American Medical Association Family Medical Guide - American Medical Association [471]
Most people do not outgrow an attention deficit disorder, but can learn to adapt by developing their natural strengths and abilities and transforming their behaviors into more socially acceptable ones. For example, physical exercise and sports are good outlets for a person with hyperactivity, and working on more than one project at a time enables a person with a short attention span to focus on a number of subjects or tasks.
Autism
Autism is a developmental disorder of the brain and nervous system that usually appears during the first 3 years of life and causes lifelong emotional and behavior problems. Autism affects 1 in every 500 people in the United States and, for unknown reasons, the incidence is increasing. Boys seem to be affected about four times as often as girls.
Living with a child who has autism presents daunting challenges to the family. These challenges are further complicated by the fact that children with autism can have multiple mental or emotional disorders—such as impulse-control disorders, psychosis, obsessive-compulsive disorder (see page 720), anxiety disorders (see page 718), or mental retardation—at the same time. Affected children sometimes also have a seizure disorder (see page 686).
Medical researchers are working hard to find the cause of autism. The biological differences in the brain structures of affected people and the fact that autism and related disorders seem to run in families point to a possible genetic influence. No specific gene for the disorder has yet been discovered, but scientists believe that a number of genes may be involved. Other research is examining the possibility of an environmental cause. Doctors do know that autism is not caused by bad parenting or bad choices made by the child about how to behave. There is no scientific evidence to support the theory that autism is linked to a vaccine.
Symptoms
Although children may be affected by the disorder from birth, they often have only subtle symptoms in the first year. Some children with autism seem to develop normally for the first 2 years of their life, acquiring language and other skills at the normal time, only to lose the acquired skill suddenly. Children who have autism usually have an impaired ability to interact socially. They appear indifferent and remote, often avoiding eye contact and not responding to their name. They give the impression that they are completely unaware of how their difficult behavior affects other people, a feature often described by parents as being “walled off.”
Autistic children have trouble interpreting other people’s tone of voice and facial expressions, so they cannot respond appropriately to verbal and nonverbal cues. Most children with autism start talking later than usual, and tend to express themselves in a singsong manner. Their conversation is on a limited range of topics, and they seldom interact with their listener. Children with autism often respond abnormally to sounds they hear and to being touched. They sometimes resist being held or cuddled. Changes in routine can be extremely upsetting to them.
In the most severe cases of autism, children engage in unusual, repetitive behavior, such as rocking or hair twisting. They may injure themselves by biting themselves or banging their heads repeatedly. They can also become extremely aggressive toward other people. Some children with autism have normal intelligence, while others appear to have below-average intelligence, including mental retardation.
Diagnosis
Autism is often not diagnosed until after