The causes and progress of autism are still being studied. Here's what we know.

By Leslie Cardé | Contributing Writer

Imagine having a child who meets all of the milestones for development as an infant, but in his toddler years, everything changes.

Progress becomes regression. Verbal skills may disappear, and younger siblings may begin to pass the child in developmental markers.

It’s a familiar scenario for anyone who has raised a child who is eventually diagnosed with autism. Just why the disorder shows up so late is a question still being studied.

Neuroscientific studies out of Columbia University have told us is that children and adolescents with autism have a surplus of synapses (part of the circuitry) in the brain, due to a slowdown in a normal brain “pruning” process during development.

An increased number of synapses creates miscommunication among neurons in the developing brain, which correlates with impairment in learning.

Scientists are still studying just how this happens.

A spectrum of issues

Autism Spectrum Disorder includes Asperger’s Syndrome, among others. There is a huge range within ASD, but everyone on the spectrum has some form of the base criteria.

“Most people on the spectrum have no intellectual disabilities but have a number of other features in common,” said Koren Boggs, PhD, clinical psychologist and team leader for the Autism Clinic at Children’s Hospital, New Orleans.

“Impairment with non-verbal communication is prevalent no matter what the disorder. It may start with not pointing to things, which is the way most children still learning language will communicate," Boggs said. "Not responding to their name is another sign. There is almost always difficulty in understanding social relationships.”

Other signs may include: inconsistent eye contact, facial expressions that don’t match what is being said, speaking in sing-song or flat robot-like tones, showing overly focused interest in specific topics or becoming upset by slight changes in routine.

On the flip side, people with autism can have many strengths, including the ability to learn things in infinite detail and retain that information for a long time. They are often strong auditory and visual learners, and can possess excellent skills in math, science, music and art.

Although researchers don’t know the primary cause of disorders on the autism spectrum, they do know there is a strong genetic component. Those include having a sibling with ASD, having older parents, and having certain genetic conditions like Down syndrome or Fragile X syndrome.

“Fragile X is still one of the most common causes of autism,” Boggs said. “Forty-six percent of boys and sixteen percent of girls with Fragile X have some disorder on the autism spectrum. Fragile X syndrome is caused by a mutation in the Fragile X messenger gene, which makes a protein that is needed for brain development." Because the defect is on the X chromosome, autism is more prevalent in boys, who have only one X chromosome, whereas girls have two.”

The American Academy of Pediatrics recommends early screening for developmental delays at 9, 18, and 24 or 30 month intervals. ASD is a complex disorder and often occurs in tandem with other disorders, so in some cases a comprehensive evaluation may include blood tests and a hearing test. The point is to diagnose the disorder early, so treatment can begin as soon as possible.

Therapy That Works

Helping those with autism learn new skills and improve upon their strengths at a very young age is critical to their development later on, because treatment isn’t as simple as a magic pill.

“There is no drug which is FDA-approved specifically for autism,” Boggs said. “If children with autism are given medication, it is for another disorder like anxiety or depression.”

The FDA has approved Applied Behavior Analysis therapy, which works on the core systems like communication and tolerating change. However, if an autistic child is involved in dangerous behavior like head-banging, then medication might be prescribed.

There is still a lot of controversy regarding the two approved drugs for irritability in autistic children because of the numerous and serious side effects of the antipsychotic medications, which some healthcare professionals have deemed unacceptable for children.

Research into the cause of autism is ongoing, but Dr. Boggs stressed that research indicates no link between any vaccine and autism. Autism is typically diagnosed between 2 and 3 years old, a time when children are getting vaccines. But, she notes, we don’t want to confuse correlation with causation. This is why numerous studies have been done delving into this.

When dealing with autism, concentrate on the positive aspects of the disorder. If you can take someone with a special ability and focus on that, people with autism spectrum disorders can often be successful.

If you feel you need help determining what’s best for your child, Louisiana has the “Early Steps Program”, which deals with children from birth to age 3 who have developmental delays. Go to https://ldh.la.gov/page/139 for more information.