Autism in Singaporeby Shaheen E Lakhan, MD, PhD, MEd, MS, FAAN | December 10, 2005
Children with Autism Spectrum Disorders (ASD) display three types of symptoms: impaired social interaction, problems with verbal and nonverbal communication, and unusual or severely limited activities and interests.
Autism is a developmental disorder of brain function. Individuals that suffer from classical autism show three types of symptoms: impaired social interaction, problems with verbal and nonverbal communication, and unusual or severely limited activities and interests. Symptoms of autism typically show up during the first three years of childhood and continue all through life. There is currently no cure for autism but appropriate early educational intervention may improve social development and reduce unwanted behaviors. Individuals with autism have a normal life expectancy.
Autism affects an estimated 10 to 20 of every 10,000 people, and males about four times as often as females. The condition occurs in all peoples, races, and social backgrounds. The condition varies a great deal in severity, with the most severe cases typified by extremely repetitive, unusual, self-injurious, and aggressive behavior.
This behavior may persist over time and prove very difficult to modify, with consequent heavy burden to those who live with, treat, and teach these persons. The mildest forms of autism looks like a personality disorder linked with a perceived learning disability.
Researchers have recognized a number of genes believed to play a role in the condition. In some children, environmental factors also may play a role as do abnormalities in several areas of the brain, including the cerebellum, amygdala, hippocampus, septum, and mamillary bodies. Neurons in these parts of the brain appear smaller than normal and have stunted nerve fibers, which may interfere with nerve signaling.
These abnormalities indicate that autism results from interruption of normal brain development early in fetal life. Other researchers found that individuals with autism have abnormalities of brain serotonin or other signaling molecules. We have now discarded the early belief that parental practices are responsible for autism.
In a few cases, disorders such as fragile X syndrome, tuberous sclerosis, untreated phenylketonuria (PKU), and congenital rubella cause autistic behavior. However, other disorders, such as Tourette syndrome, learning disabilities, and attention deficit disorder, which sometimes occur with autism do not cause it.
Individuals with schizophrenia sometimes show some autistic-like behavior but schizophrenia does not appear until the late teens or early adulthood. Furthermore, individuals with schizophrenia also often have hallucinations and delusions, which individuals with autism do not have.
The chief feature of autism is impaired social interaction with these kids often not responding to their names and avoiding making eye contact. Theses kids misinterpret voice inflection, or facial expressions. They do not respond to others’ emotions or take cues from others for the right behavior. They seem unconcerned about others’ feelings toward them.
Other features of the condition include repetitive movements such as rocking and hair twirling, or self-injurious behavior such as biting or head banging. They have speech delays and may refer to themselves by name instead of “I” or “me.”
They react to sounds, touch, or other sensory stimulus abnormally; even show less sensitivity to pain or over-sensitivity to other sensations, which may explain their resistance to being cuddled.
There is currently no cure for autism at present, with therapies, or interventions, designed to remedy specific symptoms in each person. Current therapies include educational/behavioral and medical interventions, all of which although do not cure autism, often result in substantial improvement.
Educational/behavioral interventions stress highly structured and often intensive skill-oriented training tailored to each child, including social and language skills training. Recent evidence indicates it is best to start this treatment as early as possible to take advantage of children’s abilities to learn rapidly. Furthermore, early intervention has a good chance of favorably influencing brain development.
Doctors prescribe a variety of medications to reduce self-injurious behavior or other bothersome symptoms of autism, and associated problems such as epilepsy and attention disorders. Most of these medications change serotonin levels and those or other signaling brain chemicals. Many other interventions currently are available, but remain controversial and lack scientific backing.
Video: Autism Association (Singapore)
Written by: Dr. George B. Obikoyz and Shaheen Lakhan
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