What is Autism Spectrum Disorder?
In today's topic I will discuss about Autism Spectrum Disorder.Kindly keep your patience till the end of this topic .
- What is Autism Spectrum Disorder ?
Autism spectrum disorder (ASD) stems from developmental differences in the brain. While some individuals with ASD can pinpoint a specific variance, such as a genetic condition, other underlying causes remain unidentified. Researchers propose that ASD likely results from a combination of factors, triggering alterations in the typical pathways of human development. Understanding these causes and their effects on individuals with ASD is an ongoing area of exploration, with much yet to be discovered.
Individuals with ASD may exhibit distinct behaviors, communication patterns, social interactions, and learning approaches that differ from the majority. Often, there are no outward physical features that distinguish them from others. The capabilities of individuals with ASD can widely differ. For instance, some might possess highly developed conversational abilities, while others might be nonverbal. The level of support required in their daily lives also varies significantly; while some may necessitate substantial assistance, others can independently navigate work and daily living with minimal or no support.
ASD typically initiates before the age of 3 and can persist throughout an individual's life, though symptoms might ameliorate with time. Certain children exhibit signs of ASD within their initial year, while others may manifest symptoms at 24 months or later. In some cases, children with ASD display progression in skills and developmental milestones until roughly 18 to 24 months of age, after which point they might cease acquiring new skills or experience regression, losing previously attained abilities.
As individuals with ASD transition into adolescence and young adulthood, they might encounter challenges in forging and sustaining friendships, communicating with peers and adults, and grasping societal norms in school or workplace settings. Healthcare providers may take note of their situation due to concurrent conditions like anxiety, depression, or attention-deficit/hyperactivity disorder, which tend to occur more frequently in individuals with ASD than in those without ASD.
- Symptoms/early indicators of Spectrum Disorder?
Early indicators of autism in young children comprise:
- Failure to respond to their name
- Avoidance of eye contact
- Lack of reciprocal smiling in response to your smiles
- Strong negative reactions to particular tastes, smells, or sounds
- Engaging in repetitive movements like hand flapping, finger flicking, or body rocking
- Limited speech compared to peers
- Reduced engagement in pretend play
- Repetitive use of phrases
- Difficulty understanding others' thoughts or emotions
- Unusual speech patterns, including repeated phrases and speaking in a one-sided manner
- Preference for strict, unchanging daily routines and strong emotional reactions to alterations
- Intense fascination or deep absorption in particular subjects or activities
- Strong negative reactions to requests
- Challenges in making friends or a preference for solitude
- Literal interpretation of language, struggling with idiomatic expressions like "break a leg"
- Difficulty expressing their emotions or articulating how they feel
Girls with autism might:
- Conceal certain signs of autism by imitating the behavior and play of other children
- Retreat in challenging situations
- Seem more adept at managing social interactions
- Exhibit fewer indications of repetitive behaviors
- Can a Autistic child live normal life/independently?
When considering the independence of individuals with autism, it's crucial to differentiate between those categorized as high-functioning and those classified as low-functioning.
Individuals with low-functioning autism often encounter significant hurdles in their daily lives, grappling with challenges in communication, sensory sensitivities, and mastering fundamental life skills like self-care and financial management.
Consequently, many necessitate continual assistance from caregivers or specialized housing arrangements, such as group homes or supported living facilities.
However, it's vital not to preemptively determine the capabilities of individuals with low-functioning autism. With appropriate support and resources, they can still pursue fulfilling lives and accomplish their aspirations.
This might involve accessing various therapies like occupational therapy or speech therapy, along with tailored vocational training programs that cater to their distinct strengths and abilities.
This may involve regular check-ins from family members or assistance provided by local organizations specializing in services for adults with disabilities.
The capacity of individuals with autism to live independently is contingent upon several factors, including their individual strengths and challenges, as well as the resources accessible to them. Acknowledging these differences and offering tailored support and opportunities for all individuals with autism is pivotal in ensuring that everyone has the chance to lead a satisfying life on their terms.
In summary, individuals with autism can certainly lead fulfilling lives with the right support and resources. Early intervention, education, and community support play significant roles in assisting people with autism to attain their objectives and live satisfying lives.
By embracing and understanding individuals with autism for who they are, we can empower them to reach their full potential and flourish in their distinctive way.
- What are the 5 common types of Autism?
This piece discusses the five distinct types of autism used historically to distinguish various developmental disorders associated with autism. Exploring these earlier classifications aids in gaining a deeper comprehension of ASD and can aid in approaching your child’s ASD diagnosis in relation to its previous categorizations.
1. Kanner’s Syndrome:
Named after Leo Kanner, a researcher acknowledged for his contribution to one of the original reports on autism in 1943, Kanner’s Syndrome was an antiquated term for what we currently recognize as autism. At the time of the paper's release, Kanner labeled it as "infantile autism," depicting a disorder noted in infants and children characterized by socialization challenges and repetitive behaviors, among other symptoms.
Initially, Kanner's Syndrome was not perceived as commonly occurring as we now understand it to be. Today, what was once termed Kanner's Syndrome is now identified as autism or Autism Spectrum Disorder (ASD), affecting an estimated 1 in 44 children. When autism was first included in the Diagnostic and Statistical Manual (DSM)-III, the symptoms encompassed: [additional details].
Manifestation before 30 months of age
Atypical speech patterns
Resistance towards change
Profound deficiencies in language acquisition
Consistent lack of responsiveness to others
Unusual attachments to object.
2. Asperger’s Syndrome:
Asperger’s Syndrome, previously considered a distinct developmental disorder separate from autism, was later consolidated into a broader Autism Spectrum Disorder (ASD) category with the release of the DSM-5. Although Asperger’s no longer holds its own classification, some specialists occasionally diagnose children with Asperger’s to denote a milder subtype within ASD due to its historical recognition.
While the term Asperger’s was eliminated from the DSM, many individuals still relate to this label, and its presentation doesn't always mirror the typical characteristics of autism. The association between Asperger’s and autism shares similarities but can also exhibit differences. Recognizing this unique relationship can significantly enhance the quality of life for individuals.
Before its removal from the DSM-5, Asperger’s shared symptoms and criteria with autism but also displayed distinctive features. The factors distinguishing Asperger’s from autism included:
No obligatory onset requirement before age 3
No necessity for the absence of a language delay
Lack of specific diagnostic criteria in the communication domain
Criterion indicating the absence of a cognitive development deficit
3. Rett Syndrome:
Rett Syndrome is a neurodevelopmental condition primarily affecting girls. In early childhood, children with Rett Syndrome often exhibit symptoms resembling those of autism, such as a decline in communication and social abilities. Despite these similarities, Rett Syndrome was excluded from the DSM-V as it showcases distinctive physical symptoms not typically observed in Autism Spectrum Disorder (ASD).
Nearly all instances of Rett Syndrome stem from a mutation in the MECP2 gene. Although mutations in other genes are also associated with Rett Syndrome, they are notably less frequent. Remarkably, despite being a genetic disorder, less than 1% of reported cases are inherited. Most cases arise from spontaneous mutations, although families may have asymptomatic female carriers of the mutation.
Rett Syndrome unfolds through four stages, yet the pace and severity of symptoms vary for each individual. Initially, a child with Rett Syndrome typically displays typical development but eventually experiences a regression in development, accompanied by diminished motor control, stunted growth, muscular degeneration, and cognitive impairments.
Beyond a brief period of social and communication skill loss in early childhood, the symptoms of Rett Syndrome throughout its stages may encompass:
- Reduced head growth
- Muscle weakness
- Atypical breathing patterns
- Repetitive movements
- Loss of purposeful hand skills
- Irregular gait
- Seizures
- Inability to communicate or understand language
- Development of scoliosis
4. Childhood Disintegrative Disorder (CDD):
Childhood Disintegrative Disorder (CDD) is a developmental condition that, with the advent of the DSM-5, was integrated into the Autism Spectrum Disorder (ASD) category. Before this reclassification, CDD was regarded as a rare, more severe manifestation of autism. CDD is relatively uncommon, affecting approximately 1.7 in 100,000 children.
CDD shares numerous symptoms with autism, including the regression of communication and developmental skills. However, the primary distinction lies in the later onset of CDD compared to other ASD conditions. Indicators of CDD encompass the loss of:
- Motor skills
- Play skills
- Bladder or bowel control
- Self-care and social skills
- Expressive and receptive language skills
Children with CDD might also demonstrate unconventional communication and social interaction, along with repetitive interests or behaviors. Notably, the prevalence of epilepsy is higher among children with CDD than in those with autism, and children with CDD often exhibit greater fearfulness than their counterparts with autism.
5. Pervasive Development Disorder Not Otherwise Specified (PDD-NOS)
Persuasive Developmental Disorder Not Otherwise Specified (PDD-NOS), once considered one of the primary types of autism alongside autism and Asperger’s Syndrome, differed from autism by not meeting all the defined criteria for autism before the DSM-V.
PDD-NOS served as a broad diagnosis encompassing individuals who didn't entirely meet the DSM-IV standards for autism yet displayed symptoms and developmental delays. As part of the efforts to create a more consistent diagnosis and criteria for individuals with ASD, PDD-NOS, along with CDD and Asperger’s, was incorporated into the Autism Spectrum Disorder classification, ensuring a standardized approach for providing optimal assistance.
The indications and traits associated with PDD-NOS comprised:
- Challenges in verbal and non-verbal communication
- Difficulty in social interactions
- Impaired social skills
- Struggles with changes in routine
- Repetitive movements or behaviors
- Unconventional play patterns
What are the main reasons of Autism Spectrum Disorder ?
The core causes of ASD remain uncertain to researchers, but studies indicate that an individual's genetic makeup might interact with environmental elements, influencing development in ways that could result in ASD. Various factors associated with an elevated probability of developing ASD include:
- Having a sibling with ASD
- Having advanced parental age
- Possessing specific genetic conditions (like Down syndrome or Fragile X syndrome)
- Being born with very low birth weight
What tests are used to diagnose autism?
Several diagnostic tools are employed to assess individuals who might be on the autism spectrum. These assessments typically rely on two primary sources of information: descriptions of the individual's developmental history and behavior gathered through interviews, as well as direct observations of their behavior.
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DISCO (Diagnostic Interview for Social and Communication Disorders) :
The DISCO is a comprehensive, semi-structured interview aimed at gathering in-depth details about an individual's development, behavior, and skills spanning from birth to their current daily functioning.
Originally developed for use at The Centre for Social and Communication Disorders (now known as the Lorna Wing Centres) by Dr. Lorna Wing and Dr. Judith Gould, the DISCO serves as both a clinical and research instrument, adaptable for children, young people, and adults across all ages. Its distinctive approach involves collecting data using a dimensional method, encompassing all aspects of an individual's abilities, challenges, and atypical behaviors, going beyond the features solely related to autism spectrum disorder.
Ideally, information regarding an individual's early life is acquired from an informant who has known the person since birth. However, in cases where no informant is available, items within the schedule can be completed based on the current skills, challenges, and atypical behaviors of the individual. Adults with vivid recollections of their childhood experiences contribute valuable insights into their earlier development, providing valuable information for the interviewer.
Lack of developmental history restricts the ability to provide a formal diagnosis based on the ICD or DSM classification systems. Nonetheless, the information gathered from the DISCO enables skilled clinicians to exercise clinical judgment, offering a preliminary diagnosis to facilitate the development of a care plan or management program.
The DISCO is versatile, catering to individuals of any age and ability level, regardless of the spectrum profile's subtlety. Additionally, it aids in identifying concurrent conditions often associated with the autism spectrum, such as ADHD, tics, dyspraxia, and catatonia-like disorders. Information collected from the DISCO can be used to formulate diagnostic algorithms based on various systems, including DSM5, ICD10, and the Wing and Gould triad.
It's crucial to utilize the DISCO in conjunction with psychological assessments, observations, and other reliable information sources, as highlighted in the section on its history.
The ADOS (Autism Diagnostic Observation Schedule):
The ADOS functions as a standardized, semi-structured assessment focusing on communication, social interaction, and play or imaginative material use in individuals referred due to potential autism concerns.
Unlike the other tools mentioned, the ADOS isn't reliant on developmental data, examining solely the present behavior and skills of the individual.
It is versatile, capable of assessing individuals across various developmental stages and age ranges, ranging from toddlers to adults. It caters to individuals with diverse speech abilities, from non-verbal individuals to those who are verbally fluent.
The ADI-R (Autism Diagnostic Interview - Revised) :
The ADI-R is a clinical assessment tool designed for diagnosing autism in individuals, encompassing both children and adults.
An updated version of the original ADI, the information garnered from the ADI-R contributes to diagnostic algorithms for autism according to the guidelines in both the ICD-10 and DSM-IV manuals.
This assessment tool concentrates on behavior within three key domains: reciprocal social interaction qualities, communication and language, and restricted and repetitive, stereotyped interests and behaviors.
It is suitable for assessing individuals, including children and adults, whose mental ages are approximately 18 months and beyond.
It's crucial to utilize the DISCO in conjunction with psychological assessments, observations, and other reliable information sources, as highlighted in the section on its history.
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References:
Lord C, Risi S, DiLavore PS, Shulman C, Thurm A, Pickles A. Autism from 2 to 9 years of age. Arch Gen Psychiatry. 2006 Jun;63(6):694-701
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Hyman SL, Levey SE, Myers SM, Council on Children with Disabilities, Section on Developmental and Behavioral Pediatrics. Identification, Evaluation, and Management of Children With Autism Spectrum Disorder. Pediatrics. 2020 Jan;145(1).
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