Autism

Cause

The exact cause of autism is as yet unknown. In nine out of ten cases, congenital hereditary factors play a role. There is not one single gene responsible for autism, but a combination of multiple genetic mutations, under the influence of environmental factors. Researchers suspect that due to this combination, the development of the brain is different, causing restrictions in people with autism. Autism is not caused by upbringing.

Symptoms

Characteristic for people with autism are restrictions on three areas. These restrictions occur in all people with autism to a greater or lesser extent:

• Social interaction and imagination. For example, they are very introverted or don't make eye contact with others. They find it difficult to empathise with other people.
• Communication and (body) language. They often don't recognize facial expressions (angry, happy, sad) and their language development is often delayed and abnormal. They take figurative statements literally.
• Stereotyped behavior and interests. For example, they can immerse themselves in a particular activity, so that they have no attention for anything else. In their behavior, repetitive patterns can often be recognized.

There are different types of autism: classic autism, Asperger syndrome and Pervasive Development Disorder-Not Otherwise Specified (PDD-NOS).
In addition to the above-mentioned three kinds of restrictions, classic autism has some specific symptoms that are very prominent. These people are often hypersensitive to external stimuli and are very restricted in their social interactions. Two-thirds of people with classic autism have an IQ below average. Girls with autism tend to be less intelligent than boys.
People with autism have more difficulty to shape their lives and to stand firm in life than people without autism. People with autism often need help, counseling and treatment for the problems that may arise in the course of their lives. The intensity of this aid can vary significantly from person to person and from stage of life to stage of life.

Diagnosis

The diagnosis of autism is a behavioral diagnosis and making the diagnosis can sometimes take several months. The (combination of the) three symptom areas are assessed: social interaction, communication and stereotyped behaviors and interests. The diagnosis can be made by a (child and adolescent) psychiatrist or a psychologist.

Treatment

Because the cause of autism is unknown, it is not (yet) possible to cure this disorder. Treatment of autism is limited. This treatment usually focuses on two aspects. On the one hand on the acquisition of skills to deal with the restrictions as well as possible. On the other hand on adapting the environment. For instance adjustments at school or work, such as a fixed workplace or a fixed daily schedule.

Prognosis

Although knowledge about autism has increased hugely in recent years, we still cannot predict the future that a child with autism may expect. Only ten percent of the adults have a job, five percent are married and the vast majority need lifelong support to a greater or lesser degree. Compared to people with other disorders, adults with autism need more assistence with daily activities. Intimate relationships are also a very difficult issue.

Considerations

Supporting an autistic person requires a lot from caregivers and supervisors. Several things are important when giving guidance:

• Use specific language for people with autism. Short sentences, no chattering.
• A person with autism can often only perform one thing at a time (no talking and watching at the same time).
• Ask specific questions and be patient in getting an answer, as it sometimes takes a little longer.
• Be predictable and propose changes in time.
• Provoke communication and give the autist enough time to process the information.
• Add feelings and emotions to the contact. In fact, the autist does have feelings and desires, just like any other person.
• Provide clarity and set rules. An autist may well be demanding, but that is caused by his or her need for clarity.
• Expect no response to non-verbal communication (facial expression or gesture). An autist won't recognize or be able to understand it.
• Punishing has no effect, they don’t understand why. It will naturally go well with clear agreements and rules, because these people can adhere well to this.
• If a person with autism is angry, ensure that he or she gets distraction to relax again. Talk with him or her at a later moment. Discussions and mixing emotions herein don’t make sense.

Facts

• The infantile or childhood autism was first described in 1943 by the American child psychiatrist Leo Kanner.
• The term ‘autism’ is derived from the Greek word autós (self).
• The prevalence of autism is over 1%. Of this, 14% has classic autism and 86% has Asperger’s syndrome or PDD-NOS.
• Men are four times more likely to have autism than women.