Autism Spectrum Disorder (ASD)

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According to The Dana Foundation, “It’s Alcohol Awareness Month, National Autism Awareness month, and Sports Eye Safety Month.” So let’s take a cue from them and talk about some really important things.

We’ve already done some Alcohol Awareness in a previous post, so you can always revisit that post if you haven’t already checked it out, and if you read it before, you might learn something you didn’t catch the first time.

Source: Autism Speaks

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Now let’s talk about AUTISM!

Autism, a.k.a autism spectrum disorder (ASD) is a complex disorder that involves something going terribly wrong during the development of the brain. A person with autism has difficulties with social interaction and communication – both verbal and non-verbal, while also displaying some repetitive behaviors. These symptoms are usually noticed in early childhood – between 2 and 3 years old – and can affect daily functioning of a person.  ASD can also be associated with difficulties in motor coordination and attention as well as intellectual disability (also known as mental retardation, which is now politically incorrect). On the other hand, some persons with ASD excel in music, math, art and visual skills.

It’s referred to as a ‘spectrum’ disorder because there’s a wide range of symptoms and different degrees to which a person can be affected. Some children & adults are able perform basic activities by themselves, while others would require help to perform the same activities. ASD is a collection of some other mental disorders that were once categorized differently, such as Asperger’s Syndrome, childhood disintegrative disorder and pervasive developmental disorder.

How’s Autism diagnosed?

Parents are usually the first to notice abnormal behaviors in their children, and there’s the Modified Checklist of Autism in Toddlers (M-CHAT) which parents can use to determine if there child should be further evaluated by a specialist.

A diagnostic evaluation involving a team of doctors including a pediatrician, psychologist, speech and language pathologist and occupational therapist is best for children. Sometimes, ASD is diagnosed later in life, at which point trained specialists are still needed for a diagnosis.

What causes Autism?

Just like a lot of mental disorders, it could be hereditary, or due to genetic and environmental factors. Genetic mutations during development in the womb, conception of a child taking place when the parents are older, maternal illness during pregnancy or complications during childbirth such as deprivation of oxygen to the brain are all factors that can contribute to autism. A combination of them would increase the risk of autism. In most cases, it’s a combination of genetic mutations and environmental risk factors that causes autism.

What are the symptoms of Autism?

Autism Speaks, the world’s leading autism science and advocacy organization lists the following as symptoms of Autism: 

Social Challenges 

  • Difficulty engaging in give-and-take of everyday human interactions
  • Failure to respond to their names, reduced interest in people and delayed babbling 
  • Difficulty playing social games, don’t imitate the actions of others and prefer to play alone
  • They fail to seek comfort or respond to parents’ display of anger or affection in typical ways 
  • Difficulty interpreting what others are thinking or feeling – gestures and facial expressions
  • Difficulty regulating emotions – crying or having outbursts in inappropriate situations
  • Disruptive and physically aggressive behavior 
  • Tendency to ‘lose control’ may be pronounced in unfamiliar, overwhelming or frustrating situations
  • Frustration can result in self-injurious behaviors such as head banging, hair pulling or self-biting 

Communication Difficulties 

  • Young children with autism tend to be delayed in babbling and speaking and learning to use gestures
  • Difficulty combining words into meaningful sentences; may speak only single words or repeat the same phrase over and over; may repeat what they hear (echolalia) 
  • Mildly affected children exhibit only slight delays in language or even develop precocious language and unusually large vocabularies – yet have difficulty sustaining a conversation. 
  • Some children with ASD with superior language skills tend to speak like little professors 
  • Inability to understand body language, tone of voice and expressions that aren’t meant to be taken literally
  • Facial expressions, movements and gestures may not match what they’re saying; their tone of voice may fail to reflect their feelings. 
  • Failed communication can lead to frustration and inappropriate behavior such as screaming or grabbing

Repetitive Behaviors 

  • Common repetitive behaviors including hand-flapping, rocking, jumping and twirling, arranging and rearranging objects, and repeating sounds, words, or phrases
  • Restricted range of activities such as spending hours lining up toys in a specific way instead of using them for pretend play
  • Some adults are preoccupied with having household or other objects in a fixed order of place
  • It can prove extremely upsetting if someone or something disrupts the order and slight changes can be extremely stressful and lead to outbursts 
  • Repetitive behaviors can take the form of intense preoccupations or obsessions; extreme interests in objects or depth of knowledge
  • Older children and adults with autism may develop tremendous interest in numbers, symbols, dates or science topics

Associated Medical Conditions

  • Genetic disorders including Fragile X syndrome, Angelman syndrome, tuberous sclerosis, chromosome 15 duplication syndrome and other single-gene and chromosomal disorders
  • Gastrointestinal (GI) disorders – pain by GI issues can prompt behavioral changes such as increase self soothing (rocking, head banging, etc) or out bursts of aggression and self-injury
  • Seizure disorders including epilepsy
  • Sleep problems 
  • Sensory processing problems – unusual responses to sensory input, e.g. experiences seemingly ordinary stimuli as painful, unpleasant or confusing
  • Pica – tendency to eat things that are not food such as dirt, clay, chalk or paint chips, when they’re past the age at which it’s a normal part of development (18 – 24 months)  

How is ASD treated?

Individuals with ASD have unique conditions, therefore their treatment is tailored to their specific needs. Behavioral treatment, medicines or both are interventions used in treating ASD, and treating associated medical conditions can improve behavior.

Early intervention therapies involves a child’s family working in conjunction with a team of specialists. Therapists can come to the home, parents can be trained by therapist or therapy can be delivered in a specialized center or school. Early intensive behavioral intervention improves learning, communication and social skills in children with ASD, although the outcomes varies between individuals.

Good early intervention share some core features:

  • The child receives structured, therapeutic activities for at least 25 hours per week
  • Highly trained therapists/teachers deliver the intervention
  • The therapy is guided by specific and defined learning objectives, and the children’s progress is continually evaluated and recorded
  • The intervention focuses on the areas affected by autism – social skills, language, communication, imitation, play skills, daily living and motor skills 
  • The program provides the child opportunities to interact with peers with normal development 
  • The program engages parents in the intervention
  • The therapists make clear their respect for the unique needs, values and perspectives of the child and their family
  • The program involves a team of specialists as needed, including a physician, speech-language pathologist and occupational therapist 

There are some interesting stories of children who beat autism that was published in the New York Times, it’s an interesting read, especially for anyone with a family member with autism. Check it out here – The New York Times Magazine: The Kids Who Beat Autism

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