Autism unravelled
Latest research into this condition means it can be diagnosed earlier than ever. We look into this and other new insights. 
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David was an average boy, reaching all his milestones up until 15 months. Suddenly he stopped responding to his name. Soon he was lining up toys ,banging his head against walls, and no longer making eye contact with his mom. Ilana Gerschlowitz was told that her son would never go to school, toilet train or speak. David has severe autism.

Autism spectrum disorder is a developmental disability affecting about one in 110 children worldwide (with some states in the United States reporting as many as one in every 50 children). While each child has different symptoms, most children show impairments in social interaction, communication, and behaviour. So what causes a child to lose learned skills he already mastered, or a four-year-old to act like a two-year-old? No one really knows. But since David’s diagnosis seven years ago, we have learnt that there are different ways to tackle autism. David is now a functional ten-year-old boy, who may not chat and play as freely as his peers but he can rock climb, communicate through his iPad and hug his mom – a gesture Ilana treasures.

Is autism something I did?

“There is one thing we know for sure: autism is not the fault of the parent,” says New York-based clinical nutritionist and metabolic specialist Peta Cohen. But this doesn’t mean that the genes of the parent aren’t involved. The family must have a pre-genetic disposition to autism (just like a loaded gun) and given certain environmental stressors, regressive autismis triggered. Stressors such as toxins, viral and bacterial infections, medications and nutrient deficiencies – especially while inthe womb when baby’s brain is forming– are thought to act as triggers. Theysupposedly turn autism genes on or off.

This is why one in five children with an autistic sibling also develop it. Before Ilana decided to have her third child she consulted with Peta to help minimise the risk and reduce her exposure to these environmental triggers. Years ago this wasn’t seen as possible but now eating an organic diet that is free of genetically modified foods, composed of the right nutrients and food choices, avoiding other environmental toxins, taking nutrient supplements and breastfeeding can help reduce the risk of autism. Aaron is now ten months old and so far is developing on target.

Folic acid (found naturally in wholegrains, leafy greens and eggs )is also vital to the development of the growing’s baby’s brain. The Journal of the American Medical Association says that women who take folic acid supplements before and during pregnancy are 40 percent less likely to have a child with autism. The fourth week of pregnancy is critical for activated forms of folic acid, and yet many women still don’t know they are pregnant at this stage – and many are still on the pill. “Birth control pills are concerning as they deplete vitamins and folic acid,” explains Peta.

And what about vaccines? Are they really to blame? Our children’s shots have been completely ruled out as a cause of autism thanks to a new body of research. The context of their schedule and timing are important though, says Peta. For example, if your child is sick, ask your doctor if it is better to wait until he is well to do the vaccine.

What we now know about autism

The basics have not changed, yet we are learning that autism is not so specific (not every autistic child is a carbon copy of Rain Man). “You’re not treating a label, you’re treating a person – each with a different presentation of symptoms,” explains Peta. For example, one autistic child can have language and use it as away to communicate. Another will have language but they will say the same phrase over and over, and are in fact not communicating. Another may not be able to speak at all.

For years we have viewed autism as a communication and behavioural disability, but gastrointestinal issues are a large part of it. “Children with autism are called children with starving brains as their gut doesn’t break down the food to send the nutrients to the brain. They have imbalanced gut flora, causing some foods to be toxic. Eliminating food intolerances like gluten and casein can be a huge help,” says Ilana Gerschlowitz, David’s mother, who went on to found the Star Academy for Autism.

Another noticeable problem is an autistic child’s unusual sensitivities to sounds, sights, touch, taste and smells. “High-pitched sounds, such as school bells, can be painful,” explains Danielle Forsyth, a Johannesburg educational psychologist. Children with autism can also suffer from seizures, diarrhoea, low muscle tone, immune system imbalances, auditory and visual processing problems, sleep problems and many have very high pain thresholds, making it difficult to recognise when they are in pain.

Is autism curable?

“People don’t believe that children with autism can recover, but they are wrong,” says Peter Farag, behavioural therapist at The Center for Autism in the United States. He says they have had numerous cases of children who have recovered fully from autism (essentially, they can function completely in the mainstream world and no longer fall under the spectrum of the diagnosis), and many more who have shown dramatic improvements.

A major reason for this is new research that shows that the sooner the diagnosis, the better the chances of progress. Previously you had to wait until a child was three years old to get a diagnosis; now parents can start looking for signs of autism from six months. If your child isn’t smiling, or is tuned into things and not people – go to your doctor. 

Research also shows that there is nosingle treatment that will be effective for all people on the spectrum. Each person with autism requires one-on-one tailored education programs. Simply, there is no miracle cure to “fix” the problem.

A checklist for early warning signs of autism

6 months

  • Doesn't smile or express joy.

9 months 

  • Doesn't share sounds back and forth with others 

12 months 

  • Doesn't regularly turn when you call their name. 

14 months

  • Isn't pointing to show interest. 

16 months 

  • Doesn't pretend or make believe. 

24 months 

  • Isn't making two-word combinations. 

Other signs 

  • Excessively ligns up toys. 
  • Seems hearing-impaired. 
  • Poor eye contact. 
  • Lost language skills.

New developments 

While there are countless new developments in the world of autism, one of the most noted is Applied Behaviour Analysis therapy (ABA) – which the Star Academy, among others, uses in South Africa. ABA focuses on teaching new skills and reinforcing good behavior through repetition and reward.

“We all partake in inappropriate behaviour, but we know when to do it – an autistic child doesn’t. One child constantly waved two pencils in front of his face (inappropriate behaviour). We taught him to play the drums which has the same motion (appropriate behaviour),” explains Peter.

ABA also teaches a child in the environment they are happy in –if a child only likes the swing, they get taught while on the swing. One of the biggest challenges with autistic children is their seeming inability to communicate. “Many of these children are living in their own worlds, and language is a way of drawing them out,” says Peter.

If a child with autism is nonverbal they usually exhibit within appropriate behaviour in order to communicate. “If you couldn’t speak for a day, how would you gain attention? Perhaps you would jump up and down, scream or scratch someone,” explains Ilana.

As soon as autistic children find a way to communicate, these kinds of behaviours decrease. This is where modern technology steps in. Technological devices such as iPads have opened a new world to people with autism. Programs allow them to learn word associations but also communicate.

For example the therapists will show David a picture of an apple, he then goes on to his iPad and types out a-p-p-l-e. Or they can ask him what he would like to drink, and David can answer by typing out his wish. David also undergoes prompt therapy, where therapists help David move his mouth to produce the right sounds.

It will change your life

An autistic child may not express their basic wants or needs in a manner you’re used to, making the parenting process difficult. “Parents are left playing a guessing game. Is the child crying because they are thirsty, hungry, or sick?”says Danielle.

The child’s frustration can lead to aggressive behaviour (tantrums are common among autistic children). But it is also the day-to-day routines that become difficult. “Children with autism don’t sleep well, cannot speak properly, cannot go out in public or be content to sit in a restaurant,” says Ilana.

But with medical and educational intervention, the process is made easier. “David would scream and hit his head most of the time as he couldn’t communicate. Now he is able to verbalise with simple words. We were told that he would never even say one word so we celebrate each and every word he is able to produce.”

The attitude of “goodbye and goodluck” is no longer appropriate to autism – every parent wants recovery, but functionality is best (and possible). Danielle assures parents that in this scary time you mustn’t jump to conclusions about what life is going to be like for your child. “Like everyone else, people with autism have an entire lifetime to grow and develop their abilities.”

Educational psychologist Danielle Forsyth gives some coping mechanisms for parents with a child who falls on the autism spectrum

  1. Learn about autism: Educate yourself about the treatment options, ask questions, and participate in all treatment decisions. 
  2. Become and expert on your child: Figure out what triggers your child's disruptive behaviours and what elicits a positive response. What does your autistic child find stressful? Calming? Uncomfortable? Enjoyable?
  3. Provide structure: Find out what your child's therapists are doing and continue their techniques at home. Positive reinforcement can go a long way so make an effort to "catch them doing something good".
  4. Explain autism to siblings: Do it early and do it often. From early childhood, they need explanations that help them understand thier sibling's behaviour. For the preschool child this may be as simple as, "Rick doesn't know how to talk." How many of us would keep trying to form a friendship with someone who turned her back when we spoke, or seemed angry when we approached? The good news is that young children can be taught simple skills that will enable them to engage in playful interactions. 

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