Child Health

​Autism spectrum disorder:
Autism is not a disease. When a child is diagnosed with autism, this means that his or her brain works differently from others, affecting how they interact, socialize, and behave with others. They also have different strengths and difficulties, and often there is nothing in appearance distinguishing them from others.
The term "Spectrum" refers to a wide range of symptoms and behaviors that a person may suffer from. Autism varies depending on each person with autism. Although autism can be diagnosed at any age, symptoms generally appear in the first two years of life. Some children with autism also may acquire new skills and acquire developmental milestones until the age of 18 to 24 months, and then they stop acquiring new skills or lose the skills they acquired before.

Risk factors:
There are many different factors that have been identified including environmental, biological and genetic factors. Available evidence suggests that the following may put children at greater risk of developing autism spectrum disorder:

• Having a sibling with autism spectrum disorder
• Having certain genetic or chromosomal conditions (such as fragile X syndrome or tuberous sclerosis).
• Suffering from complications during childbirth.
• Being born to older parents.

Symptoms:
It is important to note that some people without autism spectrum disorder may also experience some of these symptoms, but for people with autism these characteristics are challenging and include:
Communication and social interaction skills:

• Avoids or does not maintain eye contact.
• Does not respond when someone calls him/her by his/her name at the age of 9 months.
• Does not show facial expressions (such as: happiness, sadness, anger, or surprise) at the age of 9 months.
• May not look at objects or events that parents look at or point to.
• Uses few or no gestures by 12 months (e.g. not waving goodbye).
• Does not share interests with others by 15 months (e.g. shows something he/she likes)
• Doesn't point to anything interesting at 18 months
• Doesn't notice when others get hurt or upset by 24 months
• Does not notice other children and joins them in play by 36 months
• Does not pretend while playing as if he/she is a superhero, a teacher, or anyone else by 48 months
• Does not sing or dance by 60 months

Restricted or repetitive behaviors or interests:

• He/she arranges toys or tools and gets upset when the order is changed.
• Repeats words or phrases over and over.
• He/she plays with toys the same way every time.
• Focuses and plays on parts of objects (e.g. turning car wheels instead of playing with the car)
• He/she gets upset by simple changes.
• He/she has obsessive interests.
• He/she loves routine and order, and has difficulty changing or moving from one activity to another.
• Flapping hands, walking on toes for a long time, or spinning in circles.
• May be extremely sensitive or not sensitive at all to smells, sounds, lights, textures, and touch.
• May have an unusual use of vision or gaze - Looks at things from unusual angles.

Other features and characteristics:

• Delayed language skills
• Late movement skills
• Delayed cognitive or educational skills
• Excessive, impulsive and/or inattentive behavior
• Epileptic disorder or seizures
• Unusual eating and sleeping habits
• Digestive problems (such as: constipation)
• Abnormal mood or emotional reactions.
• Anxiety, stress, or excessive worry
• No fear or more fear than expected.

It is important to note that affected children may not have all or any of the behaviors listed as examples here.

Comparison between normal behavior and autism spectrum behavior:
Here are some examples that may help a parent differentiate between normal, age-appropriate behavior and early signs of autism spectrum disorder:

Comparison between normal behavior and autism spectrum behavior:
Here are some examples that may help a parent differentiate between normal, age-appropriate behavior and early signs of autism spectrum disorder:

Diagnosis:
Diagnosing autism spectrum disorder can be difficult because there is no medical test, such as a blood test, but the doctor looks at the child's behavior and development to make a diagnosis. It can sometimes be detected at 18 months or younger.
Diagnosing affected children as soon as possible is important to make sure that they get services and support needed to reach their full potential, which includes:

• Developmental Monitoring: It is an active and ongoing process of monitoring a child's development and encouraging conversations between parents and health care providers about the child's skills and abilities. Developmental monitoring involves observing how a child is developing and what skills most children reach by a certain age in playing, learning, speaking, behaving and moving.
• Developmental screening: The health care provider takes a close look at how the child is developing at regular visits.

Treatment:
Current treatments for autism spectrum disorder aim to reduce symptoms that interfere with daily functioning and quality of life, as the disorder affects each person differently, which means that those affected have unique strengths, challenges, and different treatment needs. There are many types of treatments available that can be divided into categories:

• Behavioral therapy: focuses on changing behaviors by understanding what happens before and after the behavior. It encourages desirable behaviors and discourages undesirable behaviors to improve a variety of skills while monitoring and measuring progress.
• Developmental therapy: Focuses on improving specific developmental skills (such as language skills, physical skills, or a wide range of interrelated developmental abilities) and most commonly is speech and language therapy, which helps improve a person's understanding and use of speech and language.
• Instructional therapy: Provided in a classroom environment, where the teacher provides methods to modify the classroom structure and improve academic and other outcomes (e.g. writing down daily routines, drawing them and placing them in the classroom, or supplementing verbal instructions with visual instructions or physical demonstrations).
• Social Relationships: Focuses on improving social skills and building emotional bonds.
• Medications: There are no medications that treat the key symptoms, but some medications treat accompanying symptoms that can help them function better (such as: medications may help manage high energy levels, inability to concentrate, or self-harming behavior), they may also help manage psychological conditions (such as: anxiety or depression), in addition to medical conditions (such as: seizures, sleep problems, stomach problems, or other digestive problems).
• Psychotherapy: It can help deal with anxiety, depression, and other mental health problems, as cognitive behavioral therapy is one of the psychological methods that focuses on learning the connections between thoughts, feelings, and behaviors. The therapist and the individual work together to set goals and then change the way the person thinks about the situation to change the way he reacts to the situation.
• Complementary and alternative therapies: Often used to supplement traditional methods (e.g. special diet, animal therapy, art therapy or relaxation therapies), parents should always talk to a doctor before starting complementary and alternative therapy.

Instructions for parents:

• Identify the stimuli that make the child run away from something or towards it (such as: water, the park, train tracks, or staying away from loud noises or bright lights).
• Secure the house, regardless of the child’s age, by closing the doors that lead to the outside.
• Teach the child self-calming strategies when stressed.
• Make sure that the child gets enough sleep, and if he suffers from sleep problems, you must talk to the doctor.
• Home swimming pools must be surrounded by a fence that prevents children from reaching them.
• Family supervision of children when swimming, as swimming lessons are not sufficient to prevent drowning.