Autism Q & A
Sutter Neuroscience Institute
What is Autism?
Autism is a medical condition that inhibits social interaction and communication. Patients can be diagnosed with autism, or have a disorder along the autism spectrum, including Asperger's syndrome.
What are the symptoms of Autism?
Autism is categorized by many different symptoms, rather than one single symptom. Symptoms usually present within the first two years of life, and may include:
- lack of response to calling a child's name
- poor eye contact or social interest
- repetitive behaviors or stereotypic movements
- abnormal toy interest or play
- communication and language delay
- other atypical aspects of normal toddler development
- failure to look at you, wave, or gesture or point
One third of patients who previously had communication or social interaction, like eye contact, hearing or speech, can loose these skills or they can regress over time.
When and how should a patient be screened?
Patients can be screened within the first 24 months of life, perhaps by 12-15 months. The American Academy of Pediatrics recently suggested two screenings before age two. We suggest the first screening between 12-15 months and the second before 18-20 months.
Simple questionnaires may allow screening by parents, pediatricians or family physicians. A failed first screening should be followed-up by a second screening in 4-6 weeks.
How is Autism diagnosed?
Diagnosis is a clinical skill based upon specific screening tools, questionnaires, observation, and documentation of core symptoms. Some research programs will also rely on confirmatory complex observational tests
There are no blood, urine, genetic, EEG, or neuroimaging tests that define autism as a diagnosis at this time. Some children with autism will also have other underlying conditions, like seizures, brain injury, genetic conditions or metabolic issues that can be diagnosed and treated. Sleep, gastrointestinal, and immunological problems can also be diagnosed with medical testing.
When should you see a child neurologist that specializes in Autism?
Patients should see a neurologist that specializes in autism as early as possible once screening failure has occurred. This will ensure that there are no underlying medical problems. Postponing treatment may affect the child's long-term outcome.
What can child neurologist help with?
Since other medical conditions or problems may mimic or add to severity of autistic features, the child neurologist can help evaluate a child for these issues and better determine if a regression has occurred. The other conditions may include genetic disorders that may have some autistic type behaviors, other learning or language issues, underlying brain injury or epilepsy, and sleep issues. Appropriate medical screening can then allow more appropriate medical diagnosis and treatment to begin so better therapy and outcome goals can be attained.
What are the different treatments for Autism?
Autism spectrum disorders have many clinical subtypes; therefore there is no single treatment for autism and there is currently no cure for autism.
Research may lead to new treatments that may modify or alter the course of autism. For time being, treatments are aimed at improving epilepsy if present, sleep treatment, behavioral medical management, and treatment of any metabolic or gastrointestinal or immune condition that may co-exist.
What is the long-term outlook for a patient with Autism?
Autism is currently a lifelong condition that may range from mild impairment to severe impairment of an individual to live independently as an adult. Therefore the earlier that intervention is medically done the better the potential outcome.
Currently, Sutter Neuroscience Institute provides transitional care for children through adults with autism and neurodevelopmental disorders.
How does the treatment differ with an adult with autism?
As this population gets older, medications may need adjustment. A physician should screen for gastrointestinal issues caused by rigid dietary habits and sleep disturbances. In addition, their mental health should be evaluated for affective and anxiety disorders.
