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My 4-year-old son seldom talks or plays with his brothers and sisters. Is he suffering from autism?
(Posted on 1 March 2008)
Have you even seen a child hide, play alone in a corner, or get lost in a world of his or her own, totally oblivious to the happy chatter of other kids playing Monopoly or computer games nearby? Could such anti-social behaviour be an early symptom of autism?
If your child has character traits like this, you might well be worried that he or she may be suffering from the onset autism. Before we can establish the truth, we must first understand the facts behind this worrying condition. Simply put, autism is a brain disorder that often affects a person's ability to communicate and relate to others. Autistic children are typically self-absorbed and lack even basic social interaction skills. They may also be impaired in their ability to be creative or indulge in imaginative play.
While most children are noisy and extroverted, some are fairly quiet and introverted. As a result, parents should never be too hasty in determining whether or not a child is autistic. Before accurately diagnosing autism, doctors must first make a thorough evaluation. If you are worried that your child is autistic, you should take time to talk to his or her school teacher and find out about the child's behaviour and interaction with classmates at school. If you are still concerned, you should make an appointment with your family paediatrician. At the end of the day, autism is just one of several possible reasons why your child may not talk or play with others.
Unsociable behaviour is only one of several early symptoms of autism. Other factors that may cause a child to shun social contact include congenital character, and whether he or she child has unpleasant memories of being cheated or attacked by others. As a parent, you should therefore try hard to thoroughly understand and strengthen communications with your child.
Source: Quality HealthCare Medical Services
- Does autism mainly develop during childhood? What are the factors leading up to it?
- I have a pre-schooler at home who spends most of the time with the maid. How can I determine whether my child is autistic?
- Can autism be treated or cured?
- Can autistic children really feel others' love and concerns while avoiding interacting with others?
- What is anxiety disorder?
- In what ways could anxiety disorder be treated?
Does autism mainly develop during childhood? What are the factors leading up to it?
Generally speaking, autistic children aged 3 or under show three distinct basic symptoms - poor social development, communication problems, and repetitive and restrictive behaviour.
Science has yet to identify definite proof of the true causes of autism. That said, most experts agree that the condition is associated with genetic factors. The fact that an affected child's genes may be more susceptible to autism means that their brain development may also be different to our own. A combination of genetic and environmental factors such as food allergies and environmental toxins may further increase a child's chances of developing autism.
I have a pre-schooler at home who spends most of the time with the maid. How can I determine whether my child is autistic?
Autistic children tend to demonstrate a lack of social skills and an under-developed language ability. Obvious examples of language under-development include problems of expression and comprehension such as unclear verbal pronunciation, use of incomplete sentences, incorrect responses to questions and an inability to understand simple instructions, etc.
In addition to slowness in developing their language abilities and problems with social interaction, autistic pre-schoolers generally:
- Prefer not to be held or cuddled
- Avoid eye contact and want to be alone
Ultimately, autistic children are not interested in their physical surroundings, and unaware of the presence of other people. As such, it is hardly surprising that they will avoid any kind of social interaction.
- Do not point at objects or people
When asked 'Where is your daddy?', most autistic children will not point at their father.
- Do not play imaginary games such as pretending to talk on the phone
As autistic kids are less imaginative than other children, they simply do not understand how to play games.
- Endlessly repeat meaningless words or phrases
Autistic children often repeat others' words and phrases parrot-fashion.
- Repeat actions over and over again
Examples include moving the body, shaking the head and wandering around apartments, etc.
Can autism be treated or cured?
Sadly, doctors currently have no way of effectively curing autism. Generally, treatment consists of a combination of training and behavioural treatment. The ultimate aim is to improve the autistic child's social interaction ability, communications skills and behaviour. The good news is that when carried out continuously, such treatment has proved to be particularly effective for pre-schoolers.
As autistic children are often both hyperactive and inattentive, it may sometimes be necessary to apply provocative stimuli that may help improve the situation. While several other treatments have been advertised, their effectiveness has yet to be proved. As a result, parents should always seek their doctor's advice on the appropriateness of individual treatments.
Can autistic children really feel others' love and concerns while avoiding interacting with others?
As autistic children's senses receive signals differently to those of 'normal' people, they can easily misunderstand or misinterpret others' use of body language and gestures to express concern. Ultimately, autistic children tend to use different ways to express their emotions and feelings. This often leads to barriers in communication and relationship-building. However, like other normal people, autistic children are also capable of having intimate friendships built on mutual love and concern.
Understanding Anxiety Disorder
I. What is Anxiety Disorder?
Anxiety disorder is a kind of mood disorder. The American Psychiatric Association (APA) has defined anxiety disorder as an irrational or excess worries and intense emotion for at least six months. The worries are often strong and uncontrollable. Patients will also experience at least 3 signs and symptoms (as in part II), which are bothersome or will affect daily activities.
According to a recent survey conducted by the Chinese University of Hong Kong, it is estimated that over 200,000 Hong Kong people have suffered from the anxiety disorder. The life prevalence rate is about 4%. The onset of disease is highest in teenagers and mid-fifties. The number of female patients nearly doubles that of male patients. Anxiety disorder is considered as a chronic and recurrent disease. Early attention and effective treatment can probably lead to prompt recovery and low relapse rate.
II. Signs and Symptoms
The patients can easily get anxious and worry about any kind of things. They may experience restlessness, fatigue, difficult concentrating and irritability. Physical symptoms may include insomnia, muscle pain and cramps.
III. Causes
Genetic factor is a modest but significant cause of anxiety disorder. From the medical point of view, the hypersensitivity of autonomous nervous system (ANS), or the imbalance of a neurotransmitter-serotonin are also the predisposing factors to anxiety disorder.
Furthermore, hyperthyroidism and hypoglycemia, or some drugs such as amphetamines, bronchodilators, corticosteroids, ephedrine and thyroid supplements may also cause anxiety disorder.
IV. Treatment
Pharmacological treatment of anxiety disorder includes the use of benzodiazepines, selective serotonin reuptake inhibitors (SSRIs) and buspirone. Non-pharmacological approach may involve the cognitive behavioral therapy.
Source: Hong Kong and Drug Education Resources Centre, The Society of Hospital Pharmacists of Hong Kong
In what ways could anxiety disorder be treated?
There are generally two kinds of treatments of anxiety disorder - pharmacological treatment and non-pharmacological treatment which is more on psychological approach.
- Pharmacological treatment of anxiety disorder
- Benzodiazepines
Examples include diazepam, clonazepam, lorazepam, oxazepam. Benzodiazepines provide rapid tranquillizing effect and can relieve anxiety symptoms within a few days. It has been one of the major drug classes used to treat anxiety disorder.
Patients taking benzodiazepines for a long time may develop tolerance to the drug, so the dose may need to be increased in order to maintain the same effect. Besides, dependence may also happen after long-term treatment. Abrupt reduction in dosage or discontinuation of drug may lead to "withdrawal symptoms" (worsening anxiety, insomnia, depression, muscle cramps, etc). Overdose may cause respiratory suppression and unconsciousness.
Other side effects include sedation, confusion, memory loss, dizziness, etc. Therefore, patients should avoid driving and operating machines after taking the drug. Pregnant women and patients with depression should also avoid the use of the drug.
Since benzodiazepines cannot cure the anxiety disorder, so it is not suitable to take the drug for a long period of time. As an adjunct to the SSRIs therapy, benzodiazepines should be tapered off gradually after SSRIs have exerted their anti-anxiolytic effect.
- Selective serotonin reuptake inhibitors (SSRIs)
This class of drug increases and balances the concentration of neurotransmitter-serotonin in the brain. Examples include fluoxetine, paroxetine, sertraline, venlafexine, etc. SSRIs are very effective in treating anxiety disorder. Improvement in the mood of patients will be seen in a few weeks. They will not cause tolerance or dependence. Side effects include gastrointestinal discomfort, sweating and constipation, etc. Some patients may experience sexual dysfunction, but this side effect will subside after a period of treatment, and disappear after the completion of the course of treatment.
- Buspirone
The drug can balance the neurotransmitters-serotonin, noradrenaline and dopamine concentration in the brain. It is an alternative for those who cannot tolerate the side effects of benzodiazepines, those who have history of drug or alcohol abuse, the elderly, or patients with depression. Its side effects are fewer than those of benzodiazepines and the risk of dependence is also lower. Side effects include dizziness, headache and nausea, etc.
- Benzodiazepines
- Non-pharmacological treatment
Through cognitive behavioral therapy (CBT), clinical psychologists assist the patients to identify and correct any negative emotions, behaviors and lifestyles. Patients receiving CBT may also have to take medicines for better control of the disease.
Source: Hong Kong and Drug Education Resources Centre, The Society of Hospital Pharmacists of Hong Kong
