Michael Abrahams | What is Autism?

APRIL IS Autism Awareness Month. Usually, at this time, programmes, events and articles concerning autism are presented to increase public awareness of the condition. Unfortunately, as the COVID-19 pandemic dominates our news cycles daily, other health issues and concerns are kicked to the curb.

But even as the pandemic rages, life must go on, and we must not neglect those who require our attention. Most of us have heard the word ‘autism’, but many have no idea what it is or misunderstand it.

Autism, or autism spectrum disorder (ASD), is classified as a developmental disorder. It is a complex and lifelong one, typically appearing in early childhood. The word ‘spectrum’ is used because those with the condition display a wide range of behaviours, ranging from being unable to communicate to being ‘high functioning’ and capable of remarkable feats, such as photographic memory, flawless mastery of musical instruments, or amazing artwork. The condition affects people differently and to varying degrees, but most will have some degree of impairment of social skills and communication.

There is no single known cause for autism, although there are several theories. There are many who believe that it is caused by vaccines, but well-conducted clinical research has not demonstrated a strong correlation between the two. It affects boys more than girls, and the diagnosis in girls may be more challenging as they tend to present differently from boys.

Signs and symptoms of ASD are often present early in childhood. Persistent differences in communication are some of the earliest signs. For example, if a child takes a long time to start talking, displays atypical speech patterns, has difficulty understanding non-verbal communication or maintaining a conversation, or consistently avoids eye contact, he or she may be on the spectrum. These children also tend to prefer solitary or parallel play rather than engaging in associative or cooperative play with other children. In other words, they may be in a room, or even a circle with other children, and be playing, but not along with the others. They would be in their own little world. Deficits in developing, maintaining, and understanding relationships are also commonplace.

It is also common for those with autism to exhibit restricted and repetitive behaviour, patterns, activities and interests. They may repeat certain sounds, words, phrases or movements, or exhibit a strong, persistent interest in a specific topic, part of a toy, or item, and adapt poorly to changes in certain routines, exhibiting a preference for predictable, structured play over spontaneous or make-believe play. They may also exhibit extreme sensitivity, or significantly lower sensitivity, to various sensory stimuli.

These symptoms and signs result from the inability of a child to properly perceive, interpret and process stimuli in his or her environment and respond appropriately to them.

Understanding ASD and being able to identify persons on the spectrum is extremely important. According to the World Health Organization (WHO), it is estimated that worldwide, one in 160 children has ASD.

Recent research from the USA found the incidence to be one in 54 in that country. It is not uncommon. We will interact with many persons with the disorder. Many will not even know they are on the spectrum. Failure to understand ASD has led to countless people being marginalised.

It is not uncommon for children to be labelled as ‘dunce’, ‘stupid’, ‘slow’, ‘rude’, ‘stubborn’, ‘unruly’ or ‘disruptive’ when, in fact, they were on the spectrum and were not diagnosed. Bullying of children on the spectrum at school by children and teachers is widely reported. And many children on the spectrum have been abandoned, neglected or abused by caregivers who did not understand what was going on with them, or lacked the tools and resources to deal with them.

No cure currently exists. However, early diagnosis and intervention has facilitated a good quality of life for many. The early introduction of speech therapy and behaviour therapy is crucial in determining the path of the life of a child with ASD. In severe cases, therapy for the children, as well as counselling and guidance for their parents and caregivers, will also improve their quality of life.

People with ASD are often misunderstood. There may be people in your life on the spectrum and you, or they, may not even know it. And being on the spectrum is not necessarily a barrier to realising remarkable achievements. Actor Sir Anthony Hopkins and singer Susan Boyle are on the spectrum, and it is believed that scientist and mathematician Albert Einstein, chess master Bobby Fischer, writer Emily Dickinson, and naturalist, geologist and biologist Charles Darwin were too.

Read as much as you can, from reputable sources, about autism. The more we understand it, the better life will be for all of us.

Michael Abrahams is a gynaecologist and obstetrician, comedian and poet. Email feedback to columns@gleanerjm.com and michabe_1999@hotmail.com, or tweet @mikeyabrahams.