Autism

Autism or Kanner's Syndrome is a condition that is characterised by mental introversion (inwardness), where the attention or interest of the person is is fastened upon their own ego, with the exclusion of anything external.

Autism is a complex, developmental disability that is often talked about as a type of 'spectrum' disorder. This simply means that the characteristics of Autism can present themselves in a wide variety of combinations and degrees of severity. Autism and related disorders (e.g. Asperger's Syndrome) are thought to affect up to 2% of the population, with four times as many males being affected than females. Autism affects the normal development of the brain that controls social interaction and communication skills. Many Autistic babies are 'different' from birth, but the onset of the condition can often be as late as the age of three years. Some common characteristics displayed by Autistic babies include: arching their back away from their parent or carer to avoid physical contact and failing to anticipate being picked up as babies normally do.

During their first year of life, Autistic children may be very passive (i.e. an infant that is very quiet and places few demands on its carers) or overly active i.e. an infant that cries a great deal, often non-stop, during waking hours. Some infants may begin to rock and/or bang their head against their cot (but this is not always the case). In the early stages of life, some Autistic children may talk, crawl and walk much earlier than non-Autistic children, but others may be quite delayed in reaching these developmental points. Up to half of Autistic children will develop normally until they are between one-and-a-half and three, when their Autistic characteristics begin to emerge (this is sometimes called regressive Autism).

During childhood, children with Autism can fall behind children of the same age in terms of communication, social skills and understanding of their external environment. Abnormal behaviors may also appear, such as repetitive, purposeless behavior like rocking and hand flapping; self-injury (e.g. hand biting and head banging); sleeping and eating problems; poor eye contact; insensitivity to pain; hyper- or hypoactivity and attention problems. A fairly common characteristic in Autistic children is their insistence on maintaining a very strict, daily routine (e.g. drinking and eating the same foods at every meal). Even the smallest change in their routine can cause significant distress. This may be because people with Autism cannot understand and cope with new situations.

SEROTONIN
Serotonin is a chemical that functions as a neurotransmitter (chemical communicator) in the brain. Serotonin can also be found in certain blood cells called platelets. Sleep, sensory perception, temperature regulation, and mood are all thought to be influenced by serotonin. Consistently high levels of serotonin have been found in the blood of some individuals with Autism. This has made serotonin interesting to Autism researchers, however, it is still unclear what this high serotonin level signifies.

Currently, the level of serotonin in an autistic person's blood stream does not influence the medical management of that person. Occasionally, medications called 'selective serotonin reuptake inhibitors' (SSRIs) are prescribed for some individuals with Autism. This type of medication is also widely used to treat depression. SSRIs keep serotonin in the brain longer to enhance its action as a chemical communicator. Studies in different populations of autistic individuals will help establish which of these people will benefit from SSRIs or other drugs that influence blood and brain serotonin levels

CAUSE
Autism is a result of either structural changes or chemical changes within the brain, but it is not clear what causes the processing and behavioral characteristics of Autistic people. There is a fairly strong genetic influence in Autism. In around 10 to 15% of cases, there is an underlying medical condition that has caused the syndrome (e.g. phenylketonuria and congenital rubella syndrome). Studies of the brains of Autistic people have shown some structural abnormalities.

TREATMENT OPTIONS
Always consult your Doctor for the diagnosis and management of Autism. Autistic children are usually managed using behavioral therapy (also called Applied Behavior Analysis or ABA), which can be learned by the parents, to help manage the child at home and at school. Examples of behavioral management are 'positive reinforcement' (rewarding 'good' behavior) and 'time-outs'. The goal is to enhance appropriate behaviors and reduce inappropriate behaviors. Speech therapy can also be an important part of the Autistic child's treatment programme. Some Autistic people improve in terms of well-being, awareness and attention when taking vitamin B6 with magnesium. Metabolic problems may be present in number of Autistic people and if this is the case, dietary modification and dietary supplements may help improve their condition.

In the past, many people with Autism were placed in institutions but now there are many sorts of flexible living arrangements available. In adulthood, many Autistic people are able to live with their parents and others live in residential facilities or in small groups. Others are able to live independently. Many Autistic people have been able to attend and graduate from university, develop adult relationships and gain employment.


DIET HINTS
Always follow the dietary advice provided by your Health Care Professional.
• Autistic children should be tested for allergies to foods such as cow's milk and other dairy products.
• Any metabolic abnormalities that have been diagnosed may require dietary modification, as this may improve behavioural patterns in Autism.
• When certain proteins called gluten and casein are digested, they produce substances in the bowel called peptides. Normally, the peptides are absorbed into the bloodstream and excreted in the urine. In Autistic people, however, they sometimes remain in the bowel and then transfer into the central nervous system. The peptides reduce transmission in the nervous system, and are believed to worsen the symptoms of Autism. An Elimination Trial diet may be beneficial. Foods containing casein include milk, cheese, butter and dairy products. Foods containing gluten including all wheat products such as bread, flour, biscuits, cakes, sauces and thickeners. Consult a Dietician for advice and supervision with elimination diets.

VITAMINS/MINERALS/HERBS
Always consult your Doctor before taking any vitamins, minerals or herbs for advice on any possible side effects or drug interactions.
• Vitamin B6 and Magnesium supplements have improved the condition of some people with Autism.
• Some Doctors believe that vitamin A supplements may improve the Autistic condition by enhancing the actions of this substance in the body.
• If dietary intake is inadequate, a multivitamin/mineral supplement may be considered.
• Omega-3 fatty acids may aid in promoting healthy brain development in children and may aid disorders such as autism.

ORGANISATIONS & SUPPORT GROUPS
National Center for Autism in India (http://www.autism-india.org/)