Autism- An Overview
While the exact mechanism of autism is not understood, we define this disorder by a particular collection of changes in how a child behaves, interacts with others and communicates. Autism is currently thought of as a spectrum of changes: some people with autism are severely disabled while others are called ‘high functioning,’ meaning their differences are only subtle compared to most other people.
For better or worse, human beings are very social creatures. An infant quickly learns to interact with, communicate with, and empathize with others (primarily mom and dad). By empathize, I am not referring to compassion or feelings so much as the understanding that other people are aware and have a perspective. This is what pointing is all about: a baby learns that when you point your index finger at something, you want her to look where you are pointing and looking. A baby learns all of your subtle facial expressions and changes in tone of voice that mean anything from, ‘follow me,’ to, ‘you’ve made me sad.’ So much of human interaction is implied or conveyed non-verbally.
Autism is the word we use to convey a deficit in this interaction, large or small. Children with severe autism often have so much trouble with this that they do not communicate with others at all and have very little control of their emotions. IQ is normally lower in these children but, obviously this is hard to test. At the other end of the spectrum are ‘high functioning’ autism and Asperger disorder. While clinicians debate the names, these children are often very intelligent but tend to miss some of the nuance used in human interactions. They have trouble modulating their voices to the appropriate tone, misread or ignore obvious facial expressions or body language and have trouble with the little verbal ‘pats on the back’ we give each other normally to re-establish communication and dissolve tension.
There currently is no cure for autism but, through early identification and engagement (sometimes intensive) significant results can be achieved. For children on the ‘higher functioning’ end of the spectrum, these interventions help to train or teach behaviors that come naturally to others, allowing these children to grow up and integrate better in the community and become more successful in school and in the workplace. For kids on the more severe side of the spectrum, this intervention could be the difference between no communication and enough to tell a caregiver what is wrong. This can make all the difference.
Autism is not always autism. Other disorders, like Fragile X, are sometimes misdiagnosed as autism. Seek care early and become educated if you notice something in an infant or child.
Finally, for those who have a child diagnosed with autism, please seek out friends within the special needs community. Support, advice and encouragement are available. Raising a child with autism can be a challenge but it is just as often a source of joy, bringing families closer together.
Matthew Toohey MD. September, 2011.