Autism, a different perception of reality

Approximately 25000 people live with autism in Kenya. But what do we actually know about autism, its causes and its symptoms?

The word "autism" is of Greek origin and means "to be highly withdrawn". Historically, children with autism in Kenya were hidden away in the house. They were sometimes considered to be a result of witchcraft or similar evil depictions  

Autism is a developmental disorder which begins in childhood and impacts an individual’s social interactions and their ability to communicate. It is difficult to diagnose autism because the causes of the disease itself are still not fully understood. 

Autism manifesting during early childhood and Asperger syndrome (AS)

Leo Kanner, an American child psychiatrist, and Hans Asperger, an Austrian paediatrician, researched two different disorders which they both called “autism”, in 1943 and 1944 respectively which has led to some confusion in the past. 

Nowadays, a distinction is made between autism which appears during early childhood (early childhood autism, a syndrome of which can be Kanner’s syndrome, a complex brain abnormality resulting in low functioning) and Asperger’s, another autism spectrum disorder (ASD) which typically only becomes noticeable after the age of three and differs from others ASDs in the fact that patients’ language and intelligence remain unimpaired. The autism spectrum classifies ASDs according to their degrees of severity and symptoms. 

  

The World Health Organisation (WHO) has called autism a “pervasive developmental disorder” in the ICD-10, its most recent classification system for diseases. For a diagnosis, noticeable difficulty must be present in three areas:    

  • the development of language, verbal and non-verbal communication 

  • social interactions 

  • narrow interests and hobbies, resulting from the special way a person with autism processes information 

Sensory overload

From a medical point of view autism is present at birth, and is, in short, a difference in the way people with autism perceive reality. As a result, it is difficult for these persons to process environmental stimuli (stimuli are the many things going on in our environment captured by our senses). Because of this impairment, a person with autism can be completely overwhelmed in a situation where they are subjected to very many stimuli in a short time. Their reaction to this can create confusion amongst their social circle, and eventually lead to their social withdrawal and behaviour which can be difficult to understand for an outsider. 

The intellect of people living with autism ranges from that of a genius to severe mental impairment. Moreover, Asperger syndrome occurs more often in males than in females, with estimates of the ratio of males to females affected ranging from 4:1 to 8:1. 

No “typical” autistic person

Stereotypical depictions of autism in the media have strongly influenced the public's image of this disorder. Autistic persons are not exclusively mute and highly introverted, however; autism can manifest itself through a large range of symptoms of widely variable degrees of severity.  

There is no such thing as a typical autistic person. Although people with mild autism have problems processing environmental stimuli and difficulties with social relationships, they often display normal if not well above average intelligence, and above average language skills. 

Savant syndrome in autistic persons

The interests of autistic people are usually limited to certain areas, and some of them have exceptional abilities in a specific field, for example in mental arithmetic, drawing, music or memory feats.  

This is part of a phenomenon referred to as the “savant syndrome” where persons with mental disabilities present high skill in some activity. The autistic persons that present such skills are known as “autistic savants”, and they represent about half of persons with savant syndrome. 

The causes of autism are not yet fully understood

The causes of autism are still not fully understood; several factors are nevertheless known to play a role in its development. One’s genetic heritage as well as certain biological processes occurring before, during and after one’s birth can affect the development of the brain and trigger autism, for example. 

The hypothesis that autism develops due to a lack of affection throughout one’s upbringing or as the result of childhood trauma, which was still believed well into the 1960s, is nowadays known to be baseless. Similarly, the contention that environmental toxins or vaccine additives can trigger autism is also unfounded; the US Food and Drug Administration (FDA) has considered such claims unsubstantiated since 2006. 

Unrecorded cases higher in earlier years

The number of cases of autism has been steadily increasing over the past decades. Globally, the expected increase in the number of cases of autism reported is predicted to be between 0.6% to 1% (2020). The Center for Disease Control (CDC) in the USA has also reported a 57% increase in cases of autism between 2002 and 2006; in 2006, one in 110 children aged eight was affected by autism.  That being said, several factors which are not at all linked to the disorder itself have contributed to this increase. The enrolment of children at school at progressively younger ages has increased the chance that autism will be detected, for example, in cities like Nairobi and Mombasa.  

In addition to this, parents nowadays are more attentive than in the past as to whether their child is developing “normally”. Autism has also become more acknowledged by society recently; a lack of understanding and awareness of the disorder may well have contributed to it not being reported or recognized as such in the past. 

Difficult autism diagnosis

Diagnosing autism is generally very difficult. The disorder is primarily diagnosed on the basis of the symptoms mentioned above but those are not, however, in any way unique to autism. Not every child that does not show interest in its surroundings or prefers to be on its own is autistic. It is generally very difficult to make a conclusive diagnosis before the age of 18 months, but it is generally preferable to act quickly in case one suspects a child might be autistic as detection at an early age allows for treatment adapted to the patient from the disorder’s onset.   

Nevertheless, therapy for autism spectrum disorders is not aimed at a cure, as this is currently not possible. Those affected by the disorder will experience it and thereby be somewhat restricted by it, particularly in their social interactions, throughout their entire lives. On the other hand, however, therapy can help alleviate these issues and improve autistic persons’ day to day lives.