A Child With Autism

Parents, families and caregivers of a child with autism may wish to work against the devastating impact this disorder has on quality of life. We may dream of an autistic child achieving goals like gratifying employment, meaningful relationships, marriage, independence and good physical and mental health.

The article A Child With Autism gives a general overview of what autism is, how the disorder is diagnosed, evaluations and other tests, how children are affected, treatment options, services and supports, prognosis, coping strategies, cause, incidence rate, costs to society, along with some useful resources.

A Child With Autism

by Wanda Brown

What is autism?

Child_Autism Image Autism is a complex lifelong neurodevelopmental disorder usually identified by age three. A child with autism will show different behaviors than typical developing children.

Parents become concerned that their child may lack eye contact, be deaf, is not yet talking, resists cuddling, appears aloof and avoids interacting with others.

These behaviors may begin shortly after birth or develop as a child grows older.

Symptoms will range from mild to severe. Mental retardation is commonly associated in autism. The Centers for Disease Control in Atlanta and others report black children have significantly higher rates of mild mental retardation than white children do and socioeconomic factors cannot explain the differences. Yeargin-Allsopp M, Drews CD, Decoufle P, Murphy CC Mild mental retardation in black and white children in metropolitan Atlanta: a case-control study. Am J Public Health. 1995 Mar;85(3):324–8. Drews CD, Yeargin-Allsopp M, Decoufle P, Murphy CC Variation in the influence of selected sociodemographic risk factors for mental retardation. Am J Public Health. 1995 Mar;85(3):329–34.

Epilepsy may also develop in some cases. The CDC reports autism is four to seven times more likely to occur in boys than in girls. Eighty percent of persons with autism are now teens and older.

Consult a pediatrician, developmental specialist or neurologist if you suspect your child may have autism.

How is autism diagnosed?

There is no biological testing available for autism. Autism is diagnosed on the observation of a specialist and parent questionnaire reporting their child's behavior, i.e. ability to play, interact with others, and communicate.

What types of evaluations and other tests may be recommended in a diagnosis of autism?

  • Hearing Assessment (Auditory Brainstem Response)
  • Speech/Language Evaluation
  • Developmental/Psychological Assessment
  • Neurological Assessment, which may include an EEG, MRI, CAT Scan and urinalysis (Amino and Organic Acid)
  • Blood work (Chromosomal testing for Fragile X Syndrome)
  • Lead Level Test and other heavy metals
  • Allergy and Immune Function Testing
  • Occupational and Physical Therapy Evaluation
  • Physical Therapy Evaluation

Why is early diagnosis so important?

Early diagnosis and treatment is essential in order to achieve further growth, development and learning which leads to a better prognosis.

Children need to be diagnosed earlier because the risk to parents of having another child with autism is increased. The probability of having a second child with autism is reported to be 1 in 20. Excerpts from Race Differences in the Age at Diagnosis Among Medicaid-Eligible Children with Autism, David S. Mandell, Sc.D., John Listerud, M.D., Ph.D.

Autism is one of the most heritable neurodevelopmental disorders. If one identical twin has it, so will the other in nearly 9 out of 10 cases. If one sibling has the disorder, the other siblings run a 35-fold greater-than-normal risk of having it. Source: National Institutes of Health

African American children with autism must be diagnosed earlier and receive early intervention, as they were found to be diagnosed later than any other ethnic group, received more misdiagnoses, and were more likely to be misdiagnosed as having organic psychoses, mental retardation, or selective mutism. Excerpts from Race Differences in the Age at Diagnosis Among Medicaid-Eligible Children with Autism, David S. Mandell, Sc.D., John Listerud, M.D., Ph.D.

Certain symptoms associated with autism, such as delayed language development and problems handling daily life tasks, are more severe in African American individuals with autism. Source: Investigation of autism and GABA receptor subunit genes in multiple ethnic groups.

Minority families and families with lower incomes or limited education were also found to have difficulty entering the early intervention system. Source: National Early Intervention Longitudinal Study

Click here for more information on disparities in health and disparities in special education.

How are children with autism affected?

A child with autism is first a child. They have the same illness, discomfort, feelings and emotions, as any person. A common misconception is that a child with autism does not show love and affection or have a sense of humor.

An autistic child seems to exist in her own world, and displays unusual behaviors, i.e. lack of eye contact, acts as if deaf, have repetitive interests, i.e. hand flapping, rocking, spins objects, an inappropriate attachment to objects, resists change in routines, difficulty sleeping, hyperactivity, lack or delayed speech, have problems in communication, resists learning, lack social and play skills, no fear of real danger, and may be destructive and aggressive at times.

Many children with autism have some degree of sensory dysfunction. Children with autism may have gastrointestinal symptoms, food intolerances or allergies, and biochemical deficiencies.

Some children with autism do not speak at all. Those who do may speak in rhyme, echolalia (repeat words), speak in a flat tone and use peculiar language.

Occasionally, a child with autism displays a special talent in math, art, music, or other specific skills. Persons with these types of splinter skills are known as autistic savants.

With early diagnosis and early intervention a child with autism has a better outcome - a brighter future.

What treatment options
are available?

Children with autism need a complete evaluation with specialized behavioral and educational programs. Learning disabilities are common in autism. Some autistic students are smart and learn easily.

Most children need a structured day at home and school in a carefully planned environment for learning.

Today there is real hope for children with autism.

According to the Centers for Disease Control and Prevention (CDC) and the Autism Research Institute, autism is treatable with no known cure yet. Autism may cause behavioral or psychological symptoms. Early and intensive education can help a child with autism develop and learn new skills.

The goal is to reduce the difficult symptoms and improve their skills that help a child talk, relate to others, play, learn and care for their own needs.

Some children with autism may benefit from treatment with medication to relieve symptoms. Structured teaching methods known as behavioral intervention or Applied Behavioral Analysis (ABA) is currently the most effective treatment.

Biomedical interventions may include nutritional supplements, special diets, treatment of bacterial and yeast overgrowth in the gut, and detoxification of heavy metals.

Appropriate treatment can improve a child's development and help to reduce disruptive behaviors and symptoms.

What services and supports are available for children and adults?

Young children from birth to age three may receive Early Intervention Services.

Every child with autism is required by federal law to receive a "free appropriate public education" or FAPE.

A child with autism having limitations in one or more daily life activities and/or displaying difficult or harmful behaviors are entitled to certain supports and services. These services are generally obtained from a state Developmental Disability Services Office or Office of Mental Retardation and Developmental Disabilities where you reside. A local Department of Mental Health or Mental Health Association may also help you apply for specialized supports and services.

What is the prognosis for persons with autism?

Although the outcome for adults with autism has improved over recent years, many remain highly dependent on their families and other adult support services.

According to a survey conducted by the National Autistic Society of over 450 children and adults with autism, an astonishing 70% of adults with autism are unable to live independently. Of these persons, 49% live with family members, creating a huge financial burden on aging parents, and 32% live in residential care facilities, which offer little or no privacy, functional independence, or stimulation. Only 3% of adults with autism live fully independently.

In terms of employment, only 6% of adults hold paid, full-time jobs. Regarding mental health, over half of adults with autism have been diagnosed with depression some time in their adult life while 11% say they have suffered a "nervous breakdown."

Although the majority of adults surveyed had participated in at least two autism interventions in childhood, 65% continue having difficulty making friends. Of teens surveyed, 74% said that they had difficulty making friends. Of children under 13-years-old, 31% participated in no social activities at all.

How do families cope with autism?

"...it is not the child’s disability that handicaps and disintegrates families; it is the way they react to it and to each other."
(Dickman & Gordon, 1985, p. 109)

The Autism Society of America offers parents and their families some coping strategies:
  • First acknowledge and admit that caring for an autistic child can be overwhelming -- you'll only make yourself feel more stressed if you try to convince yourself that it's not.
  • Each member of the family needs some time, doing what he or she enjoys and not focusing on the autistic family member. Everyone needs a break.
  • Reward yourself with a special meal, movie night, or other treat every so often while family or friends care for the autistic child.
  • Consider joining a support group or counseling session for families and parents of autistic children. Sharing your experiences with others can be a big help.
  • Try breathing and relaxation techniques.
  • Keep a journal of what you're experiencing and feeling. Getting your thoughts down on paper may help relieve stress.
Click here for more help and strategies on how to deal with stress on families.

What is the cause of autism?

The cause of autism remains unknown. We do know that parents do not cause autism. Current theories indicate a problem with the function or structure of the brain and central nervous system.

Although the dramatic increase in autism and present theories on the cause of autism is controversial, most scientists agree that a genetic predisposition and one or more environmental factors must be in place for autism symptoms to be apparent, is possible.

How common is autism?

A new study by the CDC shows the autism prevalence rate is much higher than originally thought (1 in 150). According to the study, autism affects 1 in 91 children. And 1 in 58 boys, totaling an estimated 673,000 or approximately 1% of all children in the United States. (U.S. Centers for Disease Control and Prevention October, 2009). An estimated 50 children are diagnosed with autism every day. Individuals diagnosed with autism are now estimated to be in the tens of millions.

New Jersey had the first highest rate of autism ever recorded in the United States of one in 94 children, and one in 60 boys. Source: Prevalence of the Autism Spectrum Disorders in Multiple Areas of the United States, Surveillance Years 2000 and 2002

Increased Rates Among African Americans

Three out of four recent U.S. studies found a higher incidence of autism in black children, sometimes appreciably higher. Source: Bhasin TK, Schendel D Sociodemographic Risk Factors for Autism in a US Metropolitan Area. J Autism Dev Disord. 2007 Apr;37(4):667–77. Croen LA, et al. The changing prevalence of autism in California. J Autism Dev Disord. 2002 Jun;32(3):207–15. Hillman RE, et al. Prevalence of autism in Missouri: changing trends and the effect of a comprehensive state autism project. Mo Med. 2000 May;97(5):159–63. Yeargin-Allsopp M, et al. Prevalence of autism in a US metropolitan area. JAMA. 2003 Jan 1;289(1):49–55.

According to the Autism Society of America:

  • A child is diagnosed about every 20 minutes.
  • Every day 60 American families are told they have a child with autism.
  • More children will be diagnosed with autism this year than AIDS, diabetes and cancer combined.
  • Autism receives less than 5% of the public funding contributed each year to fight all major childhood diseases.
  • Autism is the fastest-growing serious developmental disability at an alarming rate of 10 to 17 percent each and every year in the U.S.

What is the cost of autism to society?

The first study to comprehensively survey and document the costs of autism to U.S. society, was conducted at the Harvard School of Public Health. The study showed that it costs about $3.2 million to take care of a person with autism over his or her lifetime.

The estimated costs for caring for all people with autism over their lifetimes costs $35 billion per year. This study "The Costs of Autism" is published in Understanding Autism: From Basic Neuroscience to Treatment.

Practical Strategies for Families

Child with Autism Resource Kit

Department of Mental Health of Orange County, New York, provides a Child's Guide to help you organize important information about your child in one central location. The Guide offers a way for you to record your child's daily living activities, a Child Emergency Contact Form, and Educational and Medical Profile information in a central location. Service providers would find this consolidated, detailed information essential in an emergency.

Download Autism Resource Kit here.

Resources for a child with autism

Click here for practical ways to help your family and child with autism plan and manage daily living.

Autism Society of America provides advocacy, information and support. The information referral hotline is 1 (800) 3-AUTISM.

For direct links to other national autism organizations go to: www.child-autism-parent-cafe.com/autism-resources.html.

About this author
Wanda Brown is wife, mother, grandmother, volunteer, presenter at parent support groups, member autism support groups, national autism organizations, former legal assistant, service coordinator, and served as Board member to non-profit organizations, autism Advisory Groups, and has appeared on Cable 6 TV, XM Radio One, Tavis Smiley Radio, CNN Radio and WDIG Radio.

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