Autism
Autism (sometimes called "classic autism") is the most common condition known as the autism spectrum disorders (ASD). Autism is characterized by impaired social interaction, problems with verbal and nonverbal communication. A "spectrum" disorder, its symptoms vary widely, but people with autism generally can't understand other people's thoughts and motivations, and so they aren't able to respond appropriately to their environment and form relationships with other people. Many people with autism also have associated language delays and mental retardation, while others have average or above-average intelligence but the same communication problems. Experts estimate that three to six children out of every 1,000 will have autism. Males are four times more likely to have autism than females.
What are the symptoms of autism?
Autism varies widely in its severity and symptoms and may go unrecognized, especially in mildly affected children or when it is masked by more debilitating handicaps. Doctors rely on a core group of behaviors to alert them to the possibility of a diagnosis of autism. These behaviors are:
- Impaired ability to make friends with peers
- Impaired ability to initiate or sustain a conversation with others
- Absence or impairment of imaginative and social play
- Stereotyped, repetitive, or unusual use of language
- Restricted patterns of interest that are abnormal in intensity or focus
- Preoccupation with certain objects or subjects
- Inflexible adherence to specific routines or rituals
Doctors will often use a questionnaire or other screening instrument to gather information about a child's development and behavior. Some screening instruments rely solely on parent observations; others rely on a combination of parent and doctor observations. If screening instruments indicate the possibility of autism, doctors will ask for a more comprehensive evaluation.
Autism is a complex disorder. A comprehensive evaluation requires a multidisciplinary team including a psychologist, neurologist, psychiatrist, speech therapist, and other professionals who diagnose children with ASDs. The team members will conduct a thorough neurological assessment and in-depth cognitive and language testing. Because hearing problems can cause behaviors that could be mistaken for autism, children with delayed speech development should also have their hearing tested. After a thorough evaluation, the team usually meets with parents to explain the results of the evaluation and present the diagnosis.
Children with some symptoms of autism, but not enough to be diagnosed with classical autism, are often diagnosed with PDD-NOS. Children with autistic behaviors but well-developed language skills are often diagnosed with Asperger syndrome. Children who develop normally and then suddenly deteriorate between the ages of 3 to 10 years and show marked autistic behaviors may be diagnosed with childhood disintegrative disorder.
Girls with autistic symptoms may be suffering from Rett syndrome, a sex-linked genetic disorder characterized by social withdrawal, regressed language skills, and hand wringing.
Attention-deficit Hyperactivity Disorder (ADHD)
Attention-deficit hyperactivity disorder (ADHD) is the name of a group of behaviors found in many children and adults. People who have ADHD have trouble paying attention in school, at home or at work. They may be much more active and/or impulsive than what is usual for their age. These behaviors contribute to significant problems in relationships, learning and behavior. For this reason, children who have ADHD are sometimes seen as being "difficult" or as having behavior problems.
ADHD is common, affecting 4% to 12% of school-age children. It's more common in boys than in girls. You may be more familiar with the term attention deficit disorder (ADD). This disorder was renamed in 1994 by the American Psychiatric Association (APA).
What are the symptoms of ADHD?
The child with ADHD who is inattentive will have 6 or more of the following symptoms:
- Has difficulty following instructions
- Has difficulty keeping attention on work or play activities at school and at home
- Loses things needed for activities at school and at home
- Appears not to listen
- Doesn't pay close attention to details
- Seems disorganized
- Has trouble with tasks that require planning ahead
- Forgets things
- Is easily distracted
The child with ADHD who is hyperactive/impulsive will have at least 6 of the following symptoms:
- Is fidgety
- Runs or climbs inappropriately
- Can't play quietly
- Blurts out answers
- Interrupts people
- Can't stay in seat
- Talks too much
- Is always on the go
- Has trouble waiting his or her turn
What should I do if I think my child has ADHD?
Talk with your child's doctor. A diagnosis of ADHD can be made only by getting information about your child's behavior from several people who know your child. Your doctor will ask you questions and may want to get information from your child's teachers or anyone else who is familiar with your child's behavior. Your doctor may have forms or checklists that you and your child's teacher can fill out. This will help you and your doctor compare your child's behavior with other children's behavior. Your doctor will do vision and hearing tests if these tests haven't been done recently.
Your doctor may recommend trying medicine to see if it helps control your child's hyperactive behavior. A trial of medicine alone cannot be the basis for diagnosing ADHD. However, it can be an important part of evaluating your child if ADHD is suspected.
It might be hard for your doctor to tell if your child has ADHD. Many children who have ADHD aren't hyperactive in the doctor's office. For this reason, your doctor may want your child to see someone who specializes in helping children who have behavior problems, such as a psychologist.
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