Autism is a neurological developmental condition that affects the way an individual perceives and interacts with the world. In 2014, the Centers for Disease Control and Prevention reported that 1 in 68 U.S. children has an autism spectrum disorder (ASD); this is a 30% increase from 1 in 88 two years before. Males are four times more likely to have autism that females. The precise effects of autism on an individual vary from person to person, forming a spectrum from high-functioning to low-functioning. The autistic spectrum describes a range of conditions that include autism, Asperger syndrome and other pervasive developmental disorders. Low-functioning autistics often are non-verbal and can seem to live in a world of their own, while high-functioning autistics can often pass for "normal". The level of function is independent of actual intelligence; a person may be quite intelligent, and yet low-functioning, and vice-versa.
The causes of autism remain a mystery, but there is strong evidence that autism begins during pregnancy. Both genetics and environment are thought to play a role, and families with one autistic child have an increased chance of having a second child with the disorder. Some families have provided anecdotal evidence that vaccines, food additives, and pollutants can contribute to autism, but scientific studies have not been able to confirm this. However, exposure to pesticides seems to play a role in autism. A study in 2014 found that mothers who lived during pregnancy within 1.5 km (just under one mile) of an agricultural pesticide application had a 60% increased risk of giving birth to children who developed autism or had delayed cognitive skills. Vitamin deficiencies may also contribute to the incidence of autism. A study published by the Norwegian Institute of Public Health found that women who took folic acid supplements before and during the first 8 weeks of pregnancy were about 40% less likely to have a baby later diagnosed with autism. Folic acid is found in dark leafy greens and legumes like beans, peas and lentils.
A statistical analysis to determine the degree of association of autism severity with the levels of toxic metals in the blood and urine found that 38 to 47 percent of the variation of autism severity was most strongly associated with cadmium and mercury. Toxic metals enter the human body as a result of environmental contamination of air, food and water. A study of people born in Sweden over a 28-year period found that children born to fathers 45 years or older were at higher risk of developing autism, attention-deficit/hyperactivity disorder and other psychiatric problems compared with their siblings who were born when their fathers were between 20 and 24 years old. Another study found that exposure to acetaminophen, the active ingredient in Tylenol, during pregnancy increases the risk for developing attention-deficit/hyperactivity disorder (ADHD) or hyperkinetic disorders (HKDs) in children.
Autism is a developmental disorder of the brain that appears before the age of three, and affects the normal development of social and communication skills. Most parents of autistic children usually realize that something is wrong with their child by the time the child is 18 months old. Some children with autism appear to develop normally for one or two years, and then lose the language or social skills that they previously had. In normal development, a child starts babbling, pointing and waving by 12 months, and starts saying single words by 16 months and two word phrases by 24 months. A child who does not meet these milestones should be examined and tested by a pediatrician experienced in diagnosing and treating autism, particularly if the child displays symptoms such as these:
The diagnosis of disorders in the autistic spectrum depends on the opinion of a psychologist or pediatrician. Unfortunately, there are no evidence-based criteria for diagnosing Asperger Syndrome, ADHD or other conditions that may reflect mental illness, but which could be caused by other behavioral problems. A diagnosis of "mental illness" may free the parents from the guilt of incompetent parenthood, but it may result in stigma and unnecessary medication for a normal child with unusual behavior due to hearing or visual impairment.
Autistics often have difficulty understanding social cues and figures of speech. For example, phrases like "Take a seat," or "I have a frog in my throat" can mystify people on the autistic spectrum and lead to misunderstandings due to literal Interpretations. Similarly, autistics cannot easily detect when others are in a hurry or tired or bored, which leads people to conclude, incorrectly, that autistics are selfish or rude. Autistics also have difficulty distinguishing the meanings of different tones of voice (e.g. whether someone sounds angry or is merely speaking loudly).
Some autistics have difficulty communicating verbally and don't speak at all or make only grunting or other unintelligible sounds. Others may speak well but have a noticeably odd tone of voice. Even autistics who are normally verbal sometimes become non-verbal or semi-verbal in times of stress of confusion. During such times, autistics may act out more, either because of the underlying stress or frustration at not being understood. Depression is also common in such people.
In addition, autistics have difficulty generalizing and making associations. If one is asked, "Stop playing with your fork," he will usually comply – by playing with his spoon instead. Similarly, the request, "don't eat those cookies," may likely provoke the protest, "You mean I can't have cookies ever again?!" It is hard for them to understand when such requests should be understood generally or specifically.
As a result of such difficulties, it is a challenge for parents to find effective ways to discipline and teach autistic children. Most discipline is based on a strong understanding of cause-and-effect: "if you do this, you will receive a punishment; if you do this, you will receive a reward." However, this is the kind of association that an autistic child has trouble making. Since autistics often "live in the now", they can have a hard time correlating an action several minutes ago with a punishment or reward now. Their inability to read social cues and differentiate tones of voices means that they are unlikely respond to warning cues that typical children would recognize. It also does not occur to them that a phrase like "I'm losing my patience," is a warning for them to settle down rather than a simple, perhaps random, statement of fact.
Another consequence of sensory conditions associated with autism is that an autistic can be overwhelmed by sensations that don't trouble typical people. For example, autistics sometimes find flavors overwhelming and dislike trying new foods. Mild scents and perfumes can also bother them. It is typical for autistics to dislike eye contact and to avoid it when possible. This is often mistaken for inattention or rudeness but is actually the avoidance of an unpleasant sensory experience, the way a typical person might tighten a hooded coat in response to a cold breeze. Many autistics don't have a good sense of "personal space"; they will get too close to people or, sometimes, become uncomfortable when people get too close to them.
In order to cope with the sensory issues and overloads that come with autism, most autistics will display one or more mechanisms as a reaction to overstimulation. Perhaps most common is rocking, often in a hunched or crouched position. This general kind of behavior is known as "stimming" and provides some relief from a barrage of sensory information. It is also a warning sign that further problems are imminent if measures are not taken. Continued sensory overload may result in head-banging, biting, or other kind of self-injury. Sometimes, a complete meltdown consisting of crying, thrashing, and screaming will ensue. In other cases, the autistic will go into a near-catatonic "shutdown" mode and become unresponsive. With either a meltdown or a shutdown, it can be difficult to bring the person out of this state, and it sometimes requires intervention by emergency services.