Ambitious about Autism guide

Tips for an autism-friendly Christmas

 Emma Tracey | 15:01 UK time, Friday, 14 December 2012

Most of us see Christmas as a welcome excuse to break from the old routine, do lots of socialising and give and receive presents. But the holidays can prove challenging for children and adults on the autistic spectrum, who find change, crowds and surprises difficult to handle.

That's why Ambitious about Autism and the National Autistic Society have both thought to produce their own online guides to help people with ASD, and their families, to cope with Christmas time.

Tracy Beadle, mother of two children who are on the autistic spectrum, is one of the contributors to the Ambitious about Autism guide which has been crowd-sourced via social media and their Talk about Autism forums.

Her sons, seven-year-old Dylan Beadle and his four-year-old brother Jake both love Christmas but their social difficulties, sensitivities about touch, taste and noise, and untypical reactions to certain situations, have led mum Tracy and dad Glen to approach this part of the year a little differently.

Christmas preparations start for the family in late November to get Dylan and Jake ready for changes at home.

"We give the boys a count down of 'sleeps' before the decorations go up, and then again before they come down," Tracy says.

"A visual calendar is then hung in their bedroom and every night we stand and count the sleeps until Christmas Day."

The calendar is a sheet of paper with a square representing each day. All other squares are blank apart from Christmas Day which has present-bedecked stickers on it.

Both of the online guides appreciate that all children are different, so what works for one may not suit another.

The National Autistic Society suggests that some might benefit from having more events marked on their visual calendar, such as when the school holidays begin and end, when they can expect visitors and so on.

Finding out when preparation will begin at your child's school and then starting your family Christmas at home at the same time is another suggestion.

One Christmas inevitability for children is the annual school performance. Tracy's eldest son Dylan isn't a fan. "He has cried his way through the last three, so he isn't going to take part this year. It upsets him and it isn't an essential life skill."

Younger son Jake hopes to be in his school nativity play but Tracy says this took some work: "He went mad when he saw his shepherd's outfit, and said 'I go to school as a boy, not a shepherd'."

They took the costume in to school and introduced Jake to it slowly. He had learned the songs and was eager to go on stage, so after some encouragement from the teacher, Jake has been convinced to wear the robes during the show.

A fear of people in costume means that visiting Santa is not part of the Beadles' Christmas routine.

"We took Dylan once," Tracy remembers. "He was the only child there who, instead of sitting on Santa's lap, sat on a toy car and started playing with it. He wouldn't speak to Santa at all."

Like many others with autism, Jake and Dylan aren't good at faking delight if they get an unwanted gift. Friends and relatives now always ask mum and dad what the boys would like. For Tracy, this is an easy one to answer.

"They do tend to have an obsession each Christmas," she says. "It is Angry Birds this year. Last year it was Disney's Cars."

Tracy is aware of parents who discourage their autistic child's obsessions but she takes a different approach. "I completely over-indulge the obsessions, buying them every toy they want because I find that if you over-indulge them, it passes more quickly."

Both guides have plenty of tips for managing Christmas Day. Advice includes putting batteries in toys in advance so that they can be played with straight away and making sure that the Christmas meal is ready at a prearranged time.

The consensus, though, is to find a routine that works and stick to it. Through trial and error, Tracy and Glen Beadle have found a pattern of events which the boys like and which they expect to happen. So, what's their pattern?

"On Christmas Eve we go to visit my nan," says Tracy. "On the way home we take them to visit a house with thousands of pounds worth of decorations. On Christmas Day, we open presents and then my immediate family come for dinner."

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Louis Theroux on autism

Louis Theroux on autism: A very different sort of school

Continue reading the main story

In today's Magazine

• Will Self: In defence of obscure words
• Five things Tesco got wrong
• Quiz of the week's news
• Are you a Luddite?

With autism diagnoses rising more and more parents are plunged into a battle to understand the condition and find their child the right treatment, writes Louis Theroux.

Joey Morales-Ward is a 13-year-old kid who lives in suburban New Jersey. He likes playing on his computer, making books that he illustrates himself, and drawing in coloured chalk on his parents' front drive.

Joey also has violent tantrums on a daily basis, which often involve him hitting himself, punching holes in the walls all through the house, and assaulting his mother, leaving her bruised and shaken.

Joey has been diagnosed with autism.

People with autism vary widely in terms of their symptoms. Some are above average intellectually, though many are below average and struggle in mainstream schools.

Commonly, people on the autistic spectrum have trouble with social interaction - using speech, recognising emotions (their own and other people's), body language. They also often have repetitive behaviours and routines and can appear locked in their own worlds.

Continue reading the main story

For reasons that aren't fully understood, diagnosis rates for autism have gone steadily upward in America in recent years. New Jersey is at the forefront of the trend. Latest figures put the autism rates among boys in New Jersey at one in 29 (rates for girls tend to be much lower).

Despite its increasing levels of diagnosis, autism is still poorly understood. Indeed, it is not clear if the real rates of autism are climbing. Some say there are more cases due to improved detection, or, some believe, an overly expanded set of criteria.

In the popular mind, the condition is forever linked to the Dustin Hoffman character in Rain Man, an autistic savant whose idiosyncratic behaviour - obsessive routines, strange vocal mannerisms - was offset by a host of "savant" abilities. He could memorise a phone book and beat the casinos in Las Vegas.

In fact, savant abilities are rare among those with autism.

For my part, my interest in the condition stemmed from an interest in the unique nature of the relationship between parents and their diagnosed kids.

Parents of autistic children can find it a struggle to cope

Raising a child on the autistic spectrum presents a very demanding, though often rewarding, set of challenges.

As a father of two young boys, who are in psychiatric parlance "neuro-typical", I know first-hand how hard it can be when your four-year-old refuses to eat his vegetables or goes through weird phases of waking every few hours; the tantrums over certain clothes and the squabbles over who was playing with what first.

But raising a child with autism puts my stresses in the shade.

Carol has a cot next to Joey's bed where she sleeps most nights, to stop him getting out of bed and wandering around.

Children with autism sometimes sleep erratically into their teens. In terms of sleepless nights, many parents of diagnosed children remain in a kind of "newborn" mode for 10 or 15 years.

Language can develop incredibly slowly, or barely at all. Even sometimes, when the communication skills are there, an autistic child may seem to have no interest in communicating.

There can also be tantrums and outbursts.

It's not always clear what is causing a tantrum. It might be that a kid's playtime has been refused or brought to an end, but it might be something more obscure - a thought or a memory.

Nor is it always clear how best to handle a tantrum once it's started. When I first met them, Carol would lie on top of Joey to stop him from smashing up the place, sometimes in tandem with her husband Tadeo who would pin down his legs.

Continue reading the main story

A few weeks later, she implemented a new regime of giving him boxing gloves to soften his self-inflicted blows and keeping him in his room until the tantrum had blown over.

As a TV presenter, the subject of autism also put me in a tricky position. I had to figure out how to get to know children, some of whom could only speak a handful of words, and whose way of interacting socially was very different to the ones I was used to.

But this, in a way, was the point - that I should get a little glimpse of the strains, and the pleasures, of having a relationship with someone diagnosed with autism.

On the positive side, kids on the spectrum can make massive strides in their progress, in rare cases losing the diagnosis entirely.

With its high rates of autism, New Jersey is home to some of America's best services, including a remarkable school, the Developmental Learning Center in Warren, NJ. The DLC Warren lavishes resources on the 250 or so kids who go there, almost all of them diagnosed with autism. The teacher/student ratio is about 1/1.5.

One of the children I met, Nicky Ingrassia, had been non-verbal until the age of six, and yet was now highly articulate, not to mention curious and humorous. Nicky had progressed to the point that he was being moved to a more mainstream school.

But Nicky's level of progress is not the rule.

Nicky Ingrassia turns the tables on Louis Theroux

Just as typical was the story of the Englehard family.

Josephine Englehard's son Brian was eight when he burned down the family house. As he grew older, he began assaulting Josephine, often when she refused him certain items of food. Sometimes he chased her around the house and pulled her hair out in clumps.

After one particularly violent incident Josephine called the police. Brian was sent to a psychiatric hospital. From there, he moved to a group home where he still lives, aged 20.

Brian spends Saturday and Sunday back in the family home. One Saturday I went with Josephine as she picked him up. Having heard so much about Brian's tantrums, I was a little nervous about meeting him.

But over the course of the afternoon, using body language and a little bit of speech, Brian and I seemed to strike up a bit of a rapport. I found Brian outgoing, mischievous, and - especially after everything I'd heard about autism - surprisingly interested in me.

Josephine told me that, although it had been a huge wrench moving Brian out of the house, he was now much calmer and seemingly much happier - a change she partly put down to the effect of the correct use of psychiatric medication.

Continue reading the main story

Sure enough, by the end of the visit, in the early evening, it was Brian who volunteered that he wanted to go back. In the car on the drive to the home, we listened to some merengue music on a Latin radio station, and the two of us grooved together sedately in the backseat.

Joey's future remains uncertain.

Carol says she is praying for a miracle for him, that he will somehow emerge from his autism.

At the moment he is not on medication. Should his behaviour become even more disruptive as he gets bigger, Carol has resolved to try drugs as a first resort. If this doesn't help, a move to a group home like Brian's is not out of the question.

In the end, I came away from my trip in New Jersey impressed, more than anything else, by the patience and love shown by the parents of the autistic children.

The demands made of parents whose children are diagnosed with autism can be immense.

Though Carol was praying for a miracle, in the course of spending time with her I felt she was performing a small miracle of her own simply by keeping going.

An earlier version of this story incorrectly gave the ratio of teachers to students at DLC Warren as 1.5:1. The correct ratio is 1:1.5.

Here is a selection of your comments.

I feel for the parents, but especially I feel for the children. I have Asperger's Syndrome but was not diagnosed until I was well into my 50s. Growing up whilst rarely fitting in was hell. Increasing the awareness of the problems associated with autism needs to be handled carefully, many Aspies are not violent, just bewildered.

Malcolm Midgley, Papamoa Beach, New Zealand

So often autism is depicted as something where people are just a little strange but have huge abilities . In the majority of cases - and certainly amongst the parents of autistic children we know - it's more like having a 3-year-old in a 15-year-old's body . Life is difficult , sometimes violent and always stressful . Our son was an escapee - he would try and escape from the house and just run. Our house was like fort knox but he still got out. The last time he fell from the roof and broke his hip. Not exactly Rain Man is it ?

Peter Little, Herne Bay

My daughter was diagnosed at the age of two-and-a-half years old. Her speech came at the age of four, she could not pick up a pencil till the age of five. Presently she is studying at a normal school. She scores 80% to 90% marks in studies. She can understand everything. But her speech is not constructive. She cannot think in a different way. She is always withdrawn in nature.

P P Pal, Uttarpara, West Bengal, India

We are parents of three lovely, gorgeous boys. Our seven year-old is severely autistic and non-verbal but we all know that our efforts are worth it when we get a little bit of eye contact or a little smile or, on a really good day, a quick hug. The world can be a scary place for him, not knowing what to expect or what to do or how to act. But sometimes if you catch him really looking at something whether it's a flower or a ladybird or the leaves blowing in the wind - sometimes - it's good to look at things through his eyes. You realise that instead of rushing around just stop and really look at something and appreciate its beauty or its strangeness.

Janis Cuthbert, Dunfermline

As a perfectly verbal and expressive individual, I would like journalists to recognize that I AM on the spectrum. That the spectrum does not go from "genius, gifted, tragic, bit weird," to "sociopath, can't communicate,". It is a spectrum. We are as varied - and more so - than you could ever imagine. But no one wants to read stories of boring autistic people. I'm boring. I'm 22, I live at home with my family, I'm going to uni (again!) next year to do an arts subject, I have mates, I have hobbies, it's my fourth anniversary with my partner in June, and I don't hit people.

Dee, Belfast

My son was diagnosed with Aspergers Syndrome, but was badly misunderstood at school, with very distressing consequences. Anyway, he was so unhappy and home life was suffering to such an extent that we sent him to a private school. He loved it for a time and went to the top of his class until a teacher came along who wasn't so sympathetic. Again, we had the same problems so we took the monumental decision to take him out of school and have him home educated. Twelve years later, my son is at a top university studying physics with maths, two hundred miles away. He plays music in lots of groups and manages himself in the student accomodation without any support.

babies

“Babies born weighing less than 4lb (1.8kg) could be more prone to developing autism

http://www.westof.eu/healthy/page22.html

Monday October 17 2011

Most children with autism have a normal birthweight

“Babies born weighing less than 4lb (1.8kg) could be more prone to developing autism than children born at normal weight,” BBC News has reported.
This finding comes from a study that found about 5% of infants whose birthweight was less than 2000g (about 4lbs and 6oz) had autistic spectrum disorders (ASDs) at the age of 21. This was higher than previous estimates that suggested that 0.9% of US eight year olds of any birthweight have been diagnosed with some form of ASDs.
The main limitation to this study is that it did not include a control group of children with normal birthweight to compare against those with low birthweight. Instead, it relied on general population estimates to examine the relationship. This makes understanding the issue more complex as the children in this study were all given specific assessments for detecting ASDs that would not be routinely given to children in the general population.
This means we cannot be certain to what extent children with low birthweight truly do have higher rates of ASDs or if the methods used simply detected cases that would go undiagnosed in everyday life. This is supported by the fact that some of the cases identified had not previously been diagnosed by a doctor.
It is also worth noting that a large proportion of those eligible to participate did not complete the study and this may have influenced results. Overall, the findings of this study need to be confirmed by more robust studies with a control group of infants of normal birthweight.

Where did the story come from?

The study was carried out by researchers from the University of Pennsylvania and other research institutes in the US. It was funded by US National Institutes of Health and published in the peer reviewed medical journal Pediatrics.
BBC News generally placed the study into context well, noting that the findings need to be confirmed in other studies and including quotes such as those from Dorothy Bishop, professor of developmental neuropsychology at the University of Oxford. She is quoted as saying, 'the association looks real, but nevertheless, most low birthweight children don't have autism, and most children with autism don't have low birthweight'.

What kind of research was this?

This was a prospective longitudinal study that looked at what proportion of infants with low birthweight went on to develop autistic spectrum disorders (ASDs) in adolescence or early adulthood.
ASDs, including autism and Asperger’s syndrome, and are a group of related disorders that begin in childhood and persist into adulthood. They are diagnosed by the presence of three broad categories of symptoms:

• difficulties with social interaction
• impaired language development and communication skills
• unusual patterns of thought and physical behaviour

In over 90% of cases no underlying medical condition can be found to explain the symptoms of ASD, though causes continue to be investigated.
The researchers say that low birthweight is an established risk factor for cognitive and movement problems, and some studies have suggested that low birthweight may also be a risk factor for ASDs. However, they also point out that most prospective studies examining this possible association have not made firm diagnoses of ASDs using standard diagnostic methods.
This study followed only a group of low birthweight individuals, and then made comparisons with how common autism is in the population as a whole, based on the figures reported in another study. This may give some idea of whether autism is more common in low birthweight infants but there are some limitations. For example, the children in this study were given assessments to specifically test whether they had autism, which means that more cases might be picked up than would be found than in the general population, which is not routinely screened for autism.
Ideally, the study would have included groups of babies with different birthweights all born in the same period, and followed and assessed them in the same way. This could help establish whether the results seen would be genuinely due to increased prevalence or due to increased diagnosis. It would also allow them to take into account any other differences between babies of low and normal birthweights.

What did the research involve?

The researchers enrolled 1,105 low birthweight infants who weighed less than 2000g when they were born. Babies born between October 1, 1984 and July 3, 1989, at three New Jersey hospitals were eligible. Of these infants, 862 (78% of those enrolled) were eligible for follow-up at age 16, and 623 (56%) were screened to identify those that might have ASDs. At age 21, the researchers used standard diagnostic interviews for ASDs to reassess 60% of those who screened positive for autism at age 16, and 24% of those who tested negative. This confirmed which individuals had a diagnosis of ASDs. They used the figures to estimate how common autism was in the entire group of low birthweight babies.
The infants in this study were part of the Neonatal Brain Hemorrhage Study (NBHS), which included all infants admitted to three hospitals in New Jersey, which cared for 85% of low birthweight babies born in the area. The children were assessed at ages 2, 6, 9, 16, and 21 years. At age 16, this included questionnaires that the parents completed about autism symptoms and social communication. The questionnaires asked parents if their child had ever been diagnosed with ASDs by a healthcare professional.
The ASDs the researchers tested for included autism, Asperger’s syndrome, or a pervasive developmental disorder (not otherwise specified). Those scoring over set thresholds on the questionnaires or those with a professional ASD diagnosis were considered to be ‘screen positives’, and assessed again for a ASDs diagnosis at age 21.
The researchers also tested a proportion of adolescents who had screened negative at 16 to identify whether the initial screening had missed any cases. The diagnostic interviews at age 21 were conducted with the parents and with the young adult themselves, and were performed by researchers who did not know whether the participants had screened positive or negative for ASDs at age 16.

What were the basic results?

In the first ASDs screen at age 16 years, 117 low birthweight adolescents (18.8% of those tested) screened positive for ASDs. Of these 117 adolescents, 47 (40.2%) were lost to follow-up or did not complete the ASD questionnaires at age 21. Of the 70 who were assessed at age 21 years, 11 (15.7%) were confirmed as having ASD at age 21.
In the first ASD screen at age 16 years, 506 (81.2%) low birthweight adolescents had screened negative for ASDs. Of these 506 adolescents, 119 (23.5%) were selected for assessment at age 21. Of these 119 screen negatives, three (2.5%) were found to have ASD at their later assessment.
Most of the participants identified with ASDs (9 out of 14) were reported to have relatively high levels of functioning, spoken language, and with IQs of 70 or over.
Based on these figures, and the proportion of screen positives and screen negatives at age 16, the researchers calculated that about 5% of the entire low birthweight cohort assessed at age 16 had ASD. Just over half of these young adults (8 out of 14) had not been diagnosed prior to this study.
There were some differences between the individuals who could be followed up and those who could not. For example, those who were not followed up at age 21 were more likely to have had suboptimal neurodevelopmental outcomes at age 16 (for example, cognitive or movement disabilities).

How did the researchers interpret the results?

The researchers conclude that ASDs in this group of low birthweight individuals was 5%. They say that this was higher than the prevalence of 0.9% reported by the US Centers for Disease Control and Prevention for eight year olds in the general US population (all birthweights) in 2006.

Conclusion

This study has suggested that about 5% of children of low birthweight (<2000g) in the US may go on to develop autistic spectrum disorders (ASDs). This is higher than previous estimates for the general population of children in the US (estimated at 0.9% among eight year olds). When considering these results there are both strengths, such as the prospective nature of the study, and limitations that must be taken into account:

• The children in this study were specifically assessed to see if they had autism, which means that more cases might be picked up than would be found than in the general population, who are not all assessed for autism. Ultimately, this raises the question of whether the results reflect greater prevalence among underweight babies or greater rates of diagnosis. Ideally, the study would have included a group of babies of different birthweights all born in the same period, and followed them all up and assessed them in the same way. This would also allow them to take into account any other differences between low birthweight and normal birthweight babies that could influence rates of ASDs.
• The general population prevalence figures were based on children aged eight, and these figures may differ from those found among adolescents and young adults such as those in this study.
• A high proportion (40%) of those assessed at age 16 could not be assessed again at age 21, and this could have influenced the results.
• Not all participants received all parts of the screening and diagnostic assessments.

The results of this study need to be confirmed by more robust studies with a control group of infants with normal birthweight. It is also worth bearing in mind the quote from Dorothy Bishop, professor of developmental neuropsychology at the University of Oxford, in the BBC News: 'The association looks real, but nevertheless, most low birthweight children don't have autism, and most children with autism don't have low birthweight.'

Links to the headlines

Low birthweight 'linked to autism', says US study. BBC News, October 17 2011

Autism and Asperger's - Care and Support Services

02 November

Autism and Asperger's - Care and Support Services

The specialised nature of these conditions demands not only professional care, but also a level of compassion and support that is sometimes not readily available elsewhere.

Our services include accommodation and support for adults and children with Autistic spectrum conditions. These are small, friendly, homely group-living environments. Each one remains dedicated to focusing on the provision of consistent and structured support through highly trained and experienced staff.

The support focuses on tailored, person-centred care, which enables people to achieve positive outcomes and maximise their independence.

At our children's autism service we offer dedicated short-breaks provision, where we work flexibly with families and professionals to provide homely, friendly environments with continuity in care and support.

We also have a dedicated transition service - helping individuals to develop independence and work towards goals and outcomes to prepare them for their future and the transition into adulthood

A computer company in Denmark

Why a firm wants staff with autism

Lego is used to test skills

A computer company in Denmark which has made huge strides in employing workers with autism is expecting to begin work in the UK soon.
Specialisterne was started by a Danish man whose own son has autism.
Thorkil Sonne now employs more than 40 people with autism.
He is finalising plans to set up a branch in Glasgow in the coming months.
He hopes to hire 50 workers in the first three years of operating in Scotland.
Autism affects about 1% of the population across Europe.
According to the National Autistic Society (NAS), people with the condition say a job is the one thing that would really improve their lives.
And yet a survey by Autism Europe shows 62% of adults with autism do not have any work at all.
Difficulties
I visited Specialisterne and met Soeren Ljunghan, 42.
He has a form of autism called Asperger's Syndrome.
It gives him focus and persistence - traits which have helped him become a champion weight-lifter.
But autistic people find social interaction and unpredictability difficult. Soeren endured a spell of unemployment.
He said: "It was a living hell.
"I kept going to job interviews but coming second and wondering why I wasn't chosen.
"It was very stressful. I began to question whether I would work again."

People come to me who've had difficulties in the labour market and got depressed. They're like computers that need re-booting Thorkil Sonne

At Specialisterne, Soeren works 25 hours a week testing software.
He said: "I like the work because I know what to expect from each day."
The company's founder, Thorkil Sonne, recognises his staff with autism need a quiet environment and fixed routines.
Given the right conditions, they excel at technical tasks.
Robots and Lego models are used to test their skills.
Thorkil Sonne said: "People come to me who've had difficulties in the labour market and got depressed.
"They're like computers that need re-booting.
"I see them grow in self-esteem.
"It's the most motivating part of my work and a magical moment for me, as the father of a boy with autism."
Thorkil's son Lars was diagnosed at the age of three. He is now 12.
Fulfilling lives
Thorkil told me: "I read up about the condition - but there were too many books describing what people can't do.
"And yet my staff are able to go and work at the premises of our customers.
"I'm so proud. I didn't think that would be possible when I started the company five years ago."
The experience in Denmark shows autistic workers are an untapped resource.
Politicians in the UK are developing plans to help adults with autism lead more fulfilling lives.
Special strategies have been published in Wales and Northern Ireland.
A bill that will provide the first specific legislation on autism for England is making its way through Parliament at the moment, with good cross-party support.
It will lead to formal guidance for local authorities and the NHS about how to help adults with autism.
Charities say this cannot come soon enough

Autistic jobseekers 'written off'

The NAS says Jobcentre Plus staff lack understanding of autism

by poor employment and benefits support, a charity says. 

The National Autistic Society (NAS) is calling for a national strategy to help people with autism into work.
NAS chief executive Mark Lever said people with autism experienced "anxiety, confusion, delays and discrimination" when using services.
The Department for Work and Pensions said it was "determined to provide the best support possible" to them.

It is absolutely vital (people with autism) are able to access the right help and services Mark Lever, National Autistic Society

Launching its "Don't Write Me Off" campaign, the NAS says a majority of the over 300,000 working age adults with autism in the UK want to work but only 15% are in full-time paid employment.
The charity says a key problem is a lack of understanding of autism among Jobcentre Plus staff, who determine eligibility for benefits and provide employment support.
It is calling for the government to introduce autism coordinators who would work with frontline staff, local employers and employment support services.
Mr Lever said: "It is absolutely vital [people with autism] are able to access the right help and services if seeking employment and are supported financially when they cannot work."
'Multitude of problems'
The charity says many people with autism are experiencing difficulties when applying for the new Employment and Support Allowance (ESA).
The ESA replaced incapacity benefit in October 2008. The change was designed to encourage more people into work if they are able.
But the NAS says many people with autism are experiencing a "multitude of problems".
Paula Wharmby said she found the process of applying for the ESA inflexible and intimidating.
"It was clear nobody knew anything about autism and a report from my psychiatrist on my difficulties was completely ignored.
"I was denied the benefit and had to go to a tribunal to have the decision overturned.
"The system just isn't working for people like me."
In a statement, the DWP said it was working with the National Autistic Society and other groups to ensure help was available, and that the government would publish its Autism Strategy in due course.
The statement added: "We understand that people with autism have complex needs so we have arrangements in place to help, such as bringing along someone to represent them in adviser interviews if needed.
"We are determined to provide the best support possible to help them get into work, which is why our wide range of personalised support looks at what people can do, rather than what they can't."

What are autism and Asperger syndrome?

What are autism and Asperger syndrome?

http://www.richimag.co.uk/healthy/clever.people with autism and Asperger syndrome the world can appear chaotic with no clear boundaries, order or meaning.
These disorders can vary from very mild, where the person can function as well as anyone else around them, to so severe that they are completely unable to take part in normal society.

They affect more than 580,000 people in the UK

People with autism are usually more severely disabled, while those with Asperger syndrome tend to be more able, although this isn’t always so. Because of the range of severity and symptoms the conditions are collectively known as autistic spectrum disorders. They affect more than 580,000 people in the UK.

Symptoms

The main three symptoms are:

• Difficulties with social interaction - being unaware of what's socially appropriate, finding chatting or small talk difficult and not socialising much. People with autism may appear uninterested in others and find it very difficult to develop friendships and relate to others, while those with Asperger syndrome are more likely to enjoy or want to develop social contacts but find mixing very difficult.
• Problems with verbal and non-verbal communication – those affected may be able to speak fluently or, more commonly in autism, may be unable to speak at all. There may also be difficulties understanding gestures, body language, facial expressions and tone of voice, making it difficult to judge or understand the reactions of those they are talking to, or to empathise with people's feelings. As a result they may unintentionally appear insensitive or rude to others. They may also take others comments very literally, and so misunderstand jokes, metaphors or colloquialisms.
• Lack of imagination and creative play - such as not enjoying or taking part in role-play games. They may also find it difficult to grapple with abstract ideas. There may be overriding obsessions with objects, interests or routines which tend to interfere further with building social relationships (this is known as stereotyped or repetitive behaviour).

These behavioural difficulties can cause a great deal of stress for members of the family.
Babies who develop autism later may appear normal at first and reach the usual developmental milestones, including early speech. But as they grow into toddlers, they may fail to develop normal social behaviour and speech may be lost.
As a child grows, the typical difficulties of autistic spectrum disorders are:

• Repetitive behaviour and resistance to changes in routine.
• Obsessions with particular objects or routines.
• Poor coordination.
• Difficulties with fine movement control (especially in Asperger’s syndrome).
• Absence of normal facial expression and body language.
• Lack of eye contact.
• Tendency to spend time alone, with very few friends.
• Lack of imaginative play.

People with Asperger syndrome are usually more mildly affected than those with autism. In fact, many people with milder symptoms are never diagnosed at all, and some argue that Asperger syndrome is simply a variation of normal rather than a medical condition or disorder. Even so, many do find that it gives them particular problems getting on in the world and they may become aware they are different from others. This can result in isolation, confusion, depression and other difficulties, all of which could be defined as ‘disease’.
Some children with Asperger syndrome manage (or in fact even do very well) in mainstream schools especially if extra support is available. However, even when children cope well academically, they may have problems socialising and are likely to suffer teasing or bullying. More severely affected children need the specialist help provided by schools for children with learning disabilities.
With the right sort of support and encouragement, many with Asperger syndrome can lead a relatively normal life. Helping them develop some insight into the condition is an important step towards adjusting to, or at least coping with, the way the rest of the world works. Some do very well, especially in an environment or job where they can use their particular talents.
Autism tends to produce more severe symptoms. For example, a child with autism may fail to develop normal speech (the development of spoken language is usually normal in Asperger’s syndrome) and as many as 75 per cent of people with autism have accompanying learning disabilities.
Seizures are also a common problem, affecting between 15 and 30 per cent of those with autism.
Conversely, autistic children are sometimes found to have an exceptional skill, such as an aptitude for drawing, mathematics, or playing a musical instrument.

Causes and risk factors

The cause of autistic spectrum disorders is not yet clear. Genetics play an important role, and researchers are examining a number of chromosome sites that could be implicated. It's likely that autism occurs when a small number of genes interact in a specific way, possibly linked to some external event or factor.
This genetic link means there may be an inherited tendency, so autism and Asperger’s syndrome may run in families. Brothers or sisters of a child with the condition are 75 times more likely to develop it.
Doctors' ability to diagnose these disorders has improved in recent years, but older people, particularly with milder problems, may never have been diagnosed. When a child is diagnosed, parents often realise they've had the same problems themselves.
Boys are more likely to be affected than girls, though research suggests that when girls have the condition they may be more severely affected.
A variety of other environmental factors that affect brain development before, during or soon after birth, also play a part (possibly acting as a trigger). Despite reports suggesting a possible link between MMR vaccination and autistic spectrum disorders, scientific evidence has confirmed the vaccination does not increase the risk.
There's no specific test for autistic spectrum disorders. Diagnosis is based on a consideration of symptoms, and milder cases may be missed.

Treatment and recovery

There is no specific cure or particular medical treatment for autism, but much can be done to maximise a child’s potential and this is key to managing the condition

There is no specific cure or particular medical treatment for autism, but much can be done to maximise a child’s potential and this is key to managing the condition. Appropriate specialist education, speech, language and behavioural therapy are all important. There are many different approaches, some of which are based around theories about possible causes of autistic spectrum disorders (for example, the Son-Rise programme).
While many people feel they've achieved good results with some of these interventions, none of them is a cure-all, and many lack scientific evidence to demonstrate their benefits.
Others claim dietary changes or alternative remedies have helped, but these, too, are mostly unproven.
Medication is sometimes recommended when it's felt to be of benefit to the child, for example to control seizures, depression or other symptoms.
As the precise events that lead to autistic spectrum disorders aren't yet known, it isn't possible to prevent them. Neither is there yet a simple screening test to identify people carrying genes that might increase susceptibility to autism.
This article was last medically reviewed by Dr Trisha Macnair in August 2009.

Families share 'autistic traits'

'Autistic' brain changes may be seen in the relatives of those with autism

Relatives of people with autism may display autistic brain differences and behaviours despite not having the condition themselves, a study shows. New Scientist says the work could make it easier to spot families at risk of having an autistic child.
It could also help in the quest to find genetic and environmental triggers for the condition, experts hope.
Autism is a disorder that makes it hard for the individual to relate socially and emotionally to others.
'Autistic traits'
It affects about five in 10,000 people, predominantly boys and men, and is often also associated with learning disabilities.
The New Scientist piece reported on work presented at the annual meeting of the Society of Neuroscience that took place in Washington DC this month.
Dr Eric Peterson, from the University of Colorado in Denver, spoke about his work comparing the brain scans of 40 parents with autistic children with those of 40 matched parents whose children did not have autism.
The parents of autistic children shared several differences in brain structure with their offspring, including an unexpected increase in the size of brain areas linked to movement planning and imitation - the motor cortex and basal ganglia.
However, a neighbouring brain area called the somatosensory cortex was smaller than average.
This region is important for understanding social information such as facial expressions - a skill autistic people often lack.
Brain changes
The cerebellum, which is important for co-ordinating movement, and a frontal region thought to play a key role in understanding the intentions of others were also smaller than average.
Another US study, led by Brendon Nacewicz from the University of Wisconsin-Madison Medical School, showed that the amygdala, a brain region involved in processing emotions, was shrunken in both autistic children and their brothers.

It is telling us that genes, as they run through families, are affecting brain function and structure not just in the person with autism but also in their first degree relatives Professor Simon Baron-Cohen of the Autism Research Centre, Cambridge

The brothers also avoided eye contact - a common feature of autism - just as strongly as their affected siblings, even though they did not have autism themselves.
Other researchers have been attempting to identify genes predisposing people to autism, which are thought to be as many as 20.
Professor Simon Baron-Cohen, director of the Autism Research Centre in Cambridge, in the UK, said: "First-degree relatives - parents or siblings of those with autism - may have some but not all of those genes, which would explain why they do not have autism but do show some milder manifestations.
"We have known for years that family members of people with autism may share some traits.
"However, the finding that there are differences in brain structure in parents of children with autism compared to parents of children without autism is new.
"It is telling us that these genes, as they run through families, are affecting brain function and structure not just in the person with autism but also in their first degree relatives."
He said it was too early to use these brain changes to spot people who might be at risk of autism, but he added: "I'm sure that will come."