Sometime
in 2012, I heard about a girl whom they claimed had autism. They described the
symptoms and I didn't think it was autism. I asked them a couple of questions
and by the time they answered, I knew it could not be autism. Eventually, I
asked the mom what the doctor told her, and she told me the doctor said her
child had “microcephaly”. Why then was she claiming autism? She said she was
told by other people that it was autism. That brings us to another gist of what
“autism is not”.
There
are other special needs conditions that can affect a child. Autism
affects the child’s social skill, communication skill and behaviour. These
three domains have to be affected. And you cannot just conclude that a child
has autism because everybody is talking about autism. So let’s continue by
saying, Autism is not...
Microcephaly:
I’ll start with this as it’s in our introduction. Microcephaly is a medical
condition which the circumference of the individual’s head is smaller than
normal because the brain has not developed properly or has stopped growing. It
can be present at birth or it may develop in the first few years of life. It is
often caused by genetic abnormalities that interfere with the growth of the
cerebral cortex during the early months of foetal development. Abuse of drugs
and alcohol, toxic chemicals, viral infections or untreated Phenylketonuria
(PKU) are other causes of Microcephaly. Symptoms include intellectual
disability and development delays.
A
typical brain and the brain of a person with Microcephaly
Down
syndrome (DS): DS unlike autism, shows on the face of the individual. It is
also called Trisonomy 21 because it is caused by the presence of a third copy
of chromosome 21. A child with Down syndrome experiences both physical and
mental developmental delays. DS symptoms include smaller
overall stature, flat facial profile, thick epicanthal folds in the corners of
their eyes, protruding tongues, which is due to their smaller oral cavity and
muscle hypotonia - low muscle tone.
Attention Deficit Hyperactivity Disorder (ADHD): Although it is
possible to find some children with autism that also have ADHD, it is a
completely different disorder. As the name implies, a child with ADHD is
inattentive and hyperactive. The symptoms of ADHD can be seen generally in
children, but it may become a source of concern when these behaviours occur too
often. Because a child with ADHD often finds it difficult to sustain attention
during tasks or play and does not often follow through on instructions, school
work and other activities, it serves as a major challenge in academics. A
parent that is concerned should seek a doctor’s diagnosis. The school too may
advice the parent to see a doctor, but they should not just treat the child as
naughty.
Fragile X Syndrome: Fragile X is the
most common inherited form of intellectual disability. This is a genetic
condition which involves changes in part of the X chromosome. I believe we
remember, at least faintly, X chromosome from our high school Biology. Do you
remember XX for women and XY for men? X and Y chromosomes are referred to as
sex chromosomes. The mother donates the X chromosome to all her kids (that is
what she has to give anyway) and the father donates the X chromosome to his
daughter and Y chromosome to his son. So Fragile X is caused by a fragile site
on the end of the X chromosome which appears to be breaking, although not quite
separated. It is more common in males than females. As earlier said, it causes
intellectual disability in the individual. An individual with Fragile X may
also show symptoms of autism. Unlike the usual ASD, there are certain physical
features that accompany Fragile X. These may include a long narrow face,
prominent ears, high palate, flat feet, and soft velvety skin. They have low
muscle tone which may make them seem cross-eyed, and with slack facial
features. Some older males may have large testicles. They may also show
symptoms of ADHD. For a child who is suspected to have autism, it is good to test
for Fragile X, so that the right treatment can be administered.
Intellectual Disability: A
person is said to have intellectual disability (ID) when the person shows
limitations in intellectual functioning and adaptive behaviours. It is
characterized by a below average intelligence or mental ability and a lack of
skills necessary for day-to-day living. Symptoms include poor memory skill,
delayed language development, inability to connect actions with consequences
and may experience difficulty in mastering basic skills like toilet training,
feeding, bathing or dressing. Children with different disorders like autism,
Down syndrome, microcephaly, fragile X etc, may show intellectual disability,
depending on the severity of the disorder. There is no known cause for ID
except in a few cases (just about a third of the diagnosed people).
Finally, there are other Pervasive Developmental Disorders (PDD), Rett
syndrome (RS) and Childhood Disintegrative Disorder (CDD). Although these are
Pervasive Developmental Disorders, they are not classified under ASD because
they present different symptoms. Rett syndrome is characterized by normal early
development, followed by loss hand skills, distinctive hand movement,
deceleration of head growth, gait abnormalities, seizures, and mental
retardation. The child loses many skills that have been acquired initially,
including speech. RS is found in girls. CDD on the other hand can be found in
both boys and girls. It is characterized by a normal early development, usually
between ages two and four, followed by a regression and loss of skills such as
receptive and expressive language, social skills or adaptive behaviour, bowel
or bladder control, ability to play and motor skills. This regression can span
from age two to ten and it can be so dramatic that the child notices the
changes and comments on it. The child eventually shows symptoms similar to
typical autism.
There are many other possible disorders that affect people other
than autism. Therefore, the purpose of this article is for people to seek
diagnosis from a registered doctor in a registered hospital when they notice
the difference in their children. Do not conclude that a child has a disorder
because other people say so. Autism is not a name for all developmental
disorders or any disorder you don’t understand. A diagnosis is important so
that one can know the right treatment to administer. How can you treat what you
don’t know? Children with different disorders can get help. But how can the
child get the right help if you only assume the problem? Please let’s do the
right thing.
Thanks for reading my gist. Till we talk next time.... muah
