Autism spectrum disorder

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Autism Spectrum Disorder: Overview

Autism spectrum disorder (ASD) is a condition related to brain development that affects a person’s perception and socialization with others, leading to difficulties in social interaction and communication. The disorder also involves repetitive patterns of behavior. The term “spectrum” in autism spectrum disorder refers to the wide range of symptoms and severity.

ASD includes conditions that were previously considered separate, such as autism, Asperger’s syndrome, childhood disintegrative disorder, and an unspecified form of pervasive developmental disorder. Some people still use the term “Asperger’s syndrome,” which is generally considered to be at the mild end of the autism spectrum disorder.

Autism spectrum disorder typically starts in early childhood and can cause difficulties functioning in society, both socially and in school or work settings. Symptoms of autism may be observed within the first year of a child’s life. Some children appear to develop normally in the first year and then experience a period of regression between 18 and 24 months, during which autism symptoms emerge.

While there is no cure for autism spectrum disorder, early and intensive treatment can significantly improve the lives of many children.

Symptoms of Autism Spectrum Disorder

Signs of autism spectrum disorder may be evident in early infancy, such as reduced eye contact, lack of response to their name, or indifference to caregivers. Other children may initially develop typically but later show signs of withdrawal, aggression, or loss of previously acquired language skills. Symptoms are typically seen by the age of 2 years.

Each child with autism spectrum disorder may exhibit a unique pattern of behavior and severity, ranging from low functioning to high functioning. Some children with autism have difficulty learning, while others may have signs of lower than normal intelligence. On the other hand, some children may have normal to high intelligence but struggle with communication and applying their knowledge in everyday life and social situations.

Because the symptoms vary widely in each child, determining the severity can be challenging and is based on the level of impairments and their impact on the child’s ability to function.

Below are some common signs and behaviors associated with autism spectrum disorder:

Social Communication and Interaction

  • Fails to respond to their name or seems to ignore others at times.
  • Resists cuddling or holding and prefers to play alone.
  • Has poor eye contact and lacks facial expressions.
  • Exhibits delayed speech or loses previously acquired language skills.
  • Has difficulty starting or maintaining conversations and may only initiate them to make requests or label items.
  • Speaks with an abnormal tone or rhythm and may use a singsong voice or robotic-like speech.
  • Repeats words or phrases verbatim without understanding their use.
  • Struggles to comprehend simple questions or directions.
  • Appears unaware of others’ emotions or feelings and does not express their own.
  • Does not point at or share interest in objects with others.
  • Approaches social interactions inappropriately, being passive, aggressive, or disruptive.
  • Has difficulty recognizing nonverbal cues, such as interpreting facial expressions, body postures, or tone of voice in others.

Patterns of Behavior

  • Engages in repetitive movements, such as rocking, spinning, or hand flapping.
  • Displays self-harming activities, such as biting or head-banging.
  • Develops specific routines or rituals and becomes upset by even slight changes.
  • Exhibits problems with coordination or has unusual movement patterns, such as clumsiness or walking on toes, with odd, stiff, or exaggerated body language.
  • Becomes fixated on specific details of an object, like the spinning wheels of a toy car, without understanding its overall purpose or function.
  • Experiences unusual sensitivity to light, sound, or touch but may be indifferent to pain or temperature.
  • Does not engage in imitative or make-believe play.
  • Becomes intensely focused on particular objects or activities.
  • Has specific food preferences, such as eating only a few foods or refusing foods with certain textures.

As children with autism spectrum disorder mature, some may become more engaged with others and show fewer disturbances in behavior. Others, particularly those with more severe symptoms, may continue to face challenges with language and social skills, and the teenage years may bring about increased behavioral and emotional difficulties.

When to See a Doctor

Although babies develop at their own pace, children with autism spectrum disorder often show signs of delayed development before the age of 2 years. If you have concerns about your child’s development or suspect autism spectrum disorder, discuss your observations with your doctor. Keep in mind that some symptoms associated with the disorder may also be linked with other developmental disorders.

Signs of autism spectrum disorder typically manifest early in development, with noticeable delays in language skills and social interactions. Your doctor may recommend developmental tests to identify delays in cognitive, language, and social skills if your child:

  • Does not respond with a smile or happy expression by 6 months.
  • Does not mimic sounds or facial expressions by 9 months.
  • Does not babble or coo by 12 months.
  • Does not gesture, such as pointing or waving, by 14 months.
  • Does not say single words by 16 months.
  • Does not engage in “make-believe” or pretend play by 18 months.
  • Does not use two-word phrases by 24 months.
  • Experiences a loss of language or social skills at any age.

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If your child’s doctor observes signs of developmental delays or symptoms of autism spectrum disorder during regular checkups, they may refer you to a specialist who treats children with autism spectrum disorder. This specialist could be a child psychiatrist, psychologist, pediatric neurologist, or developmental pediatrician, who will conduct a thorough evaluation to determine if your child has autism spectrum disorder.

Diagnosing autism spectrum disorder can be challenging due to the wide variation in symptoms and severity. There is no specific medical test to determine the disorder, so the evaluation process may include:

  • Observing your child’s social interactions, communication skills, and behavior over time.
  • Administering tests to assess hearing, speech, language, developmental level, and social and behavioral issues.
  • Conducting structured social and communication interactions with your child and scoring their performance.
  • Using the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association.
  • Involving other specialists in the evaluation process.
  • Considering genetic testing to identify any genetic disorders that may be associated with autism spectrum disorder, such as Rett syndrome or fragile X syndrome.

Treatment of Autism Spectrum Disorder

While there is no cure for autism spectrum disorder, early and intensive treatment can significantly improve a child’s functioning by reducing symptoms and supporting development and learning. The treatment options for autism spectrum disorder vary, and there is no one-size-fits-all approach. The goal of treatment is to help children learn critical social, communication, functional, and behavioral skills.

Treatment options for autism spectrum disorder may include:

  • Behavior and communication therapies: These programs address social, language, and behavioral difficulties associated with autism spectrum disorder. Applied behavior analysis (ABA) is one such therapy that helps children learn new skills through a reward-based motivation system.
  • Educational therapies: Highly structured educational programs that include a team of specialists can help improve social skills, communication, and behavior in children with autism spectrum disorder.
  • Family therapies: These therapies involve parents and other family members in learning how to play and interact with their children in ways that promote social interaction skills and manage problem behaviors.
  • Other therapies: Depending on a child’s needs, speech therapy, occupational therapy, and physical therapy may be beneficial.
  • Medications: While no medication can improve the core signs of autism spectrum disorder, certain medications may help control specific symptoms, such as hyperactivity, severe behavioral problems, or anxiety. However, keep in mind that all medications should be used under the guidance of a healthcare provider.

It’s essential to remember that each child with autism spectrum disorder is unique, and their treatment needs may change over time. It is crucial to work with a team of professionals, including doctors, therapists, and educators, to develop a comprehensive treatment strategy tailored to the child’s specific needs.

Managing Other Medical and Mental Health Conditions

Children, teens, and adults with autism spectrum disorder may also experience other medical and mental health conditions. Some children may have medical issues such as epilepsy, sleep disorders, or limited food preferences. It is essential to address and manage these conditions alongside autism spectrum disorder. Additionally, teens and young adults with autism spectrum disorder may face challenges with the transition to adulthood, and they may experience other mental health disorders, such as anxiety and depression. Collaborate with healthcare professionals and support organizations to address these issues effectively.

Planning for the Future

Children with autism spectrum disorder continue to learn and adapt throughout their lives. However, most will require some level of support. Planning for the child’s future opportunities, such as employment, college, independent living, and the services needed for support, can help ease the transition to adulthood and ensure they receive the necessary care and resources.

Complementary and Alternative Therapies

Many parents seek complementary or alternative therapies for autism spectrum disorder, but these treatments often lack scientific evidence of effectiveness. Some therapies may reinforce negative behaviors, and others can be potentially dangerous. It’s essential to discuss any complementary or alternative therapies with your child’s doctor to ensure they are safe and appropriate.

While there is no evidence of a cure for autism spectrum disorder, some complementary and alternative therapies may offer some benefits when used in combination with evidence-based treatments. Examples include creative therapies like art or music therapy and sensory-based therapies, which focus on sensory processing. However, it’s important to note that these therapies should be used alongside evidence-based treatments.

On the other hand, certain therapies and treatments have no proven benefit and can be potentially harmful. Examples include chelation therapy, hyperbaric oxygen treatments, and intravenous immunoglobulin infusions. Avoid using these therapies, as they have not been shown to be effective for autism spectrum disorder and may pose significant risks.

Coping and Support

Raising a child with autism spectrum disorder can be physically and emotionally demanding. It’s essential to build a team of trusted professionals, including social workers, teachers, therapists, and service coordinators, to help identify and evaluate resources and support available in your area. Keeping organized records of your child’s appointments and progress can also be helpful.

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