AUTISM SPECTRUM DISORDER (ASD)
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Autism spectrum disorder (ASD) is the name for a group of developmental disorders. ASD includes a wide range, “a spectrum,” of symptoms, skills, and levels of disability.
People with ASD often have these characteristics:
- Ongoing social problems that include difficulty communicating and interacting with others
- Repetitive behaviors as well as limited interests or activities
- Symptoms that typically are recognized in the first two years of life
- Symptoms that hurt the individual’s ability to function socially, at school or work, or other areas of life
Some people are mildly impaired by their symptoms, while others are severely disabled. Treatments and services can improve a person’s symptoms and ability to function. Families with concerns should talk to their pediatrician about what they’ve observed and the possibility of ASD screening. According to the Centers for Disease Control And Prevention (CDC) around 1 in 68 children has been identified with some form of ASD.
Symptoms
Parents or doctors may first identify ASD behaviors in infants and toddlers. School staff may recognize these behaviors in older children. Not all people with ASD will show all of these behaviors, but most will show several. There are two main types of behaviors: “restricted / repetitive behaviors” and “social communication / interaction behaviors.”
Restrictive / repetitive behaviors may include:
- Repeating certain behaviors or having unusual behaviors
- Having overly focused interests, such as with moving objects or parts of objects
- Having a lasting, intense interest in certain topics, such as numbers, details, or facts.
Social communication / interaction behaviors may include:
- Getting upset by a slight change in a routine or being placed in a new or overly stimulating setting
- Making little or inconsistent eye contact
- Having a tendency to look at and listen to other people less often
- Rarely sharing enjoyment of objects or activities by pointing or showing things to others
- Responding in an unusual way when others show anger, distress, or affection
- Failing to, or being slow to, respond to someone calling their name or other verbal attempts to gain attention
- Having difficulties with the back and forth of conversations
- Often talking at length about a favorite subject without noticing that others are not interested or without giving others a chance to respond
- Repeating words or phrases that they hear, a behavior called echolalia
- Using words that seem odd, out of place, or have a special meaning known only to those familiar with that person’s way of communicating
- Having facial expressions, movements, and gestures that do not match what is being said
- Having an unusual tone of voice that may sound sing-song or flat and robot-like
- Having trouble understanding another person’s point of view or being unable to predict or understand other people’s actions.
People with ASD may have other difficulties, such as being very sensitive to light, noise, clothing, or temperature. They may also experience sleep problems, digestion problems, and irritability.
ASD is unique in that it is common for people with ASD to have many strengths and abilities in addition to challenges.
Strengths and abilities may include:
- Having above-average intelligence – the CDC reports 46% of ASD children have above average intelligence
- Being able to learn things in detail and remember information for long periods of time
- Being strong visual and auditory learners
- Exceling in math, science, music, or art.
Causes
Autism spectrum disorder has no single known cause. Given the complexity of the disorder, and the fact that symptoms and severity vary, there are probably many causes. Both genetics and environment may play a role.
- Genetic problems. Several different genes appear to be involved in autism spectrum disorder. For some children, autism spectrum disorder can be associated with a genetic disorder, such as Rett syndrome or fragile X syndrome. For others, genetic changes may make a child more susceptible to autism spectrum disorder or create environmental risk factors. Still other genes may affect brain development or the way that brain cells communicate, or they may determine the severity of symptoms. Some genetic problems seem to be inherited, while others happen spontaneously.
- Environmental factors. Researchers are currently exploring whether such factors as viral infections, complications during pregnancy or air pollutants play a role in triggering autism spectrum disorder.
Diagnosis
Because there aren't specific laboratory and imaging tests for autism, it's best to get a diagnosis from a physician or psychologist who specializes in developmental disabilities and has experience diagnosing Autism Spectrum Disorders (ASDs).
The diagnosis of autism is made by taking into account the child's complete medical and behavioral history, lengthy observation of the child's behavior, and ruling out other problems that may cause some of the same symptoms. It is important to distinguish autism from other disorders, because a misdiagnosis may result in delayed, inappropriate, or ineffective treatment.
Preventions
There's no way to prevent autism spectrum disorder, but ASD can be treated, and children can improve their language and social skills. Children with ASD typically continue to learn and compensate for problems throughout life, but most will continue to require some level of support.
If your child is diagnosed with autism spectrum disorder, talk to experts about creating a treatment strategy. Keep in mind that you may need to try several different treatments before finding the best combination of therapies for your child.
Risk Factors
Scientists don’t know the exact causes of ASD, but research suggests that genes and environment play important roles.
Risk factors include:
- Gender—boys are more likely to be diagnosed with ASD than girls
- Having a sibling with ASD
- Having older parents (a mother who was 35 or older, and/or a father who was 40 or older when the baby was born)
- Genetics—about 20% of children with ASD also have certain genetic conditions. Those conditions include Down syndrome, fragile X syndrome, and tuberous sclerosis among others.
In recent years, the number of children identified with ASD has increased. Experts disagree about whether this shows a true increase in ASD since the guidelines for diagnosis have changed in recent years as well. Also, many more parents and doctors now know about the disorder, so parents are more likely to have their children screened, and more doctors are able to properly diagnose ASD, even in adulthood.
Complications
Additional Challenges of ASD
There are often additional complications and disorders that add to the challenges of treatment, caretaking, and therapy for ASD. A person can also have companion conditions. Some of the disorders and other problems that tend to accompany ASD are described below.
Sensory Problems
Someone with an ASD can be very sensitive to sensory input. It can be severe enough that common sensations can cause significant emotional discomfort. Alternatively, they may not respond at all to some extreme sensations, such as heat, cold, or pain.
Seizures
Seizures are a very common component of ASD. They often begin in young autistic children or autistic teenagers.
Mental Health Issues
According to the National Autistic Society, people with ASD are prone to depression, anxiety, impulsive behavior, and mood swings.
Tuberous Sclerosis
This rare disorder causes benign tumors to grow in the organs, including the brain. The link between tuberous sclerosis and ASD is unclear. However, ASD rates are much higher among children with tuberous sclerosis than those without the condition.
Mental Impairment
Autistic children often have at least some level of mental impairment. This can include fragile X syndrome, which is a defect on a section of the X chromosome. This is a very common cause of mental impairment, particularly among boys.
Other Complications
Other problems that can accompany ASD are aggression, odd sleeping and eating habits, and digestive issues.
Treatment
Early treatment for ASD and proper care can reduce individuals’ difficulties while helping them learn new skills and make the most of their strengths. The very wide range of issues facing those “on the spectrum” means that there is no single best treatment for ASD. Working closely with a doctor or health care professional is an important part of finding the right treatment program. There are many treatment options, social services, programs, and other resources that can help.
Here are some tips.
- Keep a detailed notebook. Record conversations and meetings with health care providers and teachers. This information helps when its time to make decisions.
- Record doctors' reports and evaluations in the notebook. This information may help an individual qualify for special programs.
- Contact the local health department, school, or autism advocacy groups to learn about their special programs.
- Talk with a pediatrician, school official, or physician to find a local autism expert who can help develop an intervention plan and find other local resources.
- Find an autism support group. Sharing information and experiences can help individuals with ASD and/or their caregivers learn about options, make decisions, and reduce stress.
