Autism

What is Autism?

Autism is one of the conditions from a group of developmental disorders. It affects communication and social interaction. The severity of Autism varies from person to person, it can range from mild to severe, and the symptoms can become more or less severe over time. Individuals with autism have problems with learning, they may have cognitive impairments, problems with motor skills, as well as behavioral problems of different severity, they can exhibit repetitive behaviors, have no/ or poor eye contact with others, seem to be in their own world. Persons with autism can also have problems with sensory integration; they may be very sensitive or not sensitive enough to noise, touch, and light etc. More often than not, children and adults with autism have communication problems; these may be so severe that the child or adult does not speak at all, or they may have very limited speech; they can have delayed language, they may not be able to express their needs or their feelings, they may have difficulty following directions or finding objects, or have repetitive speech also known as "echolalia", some have difficulty answering questions, carrying a normal conversation when turn taking is required, finally they may not understand non verbal communication, such as facial expressions. Children with autism may have very disruptive behaviors; this symptom is often the most challenging for parents to cope with, it also inhibits their learning.

There are different types of autism in the “Autism Spectrum Disorders" or "Pervasive Developmental Disorders"

Ø      -Autistic disorder

Ø      -Asperger disorder

Ø      -Childhood disintegrative disorder

Ø      -Rett syndrome (only in girls)

Ø      -Pervasive developmental disorder, not otherwise specified

Who can diagnose Autism?

Autism is a complex disorder, which needs a comprehensive evaluation to be performed by a multidisciplinary team that may include a developmental pediatrician, a psychiatrist, a neurologist, a speech language pathologist, and an applied behavior analyst (ABA).

What is the treatment for Autism?

Most children with autism receive treatment from a speech language pathologist and where available they also may get treatment from an ABA specialist. These children need intensive therapy and individualized programs to reach their maximum potential. With the appropriate intervention and depending on the severity of their condition, some children can eventually be mainstreamed in normal schools. The earlier the intervention, the better the prognosis for the child with autism.

 ADHD  (Attention Deficit Hyperactivity Disorder)

What is ADHD?

Attention deficit hyperactivity disorder (ADHD) occurs more commonly in children, however, it can also affect adolescents and adults. It is a condition that is chronic, meaning that it can continue throughout life, and it is said to be pervasive meaning it is not confined to one situation. It can be genetically inherited, if a parent or close relative has ADHD, there is a 30% chance that a child will have the condition. The symptoms of ADHD are sub-categorized into three main areas :

Inattention

-          Loss of concentration and focus
-          Poor planning and organization
-          Poor time management, difficulty finishing tasks on time
-          Jumps from topic to topic
-          Switches from activity to activity before completing any
-          Has difficulty following or remembering instructions
-          Day dreaming, can be slow to do things, lethargic
-          Has difficulty processing information
-          Forgetful

 Hyperactivity

-          Restless and moves around incessantly
-          Fidgets continuously
-          Cannot sit still, gets up to roam around, moves leg, etc

 Impulsivity

-       Often speaks before thinking things through
-       Spontaneously reacts to situations (sometimes inappropriately, because of lack of thinking things -       through), show their emotions without control
-       Interrupts others while they are talking, cannot wait for his/her turn
-       Impatient

What causes ADHD?

There are still no definite answers as to what causes ADHD. Researchers in the field are conducting their investigations in different areas. There are studies that suggest that genes are involved, i.e. ADHD can have a genetic cause, meaning it can run in families. Other studies indicate there might be a link between smoking and alcohol use during pregnancy that may cause ADHD in the child, also, children exposed to high levels of lead may have a higher risk of developing ADHD. Some scientists are also looking at the link between food colorings and additives and ADHD. Finally, children with brain injuries sometimes exhibit similar behaviors found in children with ADHD.

Can it be treated?

The first step toward helping a child or an adult with ADHD is to get a proper diagnosis. Not every child that appears to be active, or impulsive or inattentive necessarily has ADHD. It may be the child is very energetic and exuberant or it may be that his excess activity is due to the immaturity of his age, children do mature at different rates.

If the child approaches school age, and the parents continue to feel that their child continues to exhibit many of the symptoms of ADHD, then they should speak to their pediatrician about their concerns. Often, though, it is when the child begins school that the symptoms become more apparent as they start to interfere with his/her learning and the teacher and parents are alerted that there might be a problem.

There are several types of specialists who are qualified to diagnose ADHD. A pediatrician with special training in the area can diagnose ADHD, a child psychologist can also diagnose the condition but cannot prescribe any medication to control the symptoms; however, neurologists and psychiatrists can diagnose ADHD, and are licensed to prescribe medication. A certified speech-language pathologist is also qualified to participate in the diagnosis of ADHD.

Some children with ADHD may have language based learning disability, for that reason it is important to conduct a speech-language evaluation for a child with suspected ADHD. Once all the different specialists complete their assessments, they work together with the educationalists (e.g., classroom teacher) to put together a treatment plan for the child. A child with ADHD will benefit most from a multidisciplinary approach to his/her treatment. The team should include the parents, the teacher, his/her medical doctor or psychiatrist (if he/she is on medication), the behavior therapist, and the speech-language pathologist (if there is a language disorder). Together, they will set a plan that will focus on behavior, acquiring better communication in specific situations, helping the child acquire organizational and planning skills, and study skills, and generalize these skills to real life.

Adults with ADHD

ADHD is a disorder that begins in childhood and may continue through adulthood. However, there are some medical conditions that can result in ADHD, these are generally caused by a head injury from a cardiovascular insult to the brain or a traumatic brain injury. The treatment for an adult would be similar to that for a child. The disorder would need to be diagnosed by a specialist, and a treatment plan would be devised to help the adult with ADHD lead a stress free productive life.

(For more information you can visit American Speech-Language-Hearing Association (ASHA)). 

 Ø      Speech and Language Diagnostic and Treatment Services at JISH