Thursday, 11 April 2013

Peter Polygon of Impairments in Autism - Pizza Time

Most kids love pizza; Monty is no exception and today he gets his own, by special delivery.

The first slice is that rather dull triad of impairments, which is taught to therapists learning about autism.  Autism is supposed to be the place where these three impairments overlap.  I was always rather underwhelmed by this; definitely a slice needing extra ketchup. 

So based on what I have learned myself, and read in the literature I propose a more colourful pizza, which of course gets a fancy name.

In the literature, whether or not there was a regression after birth, seems to be relevant in understanding the cause of autism, in that particular case.  It would also therefore be a factor indicating the appropriate therapy.

You may be surprised to see "depression", but it is there because there are many biological markers in autism that are also present in people with depression (and other mental health disorders).  These will be discussed in a subsequent science-heavy post.  I also note that while some autistic people look happy, at least some of the time, others look pretty miserable.  Perhaps they have depression, but nobody stopped to think about it.

Aggression is pretty self-explanatory.  Some people with autism never seem to get aggressive, but for others it can become a real issue.

Serious comorbidities, in plain English, means other serious symptoms that co-exist in that particular person's type of autism.  This again is extremely relevant in both understanding the cause of that person's autism and also the the most effective ways of treating it.  Not only do many people with autism also have epilepsy, but there is a clear overlap between what causes some types of convulsion and what provokes some autistic behaviours.  This is not fully understood in the literature.  There is already an overlap between novel therapies for epilepsy and novel therapies for autism.

MR is mental retardation; it is quite commonly associated with autism.  I suspect some unfortunate children with un-managed autism end up in such a condition where they are falsely labeled with MR.

GI disorders are gastrointestinal stomach problems such as diarrhea, constipation and reflux.  In some studies as many as 50% of autistic children have GI disorders, many being chronic.  In the literature, there is much about the connection between these disorders and autism; although to talk about it outside the literature is verging on heresy.

You will likely know that ADHD is attention deficit hyperactive disorder.  This is another diagnosis that has become extremely fashionable, particularly in the US.  I found a paper entitled "The worldwide prevalence of ADHD: is it an American condition?", the full version is free, just click it.  Anyway, lack of attention and hyperactivity are definitely symptoms of certain types of autism.  Therapy that works for ADHD should be interesting for us too. Incidentally, in my earlier posts about Autistic Sensory Overload (ASO) and the similarity with Hypokalemic Sensory Overload (hypoSO), if you read the links you would have seen that hypoSO is now being linked with ADHD, although I seem to be the only person to claim a link to ASO.

Fog and present, or not present is a phenomenon that you may know but call something else.  One reader of this blog referred to his child's zombie-like state.  Some older autistic people, who now have much reduced symptoms, refer to knowing what was going on in their youth, but as if being surrounded by fog.  People who speak better French than English, say things along the lines of "today in school, Monty was not present".  It does not quite work in English.  They mean Monty was physically in school, but his mind was somewhere else.  Fortunately, Bumetanide seems to make kids "present"; and this is a good thing.

Since all autistic kids seem to be unique, I have left the 12th triangle as a spare; for you to customize as you see fit.

Monty's own pizza is looking a bit thin and so it is time to order a Margherita for him and a Margarita for me.

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