AUTISM

By Ekta Kumari 11408014 SRM UNIVERSITY

INTRODUCTION
The human brain is the centre of the human nervous system . Enclosed in the cranium , the human brain has the same general structure as

Parts of brain affected by Autism

Amygdala:- It plays a large role in producing our emotions,
especially fear.

Hippocampus:-long-term memory. It is also involved in

interpreting incoming nerve signals .

Parietal:-cognition (including calculating location and speed of

objects), movement, orientation, recognition and speech. processing pain and touch sensation.

Cerebellum:-Mostly deals with movement. It regulates movement,

posture and balance.

What is Autism?
Autism is a complex developmental disability that typically appears
during the first three years of life It is widely recognized as a neurodevelopmental disorder that affects the functioning of the brain. There are many reason for the development of the autism so it is very complex and till now it is not well studied It cause cerebral palsy NO two autism person are exactly same

 AUTISM is the one of the three recognized disorder in the ASD . All three disorders are:1. AUTISM 2.ASPERGER SYNDROME 3.PERVASIVE DEVLOPMENTAL All three disorder are closely related to each other . Asperger syndrome have no substantial delay in language development but it is present in autism.

Autistic individual can understand the communication but they may not respond or communicate. But the person having asperger syndrome may not understand the communication.

Types Of Autism
1. CONGENITAL:- in this the symptom can be observed by the birth 2. REGRESSIVE:- It develop suddenly in a child who were going through a normal development. They stop progressing. It is found in 20% of autistic case.

HISTORY
The term autism (escape from reality) was coined by Eugen Bleuler,(1912). He is a Swiss psychiatrist

For many years children with autism were often misdiagnosed as having childhood schizophrenia Leo Kanner published the first paper identifying autistic children in 1943
adopting Bleulers term AUTISM .
.

Bruno Bettelheim promoted the "refrigerator mother" theory of autism.

Autism Statistics
it is observed that in India the prevalence is 1 in 250 In the USA it is said to be 1 in 166 (Cure Autism Now 2004) making it the third most prevalent developmental disorder in the world. Statistics show that boys are affected 4 times more than girls and the ratio is four males to one female though the reason for this is still unknown. It has no racial, ethnic or social boundaries

US-autism-6-17-1996-2007

SYMPTOMS

Communication
Avoid eye contact Act as a deaf Develop language, then abruptly stop talking Fail to use spoken language, without compensating by gesture

Social relationships
Fail to develop relationships with peers Impaired social behavior Impaired emotions Physically attack and injure others without provocation Repetitive behavior

A TRIAD OF IMPAIRMENTS
IMPAIRED COMMUNICATION

IMPAIRED SOCIAL RELATING

REPETITIVE BEHAVIOURS & RESTRICTED INTERESTS

Causes Of Autism
A specific cause is not known, but current research links autism to biological and neurological differences in the brain
Development of autism begin in 20th or 24th day of pregnancy . In this time the motor neuron of the cranial nerve is formed so it leads to the improper development of that region

It is most common in person exposed to thalidomide

Contd..
Megaloencephaly , it is the abnormal largness of the brain mainly in the occipital and perital region observed by measuring circumference of the brain, persent in the 1/5 th of the autistic people. Cellular abnormalities of the hippocampus, amygdala and other structure of the lymbic system cause the same. Complication at the time of pregnancy may lead to autism. eg uterine bleeding during 2nd or 3rd trimester ,advanced paternal and maternal age

Contd.
Environmental factor like exposure to the teratogen ( valproic acid) , maternal illness ( infection of the rubella during) may cause autism. Previously it was thought that high dosage of Hg containing vaccine may cause the autism but according to the recent study there is no relation between autism and vaccine.

Genetic basis
The genetic basis of this disease is not clear

Some researcher says that it is due to the rare mutation and some it is due to the multi gene interaction It is not a single gene disorder
The large no of autistic individual with unaffected family may result from Deletion , duplication, inversion . Most of the mutation that increase autism risk have not identified

Contd.
Study was carried out in duke university medical center in us. They observed that mutation in the shank3 gene causes the behavior like autism disease. It is due to DEL22q13.3 . They pointed out only a small proportion of autistic person have problem in shank 3 gene Shank3 is a multidomain protein. It play role in the synapse formation and as a neurotransmiter

Recent research..
One gene, FXR1,(3p24.3 ) appeared to be a likely candidate for a link to autism. FXR1 is similar to the Xchromosome Fragile X gene, FMR1. fragileX chromosome syndrome has been shown to overlap with autism, and because FXR1 is similar to the gene that causes the syndrome, USA researchers suspected FXR1 might be linked to autism. But after analyzing the entire coding sequence of FXR1, the researchers found no alterations in the gene likely to contribute to autism.

Diagnosis
No specific medical test is used for diagnosis of autism.

It depends on the observance of behavior

paediatrician commonly performs a preliminary investigation by taking developmental history and physically examining the child diagnosis and evaluations are conducted with help from ASD specialists, observing and assessing cognitive, communication, family, and other factors using standardized tools, and taking into account any associated medical conditions

 CARS:- child hood autism rating . It rates the children on

the scale of 1 to 4. ( normal to severe)
1. non autistic 2. mildly autistic 3. moderately autistic 4. severely autistic

.In this they will observe fifteen.items in the patient

Fifteen items are

relationship to people imitation emotional response body use listening response taste-smell-touch response and use fear and nervousness verbal communication non-verbal communication activity level level and consistency of intellectual response

object use
adaptation to change

general impressions
visual response

Contd.
The score value is range from 15 to 60
The cutt of value for this is 30. If the score of the individual lower then this then he must be affected by autism

Applied behaviour analysis

Applied behaviour analysis (ABA) is a science that involves using modern behavioural learning theory to modify behaviours. It teaches the social, motor and verbal behavior, and reasoning skills Baer, Wolf, and Risley's 1968 article is still used as the standard description of ABA. 1. Applied: ABA focuses on areas that are of social significance

2. 3.

Behavioural: ABA must be behavioural, i.e.: behaviour itself

must change, not just what the consumer says about behaviour

Analytic: The behaviour scientist can demonstrate believable

control over the behaviour that is being changed

4. Technological:This means that the description must be very detailed and clear. 5. Effectiveness

 This technique should be used by certified behavioral analyst

The US research includes that about 50% of the children with autism who were treated with ABA approach before the age of 4 had significant increase in IQ level and verbal ability There are no negative effect of ABA approach The tution fee of the ABA treatment (school) ranges from $ 16,000 to $25,000 per year. in some places scholarships is available

CHELATION THERAPY
Based on the discredited hypothesis that mercury poisoning may trigger the symptoms of autism, chelation therapy is widely used by alternative therapists to treat autism, with some surveys suggesting 2 8% of children with autism have had the therapy This therapy is the administration of chelating agents to remove heavy metals from the body BAL and EDTA, becoming the US standard of care for the treatment of lead, arsenic, and mercury poisoning, which it remains today.

CONTD
The chelating agent may be administered intravenously, intramuscularly, or orally, depending on the agent and the type of poisoning. These drugs bind to heavy metals in the body and prevent them from binding to other agents. They are then excreted from the body. The chelating process also removes vital nutrients such as vitamins C and E, therefore these must be supplemented. SIDE EFFECT :-A burning sensation at the site of delivery into the vein is common. nausea, stomach upset, vomiting.

MEDICATION
There is no cure for autism because a till now no causative factor is identified. Treatment goals are made to maximize the child ability to function independently and it gives the best possible quality of life Medication does not treat the underlying neurologic problems .Medications used in autism are psychoactive, meaning they affect the brain

CONTD
Antipsychotic drugs:- reduce hyperactivity, repetitive behaviors, withdrawal, and aggression

. Risperidone :- Risperidone blocks several of the receptors on nerves including dopamine type 2, serotonin type 2, and alpha 2 adrenergic receptors. believed that many psychotic illnesses are caused by abnormal communication among nerves in the brain and that by altering communication through neurotransmitters, risperidone can alter the psychotic state
olanzapine: works same as the resparidine

Contd.
Antidepressants:-It works on the neurotransmiter and control its activity . newest generation of antidepressants, including the single-receptor selective serotonin reuptake inhibitors (SSRIs) and multiple-receptor antidepressants

Stimulants :- psychoactive drugs which induce temporary improvements in either mental or physical function or both

Celebrities

Jenny McCarthy

Don Criqui

MOVIES ON AUTISM
Rain Man Mozart And The Whale My Name Is Khan

SOME TREATMENT CENTRE IN INDIA

SAKSHUM in hydrabad Dr anand balan in chennai Bright centre in mumbai

April Is Autism Awareness Month

Books Children with Autism (A parents guide) by Michael D. Powers Autism & Pervasive Developmental Disorders by Karyn Seroussi Behavioral Intervention for Young Children with Autism (A Manual for Parents and Professionals) by Catherine Maurice Visual Strategies for Improving Communication by Linda Hodgdon Solving Behavior Problems in Autism by Linda Hodgdon

Websites www.autism.org (Center for the Study of Autism) www.autism-society.org (Autism Society of America) www.autism.com/ari/contents.html (Autism Research Institute) www.nimh.nih.gov (National Institute of Mental Health) www.angelfire.com/tv2/autism/index.html (My website with other links)

Resources

Support Groups and Services Saginaw/Bay Autism Society (989) 781-3755 Guardian Angel Adult Day and Respite Care (989) 753-0824 Childrens Therapy Corner (989) 835-6333

One man is deaf; another is No one alike in the race of Not one should we judge, wrong or theyre right Whats going on may not be at first sight Look here at this boy, what a Hell push and hell pull and will thin Then an angel shines through smile Knowing Eric this way makes it while Hes loving and sweet, kind, Look past autism, and see a
Written by: Lori Schiavone, Our Guardian Angel