AUTISM IN JAMAICA - Boys more affected than girls

Maureen Samms-Vaughan, Contributor

Autistic Spectrum Disorders (ASD) are a group of disorders usually diagnosed in early childhood. Accurate figures are not currently available for Jamaica, but based on the US Centers for Disease Control's (CDC's) rate of one child in every 110 born with autism, we can expect over 400 children with autism to be born in Jamaica each year. Because boys are four times more likely to have autism than girls, one in 60 boys will have ASD. The CDC's rate is an almost 60 per cent increase on the 2007 figure.

The cause of the condition is not known, but about one in seven has a rare genetic mutation. We currently believe that autism is caused by an interaction between genes and an environmental trigger. Research is currently being undertaken at the University of the West Indies (UWI) to explore whether genes, in combination with heavy metals in the environment (for example, lead and mercury), may be associated with the development of autism.

Three types of ASD

There are three different types of ASD - Classic Autistic Disorder (AD), Asperger Syndrome (AS) and Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS). These disorders have three main features to various degrees: impairment in communication, impairment in social interaction and repeated or stereotyped behaviours.

Impairment in communication affects all types of communication - speaking, understanding the spoken word and gesturing or non-verbal communication. Some autistic children may have delayed speech from the time they begin to speak (for example, not saying single words by one year and not putting words together to form short sentences by 18 months old).

Others have normal speech development and then suddenly stop speaking. Many autistic children do not understand simple requests made by their parents (for example, to get common household objects). Autistic children often do not wave 'bye' as expected at one year of age or point to objects they need. They prefer to use another person's hand to reach for objects.

Social interaction affected

Impairment in social interaction is often reflected in children playing by themselves at school or not wanting to look people in the eye.

Repetitive behaviour is often noticed when children engage in unusual behaviours repeatedly or in common behaviours that all children do (for example, turning lights on and off, spinning objects) with a frequency and intensity that is unusual. Stereotyped behaviours are shown when children resist change in a variety of ways - in clothes, food, toys, house routines, etc.

Afraid of loud noises

Autism also presents in other ways such as in hypersensitivity to the senses - children may be afraid of loud noises (sound); they may take off their clothes frequently, enjoy lying on cold floors (touch), lick objects (taste) or smell foods and other objects (smell). They may also have unusual fears, for example of certain television personalities or shows.

Two-thirds of children with AD have intellectual impairment but, children with AS have no intellectual impairment. As these conditions are spectrum disorders, all children will not have the same behaviours or to the same degree.

Early interventionis important

Research on autism in Jamaica at the UWI has shown that most Jamaican parents become concerned about their children at about two years old, when their language is delayed. Diagnoses are often delayed for another two years. Early intervention is known to promote children's development.

Specialist behaviour therapy, particularly Applied Behaviour Analysis (ABA), has the best outcomes, but general infant stimulation techniques are also very beneficial. It is, therefore, imperative that we identify our children in Jamaica as early as possible. Concerns about children's language development, interactions with others and unusual behaviours should be discussed as soon as possible with your health-care provider.

Dr Maureen Samms-Vaughan is professor of Child Health, Child Development and Behaviour at the University of the West Indies.