Summary for HealthiNation's Autism
The following is an interview with Dr. Doreen Granpeesheh, founder of the Centers for Autism and Related Disorders (CARD).
Autism Therapy Options information also provided by Dr. Holly Atkinson after the Granpeesheh interview.
Special Guest Host: Lou Diamond Phillips
Doreen Granpeesheh, PhD: When I started working with children with autism back in 1978, it was such a rare disorder that nobody really knew what autism is. I would tell my friends I work with autistic children and they would say, "Oh, they're artistic, they draw well?" And it wasn't probably until the movie Rain Man came out when people started to recognize what autism is.
Autism is a childhood development disorder that is characterized by problems or delays in basically three areas of functioning.
The first area is social skills. Children with autism have pretty significant delayed social skills. They won't have full eye contact with anyone. They won't develop peer relationships. They won't develop friendships or want to play with another child.
The second area is communication, so children with autism will either have delayed language or language that's not appropriate to the context.
And the third area is what's called self-stimulatory or ritualistic behavior. These are behaviors like hand flapping or body rocking, lining up their toys instead of playing with them, those types of things.
If a child has a total of eight symptoms within these three areas, he will receive a diagnosis of autism. If there are fewer than that, but the child still has pervasive delays within those three areas, then he will get the diagnosis of Pervasive Developmental Disorder or PDD. Now, if a child doesn't have a language delay, but he still has those kinds of abhorrent behaviors and he still has the social delays, then he will get a diagnosis of Asperger's Syndrome. There are very subtle differences between them, and they are all part of the autism spectrum. And of course if a child has fewer delays or less pronounced delays, he or she is likely to do better.
The earliest signs that most parents notice is lack of language. So, most of the time when a parent comes to see me for the first time, they tell me that they started to get concerned when their child didn't start developing language at around age one and one- half or so. The other types of symptoms that parents tend to talk about are things like basic attachment behaviors. A lot of mothers will report that, "Even when I called his name or tried to console him when he was hurt, he did not react to me holding him, he didn't react to comfort, he's never came to me for comfort if he was hurt." Those types of attachment behaviors seem to be lacking. Those are the two areas that parents notice first.
Many years ago the belief was that autism was related to the "frigid mother." That's the idea that the mother had not provided enough of an interaction or reinforcement to the child and that's why the child had become self isolated and eventually autistic. It was around the 1960s when Dr. Bernard Rimlin wrote the book Infantile Autism and said "No, autism has nothing really to do with parenting styles rather it is a neurological disorder, and we have to be very careful to differentiate that."
Over the years we've learned that autism is a genetically-based disorder. First of all, there has to be a certain number of genes present for the child to develop this predisposition. And if you have these particular genes, then some environmental factor will set off the symptoms of autism.
Management of Autism: Therapy Options
Hosted by Dr. Holly Atkinson, MD
Autism is best managed when parents and doctors work together to recognize the warning signs and begin a treatment plan as early as possible. There are a number of different treatment philosophies. The main types include developmental and behavioral approaches and biomedical treatment. Talk to your doctor or specialist about what's right for your child and family. This partnership is the key to managing this condition. Many times families use a combination of treatments.
Developmental and Behavioral Management
The developmental approaches entail teaching autistic children certain skills to help them move forward in life. These skills include:
- Learning how to communicate better
- Creating their own ideas
- Understanding what is happening in the environment around them.
With these and other skills in place, autistic children can develop further and reach key milestones. For example, "floor time" is one of the types of the developmental approach. Under this technique, a parent or therapist will use a child's interest to advance his or her skills. In addition, behavioral approaches often use a "reward system" to produce positive actions from a child. The main type of behavioral treatment is called ABA, or Applied Behavior Analysis.
Biomedical treatments focus on medication and diet. The diet aspect of biomedical treatment is controversial and not all researchers agree on how well it works.
Medication can be used to improve behaviors that interfere with learning. These include hyperactivity, violence and obsessive-compulsive behavior. However, the medications do not cure the core symptoms or condition of autism.
There are other therapies that may be part of an overall treatment plan.
- PECS, or the Picture Exchange Communication System. This uses pictures to teach children to communicate. Through the telling of social stories, children learn about different life situations and how to handle them.
- Sensory Integration. This helps children learn to manage their sensitivity to light sound and touch.
No matter what approach you choose, the key to treating autism is early intervention. Continuing research may help us learn more about the cause of autism and how to treat it.
HealthiNation offers health information for educational purposes only; this information is not meant as medical advice. Always consult your doctor about your specific health condition.