Autism: what is it?
Autism is one of the group of pervasive developmental disorders (TED), which appear in early childhood, usually before the age of 3. Although symptoms and severity vary, all of these disorders affect the ability of the child or adult to communicate and interact with others.
The most common TEDs are:
- autism
- Asperger’s syndrome
- Rett’s syndrome
- Unspecified TEDs (TED-NS)
- Disintegrative disorders of childhood
A new classification for PDDs In the next edition (to be published in 2013) of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), the American Psychiatric Association (APA) proposes to group together all forms of autism in a single category called “autism spectrum disorders”. The other pathologies so far diagnosed separately, such as Asperger’s syndrome, pervasive developmental disorder not specified and childhood disintegrative disorder, will no longer be considered as specific pathologies but as variants of autism.16. According to the APA, the proposed new criteria will lead to more accurate diagnoses and help doctors provide better treatments. Other doctors say this new classification could exclude people with less severe disorders such as Asperger’s syndrome13 and thereby deprive them of access to the social, medical and educational services that are beneficial to them. Health insurance and public programs are largely based on the definition of illnesses established by the American Psychiatric Association (APA). In France, the Haute Autorité de Santé (HAS) recommends the use of the International Classification of Diseases – 10th edition (CIM-10) as a reference classification.17. |
Causes of autism
Autism is said to be a developmental disorder whose exact causes are still unknown. Researchers agree that many factors are at the origin of PDDs, including genetic factors et environmental, influencing brain development before and after birth.
Many Genoa would be involved in the onset of autism in a child. These are thought to play a role in fetal brain development. Certain genetic predisposing factors could increase a child’s risk of having autism or PDD.
Environmental factors, such as exposure to toxic substances before or after birth, complications during childbirth or infections before birth could also be involved. In any case, the education or behavior of parents towards the child is responsible for autism.
In 1998, a British study1 attributed a link between autism and exposure to certain vaccines, particularly vaccin against measles, rubella and mumps (MMR in France, MMR in Quebec). However, several studies have subsequently shown that there is no association between vaccination and autism² The main author of the study is now accused of fraud. (See the document on the Health Passport website: Autism and vaccination: history of a controversy)
Associated disorders
Many children with autism also suffer from other neurological disorders6, such as :
- Epilepsy (affects 20 to 25% of children with autism18)
- Mental retardation (estimated to affect up to 30% of children with PDD19).
- Bourneville tuberous sclerosis (up to 3,8% of children with autism20).
- Fragile X syndrome (up to 8,1% of children with autism20).
People with autism sometimes have:
- Problems of sleep (falling asleep or staying asleep).
- Problems gastrointestinaux or allergies.
- benefits crises convulsives that start in childhood or adolescence. These seizures can lead to unconsciousness, convulsions, that is, uncontrollable shaking of the whole body or unusual movements.
- Psychiatric disorders such asanxiety (very present and related to the difficulty in adapting to changes, whether positive or negative), phobias and depression.
- benefits cognitive disorders (attention disorders, executive function disorders, memory disorders, etc.)
Living with a child with autism brings about many changes in the organization of family life. Parents and siblings must face this diagnosis and a new organization of the everyday life, which is not always very easy. All this can generate a lot of stress for the whole household.
Prevalence
About 6 to 7 in 1000 people have PDD in those under 20, or one in 150 children. Autism affects 2 in 20 children under 1000. One third of children with PDD present with mental retardation associate. (2009 data from the Haute Autorité de Santé – HAS, France)
In Quebec, PDDs affect approximately 56 school-aged children out of 10, or 000 in 1 children. (178-2007 data, Fédération québécoise de l’Autisme)
One in 110 children in the United States has autism spectrum disorder2.
For the past 20 years, the number of autism cases has increased dramatically and is now one of the most recognized disabilities in schools. Better diagnostic criteria, the increasingly precocious identification of children with PDD, as well as the awareness of professionals and the population have undoubtedly contributed to the increase in the prevalence of PDDs all over the world.
Diagnosis of autism
Although signs of autism often appear around the age of 18 months, a clear diagnosis is sometimes not possible until the age of 3 years, when delays in language, development and social interactions are more evident. The earlier the child is diagnosed, the sooner we can intervene.
To make a diagnosis of PDD, various factors must be observed in the child’s behavior, language skills and social interactions. The diagnosis of PDD is made after a multidisciplinary investigation. Numerous examinations and tests are necessary.
In North America, the usual screening tool is the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) published by the American Psychiatric Association. In Europe and elsewhere in the world, healthcare professionals generally use the International Classification of Diseases (ICD-10).
In France, there are Autism Resource Centers (ARCs) which benefit from multidisciplinary teams specializing in diagnosing autism and PDDs.