Autism/Autism Spectrum Disorder
Cerebral Palsy (CP) is a common pediatric disorder occurring in about 2 to 2.5 per 1000 live births. Cerebral Palsy is disorder of muscle control which results from damage to some parts of the brain.
It can also be defined as a chronic motor disorder resulting from a non-progressive (static) insult to the developing brain. CP is the clinical presentation of a wide variety of cerebral cortical or sub-cortical insults occurring during the first year of life. The commonest cause of CP remains unknown in 50% of the cases; prematurity remains the commonest risk factor. Children with CP suffer from multiple problems and potential disabilities such as mental retardation, epilepsy, feeding difficulties, and ophthalmologic and hearing impairments. Screening for these conditions should be part of the initial assessment.
The child with CP is best cared for with an individualized treatment plan that provides a combination of interventions. This requires the provision of a number of family-centered services that make a difference in the lives of these children and their families. Management of spasticity can be challenging with a wide variety of possible therapeutic interventions.
The treatment must be goal oriented, such as to assist with mobility, reduce or prevent contractures, improve positioning and hygiene, and provide comfort. Each member of the child’s multidisciplinary team, including the child and both parents, should participate in the serial evaluations and treatment planning.
Autism is pervasive development disorder characterized by impaired social behavior, communication and language, and a narrow range of interests and activities that are both unique to the individual and carried out repetitively. They originate in infancy or early childhood. Usually, but not always, there is some degree of intellectual disability. Behaviors mentioned above are often seen in individuals with intellectual disabilities as well.
In addition, 70% have mild to moderate learning disorders. The remaining 30% with normal IQ are classified as either high-functioning autism (with language difficulties) or Asperger’s syndrome (with normal language). NB This last point is controversial and many would consider AS not to be classified as a form of autism. In general terms, 1-2% of those with autism have a normal life; 5-20% have a borderline prognosis (i.e. varying degrees of independence); but 70% are totally dependent upon support.
Epidemiology The onset of symptoms is typically before age 3. Male: female ratio is 3â€“4:1. Prevalence is 5-10 per 1000 individuals.
Aetiology The cause is unknown but a number of hypotheses exist: genetic (in Down’s syndrome and fragile X); obstetric complications; toxic agents; pre/postnatal infections (with maternal rubella); autoimmune (anecdotal MMR-not proven) association with neurological disorders (e.g. tuberous sclerosis)