ASD is a heterogeneous disorder i.e. no two individuals on the spectrum will have the same set of signs and symptoms. The severity and range of symptoms are highly variable. However, the symptoms or difficulties can be classified into core domains such as difficulty in social interactions, communication deficits, behavioral issues and unusual interests and certain physical attributes. An individual may present with anyone, or a combination of or all of these difficulties/symptoms. Signs and symptoms usually become noticeable in the first three years of life. This section details the range of these signs and symptoms which are usually observed in individuals with autism.
Autism is a neuro-developmental condition and the symptoms sometimes may not be evident in the early years of the child. Sometimes the late diagnosis is due to limited awareness of parents as well as denial or hesitancy in accepting their child’s problems. It is important that the parents are alert and aware of child’s behavior and if they spot anything that raises suspicion, they should immediately consult the professionals.
Diagnosis of Autism is done by a multidisciplinary team. Multidisciplinary team is a team of different professionals that look different aspects of child’s development and therefore can provide a more accurate diagnosis.
Speech and Language Pathologist
This team carries out several assessments and tests, which pinpoint the exact areas in which the child has a problem. There are several tests that can be used for screening and diagnosis of autism. Screening of Autism involves identification of early signs and symptoms of Autism during regular visits to the pediatrician and appropriate referrals for details diagnostic evaluation. Diagnostic evaluation is more detailed and involves not only tests but other investigations. Some of the common tests used for screening and diagnosis are Childhood Autism Rating Scale (CARS), Autism Behaviour Checklist (ABC), Autism Spectrum Rating scale (ASRS), Autism Diagnostic Observation Schedule (ADOS) and Indian Scale for Assessment of Autism (ISAA). The criteria used for diagnosing autism by Psychologists is the fifth diagnostic and statistical manual for psychiatric disorders (DSM-V). For detailed DSM-V criteria click here
This assessment will aid in establishing a diagnosis as well as severity of ASD. These details will help to formulate a focused personalized treatment plan for your child.
Prior to diagnosis based on clinical observations and standardized assessment tools, you may be requested to perform one or more of the following investigative procedures for your child. These will help in ruling out other possible problems.
Children who are diagnosed with Autism are known to have other co-existing problems. A thorough evaluation is needed to rule out whether the comorbidity is directly associated with ASD or is altogether a different condition in the child.
Some of the problems which may be associated with Autism are described below
Parents of children with autism usually have a few unanswered questions such as "How did my child develop autism?" "My child was absolutely fine and had even started to pick up a few words. What happened all of sudden?" "Is autism acquired?" "Could it have been prevented?" "Is it genetic?" "Can my other children also have autism?"
Medical science does not have answers for many of these questions, and although the "why" may never be known, what is becoming clearer with ongoing research is, "What is the fundamental problem in the brains of the children with Autism".
In autism, though the brain structure looks normal, there are functional abnormalities in speciﬁc regions of brain. This information, about the functioning of brain areas can be obtained from functional neuroimaging techniques like PET-CT scan and functional MRI scan of the brain. These imaging studies permit the study of the abnormal pattern of cortical activation in autism. These studies indicate that certain areas of the brain show reduced functioning like mesial temporal lobe (innermost part of the brain responsible for learning, understanding, memory, social interaction and abstract thinking), frontal lobe (the front part of the brain responsible for emotions and aggression) and cerebellum (responsible for balance, coordination, muscle tone and speech). Hence the dysfunction of these areas are responsible for problems seen in autism.
Research has also helped us to know that there isn’t one cause of autism but multiple risk factors that increase the risk of a child developing autism. Most cases of autism seem to be caused by a combination of autism risk genes and environmental factors influencing the early brain development. Over the last five years, scientists have identified a number of rare gene changes or mutations which have been associated with autism. Other factors related to children with autism and their parents that may contribute to increase the risk of Autism have also been identified. Along with these certain environmental factors have also been included in the risk factors for Autism.
Environmental factors play a role in increasing risk of Autism. With urbanization and industrialization we are exposed to chemical pollutants in air, water, soil and therefore even the food we eat. With advent of technology we are exposed to more and more electromagnetic radiations. These elements are presumed to contribute to increased risk of Autism.
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Autism Spectrum Disorder (ASD) and Autism are both common terms used for a group of complex neurodevelopmental disorders. ASD is primarily characterized by deficits in communication and social interactions, unusual behavior and interests, while impacting the nervous system and affecting overall cognitive, emotional, social and physical wellbeing of the individual. The signs and symptoms of autism are typically noticed in the first three years of life. Autism affects the way a child relates to his or her environment and their interaction with other people. Subsequently, this grossly impacts development in the areas of daily functioning and social interaction. Mental capacities may be compromised due to atypical (subnormal) functioning of some areas of the brain. Hence, children with Autism have special needs that must be addressed differently.
Autism is usually diagnosed in early childhood and despite extensive studies, the exact cause of Autism remains elusive. However, with increased awareness, rapidly evolving technology and ever-growing research, it is now understood that an intricate interplay of genetics and environmental factors may be responsible for the onset of Autism. Research has established that early diagnosis and intervention, along with access to appropriate support lead to significantly improved outcomes. When Autism is detected and treated early, disruptive behaviors can be minimized and the quality of life of the individual can be bettered and moulded significantly.
The root of the term "autism" is derived from the Greek word "autos" meaning "self".
Paul Eugen Bleuler, a Swiss psychiatrist, first coined the term in 1911 . He used it to describe a subset of schizophrenic patients who seemed to be self- absorbed and withdrawn. As time passed, our thinking and understanding of autism has evolved dramatically. An analysis of the description of behavior traits observed in several early documented cases suggests that these are in fact cases of what we now recognize as Autism. One famous and well documented example of this would be the story of Victor, the Wild Boy of Aveyron, who was found naked in a French forest. Victor did not understand language and would eat only half-burned or roasted potatoes, walnuts and raw chestnuts. Some even believed that he had been reared by wolves. The French physician Dr. Jean-Marc Gaspard Itard took Victor under his care and brought him to Paris. Dr. Itard spent several years trying to help Victor to integrate into human society and teaching him language. He was not completely successful as Victor only learned some French words, but never fully understood the language. However, there was an improvement in Victor’s fine motor skills and communication. He also developed a friendship with his caregivers. It is now known that Victor may have been autistic and whoever he lived with was unable to understand him. Hence, although Autism seems to be a new condition, a look at its history suggests that it may have always existed..
Dr. Leo Kanner (pronounced "conner") and Dr. Hans Asperger have played the most crucial roles in introducing Autism to the world. In 1943, Dr. Leo Kanner, an Austrian psychiatrist working at Johns Hopkins Hospital, published a paper describing 11 children who displayed a "strong desire of being alone", had a "resistance to change" or a "need for sameness". He introduced the term "early infantile autism" to describe his observations. A year later, Dr. Hans Asperger, also an Austrian psychiatrist, described similar characteristics in a group of children he was treating. It is was eventually accepted as a diagnosis in 1981 and coined as "Asperger’s Syndrome" by Dr Lorna Wing, an English Psychiatrist, who pioneered in child development disorders and advanced the perception of Autism, worldwide.
According to the World Health Organization (WHO), worldwide, 1 in 160 children has an ASD. This suggests that approximately 1% of the world population has ASD. The prevalence of Autism varies considerably from country to country. No factors have been identified to contribute to the increased prevalence in different countries.
The studies have picked up a steep rise in the prevalence of autism.
Studies have also shown that boys are 5 times more likely to develop Autism than girls.
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Speech therapy is an intervention which aims at enhancing a child's speech skills and abilities to understand and express language, including nonverbal language.
Vitamin B12 (Methyl-B12) is a water soluble vitamin which is naturally present in certain food items such as eggs, milk, meat and fish. But, it is commonly deficient in children with autism as they have limited ability to absorb vitamin B12. Lack of vitamin B12 is responsible for the severity of autism.
There are several theories about the association of symptoms of Autism, to the gut of the child. It has also been observed that several foods or types of foods, have an effect on the child’s behavior, and response. It could also be said that children with Autism face some trouble in getting the right kind of nutrition due to certain sensory processing difficulties. Hence, a modified, or a systematic diet plan becomes an essential part of the conventional interventions for Autism.
Medical management of autism is a method wherein specific medicines and drugs are used in order to alleviate some of the symptoms associated with autism.
As the name itself suggests, Occupational therapy is a systematic practice which assists people in developing the 'skills for the job of living', necessary for independent and satisfying lives.
It is therefore, a means of alleviating some of the social, communication, and behavioral tendencies that are associated with children on the autism spectrum.
Autism Spectrum Disorder (ASD) and autism are both common terms used for a group of complex neuro-developmental disorders Autism is a pervasive developmental disorder that involves abnormal development and function of the brain. Individuals with autism show decreased social communication skills and restricted or repetitive patterns of behaviors or interests.. Autism spectrum disorder impacts the nervous system and affects the overall cognitive, emotional, social and physical health of the affected individual. This section explains some of signs and symptoms of autism, deficits in their social, communication skills, the behavioural issues, associated problems with autism, related causes and the team involved in treating and diagnosing autism.
Treatments available for autism individuals are bifurcated by ACA under three broad canopies:
Conventional Treatments: Includes medical management like Antipsychotics, Anti-depressants, Alpha2 antagonists to reduce hyperactivity, anxiety, impulsivity and inattention, mood stabilizers to reduce aggression, repetitive behavior.
Occupational therapy in autism, psychological interventions, ABA, sensory integration for children with autism and speech therapy. Alternative Treatments include aquatic therapy, art therapy, music therapy, dance therapy, play therapy, yoga therapy, diet & nutrition and animal therapy.
For people with disabilities, technology makes things possible. Assistive technologies are "any item, device, or piece of equipment that is used to increase, maintain, or improve the functional abilities of persons with disabilities".
This section tries to educate people and modify their understanding about Autism/ASD with the help of audio podcast and videos.
Every intervention starts with analyzing the problem at hand....
Functional analysis of behaviours helps the caregiver, therapist,...
Motivation is key to creativity, performance and happiness....