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Neuroscience For Kids

Autism

A Case Study

fred Fred's parents were concerned. Fred was two and a half years old, but had not begun to talk. He didn't babble like other children his age. Fred did not make eye contact, but his vision seemed fine. He loved watching his own hands. He could sit for hours watching his hands move back and forth.

Fred was diagnosed with autism, a neurological disorder that disrupts normal development. Some children with autism can attend school with children their own age; others need special care.

The Symptoms

Autism is classified as a pervasive developmental disorder. The "pervasive" part of the name implies that the disorder is serious, or that it affects many areas of development. Symptoms vary greatly from person to person. People with autism may appear to daydream constantly or be unaware of people around them. Most children with autism prefer to play by themselves, and treat other people like furniture. The major symptoms of autism include:

table

The Cause of Autism is Unknown

It was once thought that poor parenting caused autism. This is definitely not true. Although the cause of autism is unclear, it is known that genetics do play a role. The disorder is seen often in identical twins: different studies have shown that if one identical twin has autism then there is a 63-98% chance that the other twin will have it. For non-identical twins (also called fraternal or dizygotic twins), the chance is between 0-10% that both twins will develop autism. The chance that siblings will be affected by autism is about 3%.

Chance that both people will develop autism:


63-98%
Identical Twins

0-10%
Fraternal Twins

3%
Siblings

Autism appears to be associated with other chromosomal abnormalities, such as Fragile X syndrome or brain abnormalities such as congenital rubella syndrome. A large number of people with these disorders are also diagnosed with autism. Furthermore, complicated births, such as difficult pregnancies, labor, or delivery may to contribute to the disorder.

Diagnosis

doc Autism is a behaviorally defined syndrome. There is no simple test for it. Usually parents notice that their child is not developing in the same way as other children the same age. A physician can perform a psychiatric exam, ruling out other disorders such as schizophrenia, selective mutism (when the child chooses not to speak but can speak if he wanted to), or mental retardation, to name a few. Other tests examine language skills. When all test results are examined, a physician can make a diagnosis.

Treatment

Although symptoms in children may lessen with age, autism is a lifelong disorder. Some people with autism will remain in institutionalized care and approximately 50% will remain without the ability to speak. Structured programs that do not allow the child to "tune out" have proved successful at helping many children gain language and some social skills. Many times children with autism will have other disorders, such as epilepsy (seizures), hyperactivity, and attention problems. Epilepsy, in particular, appears to get worse as autistic children get older.

Drugs that inhibit the reuptake of the neurotransmitter called serotonin have some success in treating patients with autism. These drugs, such as Fluoxetine, slow the reuptake of serotonin by the neuron that releases it. Therefore, serotonin stays in the synapse for a longer time.

Normal Synapse
With Fluoxetine

A Look at the Brain of a Person with Autism

Brain imaging techniques, such as magnetic resonance imaging (MRI), have been used to examine the brains of people with autism. However, results have been inconsistent. Abnormal brain areas in people with autism include the:

Quick Facts About Autism

References and further reading:

  1. American Psychiatric Association: Diagnostic Manual of Mental Disorders (DSM-IV), 4th Edition, Washington, D.C., American Psychiatric Association, 1994.
  2. Griffiths, D. 5-Minute Clinical Consult, Baltimore: Williams and Wilkins, Inc., 1999.
  3. Kaplan, H.I. and Sadock, B.J., Comprehensive Textbook of Psychiatry, 6th Edition, Baltimore: Williams and Wilkins, 1995.
  4. Kates, W.R. et al., Neuroanatomical and neurocognitive differences in a pair of monozygous twins discordant for strictly defined autism, Ann. Neurol., 43:782-791, 1998.
  5. Rapin, I. Autism in search of a home in the brain. Neurology, 52:902-904, 1999.
  6. Rowland, L.P., Merritt's Textbook of Neurology, 9th Edition, Malvern: Williams and Wilkins, 1995.
  7. Autism Information from the National Institute of Child Health and Human Development
  8. Autism Resources
  9. University of Washington Autism Center

Copyright © 1996-2013, Eric H. Chudler, University of Washington