What is Autism?
And the Autism Spectrum Disorder?

The Autism Spectrum Disorder (ASD) and autism are two generic terms that are part of a group of complex Neurodevelopment Disorders. This disorder (ASD) is characterized by difficulties in social interaction, verbal and non-verbal and repeated behaviors. The manifestations of this disorder (ASD) tend to vary depending on their levels, the child's developmental level and age, hence the term "spectrum".

What are the essential characteristics of Autism?

• Lack of social or emotional reciprocity;
• Delay or total absence of language development (not accompanied by attempts to compensate through gestures or mime);
• When there is language, there is a marked inability to initiate or maintain a conversation with others;
• Deficit in the use of nonverbal behaviors such as eye contact, facial expressions, body postures and gestures;
• Deficit in the development of relationships with their peers, appropriate to their level of development;
• Little spontaneous tendency to share with other pleasures, interests or objects;
• Deficit in symbolic play and imitation;
• Stereotyped and repetitive motor mannerisms (shake or rotate the hands or other complex movements);
• Inflexibility to changes in routine, insist on repetition and react negatively before minor changes;
• Highly fixed and restricted interests in an exaggerated way, both in the intensity want and in it's objective (eg can align again and again an exact number of objects, always the same way);
• Hyper- or Hypoactivity to external stimuli, such as adverse reactions to specific sounds or textures, fascination with lights or movements. Can touch or smell in an exaggerated way certain objects and have an apparent indifference to pain or temperature.

What are the warning signs of Autism?

The symptoms described above are present very early in children and are limiting to their normal development. Usually the symptoms are detected at around 2-3 years old, but can be recognized between 8-12 months, if the developmental delay is severe. The delay in language development around 2 years of age is usually one of the greatest warning signs to the parents. However, there may be earliest signs, prior to the development of language, for example:

• Lack of eye contact;
• Lack of response to name;
• Lack of recognition of the mother and father voices;
• Decrease or absence of gestures, such as pointing, saying goodbye or show (12 months);
• Delay in the acquisition of babbling (9 months);
• No response to expressions of parents;
• No expressions of joy or pleasure (from 6 months);
• Absence of the first words (16 months);
• Lack of joint attention;
• Lack of need to be close to others;
• Isolation;
• Lack of communicative intent.

What is the evolution of Autism?

The lowest severity of symptoms correspond to a better prognosis. The symptoms are most marked during childhood and adolescence. There may be children to improve their difficulties in social interaction and communication during adolescence, others in their turn worsen. Only a small proportion of individuals with ASD (Autism Spectrum Disorder) live and work independently in adulthood. Typically, individuals who can find a job that suits their special characteristics, are those who have functional language and strong intellectual abilities. In general, adult individuals with ASD may suffer from social level vulnerabilities and have difficulty achieving independence in adulthood. The chances that they will be fewer constraints and social vulnerabilities in adulthood depend heavily on the early diagnosis of ASD and its successive intervention. We can consider as good prognosis factors:

• Functional language before 5 years of age;
• Good intellectual competence;
• Specialized early intervention;
• Less severe forms of autism;
• Strong parental and educational support.

Is Autism common?

In Portugal, there are no statistics on the true reality of Autism. It is estimated that there may be in Portugal about 65,000 people with ASD (Autism Spectrum Disorder). Many people have not been diagnosed or received appropriate treatment. In the US, the ASD are Neurodevelopment Disorder that had more growth in recent years, 1 in 68 children is diagnosed with this disease. The growth of average annual rate of 10% to 17%. Boys are more likely to develop ASD in relation to girls. The prevalence is 1 in every 42 boys develop ASD. In fact, there has been a significant increase in the prevalence of this disorder. It is not clear if this increase in the number of cases of ASD is due to an increase of the diagnostic criteria are too broad or if the ASD will actually grow in frequency and gain contours of an epidemic worldwide.

What are the causes of Autism?

Until recently, nothing was known about the causes of this disorder in children Neurodevelopment. At this time, science is beginning to bear its first responses. One of the first discoveries regards the fact that there is not only one cause for Autism, there are various situations enhancer to determine the onset of this disorder.
The first cause for Autism is said to be genetic. Scientists have identified a number of rare genetic mutations associated with autism.
In most cases, what has been observed is that autism is caused by a combination of factors. The most crucial are the combination of the genetic and environmental factors that influence early development. Given a genetic predisposition to autism, there may be various enhancer environmental conditions of increased risk of developing this pathology. Some of these factors appear before and after birth:

• Advanced parental age at conception;
• Low birth weight;
• Fetal exposure to medication which can cause abnormalities;
• Difficulties in childbirth, especially situations where the baby has periods of oxygen deficiency in the brain;
• The mothers during pregnancy are exposed to high levels of pollution or pesticides.

It is important to realize that the factors described above do not by themselves cause Autism, but its combination with genetic factors. Little is known about the causes of Autism, there are several theories, some more grounded than others, but research on this disorder is increasing and consequently their most exact causes may be discovered in the coming decades.