CHILDREN'S HEALTH FAMILY

Autism Spectrum Disorder

Written by Lindsay Pearson

Classic autism is a complex, neurological disorder which is part of a group of disorders known as, Autism Spectrum Disorders (ASD). People with ASDs usually have distinct social, communication, and behavioural differences in common and Autism Society Canada defines the term “spectrum” as referring to, “a continuum of severity or developmental impairment.” As authors of The Autism Book, S. Jhoanna Robledo and Dawn Ham-Kucharski point out, children who are diagnosed with classic autism tend to demonstrate, “significant delays in three specific areas:” difficulty communicating their ideas, thoughts, and feelings to others; their lack of “social reciprocity,” or the ability to build relationships with people; and their tendency to engage in behaviours that are repetitive (4-5).
Autism Society Canada lists some general characteristics of autism which may include; avoiding eye contact, or not making eye contact with others at all; not responding to, or understanding, smiles and facial gestures; difficulty “joining in”, and children may prefer adult company rather than their own age group; very slow speech development and in some cases not at all. Often their voices may sound flat or monotonous or have an unusual rhythm and pitch to their speech; unusual actions such as, “spinning, rocking, staring, finger flapping, hitting self, etc.” may be repeated over and over again; they may have unusual postures or movements; and some may experience mild to severe hypo-sensitivities to sounds, sights, touch, taste, and smells.

Autism Speaks Canada provides some insight into the prevalence of autism in children living in North America; the numbers are staggering, and on the rise. Currently, the disorder affects 1 in every 150 children in both Canada and the United States. Studies have shown that boys tend to be more susceptible to develop autism than girls, in fact, four times more likely; increasing their odds to 1 out of every 94 boys. “Government statistics suggest the rate of autism is rising 10 to 17 percent annually,” and such dramatic increases are prompting further investigation into why the disorder has become so widespread. Presently, “more children are diagnosed with autism than pediatric cancer, diabetes and AIDS, combined.” Although experts are unable to link autism to one particular known cause, nor is there a cure, ongoing studies have shed some light on what may be possible triggers, as well as treatments and therapies that might mitigate the behaviours and other medical concerns linked to autism.

While most cases of autism are idiopathic, experts state that the neurological disorder is not a form of child psychosis or a mental illness, nor is it a case of kids misbehaving. There are many speculations of causes including, “increasing maternal and paternal age, low birth weight, multiple pregnancies,” (Alice Park) and at one point the disorder was even thought to have been caused by “cold” parenting. This particular theory has since been debunked and scientists are now focussing the majority of their research on what appears to be, a strong genetic component, as well as environmental and immunologic factors.

Recent studies confirm that genetics play a large part in the development of autism; the disorder can be inherited, or genetic mutations can occur, which jeopardize the structure of proteins within a cell. An article in, Scientific American Magazine, points out that, “A new genetic mutation can change the way proteins are made – they might be made incorrectly, too often or not at all.” In order for a cell to function properly, a full group of proteins is required. Each protein has an important, and specific, job to do and they act in a similar way to that of a community. If one is unable to perform its job, “major systems will start to falter” (Katherine Harmon 2). Research conducted by C. Leigh Broadhurst, PhD., pertaining to the inheritance of autism, indicates that, “identical twins have an up to 92 percent rate of both having ASD,” and “fraternal twins have an up to 10 percent rate of both having ASD.” Further epidemiological observations have declared that, “80 percent of ASD cases are male;” as well, “ the risk of ASD in siblings is between 2 and 8 percent greater than in unrelated children.” Technological advances have allowed for some major discoveries when looking at the role of genetics and autism; there are now hundreds of proteins flagged as instigators compared to only a couple dozen a few years ago; however, there is still much more to learn about the disorder’s genetic roots (Harmon 2).
In addition to a genetic element, environmental factors seem to play quite a large role in determining possible causes of autism. Dr. Joachim Hallmayer at the Stanford University School of Medicine claims, “Shared environmental influences may account for as much as 55% of autism risk, while less than 40% can be attributed to genes.”
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It appears that the number of children diagnosed with ASD has been on the rise since the early 1990’s; this has researchers questioning, “What in the environment has changed since the early 1990’s that could account for such an enormous rise in the brain disorder?” (Marla Cone 1). The list of neurodevelopmental toxins that one may come into contact with is extensive, and includes: metals such as lead and mercury, polychlorinated biphenyls (PCBs), brominated flame retardants, and pesticides. These types of toxins have an effect on how the brain grows; common household items such as vinyl, cosmetics, antibacterial soaps, and pet flea shampoos may contain such brain altering ingredients, some of which have been linked with autism. Granted, in recent decades exposure to PCBs has diminished, however, the use of brominated flame retardants in the manufacturing of furniture and electronics, in addition to the use of pesticides, has increased (Cone 2). As Marla Cone reports, “Many researchers have theorized that a pregnant woman’s exposure to chemical pollutants, particularly metals and pesticides, could be altering a developing baby’s brain structure, triggering autism” (1-2). An expectant mother will generally do everything within her power to provide a healthy environment for her growing baby; of course, it would prove impossible to avoid ever coming into contact with one of these ingredients, however, it is certainly something to consider as a consumer of such household products.

Lastly, there is the highly controversial, immunologic factor of childhood vaccines. The idea behind vaccines is, of course, to further protect one’s child from negative elements and diseases in the environment. Many parents of children with autism continue to
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support the theory that vaccines; specifically, those that contain thimerosal, like the measles-mumps-rubella (MMR) shot, are somehow linked with autism. Cone defines thimerosal as containing a mercury compound which acts as a preservative, and was thought to have acted as a trigger for developing autism. It is important to note, however, that in 1999 thimerosal was removed from most vaccines, yet the rates of autism continue to increase (Cone 1). Broadhurst points out other facts to consider when looking at vaccines as a culprit for causing ASD:
 – Boys and girls are both vaccinated, yet ASD is much rarer in females.
 – Infant/toddler immigrants from countries with entirely different vaccination
 schedules have the same incidence of ASD as native-born North American
 children.
 – Mercury preservatives have been discontinued in North America since 1996-
 1999, depending on the specific location and vaccine type, yet ASD incidence
 continues to rise. Further, unlike the US, Canada never used mercury
 preservative in the common diphtheria-pertussis-tetanus-hepatitis
 (DTP or DTPH) vaccine. 
While it is not difficult to understand why parents of children affected by autism would grasp at causes and continue to accuse vaccines for the disorder, scientists now seem to be satisfied with the conclusion that there is no link between vaccines and autism.
As experts continue to gather data and learn more about the disorder, government funding and research groups such as the Kilee Patchell-Evans Autism Research Group,
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and the Autism Treatment Network, assist in backing up and spearheading further studies in the hopes of being able to pinpoint causes of ASD. Of course, the earlier a child can be diagnosed, the sooner treatment programs and intervention can begin, giving the child the tools and coping mechanisms they will require to live with the lifelong disorder.
Several symptoms can be observed in children as young as 18 months old: a lack of eye contact, no joyful facial expressions such as big smiles, no babbling by 12 months, and no speech by 2 years. Naturally, parents will be the first to recognize when a child is not reaching important developmental milestones and should seek attention from a physician immediately. While there are no medical tests used to diagnose autism, a series of interviews, observations, and evaluations are in place to assist with proper diagnoses. It is important to note that diagnoses is not based on a single factor, a combination of delays in communication and social interaction will act as “red flags,” indicating that the child should be evaluated (Autism Speaks Canada).
Once diagnosis has been confirmed, the physician, along with the parents, will determine the best course of action in terms of intervention, treatment, and therapy for the child. Experts agree that there is no standard treatment for those with ASD, as well, the philosophies of doctors and therapists will differ. However, most will agree that early intervention can reduce challenges, lessen disruptive behaviour, and provide some

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independence for those affected. Treatments include, but are not limited to, behavioural and biomedical therapies.
Behavioural therapies, such as Applied Behaviour Analysis (ABA) and Social Communication and Emotional Regulation, as well as the implementation of Transactional Supports (SCERTS®), have both proved to be beneficial when dealing with an autistic child’s behavioural issues. Autism Speaks Canada explains ABA as “a natural science of behaviour.” Originally defined in the 1930’s, ABA uses behavioural observation and positive reinforcement, or prompting, to teach the child reasoning skills, motor, and social behaviours they may not have “picked up” on their own. In fact, studies have shown that approximately 50% of autistic children treated with ABA during their first four years, had more developed social functioning and notable increases in IQ (Autism Canada).

In addition to ABA, SCERTS® is a “comprehensive, team-based, multidisciplinary model,” (Autism Speaks Canada) used to promote communication initiated by the child. The goal of SCERTS® is to ultimately build social and functional communication skills, and to provide the child with the tools they require to develop spontaneous, secure, and trusting relationships with kids and adults. Visual tools such as photos and picture symbols are used extensively to help sustain the child’s attention and promote active participation. Developed by a team of clinicians, researchers, and educators, the

SCERTS® method works well with children of all ages who have varying degrees of ASD (Autism Speaks Canada).

Once therapies for behavioural aspects are in place, dietary and medical treatments should also be considered and included in the child’s treatment schedule. Broadhurst points to a gluten-casein connection with people who are autistic, suggesting they have a harder time digesting these proteins. Foods such as wheat, oats, rye, barley, and most dairy products, can contribute to intestinal disorders and gastrointestinal inflammation associated with autism. Autism Society Canada reports that “higher than normal levels of certain peptides have been found in the urine of children with autism, suggesting an incomplete breakdown of these proteins into amino acids.” Neurological and gastrointestinal damage can occur when there is over-absorption of peptides so removing these proteins from the child’s diet is thought to prevent such issues (Autism Society Canada).

Other medical concerns linked with ASD include, severe hyperactivity, impulsive behaviours, low attention span, seizures, and anxiety. Although controversial, sometimes anti-convulsant, anti-depressant, and in severe cases, anti-psychotic medications are required to treat ASD. When these issues are properly managed, the child will further benefit from the other educational and behavioural therapies in place (Autism Society Canada).

In spite of the mystery that continues to shroud autism, experts can agree that early diagnoses and intervention, along with well trained practitioners and therapists providing extensive, consistent treatment, will contribute greatly to the success of a child with ASD. Ongoing research into causes and triggers of the disorder continue, and are expanding, as governments and organizations become more involved and technological advances allow for new studies to emerge.

Autism spectrum disorder presents many challenges, not only for those with the disorder, but also for family members, teachers, and other professionals involved. While ASD conditions can be severely disabling, tailored treatment schedules, biomedical approaches, and ongoing support therapies, can aid autistic children in achieving a somewhat independent lifestyle. Science continues to get closer to pinpointing causes, and researchers are developing new theories and hypothesis which may contain some of the answers to the many burning questions that envelop ASD; until then, a complete understanding of autism remains elusive.

Works Cited

Autism Canada Foundation. N.p., n.d. Web. 20 Nov. 2011. .
Autism Society Canada. N.p., 8 July 2011. Web. 20 Nov. 2011. .
Autism Speaks Canada. N.p., n.d. Web. 20 Nov. 2011. .
Broadhurst, Leigh C. “Autism: The Science and the Fiction.” Alive: Canada’s Natural Health and Wellness Magazine Sept. 2009: 1. Web. 20 Nov. 2011.
Cone, Marla. “New Study: Autism Linked to Environment.” Scientific American 9 Jan. 2009: 1-2. Web. 20 Nov. 2011.
Harmon, Katherine. “Autism’s Tangled Genetics Full of Rare and Varied Mutations.”
Scientific American 8 June 2011: 1-3. Web. 20 Nov. 2011.
Park, Alice. “Study: Environmental Factors May Be Just as Important as Genes in Autism.” Time Healthland 5 July 2011: 1. Web. 20 Nov. 2011.
Robledo, Jhoanna S., and Dawn Ham-Kucharski. The Autism Book: answers to your most pressing questions. N.p.: Penguin, 2005. 4-5. Google Books. Web. 20 Nov. 2011.

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About the author

Lindsay Pearson

As the editor for Victoria, Vancouver and Surrey Lifestyles Magazine, Lindsay's passion for expressing herself through writing, and interacting with creative people, mingle and meld to bring quality editorial content to readers. Just as the industry is perpetually growing and changing, Lindsay's focus on expanding and refining her knowledge is ongoing. Lindsay gleans inspiration from a melange of sources as she surrounds herself with others who share her passion for writing, and love of language.