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Autism is a neurological disorder that affects the normal functioning of the brain, impacting with normal development of reasoning, social interaction and communication skills. It is a lifelong developmental disability that makes learning difficult and can lead to serious behavior problems.  It usually appears within the first three years of life (sometimes after a period of typical development).

It occurs four times more often in males than females. Autism has been found throughout the world in all ethnic, racial and socioeconomic groups. The occurrence rate is estimated to be up to one in 167 (Baron, 1993). This paper will address how autism is observed, diagnosed, and treated in three different cultures/countries.

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Both children and adults with autism typically show difficulties in verbal and non-verbal communication, social interactions, and leisure or play activities.

One should keep in mind however, that autism is a spectrum disorder and it affects each individual differently and at varying degrees – this is why early diagnosis is so crucial. How is autism diagnosed? Because there are no medical tests for autism, diagnosis must be based on observations by a professional who has experience with autism.  A great deal of helpful information may be gained through assessment by a multidisciplinary team which may include a physician, psychologist, speech pathologist, occupational therapist, and behavior management specialist.

Any complete assessment must include maximal parental involvement. However, because many of the behaviors associated with autism are shared by other disorders, various medical tests may be ordered to rule out or identify other possible causes of the symptoms being exhibited. At first glance, some persons with autism may appear to have mental retardation, a behavior disorder, problems with hearing, or even odd and eccentric behavior.

To complicate matters further, these conditions can co-occur with autism. However, it is important to distinguish autism from other conditions, since an accurate diagnosis and early identification can provide the basis for building an appropriate and effective educational and treatment program. A brief observation in a single setting cannot present a true picture of an individual’s abilities and behaviors. Parental (and other caregivers’ and/or teachers) input and developmental history are very important components of making an accurate diagnosis.

The characteristic behaviors of autism spectrum disorders may or may not be apparent in infancy (18 to 24 months), but usually become obvious during early childhood (24 months to 6 years).

The National Institute of Child Health and Human Development (NICHD) lists five behaviors that signal further evaluation is warranted: Does not babble or coo by 12 months; Does not gesture (point, wave, grasp) by 12 months; Does not say single words by 16 months; Does not say two-word phrases on his or her own by 24 months; Has any loss of any language or social skill at any age. Having any of these five “red flags” does not mean a child has autism (Baird, Cass & Slonims, 2003).

Today attention is focused on an emotional debate as to whether autism is primarily genetic in origin or caused by the mercury in childhood vaccinations in the 1990s (Sacks, 1995). Vaccines are those life-saving miracle drugs that have successfully fought back everything from polio, small pox, and diphtheria, to measles, mumps and rubella. It began to be phased out a few years ago, but until then, most infant vaccines included something called ethyl mercury in a preservative called thimerasol.

Although different from methyl mercury, the kind found in pollution, ethyl mercury in high enough doses, can also damage the nervous system. What the Food and Drug Administration discovered was that along with getting more shots, by 1992, children were also getting more mercury.  The vaccines undoubtedly were protecting the children from a variety of deadly diseases, but were they also causing autism in some children? Symptoms of mercury toxicity are similar to those of autism. But the clinical features of these conditions are quite distinct.

Mercury poisoning causes ataxia and dysarthria, visual field disturbances, and peripheral neuropathy. In mild cases it produces a non-specific anxiety and depression; in more severe cases, a toxic psychosis can result. None of these features is characteristic of autism. The American Academy of Pediatrics and many other scientists also reject the link between vaccines and autism but urged that more research be done on autism.

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