What Is Autism?
Krista's younger brother seemed really quiet when Iris met him for the first time. "Yeah, he has autism," Krista said while they sorted through her CDs. Then she started talking about a new band, so Iris didn't have a chance to ask her any questions. It left her wondering: What is autism? How does someone get it? Can it be treated?
Autism is a developmental disorder that some people are born with — it's not something you can catch or pass along to someone else. It affects the brain and makes communicating and interacting with other people difficult.
People who have autism often have delayed language development, prefer to spend time alone, and show less interest in making friends. Another characteristic of autism is what some people describe as "sensory overload": Sounds seem louder, lights brighter, or smells stronger. Although many people with autism also have mental retardation, some are of average or high intelligence.
Not everybody with autism has the exact same symptoms. Some people may have autism that is mild, whereas others may have autism that is more severe. Because it affects people differently, autism is known as a spectrum disorder. Two people with the same spectrum disorder may not act alike or have the same skills.
As many as 1 in 150 people have autism, and it's more common in guys than in girls. Although doctors do not know exactly what causes it, many researchers believe autism is linked to differences in brain chemicals (neurotransmitters). These differences may be caused by something in our genes — families who have one child with autism have a higher risk of having another child with autism or a similar disorder. Research suggests that in most cases it's probably a combination of genes that causes the disorder, not a single autism gene.
Sometimes you may hear other developmental disorders mentioned in the same way as autism, such as Asperger syndrome, Rett syndrome, and childhood disintegrative disorder. These disorders, along with autism, are all considered pervasive developmental disorders. People diagnosed with any of these disabilities have problems with social skills and communication.
What Do Doctors Do?
Autism is usually diagnosed at a very young age, when a child is 1½ to 4 years old. There are no medical tests to determine whether someone has autism, although doctors may run various tests to rule out other causes of the symptoms.
The best way to identify autism is to watch how a child behaves and communicates. Parents can help by telling the doctor how the child acts at home. Then a team of specialists — which may include a psychologist, a neurologist, a psychiatrist, a speech therapist, and a developmental pediatrician — will evaluate the child and compare levels of development and behavior with those of other kids the same age. Together, they will decide whether the child has autism or something else.
How Is Autism Treated?
Autism is not treated with surgery or medicine (although some people with autism may take medicine to improve certain symptoms, like aggressive behavior or attention problems). Instead, people who have autism are taught skills to help them do the things that are difficult for them. The best results are usually seen with kids who begin treatment when they're very young and as soon as they're diagnosed.
Special education programs that are tailored to the child's individual needs are usually the most effective form of treatment. These programs work on breaking down barriers by teaching the child to communicate (sometimes by pointing or using pictures or sign language) and to interact with others. Basic living skills, like how to cross a street safely or ask for directions, are also emphasized.
A treatment program might also include any of the following: speech therapy, physical therapy, music therapy, changes in diet, medication, occupational therapy, and hearing or vision therapy. The same specialists who helped diagnose the condition usually work together to come up with the best combination of therapies to use in addition to the educational program.
By the time they are teens, people with autism may be taking regular classes or attending special classes at the high school level. Some may go to a special school because of ongoing behavioral problems.
What Are Teens With Autism Like?
Because their brains process information differently, teens with autism may not act like other people you know (or each other, because the symptoms of autism vary from person to person). People with autism can have trouble talking and sometimes communicate with gestures instead of words. Some spend a lot of time alone, don't make friends easily (and may not act like they want to), and may not react to social cues like someone smiling or scowling at them. They often do not make eye contact when you are talking to them. They also find it hard to join in a game or activity with other people. If they are sensitive to sensations, they might draw back when hugged or startle easily when they hear a sudden noise, even if it's not very loud.
Some teens with autism are passive and withdrawn; others are overactive and may have tantrums or act aggressively when they are frustrated. It's important to realize that this is part of the disorder.
Some teens with autism also have intellectual limitations and learning problems. Because they don't have the ability to express emotions like anger and frustration in more acceptable ways, they might express themselves in ways that seem inappropriate. Many have difficulty coping with change and get anxious if their daily routine is altered. In more severe cases, a person with autism might fixate on different objects or ideas or display repetitive motions like rocking or hand flapping.
One common misconception is that people with autism don't feel or show emotion. Although they can feel affection, they often don't express it the same way others do. To an outsider, this can come across as being cold or unemotional.
Living With Autism
Perhaps the most difficult part of coping with autism is interacting with other people every day. Because the brain of someone with autism works a little differently, learning to communicate can be like learning a foreign language. This can make it hard for people with autism to express themselves or for others to understand them, so just talking with a classmate becomes stressful and frustrating.
When even a casual conversation requires so much effort, it's hard to make friends. Teens with autism may have to think constantly about how other people will view their actions. They may have to make a conscious effort to pay attention to social cues the rest of us handle without even thinking. Basically, it takes a lot of work for someone with autism to do what comes naturally to most people.
So if you know someone who has autism, be extra patient when you're talking with him or her. Don't expect a person with autism to look at things the same way you do. You should also realize that some behaviors you think are rude (like interrupting you when you're talking) come from a different perception of the world: It's tough for people who can't read social cues and recognize the natural pauses in a conversation to know when to jump in with their own thoughts. The more understanding and supportive you are, the more enjoyable your time together will be.
Despite all the day-to-day hurdles, though, many people with autism lead fulfilling, happy lives on their own or with help from friends and family. Most teens with autism like school, and some can attend regular classes with everyone else. They have individual tastes and enjoy different activities, just like you do.
Some people with autism go on to vocational school or college, get married, and have successful careers. Consider Temple Grandin, for example. Despite having autism, she earned a PhD and became a college professor and expert in animal behavior. She's written several books, including one about her experience called Thinking in Pictures: And Other Reports From My Life With Autism. Although she still struggles with the disorder almost daily, she leads a normal life, just like many other people with autism.
Reviewed by: Steven Dowshen, MD
Date reviewed: April 2008
Originally reviewed by: Anne M. Meduri, MD
