Pervasive developmental disorders are defined as a group of psychiatric conditions in which expected social skills, language development, and behavior are either not will developed or are lost in early childhood. Autism is one of the pervasive developmental disorders of the brain function . The current Diagnostic and Statistical Manual of Mental disorders (DSM-IV) delineates that Autistic spectrum disorder (ASD) is characterized by impairment in social interaction and communication plus repetitive and stereotyped patterns of behaviors, with the onset in the first 3 years of life (American Psychiatric Association,1994). Including individual psychotherapy has proved to be ineffective. Language therapy and behavioral modification are currently considered the treatment
of choice
Dietary consultation may be useful to evaluate the benefits of special diet. However, individuals with autistic disorder and related conditions need three well balanced meals, including gluten and casein free diet.
aetiology of autism:
1-Perinatal factors:
A high incidence of various perinatal complications seems to occur in children with autistic disorder e.g., maternal bleeding after the first trimester and neonatal anemia
2- Genetic causes:
The most frequently involved genetic components are the structural and numerical abnormalities of sex chromosomes, anomalies of chromosome 15 ,chromosome 17 and Fragile X syndrome
3-Neural causes:
The most common abnormality found in autism with or without mental retardation is the reduction of cerebellar hemisphere size
4-Neurochemistry Abnormalities:
At least one third of autistic disorder patients have elevated plasma serotonin
5-Dietary Causes:
The combination of ileocolonic lymphoid nodular hyperplasia and inflammatory changes are detected in the upper gastrointestinal tract in children with autism
6-Yeast Infections:
It has been suggested that the presence of yeast infection (candida albicans) in the gut and perhaps other parts of the body, could result in autism .
7-Viral Infections:
Infection during pregnancy , congenital rubella,HIV,and herpes simplex all have been suggested as possible causes of autism .
Description of the disorder:
Age of onset:
Onset occurs before the age of 3 years. Age of identification is another term that may be used because the age of onset is not usually accurately known
Social deficits:
Disturbances in social relations are manifested by poor or absent eye contact and lack of interest to people .
Restricted and odd range of activities and interests:
Interests are narrow and repetitive. Autistic children display stereotyped movements such as flapping of hands and running around circles .
>Deficits in language and communication:
Language disturbances can consist of complete lack of speech, failure to communicate by pointing and echoli
treatment:
1 -Family Counseling:
Counseling and careful training of parents with autistic children may yields considerable gain in child language, cognitive and social areas of behavior.
2-Language Therapy:
Language therapy is an important line in management of autism. Ideally, a child with autism should begin language therapy as early as possible
3-Applied Behavior therapy:
The use of different behavioral interventions are of special significance in the treatment of autistic children.
4-Hyperbaric Oxygen Therapy (HBOT)
The use of hyperbaric oxygen therapy (HBOT) for autism has been used in many countries worldwide and the results are encouraging
5-Pharmacotherapy
There are many psychiatric medications used for treating specific symptoms often found in autism, such as aggression and self injury.
6-Dietary Management:
Dietary management had achieved great improvement in the course of management of many cases of ASD
Dietary Management:
1-Eliminate Gluten and Casein: Most autistic children benefit from a diet completely free of gluten and casein proteins which are found in wheat and milk and their products)Rimland 2004(
2- Hydrogenated fats (such as margarine) are harmful to autistic children. Fats which are recommended for cooking are: corn oil and coconut butter
3- Protein such as eggs ,chicken and fish are healthy to be included in the specific diet program
4-Lot of raw fruits and vegetables every day are recommended like carrots, bananas and lemons
5- Diet should be free of artificial colors, flavors, sweeteners, and preservatives.
The signs of improvement which could be observed during the course of dietary management include:
-Increase attention and improved eye contact
-Decrease in hyperactivity and self injurious behaviors
improved sleep habits
Improvement in verbal and non verbal communication children with autism derive most benefit from early diagnosis and intervention. Diet is an essential part of a well rounded autism treatment program. It had achieved great improvement in the course of management of many cases of autism. So it deserves to be tried as early as possible.
Dietary program should be tried as early as possible before occurrence of structural damage caused by long term uptake of exorphins which lead to slow and incomplete response to dietic management.
Any alteration to the diet should take place gradually not overnight
Dietary program should be applied under professional supervision to gain best results and avoid hazards of wrong application .
It is of importance that the parents should follow strict deitic protocol to achieve good results.
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