with Acute Stress Disorder have a decrease in emotional responsiveness, often finding it difficult or impossible to experience pleasure in previously enjoyable activities, and frequently feel guilty about pursuing usual life tasks.

A person with Acute Stress Disorder may experience difficulty concentrating, feel detached from their bodies, experience the world as unreal or dreamlike, or have increasing difficulty recalling specific details of the traumatic event (dissociative amnesia).

In addition, at least one symptom from each of the symptom clusters required for Posttraumatic Stress Disorder is present. First, the traumatic event is persistently reexperienced (e.g., recurrent recollections, images, thoughts, dreams, illusions, flashback episodes, a sense of reliving the event, or distress on exposure to reminders of the event). Second, reminders of the trauma (e.g., places, people, activities) are avoided. Finally, hyperarousal in response to stimuli reminiscent of the trauma is present (e.g., difficulty sleeping, irritability, poor concentration, hypervigilance, an exaggerated startle response, and motor restlessness).

Specific Symptoms of Acute Stress Disorder:

Acute stress disorder is most often diagnosed when an individual has been exposed to a traumatic event in which both of the following were present:

• The person experienced, witnessed, or was confronted with (e.g., can include learning of) an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others
• Though not required, the person’s  response is likely to involve intense fear, helplessness, or horror

Either while experiencing or after experiencing the distressing event, the individual has 3 or more of the following dissociative symptoms:

• A subjective sense of numbing, detachment, or absence of emotional responsiveness
• A reduction in awareness of his or her surroundings (e.g., “being in a daze”)
• Derealization
• Depersonalization
• Dissociative amnesia (i.e., inability to recall an important aspect of the trauma)

The traumatic event is persistently re-experienced in at least one of the following ways: recurrent images, thoughts, dreams, illusions, flashback episodes, or a sense of reliving the experience; or distress on exposure to reminders of the traumatic event.

Acute stress disorder is also characterized by significant avoidance of stimuli that arouse recollections of the trauma (e.g., avoiding thoughts, feelings, conversations, activities, places, people). The person experiencing acute stress disorder also has significant symptoms of anxiety or increased arousal (e.g., difficulty sleeping, irritability, poor concentration, hypervigilance, exaggerated startle response, motor restlessness).

For acute stress disorder to be diagnosed, the problems noted above must cause  clinically significant distress or impairment in social, occupational, or other important areas of functioning or impairs the individual’s ability to pursue some necessary task, such as obtaining necessary assistance or mobilizing personal resources by telling family members about the traumatic experience.

The disturbance in an acute stress disorder must last for a minimum of 3 days and a maximum of 4 weeks, and must occur within 4 weeks of the traumatic event. Symptoms also can not be the result of substance use or abuse  (e.g., alcohol, drugs, medications), caused by or an exacerbation of a general or preexisting medical condition, and can not be better explained by a a Brief Psychotic Disorder.

This disorder has been updated according to DSM-5 criterion

Tips for Parenting a Child With Autism

The shock of finding out your child has autism is life-changing for most parents. But new findings show parents can fare well emotionally and still have a strong bond with their child.

Studies into the coping skills of mothers of children with autismconfirm that they are more likely to report "poor or fair" emotional andmental health than other moms, but they are also more likely to show remarkable strengths.

These findings, published in the journal Pediatrics, come from a nationally representative survey of almost 62,000 mothers of school-aged children, including 364 mothers of children with autism. Researchers concluded that moms of children with autism were just as likely as other moms to report having a close relationship with their child and five times as likely to do so as mothers of children who had other developmental problems (not including autism).

Autism and other pervasive developmental disorders (or PDD) typically begin before age 3. They are a complex group of developmental disabilities marked by great difficulty in social interaction and communication. Difficulties on the spectrum range from mild to severe.

If your child has autism, you know how this developmental disorder can disrupt every part of your life -- your relationships, physical and emotional health, and career aspirations. But there is hope and help. Consider the following strategies as you tackle the special challenges and receive the unique joys of parenting a child with autism.

1. Learn All You Can About Autism

You can't "catch" autism. You either have it or you don't. And today, about one in 68 children has been diagnosed with autism or an autism spectrum disorder (also called ASD), which encompasses several related disorders, such as Asperger's syndrome. They are all complex developmental disabilities that affect the development of a child's social skills, communication skills, and behavior.

Autism is usually detected during a child's formative years, so experts know that early diagnosis, intervention, and treatment are the keys to helping young children with autism develop to their full potential. The primary goal of autism treatment is to improve the overall ability of the child to function.Because autism symptoms and behaviors often change over time, treatment strategies are tailored to the child's needs and available family resources. In general, however, children with autism respond best to highly structured and specialized treatment. A program that addresses helping parents and improving communication, social, behavioral, adaptive, and learning aspects of a child's life will be most successful.

Talk to your doctor about the bestautism treatments and goals for educational services so that you and your child can take advantage of all available resources. Read all you can on autism so you understand the symptoms and behaviors and the differences in medications or alternative therapies. Communicate with other professionals and parents and learn from those who've crossed this bridge before you -- as they share insights into common autism concerns. In addition, become very familiar with public policies so you can be your child's advocate in gaining the best education and care possible. Make sure, for example, that plans (504 or IEP) are in place for your child to receive therapies at school.

2. Get a Strong Social Network

Parenting a child with any chronic illness is emotional; it affects every part of your being. But the day-to-day care of children with autism is especially stressful because of the lack of essential social interaction and communication between the child and adult. Making sure your child gets the help he needs can also pose a challenge, depending on whether quality support services are available in your area. At the same time, you are likely to have ongoing worries about your child's prognosis and long-term well-being. For all these reasons, you need to find strong social support for yourself, as well as for your child.Gathering your support network involves knowing ahead of time whom you can call for different types of support, even for emergencies, including:

• Emotional: A close friend or family member who is a confidant and whom you trust with your most personal feelings and concerns
• Social: A friend or colleague you enjoy being with and who helps you survive disappointments and shares your victories
• Informational: Your child's doctor, teachers, therapists, or other caregivers you can ask for advice on major decisions regarding his or her treatment
• Practical: A neighbor or close friend who will help you out in a pinch

  2. Get a Strong Social Network continued...

  In addition to these different types of support, you can seek out local groups and parent network organizations for families of children with autism. Ask your doctor or child developmental specialist for referrals. Join online chat groups for parents of children with autism.
  The more you know about autism and the stronger your support network, the more empowered you will be to live confidently, knowing that your child can get the help he or she deserves.

  3. Teach Your Family About Autism

  Many moms of kids with autism talk about feeling isolated. Once a child is diagnosed, moms often find that family members stop asking about the child or the child is left out of birthday parties or other family gatherings.Spouses and other children in the family may feel stressed, lonely, and even angry, as all attention is focused on the child with autism. While these feelings are natural, you can help your family members cope by educating them about autism and the child's specific needs.
  Training family members about autism and how to effectively manage the symptoms has been shown to reduce family stress and improve the functioning of the child with autism. Some families will need more outside assistance than others, depending on their internal functioning, established support systems, and financial situation.

  In addition, plan outings with other families who have a child with autism. There are many families who share your concerns and daily challenges. Talking openly with these families can give you new insight and better ways of coping. Local and national groups can help connect families and provide much-needed sources of information. Most health professionals can recommend some of these organizations.

  4. Review the Recommended Autism Treatment Options

  Child development experts agree that a child with autism should receive treatment as soon after diagnosis as possible. There is no cure for autism, but early intervention using skills training and behavior modification techniques can yield good results. This type of educational and behavioral treatment tackles autism symptoms -- impaired social interaction, communication problems, and repetitive behaviors -- and can boost an autistic child's chances of being able to go to school and participate in normal activities.

  4. Review the Recommended Autism Treatment Options continued...

  The American Academy of Pediatrics (AAP) recommends the following strategies for helping a child with autism improve overall function and reach his or her potential:

  • Behavioral training and management. Behavioral training and management uses positive reinforcement, self-help, and social skills training to improve behavior and communication. Many types of treatments have been developed, including Applied Behavioral Analysis (ABA), Treatment and Education of Autistic and Related Communication Handicapped Children (TEACCH), and sensory integration.
  • Specialized therapies. Specialized therapies include speech, occupational, and physical therapy. These therapies are important components of managing autism and should all be included in various aspects of the child's treatment program.

  Speech therapy can help a child with autism improve language and social skills to communicate more effectively. Occupational and physical therapy can help improve any deficiencies in coordination, muscle tone, and motor skills. Occupational therapy may also help a child with autism to learn to process information from the senses (sight, sound, hearing, touch, and smell) in more manageable ways. It can also help in performing normal activities of daily living.

  Remember, when considering any type of treatment for your child, it is important to know the source of information and to ensure that studies are scientifically sound. Accounts of individual success are not sufficient evidence to support using a treatment. Look for large, controlled studies to validate claims.

  5. Learn More About Behavioral Training

  Behavioral training teaches people of all ages with autism how to communicate appropriately. This type of training can reduce behavior problems and improve adaptation skills.

  Both behavioral training and behavioral management use positive reinforcement to improve behavior. These therapies also use social skills training to improve communication. The specific program should be chosen according to the child's needs. As an example, a high-functioning child with autism may be enrolled in mainstream classrooms and child care facilities. The behaviors of other normally developing children can provide examples for the child with autism to follow. However, other children with autism are overly stimulated in a regular classroom and work best in smaller, highly structured environments.

  5. Learn More About Behavioral Training continued...

  Consistent use of these behavioral interventions produces the best results for the child with autism. The child's functional abilities, behavior, and daily environment should be thoroughly assessed before behavioral training and management begins. Parents, other family members, teachers, and caregivers of the autistic child should all be trained in these techniques.

  An intensive approach using behavior therapy, often called applied behavior analysis (ABA), is uniformly recommended by experts, including a recommendation by the U.S. surgeon general. The prototype program is called classic ABA and involves intensive, one-on-one work for 30 to 40 hours a week. More commonly now, therapists use a “modified" ABA that calls for ten to 12 hours per week of intensive work, allowing for time in school, other therapies, and social interactions with family members and peers.

  The goal of behavior therapy programs is to reinforce desirable behaviors and decrease undesirable ones. As an example, the child with autism is taught to perform tasks in a series of simple steps and is given a predictable schedule. The behavioral therapy is then continued at home.

  Often, both behavioral therapy and occupational therapy are given at the same time. The downside is that this type of therapy is expensive and often not covered by health insurance plans.

  6. Assess Your Child's Need for Medication

  While there is no medication for autism, there are drugs for specific symptoms that kids with autism might display. For example, short attention spans can sometimes be improved with stimulant drugs that are used to treat ADD or ADHD. Children with autism who have anxiety, depression, or 

  Drugs have a limited role in improving symptoms of autism. However, some may help prevent self-injury and other behaviors that are causing difficulty. Medicines may also take a child with autism to a functional level at which they can benefit from other treatments.

  6. Assess Your Child's Need for Medication continued...

  The American Academy of Pediatrics suggests targeting the main problem behaviors when considering medicines. Medicines that are sometimes used to treat behaviors related to autism include selective serotonin reuptake inhibitors (antidepressants) and antipsychotic medicines.

  Selective serotonin reuptake inhibitors (SSRIs) include Celexa,Prozac, and Zoloft, for example. The high rate of effectiveness fordepression, anxiety, and obsessive, stereotypical behaviors has made these medicines a popular choice for managing autism. They may also improve general behavior, language, learning, and socialization. In addition, although SSRIs have side effects such as weight gain or loss,insomnia or drowsiness, and increased agitation, they tend to be less serious than those of antipsychotic medicines.

  Antipsychotic medicines, such as Haldol, Risperdal, Zyprexa, and thioridazine work by changing the effects of brain chemicals. They may help decrease problem behaviors that can occur with autism. A well-designed study found that Risperdal was effective for the treatment of tantrums, aggression, and self-harming behavior in children with autism. Both Risperdal and Abilify have been formally approved by the FDA for treating irritability and aggression in children with autism.

  However, these medicines can have side effects, including sleepiness, tremors, and weight gain. Their use is usually considered only after behavior management has failed to address the problem behaviors.

  Other medicines that are sometimes used for behavioral problems in autism include:

  • Catapres and Tenex. These medicines are typically used to lowerblood pressure, but are also used to treat impulsive and aggressive behaviors in children with autism. Kapvay and Intuniv, respectively, are longer-acting forms of these older agents, that have been FDA approved for use in hyperactive and impulsive individuals.
  • Lithium and anticonvulsants, such as carbamazepine and valproic acid. Children who are occasionally aggressive may become more stable when using these medicines, although monitoring the level of the drug in the body through regularly scheduled blood tests is required.

  The effectiveness of these medicines varies. Side effects are possible and should be discussed with your health professional. Some health professionals may advise going off a medicine temporarily in order to identify whether it is having a positive or negative effect on the child with autism.

  7. Learn More About Diet Changes

  Diet changes are based on the idea that food allergies cause symptoms of autism, and an insufficiency of a specific vitamin or mineral may cause some autistic symptoms. If you decide to try a special diet for a given period of time, be sure you talk to your pediatrician and a registered dietitian. The child's nutritional status must be assessed and carefully measured.

  One diet that some parents have found helpful is a gluten-free,casein-free (GFCF) diet. Gluten is acasein-like substance found in wheat, oats, rye, and barley. Caseinis the principal protein in dairy products such as milk. There is no scientific evidence to support the use of this diet in individuals with autism, so it's important to ask for guidance from your child's doctor or nutritionist to ensure your child is getting adequate nutritional value from his or her diet.

  The theory of the GFCF diet is that in autistic children these proteins result in an overproduction of opiates in the brain, contributing to social awkwardness and thwarting brain maturation. Since gluten and milk are found in many of the foods we eat, following a gluten-free, casein-free diet is extremely difficult.

  Parents of a child with autism who also has food allergies or intolerance may be more likely to attempt the restrictive GFCF diet. However, food sensitivities are not proven to be more common in children with autism than in normally developing children. Still, some parents claim benefit from restrictive diets.One supplement some parents feel is helpful for a child with autism is vitamin B-6, which is taken with a magnesium supplement. The results of research studies are mixed on vitamin B-6 and magnesium supplementation. While some children respond positively, others respond negatively or not at all. You need to be careful with "megavitamins." It's possible to overdose on magnesium when takingsupplements, and that can cause other neurological problems.

  8. Use Caution With Unproven Therapies for Autism

  The safety and effectiveness of some therapies used to treat autism are not known. Many unproven treatments circulate through websites, word of mouth, or the media. Most have not been subjected to thorough, sound research and are considered nonstandard and controversial. Even if someone else has found tremendous success with an "unproven" therapy, it's important to be cautious about a treatment for autism if:

  • The autism treatment is based upon oversimplified scientific theories.
  • It benefits more than one condition.
  • It provides dramatic and "miraculous" results.
  • The only available evidence is based upon a few stories (anecdotal evidence), testimonials, and little or no scientific research.
  • Specific treatment goals or target behaviors are not identified.
  • Controlled, scientific research is said not to be needed because there are no risks or side effects.

    8. Use Caution With Unproven Therapies for Autism continued...

    Examples of nonstandard, unproven therapies for autism that are receiving attention include:
  • Immune globulin therapy. An intravenous (IV) injection of immune globulin is based on the assumption that autism is caused by an autoimmune abnormality.
  • Secretin. This treatment uses an IV injection of secretin (a hormone that stimulates thepancreas and liver) to manage autistic behavior. Anecdotal reports have shown improvement in autism symptoms, including sleeppatterns, eye contact, language skills, and alertness. Severalclinical trials conducted in the last few years have found no significant improvements in symptoms between children with autism who received secretin and those who received a placebo.
  • Chelation therapy. Mercury exposure as a cause of autism is the basis for this therapy, which uses medications to help the body eliminate the toxins. Children with autism often have a craving for nonfood items or unusual diets that may result in mercury exposure; therefore, mercury exposure may be more of an effect of autism than a cause. Chelation therapy has caused several deaths in the U.S.
  • Auditory integration training (AIT). Based upon a theory that autism is caused by hearing problems that result in distorted sounds or oversensitivity to noises, this treatment delivers music through special devices.
  • Facilitated communication. This method uses a keyboard to assist communication. It has not been found to be helpful, and in some cases has been harmful.

    9. Plan Time for Breaks

    Many parents of children with autism feel exhausted, overwhelmed, and sometimes defeated. They talk about difficulties in their marriage and other relationships. While there is no quick fix for resolving detrimental emotions, you can take measures to protect yourself so your child's condition does not get in the way of your physical or emotional health.
    Review your calendar weekly. In the midst of the many appointments your child might have with speech or occupational therapists or otherhealth care professionals, write in "appointments" for yourself and your relationships. Schedule regular dates with your partner, other children in the family, and close friends.
    Exercise regularly. Keep up with the physical activities you enjoy. Eat abalanced diet and stay at a normal weight. Staying fit and healthy is essential to your physical and emotional wellness -- and to caring for a child with special needs.

    9. Plan Time for Breaks continued...

    Seek help if you or your partner is feeling persistently overwhelmed or depressed, or the stress of caring for child with autism is affecting your family relationship. Watch for signs of anger, resentment, or opposition from other children in the family. Your doctor can help you find a qualified individual, couples, or family therapist to help you figure out the best ways to cope.
    In addition, plan time for a break away from a child with autism. Trained personnel can help relieve you from these duties as needed. These breaks can help families communicate in a less stressful context and allow parents to focus on their relationships with their other children. Having regular breaks may also help a family continue to care for a child with autism at home rather than becoming so exhausted that they resort to institutional care. Government programs exist to help families who cannot afford this occasional care.
    Moms of kids with autism talk about having very close relationships with their children, as they organize the child's therapy, hire specialists, purchase supplies, and act as their child's advocate to receive the best treatment. The biggest payoff comes from a unique bond you can have with your child and the joy you receive in every developmental accomplishment.

    9. Plan Time for Breaks continued...

    Seek help if you or your partner is feeling persistently overwhelmed or depressed, or the stress of caring for child with autism is affecting your family relationship. Watch for signs of anger, resentment, or opposition from other children in the family. Your doctor can help you find a qualified individual, couples, or family therapist to help you figure out the best ways to cope.
    In addition, plan time for a break away from a child with autism. Trained personnel can help relieve you from these duties as needed. These breaks can help families communicate in a less stressful context and allow parents to focus on their relationships with their other children. Having regular breaks may also help a family continue to care for a child with autism at home rather than becoming so exhausted that they resort to institutional care. Government programs exist to help families who cannot afford this occasional care.
    Moms of kids with autism talk about having very close relationships with their children, as they organize the child's therapy, hire specialists, purchase supplies, and act as their child's advocate to receive the best treatment. The biggest payoff comes from a unique bond you can have with your child and the joy you receive in every developmental accomplishment.There's no doubt that raising a child with autism is the ultimate parenting challenge. But with the necessary support and ongoing training, you and your family can learn how to cope and work as a team.

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