AUTISM
A
PROCEDURE FOR AUSCULTATION
A doctor’s examination often includes auscultation (listening
to sounds within the body using a stethoscope). Some sounds,
such as movement of fluid through the stomach and intestine,
opening and closing of heart valves, and flow of air through the
lungs and airways, are made during normal functioning of
organs. The presence of abnormal sounds usually indicates
disease of that tissue, however. An obstetrician listens for the
baby’s heartbeat as part of routine antenatal examination.
STETHOSCOPE
Using a stethoscope
The end is held against the skin. The diaphragm
picks up most noises, while the bell detects
quiet, deep noises.
The heart
The stethoscope is
usually placed at four
places on the chest
overlying the sites of
the heart valves. The
doctor listens for the
presence of murmurs,
clicks, and extra heart
sounds that may
indicate disease of
a heart valve.
Carotid artery and
abdominal aorta
The doctor may listen
to the flow of blood
through a blood
vessel that passes
just beneath the skin.
The presence of
bruits (sounds of
turbulence) usually
indicates abnormal
narrowing or
widening of an artery.
The abdomen
The doctor may listen
to the abdomen for the
sounds made by the
movement of fluid
through the intestine.
A disorder of the
intestine may cause
these sounds to be
absent, abnormal, or
very loud.
The lungs
The doctor places
the stethoscope over
several different
areas of the chest and
backto listen to the
sounds made during
breathing. The
presence of crackles
and dry or moist
wheezes indicates
various types of lung
disease.
that are made by the movement of air
and fluid in the intestine), and also for
abnormal bowel sounds that may indi-
cate intestinal obstruction (see
intestine,
obstruction of).
autism
A rare condition in which an affected
person has difficulty with social rela-
tionships,
communication,
and with
imagination, together with repetitive
patterns of behaviour. Autism is more
common in boys. The condition is, by
definition, evident before the age of 30
months and is usually apparent in the
first year of life. The precise causes of
autism are unknown.
SYMPTOMS AND SIGNS
Autistic children often seem normal for
the first few months of life, before
becoming increasingly unresponsive to
parents or other stimuli. The child fails
to form relationships, avoids eye con-
tact, and has a preference for playing
alone. Extreme resistance to change of
any kind is an important feature of the
condition, which can make it very diffi-
cult to teach the autistic child new skills.
Rituals develop in play, and there is
often attachment to unusual objects or
obsession with
one
particular
idea.
Delay in speaking is common and most
autistic children have a low
IQ.
Other
behavioural abnormalities may include
walking on tip-toe, rocking, self-injury,
screaming fits, and
hyperactivity.
Appearance
and
coordination
are
normal. Some autistic people have an
isolated special skill, such as musical
ability or an outstanding rote memory.
TREATMENT AND OUTLOOK
There is no cure for autism, which is a
lifelong
condition.
Special
schooling,
support and
counselling
for the families,
and, sometimes,
behaviour therapy
(such
as to reduce violent self-injury) can be
helpful. Medication is useful only for
specific problems, such as hyperactivity.
The outlook depends on the intel-
ligence and language ability of the
individual. The majority of autistic peo-
ple need special care.
autism spectrum disorders
A range of developmental disorders that
are characterized by obsessive behavi-
our and impaired communication and
social skills
(see
Asperger’s syndrome;
autism).
Autism spectrum disorders are
usually diagnosed during childhood.
autoantibody
An
antibody
(a protein that is manufac-
tured by the immune system) that reacts
against the body’s own cells (see
auto-
immune disorders
).
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