Autism is not a disease, but a development disorder, that mainly affects the communication and imagination, behavioral and social areas.  Individuals suffering from that disorder may have a physical development according to their age, that is, they have a “normal” appearance, they move around and feed by themselves, nevertheless, a great percentage of individuals with autism, further present intellectual impairment (mental retardation), therefore their development and skill attainment will be inferior in all and each of the areas.

Since this disorder is a development alteration, the first symptoms become evident during early childhood, especially between 18 and 36 months of age.                                  

The characteristics presented by a person with autism are multiple and diverse, manifesting themselves in each individual differently and simultaneously affecting to a greater or lesser extent the three aforementioned areas.

•  Communication and Imagination Area :
The development of the communicative and imaginative skills is substantially affected, thus, in many cases being the first “red alert light”, since the minor “does not speak”, “seldom speaks”, “has speech difficulties”, or his/her “speech and language is peculiar”, these are some of the references provided by parents as a reason for consultation.  Following, there is a specific description of the impairment they might present in this area.

• They fail to develop verbal communication
• Might present language regression (acquire some words and then lose them)
• If they lack verbal communication, they tend to point at objects they want.
• They don’t develop a mimic as such, to compensate for the lack of verbal language, but they point at things as already mentioned.
• They spontaneously repeat words, even though those words might not be of everyday use.
• Selective mutism, that is, they only emit words with certain people.
• If speech is present, it generally consists of repetitions, which can be all that is said at that time (immediate echolalia), that is, repeating phrases, dialogues of movies, cartoons, commercials or other TV programs, a while after he/she heard them (delayed echolalia). These echolalias have the same intonation as heard by him/her.
• In his/her spontaneous word emissions, their intonation is monotonous, it would seem that they are always asking a question or use a “singing” tone.
• They don’t have a clear facial expression.
• They use short phrases to communicate themselves.
• They use these phrases in second or third person when they talk about themselves; for example: “You want some bread?” instead of saying “I want some bread”.
• Their expressive language is very perseverant, that is, they repeat a same phrase, word or question several times.
• Individuals who develop a fluid language, present several difficulties to develop an abstract thinking.

•  Socialization Area :

• They tend to isolate themselves.
• They don’t relate with children their age.
• There is no reciprocity in many actions.
• They might show themselves indifferent to the diverse mood states of others
• They show severe difficulties to follow social rules, such as saying goodbye, greeting, respecting other people’s objects.
• If they ever do relate with others, they do it with adults.
• They prefer to play alone.
• They show themselves indifferent to physical contact, and there are also some occasions when they reject physical contact.
• In some children physical rigidity is noticed when they are carried or caressed.
• They don’t show anticipation before some situations of sharing things.

•  Behavioral Area:

• It is characteristic that when babies they usually are very peaceful or excessively irritable.
• They resist to routine changes.
• Their interests are very limited or unusual.
• They show very frequent rages and of difficult handling.
• They experience sudden mood state shifting.
• They may show unrestrained laughter without an apparent reason.
• As a response to their frustration, they may harm themselves or assault others
• Very poor tolerance to frustration.
• They show very repetitive movements such as running from one place to the other, turning lights on and off.
• Moreover their motor stereotypies are very common and consist in: finger and hand movement or contortion, (similar to wing flapping), balancing or swinging of their body, just to mention some examples.
• They walk on their toes.
• They get easily irritated.
• A high percentage of children with autism, at about two years of age usually show excessive activity.
• They tend to make many rituals.

It is important to clarify that to clinically determine that an individual suffers from autism; it is indispensable that he/she presents several symptoms of all and each of the aforementioned areas, since the aggregate of symptoms indicate the autism disorder.  Therefore, if your child also presents similar behaviors that only include a single area, it might be due to another type of disorder, which shall equally be assessed.                  

Autism is a disorder for which there is no cure, if a person is diagnosed with autism, he/she shall have this disorder all of his/her life, nevertheless, if adequately stimulated, he/she may develop skills in all the areas and even some of these people get to develop a great potential that allows them an integration and functioning in everyday life which is nearly ‘normal’, though difficulties will continue to appear especially as to social and thinking matters.

Its etiology is still unknown.  There are several theories, such as:

• That which affirms that autism disorder may be provoked by nutritional factors.  For example the gluten and casein.
• It is also considered that autism shows up due to high indexes of concentration of lead and mercury in the bloodstream, as a consequence of contamination and some vaccines.
• Also, in current times, the theory that has gained more and more strength is that autism may be due to anatomical and functional alterations of the Central Nervous System.
• It was believed that a child with autism, was a result of cold and indifferent parents, to this date THIS CRITERION HAS BEEN TOTALLY DISCARDED.

Nevertheless in the diverse studies, no conclusive evidence has been found about what triggers autism.   

• The required treatment must be a multidisciplinary one, that is, to have support and supervision from diverse specialists such as clinical or educational Psychologists, Neuropediatricians, Speech therapists, special education teachers and Pedopsychiatrists.
  
  
• Behavioral-Remedial Therapy, that is, the child must receive therapeutic support, focused on modifying disruptive behaviors, facilitating the integration into the family, school and social environment, and the stimulation of all the areas in general.  This treatment, most of the time is handled at individual level and later integrated into group therapy which is the special education environment; nevertheless, in only a few cities there are school centers specialized in treating people with this disorder, therefore the handling consists mainly in individual therapy.
  
• Pharmacological Treatment: Not all children require taking some drug, it is prescribed when a child along with autism shows Attention Deficit combined or not combined with Hyperactivity and Impulsivity, associated to autism.  Also when the patient shows behavioral alterations of generalized anxiety, self-aggression or aggression, same that are not modified with behavioral modification strategies or some central nervous system alteration, the most common convulsive crisis.  It is important pointing out that the specialists for this treatment are Pediatric Neurology Physicians or Pedopsychiatrists.  If the patient shows neurological disorders, the intervention of a Neurologist is indispensable.
  
• Speech Therapies.  Focused on developing communicative and linguistic skills that would enable the minor to express and comprehend the language better, in such a way that he/she would integrate better to all environments.

Yes, though only a minimum percentage of the population suffering from autism disorder does.  As opposed to popular belief, it is feasible that a child with autism integrates himself/herself to a regular education system.  For such a purpose, it is indispensable that the minor has an intelligence within the average parameters, linguistic skills that enable him/her to understand and express everyday situations and the acquisition of academic knowledge, but above all, that at behavioral level he/she is a child that can handle himself/herself and adapt to new situations without presenting disruptive behavior such as self-aggressions or aggressions.

It is recommended that once the child is promoted to enroll in a regular school, the integration is carried out in a systemized fashion, that is, that the child assists two days to the new school to which he/she shall be accompanied by a “shadow” assistant, as the child integrates himself/herself, his/her stay is increased until he/she assists on an everyday basis and little by little the presence of the “shadow” assistant is removed.

A “shadow” is defined as an assistant teacher, who will accompany the student during the school hours; her role consists mainly in helping the minor to adapt himself/herself to the new situations without becoming altered, as well as providing support in the diverse academic activities as required.  Nonetheless, the teacher is responsible for the curriculum and academic objectives.