Saturday, October 29, 2011

[sehat] Digest Number 16369

Messages In This Digest (25 Messages)

1a.
Re: Diare + batuk pilek pada bayi 10 m From: aries3_dee84@yahoo.com
1b.
Re: Diare + batuk pilek pada bayi 10 m From: diahfa@yahoo.com
1c.
Re: Diare + batuk pilek pada bayi 10 m From: purnamawati.spak@cbn.net.id
2a.
Re: Pusing karena KB From: ✽jenita✽
3a.
Telinga seperti sedang berada di pesawat From: mommyarsa@yahoo.com
3b.
Re: Telinga seperti sedang berada di pesawat From: ursula_maniez@yahoo.com
3c.
Re: Telinga seperti sedang berada di pesawat From: mommyarsa@yahoo.com
4a.
Re: General Medical Check-Up From: Yeptirani Syari
4b.
Re: General Medical Check-Up From: wulan
4c.
Re: General Medical Check-Up From: Ida Rifai
4d.
Re: General Medical Check-Up From: Regia Delonie @Gmail
4e.
Re: General Medical Check-Up From: Inta
4f.
Re: General Medical Check-Up From: Erieka
5a.
Re: [OOT] senangnya... From: purnamawati.spak@cbn.net.id
6a.
Re: FW: [sehat] tonsil dan usus buntu sudah diangkat, apa yang perlu From: purnamawati.spak@cbn.net.id
7.1.
Re: hasil skrining hepatitis - Att Bunda Wati From: purnamawati.spak@cbn.net.id
8a.
Re: positif ISK From: triana dany
9a.
Re: tanya bhs medis utk pengapuran From: roxiefoxy@yahoo.com
9b.
Re: tanya bhs medis utk pengapuran From: aina
9c.
Re: tanya bhs medis utk pengapuran From: umialiyah_dzatil@yahoo.co.id
9d.
Re: tanya bhs medis utk pengapuran From: mommyarsa@yahoo.com
9e.
Re: tanya bhs medis utk pengapuran From: roxiefoxy@yahoo.com
9f.
Re: tanya bhs medis utk pengapuran From: Oke Mieske
10a.
Re: (OOT) RS/Dokter di Bali From: purnamawati.spak@cbn.net.id
11.
[news] A Parent�s Guide to Autism Spectrum Disorder From: /ghozansehat

Messages

1a.

Re: Diare + batuk pilek pada bayi 10 m

Posted by: "aries3_dee84@yahoo.com" aries3_dee84@yahoo.com   aries3_dee84

Fri Oct 28, 2011 5:46 pm (PDT)



Saya copas dr webmilissehat http://milissehat.web.id/?p=1855

Diare biasa diartikan sebagai buang air besar yang lebih sering dan lebih encer dari pada biasanya. Oleh karena itu penting untuk mengetahui seperti apa buang air yang biasa itu?

Pada bayi dengan ASI eksklusif, frekuensi buang air besar dapat sampai 4-5 kali sehari, ini adalah frekuensi yang normal. Tinja pada bayi dapat berbentuk seperti selai kacang atau bubur kental dan ini masih dalam batas normal. Pada anak yang lebih besar, buang air besar lebih dari tiga kali sehari dapat dikatakan diare dengan tinja yang lebih encer dari pada biasanya.

Buang air besar� sedikit-sedikit (encopresis), meskipun frekuensinya cukup sering belum tentu dikategorikan sebagai diare. Darah pada tinja juga bukan petanda diare, meskipun diare dapat disertai darah. Sebagai kesimpulan, diare adalah buang air besar yang lebih sering dengan tinja yang lebih encer.

Sebagian besar diare pada anak disebabkan oleh infeksi virus.� Pengobatan diare bukan bertujuan untuk membunuh virus tapi mencegah dehidrasi. Infeksi virus akan membaik dengan sendirinya diatasi oleh daya tahan tubuh.

Intake cairan dan berikan oralit sedikit2 tp sesering mungkin, sering2 cuci tangan.

Get well soon ya mba camelia.

Rgds
Dian-bunda Akhtar
Sent from my AXIS Worry Free BlackBerry� smartphone
1b.

Re: Diare + batuk pilek pada bayi 10 m

Posted by: "diahfa@yahoo.com" diahfa@yahoo.com   diahfa

Fri Oct 28, 2011 5:50 pm (PDT)



Mba,
Pup encer tidak selalu berarti diare.
Amati behaviour anak.
Sdh tepat dg perbanyak intake cairan,
Tetapi knp pake larutan gula, boleh tau alasannya?
Bukankah bayi sebaiknya no gulgar (gula garam) dulu?
Kalo khawatir dehidrasi bukan lar gula solusinya tetapi oralit ya mba.

Maaf kalo kurang berkenan.

Salam,
Diah
@diahapt

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1c.

Re: Diare + batuk pilek pada bayi 10 m

Posted by: "purnamawati.spak@cbn.net.id" purnamawati.spak@cbn.net.id

Fri Oct 28, 2011 7:58 pm (PDT)



Dear Mely
Anakmu infeksi virus ya
Sama seperti SP, mau tanya, yang dimaksud larutan gula itu apa ya?
Wati

Patient Safety, first

2a.

Re: Pusing karena KB

Posted by: "✽jenita✽" jenit@xl.blackberry.com   jyatni

Fri Oct 28, 2011 6:40 pm (PDT)



Makasih mba Diah
Wah harus beraniin diri spiral kl gini

Salam
Jeni

3a.

Telinga seperti sedang berada di pesawat

Posted by: "mommyarsa@yahoo.com" mommyarsa@yahoo.com   mommyarsa

Fri Oct 28, 2011 7:41 pm (PDT)



Dear SPs dan Docs,

Sejak 2 hari yll, setiap habis menguap, telinga seperti berdengung seperti sedang berada di ketinggian ketika di dalam pesawat. Tidak hilang walopun sudah menelan ludah dan mengunyah permen karet. Rasanya sangt mengganggu dan tidak nyaman. Kira2 ada yg pernah ngalamin kah? Kenapa ya? apakah itu gangguan THT, jika iya, apa nama medisnya?

Please advice nya ya... Hatur Thank You

Sanny
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3b.

Re: Telinga seperti sedang berada di pesawat

Posted by: "ursula_maniez@yahoo.com" ursula_maniez@yahoo.com   ursula_maniez

Fri Oct 28, 2011 8:49 pm (PDT)



Waaaahhhh
Mom Sanny toss dl donk. Ak br mau share masalah yg sama.
Baru aware slama khamilan k-2 ini ada dikit gangguan yg ga biasax. Telingaku sring trasa kyak penuh udara mirip kl kt lg d pswat. Tp cm telinga sbelah kanan.
Kmaren kontrol ke DSOg skalian nanya tp kata bliau mgkin itu pengaruh lg flu ato byak lendir.
Well, flu trakhir mlandaku 1,5bln yg lalu lhoo. Batuk sih kadang2 doang tp cm bentar.
itu tlinga kyk gt knapa yaa?
Aman ga kl berpergian pake pswat?
Oiya skalian nanya
Umur khamilan udah 27mg 4 hari
Bsok bkal k Jkt dan lanjut S'pore, msih aman kah utk berpergian dgn khamilan sperti ini?
Khamilan pertama sih prnh jg dinas ke Macau n hkg tp usia khamilan saat itu baru menjelang 6blan. Gangguanx cm pas 20-an mnit stlah take off lgsg di landa migrain ampe kurasa urat2 d dahi muncul smua. Tp bgtu landing lgsg ilang.
Makax agk deg2an jg mo lakukan perjalanan ini d tambah lg dgn kondisi tlinga yg sring penuh udara kyak gini.
Mohon advisex dunk SPs
Makasiiiiih

Salam
Ursula
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3c.

Re: Telinga seperti sedang berada di pesawat

Posted by: "mommyarsa@yahoo.com" mommyarsa@yahoo.com   mommyarsa

Fri Oct 28, 2011 8:54 pm (PDT)



Mba Ursula,

Iya ini jg lagi hamil masuk week 28, lagi cari2 info di babycenter, tpi blm nemu...
Ga tau nih knp ya telinga nya gini, pdhl ga lagi flu atau batuk. Bikin ga nyaman banget.

Dear SPs,
Mohon sharing n advice nya ya? Apa musti konsul ke dr THT?


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4a.

Re: General Medical Check-Up

Posted by: "Yeptirani Syari" sehat.syari@gmail.com

Fri Oct 28, 2011 7:41 pm (PDT)



ikutan nanya donk... pap smears wajib yak?
klo lahirannya udah sesar gitu, msh wajib ya?

hehehe, gak suka periksa dalam soalnya.. :p

--
Yeptirani Syari, ~Dandanya Zee~
"kalo mo japri, ke *y.syari@gmail.com* ajah... biar gak nyelip :p"

[Non-text portions of this message have been removed]

4b.

Re: General Medical Check-Up

Posted by: "wulan" wulan.wuls@gmail.com   wulanokey

Fri Oct 28, 2011 8:14 pm (PDT)



Pap smears itu kan deteksi dini, salah satu bentuk pencegahan. Skrg pilihannya tinggal mba timbang sendiri deh. Mau nyaman bebas dr periksa dalam atau hidup dg resiko penyakit krn tdk terdeteksi sejak awal

Rgds,
- Wulan -
@wulsnih

4c.

Re: General Medical Check-Up

Posted by: "Ida Rifai" riffatriffan@gmail.com   farida_indriyani

Fri Oct 28, 2011 8:39 pm (PDT)



Quote:
ikutan nanya donk... pap smears wajib yak?

klo lahirannya udah sesar gitu, msh wajib ya?

Me:
Ga ada hubungannya mba lahiran normal/cesar sama papsmear. Papsmear wajib untuk deteksi dini kanker leher rahim. Kanker leher rahim tidak bergejala utk stadium awal makanya deteksi rutin melalui papsmear agar cepet ketahuan.

Ida
Mama 2R

4d.

Re: General Medical Check-Up

Posted by: "Regia Delonie @Gmail" just.regia@gmail.com   reggie_zain

Fri Oct 28, 2011 9:14 pm (PDT)



Mbak, mau nambahin aja.. Papsmear tuh bentar bgt kok, cepet bgt ngelakuinnya, paling cm berapa detik..
Yg penting kitanya gak tegang, rileks aja..


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4e.

Re: General Medical Check-Up

Posted by: "Inta" dini.maesarinta@gmail.com

Fri Oct 28, 2011 9:29 pm (PDT)



Nambahin mba Ida dan Wulan,

Penularan kanker serviks karena hubungan seksual bukan karena melahirkan normal loh mba ;)

Cheers, Inta
@Intamaesarinta
terkirim dari henponkuh

4f.

Re: General Medical Check-Up

Posted by: "Erieka" E_prue@yahoo.com   e_prue

Fri Oct 28, 2011 9:35 pm (PDT)



Pengalaman pribadi saya, periksa dalem sama nunggu hasil papsmear lbh menegangkan nunggu hasilnya :). Untung gak ada yg aneh2, nah kl ada yg aneh2 tp gak terdeteksi dini lebih tegang bin semaput deh -sol panjang- erieka
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5a.

Re: [OOT] senangnya...

Posted by: "purnamawati.spak@cbn.net.id" purnamawati.spak@cbn.net.id

Fri Oct 28, 2011 7:51 pm (PDT)



Dear Wulan

Welcome back
Senangnyaaa

Wati

Patient Safety, first

6a.

Re: FW: [sehat] tonsil dan usus buntu sudah diangkat, apa yang perlu

Posted by: "purnamawati.spak@cbn.net.id" purnamawati.spak@cbn.net.id

Fri Oct 28, 2011 7:55 pm (PDT)



Dear Ariany

Maaf boleh nimbrung ya ... Meski belakangan nimbrungnya.
Saya tertarik statement mu:
"kalo kasus saya mah brarti sumber sistem imunnya sudah di"habisin" semua"

Pertama, kamu benar
Pengangkatan tonsil dan usus buntu tidak berarti sistem imun sudah "habis"

Kedua, untuk pembelajaran ... Ada baiknya dianalisis, mengapa tonsilmu harus diangkat. Apa indikasi pengangkatannya saat itu?
Jaraaaang banget tonsil terindikasi untuk dibuang
Toh usia 10 tahun kempes sendiri

Wati

Patient Safety, first

7.1.

Re: hasil skrining hepatitis - Att Bunda Wati

Posted by: "purnamawati.spak@cbn.net.id" purnamawati.spak@cbn.net.id

Fri Oct 28, 2011 7:56 pm (PDT)



Silakan imunisasi hep B kalau memang belum punya antibodi

Wati

Patient Safety, first

8a.

Re: positif ISK

Posted by: "triana dany" pijar_api@yahoo.co.id

Fri Oct 28, 2011 8:08 pm (PDT)



dear all...

makasi supportnya...
dosis uda di email kan DSAnya (3 x 3,5ml/tergantung BB anak), obat juga sudah dibeli di apotik.

karena subuh tadi Revan diare, jadi pengobatan akan segera dilakukan segera setelah diare Revan sembuh.

makasi perhatiannya..
salam,
Triana

[Non-text portions of this message have been removed]

9a.

Re: tanya bhs medis utk pengapuran

Posted by: "roxiefoxy@yahoo.com" roxiefoxy@yahoo.com   roxiefoxy

Fri Oct 28, 2011 8:15 pm (PDT)



Dear all

Mohon bantuan Sesuai judul.thanks

Sol

Menda

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9b.

Re: tanya bhs medis utk pengapuran

Posted by: "aina" aina.anwar@yahoo.com   aina.anwar

Fri Oct 28, 2011 8:16 pm (PDT)



Osteoporosis - sol

merci beaucoup
wassalamu'alaikum wr wb,

aina f.

9c.

Re: tanya bhs medis utk pengapuran

Posted by: "umialiyah_dzatil@yahoo.co.id" umialiyah_dzatil@yahoo.co.id   umialiyah_dzatil

Fri Oct 28, 2011 8:17 pm (PDT)



Osteoporosis bukan? - cmiiw & sol


Atun

Sent from my BlackBerry� smartphone from Sinyal Bagus XL, Nyambung Teruuusss...!
9d.

Re: tanya bhs medis utk pengapuran

Posted by: "mommyarsa@yahoo.com" mommyarsa@yahoo.com   mommyarsa

Fri Oct 28, 2011 8:23 pm (PDT)



Calsification?

Cmiiw...
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9e.

Re: tanya bhs medis utk pengapuran

Posted by: "roxiefoxy@yahoo.com" roxiefoxy@yahoo.com   roxiefoxy

Fri Oct 28, 2011 8:25 pm (PDT)



Thanks sp's ,

Lg browsing2 juga dapet osteoarthritis,
Cmiiw?


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9f.

Re: tanya bhs medis utk pengapuran

Posted by: "Oke Mieske" okemieske@gmail.com   yoenx

Fri Oct 28, 2011 8:40 pm (PDT)



Cmiiw...

Osteoporosis, urusannya sama tulang
Osteoarthritis, urusannya sama sendi (antar tulang)

Nah, pengapuran yg dimaksud pengapuran yg mana? Yg ditulang? Atau yg di sendi?

Maap ga potek, biar nyambung...

Salam,
Okemieske
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-----Original Message-----
From: roxiefoxy@yahoo.com
Sender: sehat@yahoogroups.com
Date: Sat, 29 Oct 2011 03:25:21
To: <sehat@yahoogroups.com>
Reply-To: sehat@yahoogroups.com
Subject: Re: [sehat] tanya bhs medis utk pengapuran

Thanks sp's ,

Lg browsing2 juga dapet osteoarthritis,
Cmiiw?


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------------------------------------

Milis SEHAT mengucapkan terimakasih kepada:
- Asuransi AIA atas partisipasinya sebagai sponsor PESAT Bali 2011
- PT LG Electronics Indonesia atas partisipasinya sebagai Sponsor Tunggal FAMILY FUN DAY MILIS SEHAT 2011.

Terima kasih & penghargaan sedalam-dalamnya kepada : HBTLaw, PT.Intiland, dan PT. Permata Bank Tbk. yang telah dan konsisten mensponsori program kami, PESAT (Program Edukasi Kesehatan Anak Untuk Orang Tua)."

"Milis SEHAT didukung oleh : CBN Net Internet Access &Website.
=================================================================
Milis Sehat thanks to:
- AIA Insurance as sponsor for PESAT Bali 2011
- PT LG Electronics Indonesia as exclusive partner of FAMILY FUN DAY MILIS SEHAT 2011.

Our biggest gratitude to: HBTLaw, PT. Intiland, and PT. Permata Bank Tbk. who have consistently sponsored our program, PESAT (Program Edukasi Kesehatan Anak Untuk Orang Tua)."
"SEHAT mailing list is supported by CBN Net for Internet Access &Website.

Kunjungi kami di (Visit us at):
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FB : http://www.facebook.com/pages/Milissehat/131922690207238
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==================================================================
Donasi (donation):
Rekening Yayasan Orang Tua Peduli
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Cabang Kemang Raya Jakarta
Account Number: 126.000.4634514
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10a.

Re: (OOT) RS/Dokter di Bali

Posted by: "purnamawati.spak@cbn.net.id" purnamawati.spak@cbn.net.id

Fri Oct 28, 2011 8:25 pm (PDT)



Dear Rizaini

Terimakasih atas kepedulianmu. Ada beberapa isu penting yang "menarik" untuk jadi bahan pembelajaran

1. "blm vaksin MMR (2,5 th) krn dl kt dokternya ga perlu krn udh campak"
---- jelas keliru ya (maaf, tanpa mengurangi rasa hormat)
Mengapa keliru?
Karena:
pertama, 6 bulan pasca imunisasi campak, kadar antibodi campak sudah menurun jadi harus "booster" dalam bentuk imunisasi MMR.
Kedua, MMR memberikan proteksi thdp 3 penyakit
Kasian banget kalau anak gak diimunisasi MMR

2. "Mau dipaketin sm HiB jd 900rb".
---- simultan maksudnya?
Pertama, memang HiB sudah berapa kali?
Memangnya usia 18 bulan gak booster DPT - HiB?
Kalau sudah, gak usah HiB lagi
Kedua, harga MMR sekitar seratus ribu; harga ActHiB atau Hiberix paling 200 ribuan (ya mungkin lebih karena saya tdk tau harga)
Yang jelas, simultan keduanya gak sampai 400 ribu
Lalu biaya dokter kan kurang lebih 150 ribu (incl adm)

Jadi?
Bagaimana kalau cari bidan
Minta disediakan kedua vaksin ini (kalau memang butuh HiB)

Salam hormat buat temanmu

Wati
Patient Safety, first
11.

[news] A Parent�s Guide to Autism Spectrum Disorder

Posted by: "/ghozansehat" ghozansehat@yahoo.com.sg   ghozansehat

Fri Oct 28, 2011 10:19 pm (PDT)



fyi
gratis ngunduh versi pdf.
kalau ada yang berkenan menterjemahkan kedalam bahasa indonesia tentu
akan lebih banyak lagi yg manfaatnya

semoga bermanfaat

salamku
bapakeghozan

A Parent�s Guide to Autism Spectrum Disorder

This guide is intended to help parents understand what autism spectrum
disorder (ASD) is, recognize common signs and symptoms, and find the
resources they need. It�s important to remember that help is available.

* View the publication by section
<http://www.nimh.nih.gov/health/publications/a-parents-guide-to-autism-spectrum-disorder/index.shtml>

* Order a hardcopy
<http://infocenter.nimh.nih.gov/subject.cfm?category=3>
* Download for: PDF
<http://www.nimh.nih.gov/health/publications/a-parents-guide-to-autism-spectrum-disorder/parent-guide-to-autism.pdf>

----------------------------------------------------------

What is autism spectrum disorder (ASD)?

Autism is a group of developmental brain disorders, collectively called
autism spectrum disorder (ASD). The term "spectrum" refers to the wide
range of symptoms, skills, and levels of impairment, or disability, that
children with ASD can have. Some children are mildly impaired by their
symptoms, but others are severely disabled.

ASD is diagnosed according to guidelines listed in the /Diagnostic and
Statistical Manual of Mental Disorders, Fourth Edition - Text Revision/
(DSM-IV-TR).^1 The manual currently defines five disorders, sometimes
called pervasive developmental disorders (PDDs), as ASD:

* Autistic disorder (classic autism)
* Asperger's disorder (Asperger syndrome)
* Pervasive developmental disorder not otherwise specified (PDD-NOS)
* Rett's disorder (Rett syndrome)
* Childhood disintegrative disorder (CDD).

This information packet will focus on autism, Asperger syndrome, and
PDD-NOS, with brief descriptions of Rett syndrome and CDD in the
section, "Related disorders." Information can also be found on the
/Eunice Kennedy Shriver/ National Institute of Child Health and Human
Development website <http://www.nichd.nih.gov> and the Centers for
Disease Control and Prevention website
<http://www.cdc.gov/ncbddd/autism/index.html>.

What are the symptoms of ASD?

Symptoms of autism spectrum disorder (ASD) vary from one child to the
next, but in general, they fall into three areas:

* Social impairment
* Communication difficulties
* Repetitive and stereotyped behaviors.

Children with ASD do not follow typical patterns when developing social
and communication skills. Parents are usually the first to notice
unusual behaviors in their child. Often, certain behaviors become more
noticeable when comparing children of the same age.

In some cases, babies with ASD may seem different very early in their
development. Even before their first birthday, some babies become overly
focused on certain objects, rarely make eye contact, and fail to engage
in typical back-and-forth play and babbling with their parents. Other
children may develop normally until the second or even third year of
life, but then start to lose interest in others and become silent,
withdrawn, or indifferent to social signals. Loss or reversal of normal
development is called regression and occurs in some children with ASD.^2

Social impairment

Most children with ASD have trouble engaging in everyday social
interactions. According to the /Diagnostic and Statistical Manual of
Mental Disorders, Fourth Edition - Text Revision/, some children with
ASD may:

* Make little eye contact
* Tend to look and listen less to people in their environment or
fail to respond to other people
* Do not readily seek to share their enjoyment of toys or activities
by pointing or showing things to others
* Respond unusually when others show anger, distress, or affection.

Recent research suggests that children with ASD do not respond to
emotional cues in human social interactions because they may not pay
attention to the social cues that others typically notice. For example,
one study
<http://www.nimh.nih.gov/science-news/2008/lack-of-eye-contact-may-predict-level-of-social-disability-in-two-year-olds-with-autism.shtml>
found that children with ASD focus on the mouth of the person speaking
to them instead of on the eyes, which is where children with typical
development tend to focus.^3 A related study
<http://www.nimh.nih.gov/science-news/2009/autism-skews-developing-brain-with-synchronous-motion-and-sound.shtml>
showed that children with ASD appear to be drawn to repetitive movements
linked to a sound, such as hand-clapping during a game of pat-a-cake.^4
More research is needed to confirm these findings, but such studies
suggest that children with ASD may misread or not notice subtle social
cues�a smile, a wink, or a grimace�that could help them understand
social relationships and interactions. For these children, a question
such as, "Can you wait a minute?" always means the same thing, whether
the speaker is joking, asking a real question, or issuing a firm
request. Without the ability to interpret another person's tone of voice
as well as gestures, facial expressions, and other nonverbal
communications, children with ASD may not properly respond.

Likewise, it can be hard for others to understand the body language of
children with ASD. Their facial expressions, movements, and gestures are
often vague or do not match what they are saying. Their tone of voice
may not reflect their actual feelings either. Many older children with
ASD speak with an unusual tone of voice and may sound sing-song or flat
and robotlike.^1

Children with ASD also may have trouble understanding another person's
point of view. For example, by school age, most children understand that
other people have different information, feelings, and goals than they
have. Children with ASD may lack this understanding, leaving them unable
to predict or understand other people's actions.

Communication issues

According to the American Academy of Pediatrics' developmental
milestones, by the first birthday, typical toddlers can say one or two
words, turn when they hear their name, and point when they want a toy.
When offered something they do not want, toddlers make it clear with
words, gestures, or facial expressions that the answer is "no."

For children with ASD, reaching such milestones may not be so
straightforward. For example, some children with autism may:

* Fail or be slow to respond to their name or other verbal attempts
to gain their attention
* Fail or be slow to develop gestures, such as pointing and showing
things to others
* Coo and babble in the first year of life, but then stop doing so
* Develop language at a delayed pace
* Learn to communicate using pictures or their own sign language
* Speak only in single words or repeat certain phrases over and
over, seeming unable to combine words into meaningful sentences
* Repeat words or phrases that they hear, a condition called echolalia
* Use words that seem odd, out of place, or have a special meaning
known only to those familiar with the child's way of communicating.

Even children with ASD who have relatively good language skills often
have difficulties with the back and forth of conversations. For example,
because they find it difficult to understand and react to social cues,
children with Asperger syndrome often talk at length about a favorite
subject, but they won't allow anyone else a chance to respond or notice
when others react indifferently.^1

Children with ASD who have not yet developed meaningful gestures or
language may simply scream or grab or otherwise act out until they are
taught better ways to express their needs. As these children grow up,
they can become aware of their difficulty in understanding others and in
being understood. This awareness may cause them to become anxious or
depressed. For more information on mental health issues in children with
ASD, see the section: What are some other conditions that children with
ASD may have?

Repetitive and stereotyped behaviors

Children with ASD often have repetitive motions or unusual behaviors.
These behaviors may be extreme and very noticeable, or they can be mild
and discreet. For example, some children may repeatedly flap their arms
or walk in specific patterns, while others may subtly move their fingers
by their eyes in what looks to be a gesture. These repetitive actions
are sometimes called "stereotypy" or "stereotyped behaviors."

Children with ASD also tend to have overly focused interests. Children
with ASD may become fascinated with moving objects or parts of objects,
like the wheels on a moving car. They might spend a long time lining up
toys in a certain way, rather than playing with them. They may also
become very upset if someone accidentally moves one of the toys.
Repetitive behavior can also take the form of a persistent, intense
preoccupation.^1 For example, they might be obsessed with learning all
about vacuum cleaners, train schedules, or lighthouses. Children with
ASD often have great interest in numbers, symbols, or science topics.

While children with ASD often do best with routine in their daily
activities and surroundings, inflexibility may often be extreme and
cause serious difficulties. They may insist on eating the same exact
meals every day or taking the same exact route to school. A slight
change in a specific routine can be extremely upsetting.^1 Some children
may even have emotional outbursts, especially when feeling angry or
frustrated or when placed in a new or stimulating environment.

No two children express exactly the same types and severity of symptoms.
In fact, many typically developing children occasionally display some of
the behaviors common to children with ASD. However, if you notice your
child has several ASD-related symptoms, have your child screened and
evaluated by a health professional experienced with ASD.

Related Disorders

Rett syndrome and childhood disintegrative disorder (CDD) are two very
rare forms of ASD that include a regression in development. Only 1 of
every 10,000 to 22,000 girls has Rett syndrome.^5,6 Even rarer, only 1
or 2 out of 100,000 children with ASD have CDD.^7

Unlike other forms of ASD, Rett syndrome mostly affects girls. In
general, children with Rett syndrome develop normally for 6�18 months
before regression and autism-like symptoms begin to appear. Children
with Rett syndrome may also have difficulties with coordination,
movement, and speech. Physical, occupational, and speech therapy can
help, but no specific treatment for Rett syndrome is available yet.

With funding from the /Eunice Kennedy Shriver/ National Institute of
Child Health and Human Development, scientists have discovered that a
mutation in the sequence of a single gene is linked to most cases of
Rett syndrome.^8 This discovery may help scientists find ways to slow or
stop the progress of the disorder. It may also improve doctors' ability
to diagnose and treat children with Rett syndrome earlier, improving
their overall quality of life.

CDD affects very few children, which makes it hard for researchers to
learn about the disease. Symptoms of CDD may appear by age 2, but the
average age of onset is between age 3 and 4. Until this time, children
with CDD usually have age-appropriate communication and social skills.
The long period of normal development before regression helps to set CDD
apart from Rett syndrome. CDD may affect boys more often than girls.^9

Children with CDD experience severe, wide-ranging and obvious loss of
previously-obtained motor, language, and social skills.^10 The loss of
such skills as vocabulary is more dramatic in CDD than in classic
autism.^11 Other symptoms of CDD include loss of bowel and bladder
control.^1

How is ASD diagnosed?

ASD diagnosis is often a two-stage process. The first stage involves
general developmental screening during well-child checkups with a
pediatrician or an early childhood health care provider. Children who
show some developmental problems are referred for additional evaluation.
The second stage involves a thorough evaluation by a team of doctors and
other health professionals with a wide range of specialities.^12 At this
stage, a child may be diagnosed as having autism or another
developmental disorder.

Children with autism spectrum disorder (ASD) can usually be reliably
diagnosed by age 2, though research suggests that some screening tests
can be helpful at 18 months or even younger.^12,13

Many people�including pediatricians, family doctors, teachers, and
parents�may minimize signs of ASD at first, believing that children will
"catch up" with their peers. While you may be concerned about labeling
your young child with ASD, the earlier the disorder is diagnosed, the
sooner specific interventions may begin. Early intervention can reduce
or prevent the more severe disabilities associated with ASD. Early
intervention may also improve your child's IQ, language, and everyday
functional skills, also called adaptive behavior.^14

Screening

A well-child checkup should include a developmental screening test, with
specific ASD screening at 18 and 24 months as recommended by the
American Academy of Pediatrics.^14 Screening for ASD is not the same as
diagnosing ASD. Screening instruments are used as a first step to tell
the doctor whether a child needs more testing. If your child's
pediatrician does not routinely screen your child for ASD, ask that it
be done.

For parents, your own experiences and concerns about your child's
development will be very important in the screening process. Keep your
own notes about your child's development and look through family videos,
photos, and baby albums to help you remember when you first noticed each
behavior and when your child reached certain developmental milestones.

Types of ASD screening instruments

Sometimes the doctor will ask parents questions about the child's
symptoms to screen for ASD. Other screening instruments combine
information from parents with the doctor's own observations of the
child. Examples of screening instruments for toddlers and preschoolers
include:

* Checklist of Autism in Toddlers (CHAT)
* Modified Checklist for Autism in Toddlers (M-CHAT)
* Screening Tool for Autism in Two-Year-Olds (STAT)
* Social Communication Questionnaire (SCQ)
* Communication and Symbolic Behavior Scales (CSBS).

To screen for mild ASD or Asperger syndrome in older children, the
doctor may rely on different screening instruments, such as:

* Autism Spectrum Screening Questionnaire (ASSQ)
* Australian Scale for Asperger's Syndrome (ASAS)
* Childhood Asperger Syndrome Test (CAST).

Some helpful resources on ASD screening include the Center for Disease
Control and Prevention's General Developmental Screening tools and ASD
Specific Screening tools on their website
<http://cdc.gov/ncbddd/autism/screening.html>.

Comprehensive diagnostic evaluation

The second stage of diagnosis must be thorough in order to find whether
other conditions may be causing your child's symptoms. For more
information, see the section: What are some other conditions that
children with ASD may have?

A team that includes a psychologist, a neurologist, a psychiatrist, a
speech therapist, or other professionals experienced in diagnosing ASD
may do this evaluation. The evaluation may assess the child's cognitive
level (thinking skills), language level, and adaptive behavior
(age-appropriate skills needed to complete daily activities
independently, for example eating, dressing, and toileting).

Because ASD is a complex disorder that sometimes occurs along with other
illnesses or learning disorders, the comprehensive evaluation may
include brain imaging and gene tests, along with in-depth memory,
problem-solving, and language testing.^12 Children with any delayed
development should also get a hearing test and be screened for lead
poisoning as part of the comprehensive evaluation.

Although children can lose their hearing along with developing ASD,
common ASD symptoms (such as not turning to face a person calling their
name) can also make it seem that children cannot hear when in fact they
can. If a child is not responding to speech, especially to his or her
name, it's important for the doctor to test whether a child has hearing
loss.

The evaluation process is a good time for parents and caregivers to ask
questions and get advice from the whole evaluation team. The outcome of
the evaluation will help plan for treatment and interventions to help
your child. Be sure to ask who you can contact with follow-up questions.

What are some other conditions that children with ASD may have?

Sensory problems

Many children with autism spectrum disorder (ASD) either overreact or
underreact to certain sights, sounds, smells, textures, and tastes. For
example, some may:

* Dislike or show discomfort from a light touch or the feel of
clothes on their skin
* Experience pain from certain sounds, like a vacuum cleaner, a
ringing telephone, or a sudden storm; sometimes they will cover
their ears and scream
* Have no reaction to intense cold or pain.

Researchers are trying to determine if these unusual reactions are
related to differences in integrating multiple types of information from
the senses.

Sleep problems

Children with ASD tend to have problems falling asleep or staying
asleep, or have other sleep problems.^15 These problems make it harder
for them to pay attention, reduce their ability to function, and lead to
poor behavior. In addition, parents of children with ASD and sleep
problems tend to report greater family stress and poorer overall health
among themselves.

Fortunately, sleep problems can often be treated with changes in
behavior, such as following a sleep schedule or creating a bedtime
routine. Some children may sleep better using medications such as
melatonin, which is a hormone that helps regulate the body's sleep-wake
cycle. Like any medication, melatonin can have unwanted side effects.
Talk to your child's doctor about possible risks and benefits before
giving your child melatonin. Treating sleep problems in children with
ASD may improve the child's overall behavior and functioning, as well as
relieve family stress.^16

Intellectual disability

Many children with ASD have some degree of intellectual disability. When
tested, some areas of ability may be normal, while others�especially
cognitive (thinking) and language abilities�may be relatively weak. For
example, a child with ASD may do well on tasks related to sight (such as
putting a puzzle together) but may not do as well on language-based
problem-solving tasks. Children with a form of ASD like Asperger
syndrome often have average or above-average language skills and do not
show delays in cognitive ability or speech.

Seizures

One in four children with ASD has seizures, often starting either in
early childhood or during the teen years.^17 Seizures, caused by
abnormal electrical activity in the brain, can result in

* A short-term loss of consciousness, or a blackout
* Convulsions, which are uncontrollable shaking of the whole body,
or unusual movements
* Staring spells.

Sometimes lack of sleep or a high fever can trigger a seizure. An
electroencephalogram (EEG), a nonsurgical test that records electrical
activity in the brain, can help confirm whether a child is having
seizures. However, some children with ASD have abnormal EEGs even if
they are not having seizures.

Seizures can be treated with medicines called anticonvulsants. Some
seizure medicines affect behavior; changes in behavior should be closely
watched in children with ASD. In most cases, a doctor will use the
lowest dose of medicine that works for the child. Anticonvulsants
usually reduce the number of seizures but may not prevent all of them.

For more information about medications, see the NIMH online booklet
<http://www.nimh.nih.gov/health/publications/mental-health-medications/index.shtml>,
"Medications". None of these medications have been approved by the FDA
to specifically treat symptoms of ASD.

Fragile X syndrome

Fragile X syndrome is a genetic disorder and is the most common form of
inherited intellectual disability,^18 causing symptoms similar to ASD.
The name refers to one part of the X chromosome that has a defective
piece that appears pinched and fragile when viewed with a microscope.
Fragile X syndrome results from a change, called a mutation, on a single
gene. This mutation, in effect, turns off the gene. Some people may have
only a small mutation and not show any symptoms, while others have a
larger mutation and more severe symptoms.^19

Around 1 in 3 children who have Fragile X syndrome also meet the
diagnostic criteria for ASD, and about 1 in 25 children diagnosed with
ASD have the mutation that causes Fragile X syndrome.^19

Because this disorder is inherited, children with ASD should be checked
for Fragile X, especially if the parents want to have more children.
Other family members who are planning to have children may also want to
be checked for Fragile X syndrome. For more information on Fragile X,
see the /Eunice Kennedy Shriver/ National Institute of Child Health and
Human Development website
<http://www.nichd.nih.gov/health/topics/fragile_x_syndrome.cfm>.

Tuberous sclerosis

Tuberous sclerosis is a rare genetic disorder that causes noncancerous
tumors to grow in the brain and other vital organs. Tuberous sclerosis
occurs in 1 to 4 percent of people with ASD.^18,20 A genetic mutation
causes the disorder, which has also been linked to mental retardation,
epilepsy, and many other physical and mental health problems. There is
no cure for tuberous sclerosis, but many symptoms can be treated.

Gastrointestinal problems

Some parents of children with ASD report that their child has frequent
gastrointestinal (GI) or digestion problems, including stomach pain,
diarrhea, constipation, acid reflux, vomiting, or bloating. Food
allergies may also cause problems for children with ASD.^21 It's unclear
whether children with ASD are more likely to have GI problems than
typically developing children.^22,23 If your child has GI problems, a
doctor who specializes in GI problems, called a gastroenterologist, can
help find the cause and suggest appropriate treatment.

Some studies have reported that children with ASD seem to have more GI
symptoms, but these findings may not apply to all children with ASD. For
example, a recent study found that children with ASD in Minnesota were
more likely to have physical and behavioral difficulties related to diet
(for example, lactose intolerance or insisting on certain foods), as
well as constipation, than children without ASD.^23 The researchers
suggested that children with ASD may not have underlying GI problems,
but that their behavior may create GI symptoms�for example, a child who
insists on eating only certain foods may not get enough fiber or fluids
in his or her diet, which leads to constipation.

Some parents may try to put their child on a special diet to control ASD
or GI symptoms. While some children may benefit from limiting certain
foods, there is no strong evidence that these special diets reduce ASD
symptoms.^24 If you want to try a special diet, first talk with a doctor
or a nutrition expert to make sure your child's nutritional needs are
being met.

Co-occurring mental disorders

Children with ASD can also develop mental disorders such as anxiety
disorders, attention deficit hyperactivity disorder (ADHD), or
depression. Research shows that people with ASD are at higher risk for
some mental disorders than people without ASD.^25 Managing these
co-occurring conditions with medications or behavioral therapy, which
teaches children how to control their behavior, can reduce symptoms that
appear to worsen a child's ASD symptoms. Controlling these conditions
will allow children with ASD to focus more on managing the ASD.^26

How is ASD treated?

While there's no proven cure yet for autism spectrum disorder (ASD),
treating ASD early, using school-based programs, and getting proper
medical care can greatly reduce ASD symptoms and increase your child's
ability to grow and learn new skills.

Early intervention

Research has shown that intensive behavioral therapy during the toddler
or preschool years can significantly improve cognitive and language
skills in young children with ASD.^27,28 There is no single best
treatment for all children with ASD, but the American Academy of
Pediatrics recently noted common features of effective early
intervention programs.^29 These include:

* Starting as soon as a child has been diagnosed with ASD
* Providing focused and challenging learning activities at the
proper developmental level for the child for at least 25 hours per
week and 12 months per year
* Having small classes to allow each child to have one-on-one time
with the therapist or teacher and small group learning activities
* Having special training for parents and family
* Encouraging activities that include typically developing children,
as long as such activities help meet a specific learning goal
* Measuring and recording each child's progress and adjusting the
intervention program as needed
* Providing a high degree of structure, routine, and visual cues,
such as posted activity schedules and clearly defined boundaries,
to reduce distractions
* Guiding the child in adapting learned skills to new situations and
settings and maintaining learned skills
* Using a curriculum that focuses on
o Language and communication
o Social skills, such as joint attention (looking at other
people to draw attention to something interesting and share
in experiencing it)
o Self-help and daily living skills, such as dressing and grooming
o Research-based methods to reduce challenging behaviors, such
as aggression and tantrums
o Cognitive skills, such as pretend play or seeing someone
else's point of view
o Typical school-readiness skills, such as letter recognition
and counting.

One type of a widely accepted treatment is applied behavior analysis
(ABA). The goals of ABA are to shape and reinforce new behaviors, such
as learning to speak and play, and reduce undesirable ones. ABA, which
can involve intensive, one-on-one child-teacher interaction for up to 40
hours a week, has inspired the development of other, similar
interventions that aim to help those with ASD reach their full
potential.^30,31 ABA-based interventions include:

* *Verbal Behavior�*focuses on teaching language using a sequenced
curriculum that guides children from simple verbal behaviors
(echoing) to more functional communication skills through
techniques such as errorless teaching and prompting^32
* *Pivotal Response Training�*aims at identifying pivotal skills,
such as initiation and self-management, that affect a broad range
of behavioral responses. This intervention incorporates parent and
family education aimed at providing skills that enable the child
to function in inclusive settings.^33,34

Other types of early interventions include:

* *Developmental, Individual Difference,
Relationship-based(DIR)/Floortime Model�*aims to build healthy and
meaningful relationships and abilities by following the natural
emotions and interests of the child.^35 One particular example is
the Early Start Denver Model, which fosters improvements in
communication, thinking, language, and other social skills and
seeks to reduce atypical behaviors. Using developmental and
relationship-based approaches, this therapy can be delivered in
natural settings such as the home or pre-school.^33,34
* *TEACCH (Treatment and Education of Autistic and related
Communication handicapped Children)�*emphasizes adapting the
child's physical environment and using visual cues (for example,
having classroom materials clearly marked and located so that
students can access them independently). Using individualized
plans for each student, TEACCH builds on the child's strengths and
emerging skills.^34,36
* *Interpersonal Synchrony�*targets social development and imitation
skills, and focuses on teaching children how to establish and
maintain engagement with others.

For children younger than age 3, these interventions usually take place
at home or in a child care center. Because parents are a child's
earliest teachers, more programs are beginning to train parents to
continue the therapy at home.

Students with ASD may benefit from some type of social skills training
program.^37 While these programs need more research, they generally seek
to increase and improve skills necessary for creating positive social
interactions and avoiding negative responses. For example, Children's
Friendship Training focuses on improving children's conversation and
interaction skills and teaches them how to make friends, be a good
sport, and respond appropriately to teasing.^38

Working with your child's school

Start by speaking with your child's teacher, school counselor, or the
school's student support team to begin an evaluation. Each state has a
Parent Training and Information Center and a Protection and Advocacy
Agency that can help you get an evaluation. A team of professionals
conducts the evaluation using a variety of tools and measures. The
evaluation will look at all areas related to your child's abilities and
needs.

Once your child has been evaluated, he or she has several options,
depending on the specific needs. If your child needs special education
services and is eligible under the Individuals with Disabilities
Education Act (IDEA), the school district (or the government agency
administering the program) must develop an individualized education
plan, or IEP specifically for your child within 30 days.

IDEA provides free screenings and early intervention services to
children from birth to age 3. IDEA also provides special education and
related services from ages 3 to 21. Information is available from the
U.S. Department of Education <http://idea.ed.gov>.

If your child is not eligible for special education services�not all
children with ASD are eligible�he or she can still get free public
education suited to his or her needs, which is available to all
public-school children with disabilities under Section 504 of the
Rehabilitation Act of 1973, regardless of the type or severity of the
disability.

The U.S. Department of Education's Office for Civil Rights enforces
Section 504 in programs and activities that receive Federal education
funds. More information on Section 504 is available on the Department of
Education website <http://www.ed.gov/about/offices/list/ocr/504faq.html>.

More information about U.S. Department of Education programs for
children with disabilities is available on their website
<http://www.ed.gov/parents/needs/speced/edpicks.jhtml?src=ln>.

During middle and high school years, your child's teachers will begin to
discuss practical issues such as work, living away from a parent or
caregiver's home, and hobbies. These lessons should include gaining work
experience, using public transportation, and learning skills that will
be important in community living.^29

Medications

Some medications can help reduce symptoms that cause problems for your
child in school or at home. Many other medications may be prescribed
off-label, meaning they have not been approved by the U.S. Food and Drug
Administration (FDA) for a certain use or for certain people. Doctors
may prescribe medications off-label if they have been approved to treat
other disorders that have similar symptoms to ASD, or if they have been
effective in treating adults or older children with ASD. Doctors
prescribe medications off-label to try to help the youngest patients,
but more research is needed to be sure that these medicines are safe and
effective for children and teens with ASD.

At this time, the only medications approved by the FDA to treat aspects
of ASD are the antipsychotics risperidone (Risperdal) and aripripazole
(Abilify). These medications can help reduce irritability�meaning
aggression, self-harming acts, or temper tantrums�in children ages 5 to
16 who have ASD.

Some medications that may be prescribed off-label for children with ASD
include the following:

* *Antipsychotic medications* are more commonly used to treat
serious mental illnesses such as schizophrenia. These medicines
may help reduce aggression and other serious behavioral problems
in children, including children with ASD. They may also help
reduce repetitive behaviors, hyperactivity, and attention
problems.^29
* *Antidepressant medications*, such as fluoxetine (Prozac) or
sertraline (Zoloft), are usually prescribed to treat depression
and anxiety but are sometimes prescribed to reduce repetitive
behaviors. Some antidepressants may also help control aggression
and anxiety in children with ASD.^29 However, researchers still
are not sure if these medications are useful; a recent study
<http://www.nimh.nih.gov/science-news/2009/citalopram-no-better-than-placebo-treatment-for-children-with-autism-spectrum-disorders.shtml>
suggested that the antidepressant citalopram (Celexa) was no more
effective than a placebo (sugar pill) at reducing repetitive
behaviors in children with ASD.^39
* *Stimulant medications*, such as methylphenidate (Ritalin), are
safe and effective in treating people with attention deficit
hyperactivity disorder (ADHD). Methylphenidate has been shown to
effectively treat hyperactivity in children with ASD as well. But
not as many children with ASD respond to treatment, and those who
do have shown more side effects than children with ADHD and not
ASD.^40

All medications carry a risk of side effects. For details on the side
effects of common psychiatric medications, see the NIMH website
<http://www.nimh.nih.gov/health/publications/mental-health-medications/index.shtml>
on "Medications".

FDA warning about antidepressants

Antidepressants are safe and popular, but some studies have suggested
that they may have unintended effects on some people, especially in
teens and young adults. The FDA warning says that patients of all ages
taking antidepressants should be watched closely, especially during the
first few weeks of treatment. Possible side effects to look for are
depression that gets worse, suicidal thinking or behavior, or any
unusual changes in behavior such as trouble sleeping, agitation, or
withdrawal from normal social situations. Families and caregivers should
report any changes to the doctor. The latest information is available on
the FDA website <http://www.fda.gov>.

A child with ASD may not respond in the same way to medications as
typically developing children. You should work with a doctor who has
experience treating children with ASD. The doctor will usually start
your child on the lowest dose that helps control problem symptoms. Ask
the doctor about any side effects of the medication and keep a record of
how your child reacts to the medication. The doctor should regularly
check your child's response to the treatment.

You have many options for treating your child's ASD. However, not all of
them have been proven to work through scientific studies. Read the
patient information that comes with your child's medication. Some people
keep these patient inserts along with their other notes for easy
reference. This is most useful when dealing with several different
prescription medications. You should get all the facts about possible
risks and benefits and talk to more than one expert when possible before
trying a new treatment on your child.

How common is ASD?

Studies measuring autism spectrum disorder (ASD) prevalence�the number
of children affected by ASD over a given time period�have reported
varying results, depending on when and where the studies were conducted
and how the studies defined ASD.

In a 2009 government survey on ASD prevalence, the Centers for Disease
Control and Prevention (CDC) found that the rate of ASD was higher than
in past U.S. studies. Based on health and school records of 8-year-olds
in 14 communities throughout the country, the CDC survey found that
around 1 in 110 children has ASD.^41 Boys face about four to five times
higher risk than girls.

Experts disagree about whether this shows a true increase in ASD
prevalence. Since the earlier studies were completed, guidelines for
diagnosis have changed. Also, many more parents and doctors now know
about ASD, so parents are more likely to take their children to be
diagnosed, and more doctors are able to properly diagnose ASD. These and
other changes may help explain some differences in prevalence numbers.
Even so, the CDC report confirms other recent studies showing that more
children are being diagnosed with ASD than ever before. For more
information, please visit the autism section of the CDC website
<http://www.cdc.gov/ncbddd/autism>.

What causes ASD?

Scientists don't know the exact causes of autism spectrum disorder
(ASD), but research suggests that both genes and environment play
important roles.

Genetic factors

In identical twins who share the exact same genetic code, if one has
ASD, the other twin also has ASD in nearly 9 out of 10 cases. If one
sibling has ASD, the other siblings have 35 times the normal risk of
also developing the disorder. Researchers are starting to identify
particular genes that may increase the risk for ASD.^42,43

Still, scientists have only had some success in finding exactly which
genes are involved. For more information about such cases, see the
section, "What are some other conditions that children with ASD may also
have?" which describes Fragile X syndrome and tuberous sclerosis.

Most people who develop ASD have no reported family history of autism,
suggesting that random, rare, and possibly many gene mutations are
likely to affect a person's risk.^44,45 Any change to normal genetic
information is called a mutation. Mutations can be inherited, but some
arise for no reason. Mutations can be helpful, harmful, or have no effect.

Having increased genetic risk does not mean a child will definitely
develop ASD. Many researchers are focusing on how various genes interact
with each other and environmental factors to better understand how they
increase the risk of this disorder.

Environmental factors

In medicine, "environment" refers to anything outside of the body that
can affect health. This includes the air we breathe, the water we drink
and bathe in, the food we eat, the medicines we take, and many other
things that our bodies may come in contact with. Environment also
includes our surroundings in the womb, when our mother's health directly
affects our growth and earliest development.

Researchers are studying many environmental factors such as family
medical conditions, parental age and other demographic factors, exposure
to toxins, and complications during birth or pregnancy.^29,46�48

As with genes, it's likely that more than one environmental factor is
involved in increasing risk for ASD. And, like genes, any one of these
risk factors raises the risk by only a small amount. Most people who
have been exposed to environmental risk factors do not develop ASD. The
National Institute of Environmental Health Sciences is also conducting
research in this area. More information is available on their website
<http://www.niehs.nih.gov/health/topics/conditions/autism/index.cfm>.

Scientists are studying how certain environmental factors may affect
certain genes�turning them on or off, or increasing or decreasing their
normal activity. This process is called epigenetics and is providing
researchers with many new ways to study how disorders like ASD develop
and possibly change over time.

ASD and vaccines

Health experts recommend that children receive a number of vaccines
early in life to protect against dangerous, infectious diseases, such as
measles. Since pediatricians in the United States started giving these
vaccines during regular checkups, the number of children getting sick,
becoming disabled, or dying from these diseases has dropped to almost zero.

Children in the United States receive several vaccines during their
first 2 years of life, around the same age that ASD symptoms often
appear or become noticeable. A minority of parents suspect that vaccines
are somehow related to their child's disorder. Some may be concerned
about these vaccines due to the unproven theory that ASD may be caused
by thimerosal. Thimerosal is a mercury-based chemical once added to
some, but not all, vaccines to help extend their shelf life. However,
except for some flu vaccines, no vaccine routinely given to preschool
aged children in the United States has contained thimerosal since 2001.
Despite this change, the rate of children diagnosed with ASD has
continued to rise.

Other parents believe their child's illness might be linked to vaccines
designed to protect against more than one disease, such as the
measles-mumps-rubella (MMR) vaccine, which never contained thimerosal.

Many studies have been conducted to try to determine if vaccines are a
possible cause of autism. As of 2010, none of the studies has linked
autism and vaccines.^49,50

Following extensive hearings, a special court of Federal judges ruled
against several test cases that tried to prove that vaccines containing
thimerosal, either by themselves or combined with the MMR vaccine,
caused autism. More information about these hearings is available on the
U.S. Court of Federal Claims' website
<http://www.uscfc.uscourts.gov/omnibus-autism-proceeding>.

The latest information about research on autism and vaccines is
available from the Centers for Disease Control and Prevention
<http://cdc.gov/ncbddd/autism/topics.html>. This website provides
information from the Federal Government and independent organizations.

What efforts are under way to improve the detection and treatment of
ASD?

Many recent research studies have focused on finding the earliest signs
of autism spectrum disorder (ASD). These studies aim to help doctors
diagnose children at a younger age so they can get needed interventions
as quickly as possible.

For example, one early sign of ASD may be increased head size or rapid
head growth. Brain imaging studies have shown that abnormal brain
development beginning in an infant's first months may have a role in
ASD. This theory suggests that genetic defects in growth factors, which
direct proper brain development, cause the brain abnormalities seen in
autism. It's possible that an infant's sudden, rapid head growth may be
an early warning signal, which could help in early diagnosis and
treatment or possible prevention of ASD.^51

Current studies on ASD treatment are exploring many approaches, such as:

* A computer-based training program designed to teach children with
ASD how to create and respond to facial expressions appropriately^52
* A medication that may help improve functioning in children with
Fragile X syndrome^53
* New social interventions that can be used in the classroom or
other "everyday" settings
* An intervention parents can follow to reduce and prevent
ASD-related disability in children at high risk for the disorder.^54

More information about clinical trials on ASD funded by the National
Institute of Mental Health is available on the website
<http://www.nimh.nih.gov/health/trials/autism-spectrum-disorders-pervasive-developmental-disorders.shtml>.

You can read about future research plans on the Interagency Autism
Coordinating Committee's (IACC's) website <http://iacc.hhs.gov>. The
IACC is made up of representatives of Federal agencies and members of
the public and coordinates efforts within the U.S. Department of Health
and Human Services concerning ASD.

How can I help a child who has ASD?

After your child is diagnosed with autism spectrum disorder (ASD), you
may feel unprepared or unable to provide your child with the necessary
care and education. Know that there are many treatment options, social
services and programs, and other resources that can help.

Some tips that can help you and your child are:

* Keep a record of conversations, meetings with health care
providers and teachers, and other sources of information. This
will help you remember the different treatment options and decide
which would help your child most.
* Keep a record of the doctors' reports and your child's evaluation.
This information may help your child qualify for special programs.
* Contact your local health department or autism advocacy groups to
learn about the special programs available in your state and local
community.
* Talk with your child's pediatrician, school system, or an autism
support group to find an autism expert in your area who can help
you develop an intervention plan and find other local resources.

Understanding teens with ASD

The teen years can be a time of stress and confusion for any growing
child, including teenagers with autism spectrum disorder (ASD).

During the teenage years, adolescents become more aware of other people
and their relationships with them. While most teenagers are concerned
with acne, popularity, grades, and dates, teens with ASD may become
painfully aware that they are different from their peers. For some, this
awareness may encourage them to learn new behaviors and try to improve
their social skills. For others, hurt feelings and problems connecting
with others may lead to depression, anxiety, or other mental disorders.
One way that some teens with ASD may express the tension and confusion
that can occur during adolescence is through increased autistic or
aggressive behavior. Teens with ASD will also need support to help them
understand the physical changes and sexual maturation they experience
during adolescence.

If your teen seems to have trouble coping, talk with his or her doctor
about possible co-occurring mental disorders and what you can do.
Behavioral therapies and medications often help.

Preparing for your child's transition to adulthood

The public schools' responsibility for providing services ends when a
child with ASD reaches the age of 22. At that time, some families may
struggle to find jobs to match their adult child's needs. If your family
cannot continue caring for an adult child at home, you may need to look
for other living arrangements. For more information, see the section,
"Living arrangements for adults with ASD."

Long before your child finishes school, you should search for the best
programs and facilities for young adults with ASD. If you know other
parents of adults with ASD, ask them about the services available in
your community. Local support and advocacy groups may be able to help
you find programs and services that your child is eligible to receive as
an adult.

Another important part of this transition is teaching youth with ASD to
self-advocate. This means that they start to take on more responsibility
for their education, employment, health care, and living arrangements.
Adults with ASD or other disabilities must self-advocate for their
rights under the Americans with Disabilities Act at work, in higher
education, in the community, and elsewhere.

Living arrangements for adults with ASD

There are many options for adults living with ASD. Helping your adult
child choose the right one will largely depend on what is available in
your state and local community, as well as your child's skills and
symptoms. Below are some examples of living arrangements you may want to
consider:

* *Independent living.* Some adults with ASD are able to live on
their own. Others can live in their own home or apartment if they
get help dealing with major issues, such as managing personal
finances, obtaining necessary health care, and interacting with
government or social service agencies. Family members,
professional agencies, or other types of providers can offer this
assistance.
* *Living at home.* Government funds are available for families who
choose to have their adult child with ASD live at home. These
programs include Supplemental Security Income, Social Security
Disability Insurance, and Medicaid waivers. Information about
these programs and others is available from the Social Security
Administration (SSA). Make an appointment with your local SSA
office to find out which programs would be right for your adult child.
* *Other home alternatives.* Some families open their homes to
provide long-term care to adults with disabilities who are not
related to them. If the home teaches self-care and housekeeping
skills and arranges leisure activities, it is called a
"skill-development" home.
* *Supervised group living.* People with disabilities often live in
group homes or apartments staffed by professionals who help with
basic needs. These needs often include meal preparation,
housekeeping, and personal care. People who are more independent
may be able to live in a home or apartment where staff only visit
a few times a week. Such residents generally prepare their own
meals, go to work, and conduct other daily activities on their own.
* *Long-term care facilities.* This alternative is available for
those with ASD who need intensive, constant supervision.

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For More Information on Autism Spectrum Disorder

Visit the National Library of Medicine's:

MedlinePlus <http://medlineplus.gov>

En Espa�ol <http://medlineplus.gov/spanish>

For information on clinical trials
<http://www.nimh.nih.gov/health/trials/index.shtml>

National Library of Medicine clinical trials database
<http://www.clinicaltrials.gov>

Information from NIMH is available in multiple formats. You can browse
online, download documents in PDF, and order materials through the mail.
Check the NIMH Website <http://www.nimh.nih.gov> for the latest
information on this topic and to order publications. If you do not have
Internet access please contact the NIMH Information Resource Center at
the numbers listed below.

*National Institute of Mental Health*
Science Writing, Press & Dissemination Branch
6001 Executive Boulevard
Room 8184, MSC 9663
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Phone: 301-443-4513 or 1-866-615-NIMH (6464) toll-free
TTY: 301-443-8431 or 1-866-415-8051 toll-free
FAX: 301-443-4279
E-mail: nimhinfo@nih.gov <mailto:nimhinfo@nih.gov>
Website: http://www.nimh.nih.gov

Reprints

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without permission from NIMH. We encourage you to reproduce it and use
it in your efforts to improve public health. Citation of the National
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* NIMH does not endorse or recommend any commercial products,
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U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES
National Institutes of Health
NIH Publication No. 11-5511
Revised 2011

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