News Article Details

Autism disorders have range of symptoms, severity

Tahlequah Daily Press - 4/5/2018

April 05--Monday marked a day of activities and education concerning an array of disorders about which misunderstanding is common, though many people are aware of them.

April 2 was World Autism Awareness Day, intended to focus on the spectrum and those who deal with autism.

Today, the Diagnostic and Statistical Manual of Mental Disorders uses "autism spectrum disorders" as a general term encompassing autism, Rett syndrome, Asperger syndrome, childhood disintegrative disorder and "pervasive developmental disorder not otherwise specified."

Dr. John Fell, who practices at Northeastern Health System'sTahlequah Medical Group, is the father of six. His son Conner, 12, is autistic.

"His mother noticed at a very young age that he wasn't interacting socially very well," Fell said. "She took him to three or four specialists before someone diagnosed him. There is a whole spectrum. He was non-verbal until he was 5-1/2. I began to wonder if he would ever speak."

Fell said raising an autistic son requires some understanding of the challenges the child faces.

"He reacts to his environment differently than most people," Fell said. "He is prone to having 'flutters' and getting upset by something happening publicly. We may be out as a family and he starts to get upset. People look at us, waiting for us to do something about him. They don't understand that disciplining him won't do any good. Sometimes you can get him focused on something else, and he has improved a lot between the ages of 8 and 12. He now communicates verbally."

ASD commonly manifests as severe and often incapacitating difficulties with social development and communication, and repetitive behavior. As babies, autistic children smile less and respond less frequently when hearing their names. Toddlers make less eye contact and fewer gestures, and preschool children have severe problems functioning in social situations.

Repetitive behavior that can include rigid rules when performing tasks, arranging toys in a specific order, and repeating movements like head rolling or hand flapping, can be an indicator of autism.

However, a couple of odd behaviors or delayed development of communication skills do not result in diagnoses of ASD. Problems with social interaction must span many circumstances and be supported by observation of the child and parental interview. Diagnosis often occurs around ages 2-3, but in some cases, it happens between 14 and 24 months.

Early symptoms of autism include no gesturing or babbling by 12 months, and no single-word speech by 16 months.

It is usually between 18 and 24 months that parents notice behavior that is possibly autistic.

The causes of autism are not well-understood, though research suggests most cases have a genetic basis, and that interference with synaptic function may occur. Studies also indicate that factors linked to autism affect the fetus within the first two months of a pregnancy.

Among environmental variables, a 2014 study suggested air pollution containing heavy metals could increase the risk of autism. Other environmental elements have been attached to ASD, but without objective study -- most notoriously, the measles-mumps-rubella vaccine. Further studies attempting to duplicate those findings of a British doctor instead showed no connection between autism and MMR, and the link is considered fully debunked by an overwhelming majority in the medical profession.

The challenge of educating autistic children often correlates with the severity of the disorder. Medications are sometimes used to help children with ASD to function in school and public settings. Prescriptions vary with the needs of the patient.

"Autism disorders have a very wide range," said Dr. Jason Mutz, pharmacist for the Reasor's in Tahlequah. "Some children are almost 100 percent functional and other cases are more severe, so it is different and individualized for everybody. Some are aggressive, in which case they may be prescribed psychiatric medications to help them keep calm. Some have difficulty focusing, and may be prescribed ADHD meds. Some may take anti-depressants, or selective serotonin reuptake inhibitors that can help with anxiety."

There is little clinical data on autistic adults. There is no cure for any ASD, but in many cases, outward symptoms seem to diminish in severity with age. Improvement sometimes even reaches the threshold of the ASD diagnosis being withdrawn. But due to the dearth of study, the frequency is unknown.

However, most with ASD face many challenges as they become adults. Anecdotally, autistic adults have reported difficulty making new friends and finding employment, and independent living is rare for those with severe symptoms.

There are challenges with an autistic kid, but Conner also brings immense joy for the Fells.

"You never go a moment without laughing, even if you want to cry," said mother Kira Fell. "This is a blessing. I sometimes get cross looks for saying this, but my kid is weird. That's all he is. He is happy, healthy and he will live a long life. He likes who he is."

Dr. Fell said he was excited when Conner began reading.

"Then we discovered he is really extraordinary with dates and numbers," Fell said. "You can ask him when something happened in our family, he can tell you what day and year it happened. In the future, he can instantly tell you what day of the week a date falls on. He has this recall of dates. He memorized all the moves of his favorite dance on YouTube. We went to Special Olympics this weekend. He finished last, but that's because he was so excited to be there, he was running sideways waving his hands in the air."


(c)2018 the Tahlequah Daily Press (Tahlequah, Okla.)

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