Autism Spectrum Disorder - Signs, Causes, Diagnosis, and Treatment

What is Autism?

Autism means a developmental disorder characterized by difficulty in communication, speech, social interaction, or repetitive behavior and thoughts. It is associated with the maldevelopment of the neural system, which results in abnormal brain function. It causes significant impairment in important areas of life.

Autism definition:

“It is a severe neurodevelopmental disorder that causes impairment in the ability to interact or communicate.”

According to the Center for Autism and Related Disorder (CARD), it affects 1 in 54 children in the United States. CARD is the world’s biggest autism treatment organization, founded in 1990by Doreen Granpseeheh. This organization provides several services for children and adults with autism.

History

The word autism is the English meaning of the Latin word “autismus.” It is derived from the Greek word “autos,” meaning “self.” It refers to morbid self-admiration, which means the autistic withdrawal of a person to his fantasies.

Long before autism was named, many symptoms and treatments were described. The Table Talk of Martin Luther was based on a severely autistic 12 years old boy story. Luther thought that the boy was a soulless mass of flesh possessed by the devil.

In 1747, Hugh Blair of Borgue, the first well-documented case of autism, was reported. Another case of a feral child, the Wild Boy of Aveyron, was reported in 1798. The boy has shown several autism signs. They were treated by a behavioral program designed to teach them to form social attachments.

Swiss psychiatrist Paul Eugen Bleuler first coined the term autism in 1911. He used this term to describe schizophrenia patients who were self-absorbed and withdrawn. In 1943, Dr. Leo Kanner, an American psychologist, published a paper. In his report, he described eleven brilliant children who want to be alone all the time. Leo described this condition as “an obsessive insistence on persistent sameness” and named it “early infantile autism.”

In 1944, Hans Asperger, a german scientist, worked with a group of intelligent boys who had difficulty in social interactions. Those boys take an interest only in the things they were obsessed with. Hans named this mild autism Asperger syndrome.

Research on twins was conducted in 1977. It found that autism is mostly caused by genetics and biological differences in brain development.

Finally, in 1980, the Diagnostic and Statistical Manual of Mental Disorders (DSM) officially separated “Childhood Schizophrenia” from “Infantile Autism.” In 1987, The DSM replaced “Infantile Autism” with “Autism Disorder” and introduced a diagnostic criteria checklist. In 1994, the DSM included Asperger Syndrome to include the mild autism in which high functioning autism diagnosis was involved.

A debate regarding the MMR vaccine causing autism began in 1998, which was quickly debunked. Later in 2000, the vaccine manufacturers removed the preservative thimerosal from all childhood vaccines. It was done because of the public fear regarding vaccines causing autism.

A debate regarding the MMR vaccine causing autism began in 1998, which was quickly debunked. Later in 2000, the vaccine manufacturers removed the preservative thimerosal from all childhood vaccines. It was done because of the public fear regarding vaccines causing autism.

In 2009, the Center for Disease Control and Prevention (CDC) estimated that 1 in 110 children experiences autism. And finally, in 2013, the DSM-5 has unfolded all the subcategories into one umbrella of “Autism Spectrum Disorder (ASD).” They defined ASD by two categories: repetitive or restricted behavior and impaired social communication and interaction.

Types of Autism

Autism spectrum disorder has three types: Asperger syndrome, autistic disorder, and pervasive development disorder.

• Asperger Syndrome

  It is a mild form of autism in which a patient experiences social challenges, unusual behavior, and interests. People with Asperger syndrome are usually intelligent and take part in talking about the topics they like. They can handle their daily life but have a harder time socially.

• Autistic Disorder

  It is commonly known as classic autism. Significant language delays, unusual behavior and interest, and social and communication challenges are associated with this type. These people have intellectual disabilities to a severe level.

• Pervasive Development Disorder

  It is commonly known as atypical autism or Pervasive Development Disorder - Not Otherwise Specified (PDD-NOS). People with PDD-NOS show the symptoms of both Asperger syndrome and autistic disorder. The PDD-NOS is more severe than Asperger syndrome but less severe than the autistic disorder.

Autism Symptoms and Signs

The early signs of autism are impairment in emotional, social, and communication skills. People with ASD may repeat specific behavior or might act strange. Symptoms of autism are different in different people and usually begin during early childhood and last throughout life.

Signs of autism in babies and adult are:

• Abnormal body posturing or facial expression
• Developmental delay and abnormal tone of voice
• Lack of empathy
• Sleep disturbance
• Having trouble making eye contact
• Do not show interest in things when a person points at them
• Learning disability and delay in learning to speak
• Having trouble talking about their feelings or understanding others feelings
• Cannot focus on one topic or repeatedly talk about the same topic
• Lack of understanding of social cues
• Interested in talking to people but don’t know how to interact with them
• Cannot express their needs
• Self-abusive behavior
• Social withdrawal
• Repeatedly perform the same action
• An unusual or abnormal reaction in social settings

Autism Causes and Risk Factors

The exact cause of autism is still unknown, but it is believed that genetic disorders and environmental factors are involved. However, there may be many factors that cause autism, and they are:

• Certain genetic conditions like Rett syndrome, Down syndrome, or fragile x syndrome
• Having older parents
• Born with very low weight
• Having a sibling with ASD
• The prescriptive drugs thalidomide and valproic acid, taken during pregnancy

Most scientists believe that genes play a significant role in the development of autism in a person. The risk of autism begins before, during, or immediately after birth. Autism has continued to be a paramount public health concern.

Autism Diagnosis

The diagnosis of ASD is difficult since the exact cause is still unknown, and there is no autism test. Medical tests like a blood test or any other test for diagnosing the disorder are not available. The only autism diagnosis is to look at child development or an adult's behavior.

The early symptoms of autism usually begin during childhood so that it can be detected at earlier ages. The diagnosis in children and adolescents can sometimes be made at 1.5 years or younger. Moreover, by the age of 2, a reliable diagnosis can be made by a professional.

However, sometimes a final diagnosis cannot be made until a much older age. This delay in diagnosis means the autistic child might not get the early help he needs. Therefore, timely evaluation, screening, and monitoring of ASD are essential. It is to ensure children get the help they require to reach their full potential.

The following steps are involved in the diagnosis process:

1. Developmental Monitoring

   It is the observation of how a child grows and changes over time. It monitors whether a child meets the typical developmental milestones in learning, behaving, speaking, playing, and moving. Caregivers, grandparents, or parents can take part in developmental monitoring.

   Parents can make a milestones checklist to see how their kid is growing. If they notice that their kid is not meeting milestones, they can talk to their child’s doctor about their concern.

   When parents take their child on a visit, the doctor also does developmental monitoring. The doctor might have asked parents several questions related to the child’s development. For clearer observation, the doctor might play or talk to the child to see if he meets the milestones.

   Any missed milestone could be a sign of a problem. Hence, the doctor will closely examine the child by using a thorough test. The childcare professional is also a valuable source of information on how the child should grow or develop.

2. Developmental Screening

   The next step is to closely observe how a child is growing and developing. It is more formal than developmental monitoring and usually done less often than developmental monitoring. It becomes essential if any of the autism signs are observed in a child. However, it is also a regular part of doctor’s visits for all children, even if there is no autism sign.

   In the developmental screening, the doctor might take the child’s brief test or ask parents to fill in a questionnaire. The tools involved in the screening process are questionnaires or checklists. These tools are based on asking formal questions about the development of children. The questions are related to emotions, behavior, thinking, movement, and language development.

   The screening is recommended by the American Academy of Pediatrics (AAP) for regular well-child visits at the following ages:

   • 9 months
   • 1.5 year
   • 2.5 year

   Additionally, AAP recommends that all children should be screened for ASD during regular well-child visits at the following ages:

   • 1.5 year
   • 2 year
   • Additional screening is required if a child has a sibling with ASD or any sign associated with ASD is observed.

   Moreover, additional screening is required if a child is at high risk for developmental problems due to environmental factors. The factors may include lead exposure, low birth weight, preterm birth, or any other aspect.

3. Comprehensive Developmental Evaluation

   The final step is the comprehensive development evaluation (CDE). The tools used in developmental screening might not be enough for a reliable diagnosis. However, they indicate that a child needs a closer observation or he is right on the track. These tools identify the area of concern where a formal developmental evaluation is required.

   The CDE is the formal evaluation that gives an in-depth insight into children’s development. It is usually done by trained specialists, such as occupational therapists, speech-language pathologists, child psychologists, or other specialists. These specialists may do the following things for CDE:

   • Observe the child’s behavior.
   • Ask the child to perform a specific task.
   • Ask the parents some questions about their child.

   Based on the results, the specialist determines whether a child needs early intervention services, special treatment, or both.

Autism Treatment

Currently, there is no cure for ASD. However, researches have shown that a child’s development can be improved by early intervention treatment services. These services help children from birth to 3 years old learn essential skills. These services include:

• Therapies
• Nutrients
• Communication treatments

These early interventions may reduce the symptoms and help children to function and participate in the community. These services also improve daily living skills and cognitive abilities. However, ASD affects each person differently, so the treatment plans are usually multidisciplinary.

The type of treatment a child gets totally depends on the child’s individual needs. There are various autism treatments, and they include:

• Behavior and communication treatment
• Medication
• Nutrition
• Therapies

All these treatments aim to reduce the symptoms and improve the child’s development and learning.

Behavior and Communication Treatment

The national research council and AAP defined the behavior and communication treatment as an organization, structure, and direction for the child. These approaches include:

• Applied Behavior Analysis (ABA)

  This approach discourages negative behavior and encourages positive behavior to improve a variety of skills. It is widely used in schools, clinics and became accepted by childcare professionals. The following are the different types of ABA treatment:

  • Early Start Denver Model (ESDM): It is designed explicitly for 1-4-year-old children. Play and joint activities are involved in ESDM to improve children’s cognitive, language, and social skills.
  • Verbal Behavior Intervention (VBI): It is designed to teach children verbal and language skills.
  • Discrete Trial Training (DTT): It uses positive reinforcement and various lessons to teach the desired behavior.
  • Pivotal Response Training (PRT): It motivates the child to communicate, learn, and observe their own behavior.
  • Early Intensive Behavioral Intervention (EIBI): It often works best for children younger than 3 years. It uses structured teaching methods to reduce unwanted behavior and build positive behavior.

  These ABA procedures are focused on observing and measuring the child’s progress. Other treatments can also be added with ABA techniques to enhance positive results.

• The Picture Exchange Communication System (PECS)

  It is a visual-based treatment that uses symbols to help children learn specific behavior. These symbols motivate the child to learn to initiate communication and ask questions.

• Treatment and Education of Autistic and Related Communication Handicapped Children (TEACCH)

  It is another visual-based treatment that uses visual cues instead of symbols like picture cards. TEACCH helps children learn necessary routine life skills like eating and getting dressed.

• Developmental, Individual Differences, Relationship-Based Approach (DIR)

  It is commonly known as Floortime and focused on emotional and relationship development. It is named Floortime because it involves the child getting on the floor to play or do other activities. It also uses visual cues like TEACCH to teach kids a variety of daily routine skills.

Medication

There is no specific medication or vaccines for the cure of ASD. However, some medicines can help people function better and reduce symptoms like insomnia, seizure, and depression.

The medication may also help in managing high energy levels, self-injury, and behavioral reactivity. However, the medicine may not affect all people with ASD in the same way. Many studies showed that drugs work best when combined with different therapies.

For the treatment of children with ASD, Food and Drug Administration (FDA) only approved Risperidone medicine. It can be prescribed to 5-16 years old children to help them with irritability.

However, doctors might prescribe some other medicines in particular cases, including stimulants, anti-anxiety medication, and selective serotonin reuptake inhibitors (SSRIs). But these drugs are not approved by the FDA for the treatment of ASD.

When a child is on medication, he should be closely observed to monitor medication’s progress and reactions. It is important to ensure that the negative side effects of the drug do not outweigh the benefits.

Nutrition

There is no specific diet recommended by the experts for children with ASD, but getting proper nutrition is important. Autistic children usually restrict their diet, or parents eliminate some things to see if they help reduce the symptoms.

However, this is not the right approach, as every food item has its benefits and is essential for proper nutrition. Thinner and weak bones are very common in children with ASD, so bone-building foods should be included in the diet.

Over the years, many dietary treatments have been designed for ASD. These plans are focused on removing the food items that cause allergies and including vitamins and mineral supplements.

Therapies

Therapies have played a promising role in the treatment of ASD. When they are combined with other treatment processes, the combination gives the best results. Many therapies are involved in the treatment of ASD, and they are:

• Occupational Therapy

  It involves teaching children life skills so that they can live as independently as possible. The skills may include bathing, eating, dressing, and how to relate to people.

• Speech Therapy

  It helps the child to learn how to communicate with people. Many kids can learn verbal communication skills. However, for others, the usage of picture boards or gestures might be a more realistic approach.

• Sensory Integration Therapy

  It involves teaching kids how to deal with sensory information. For example, certain sounds, bright lights, or the feeling of being touched.

• Social Skills Training

  It involves teaching kids how to behave in a social setting. For example, how to initiate communication, have a conversation, interact with people, or problem-solving skills.

Parenting a Child With ASD

Parents have to spend most of the time with their autistic kids. So they can play a vital role in the treatment and wellbeing of their child. Apart from therapies, medication, or other treatments, some simple and basic things can make a huge difference.

Here are some tips for the parents of children with autism:

• Do not let negativity intervene in your child’s progress, as there is no complete cure for ASD. Focus on positivity; a little improvement can be very effective in the long run.
• Praise your child for their good behavior and ignore the incorrect and wrong behavior. Kids with ASD often respond well to positive reinforcement.
• Find different ways to regard your kid and be specific so let them know what you like about their behavior.
• Stay consistent and on schedule. People with ASD do not like inconsistent routines. They want everything on time.
• Make sure your child gets consistent guidance and practice what they learn through therapy.
• Find activities that seem like pure fun and not some therapy or education.
• Stay positive with their performance and try not to get discouraged if your child is not responding well to treatment.

These tips can help you handle your child with ASD. Moreover, you can also get your child an emotional support animal (ESA). ESA helps autistic people with meltdowns by providing comforting and calming interactions. The ESAs are usually friendly, loving, and compassionate creatures that can become the best companions.

To get an ESA, all you have to do is get an emotional support animal letter. The ESA letter is a prescription from a mental health provider that specifies the mental disability. It makes you eligible to live and travel with your ESA. you can get a valid ESA letter from RealESALetter.com at reasonable prices.