Autism Spectrum Disorder: The Complete Facts and Knowledge

You may probably be feeling anxious about what comes next if you recently learned that your child has or may have autism spectrum disorder (ASD). An ASD diagnosis can be particularly terrifying since no parent is ever ready to learn that their child is anything other than healthy and happy. As a parent of an autistic child, you may be uncertain about how to help your child or feel confused by conflicting therapy recommendations that you get from different sources. Or perhaps you may have been told that ASD is an incurable, lifelong diagnosis, making you worried that nothing you do will make a difference.

Even though ASD is not something a person can “grow out of,” there are numerous treatments that can assist kids in learning new abilities and overcoming a number of developmental challenges. Let’s indulge further to know how! 

What Is Autism Spectrum?

ASD, often known as an autism spectrum disorder, is a neurological and developmental condition that affects how people connect with others, communicate, learn, and behave. Although autism can be identified at any age, it is referred to be a “developmental condition” because symptoms typically emerge in the first two years of life.

People with ASD often show the following difficulties according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5):

• Difficulties in social communication and interaction with other people
• Repetitive behaviors and restricted interests 
• Functional impairment at school, work, and other areas of life

Understanding Autism & Autism Awareness

Autism spectrum disorder usually begins in early childhood and eventually results in difficulty functioning socially, in school, or at work. Within the first year, children often show symptoms of autism. For some children, development may be normal in the first year, but then go through a period of regression between 18 and 24 months of age when they develop autism symptoms.

 Autism is considered a “spectrum” disorder because there is great variation in the type and severity of symptoms people experience. Individuals of any gender, race, ethnicity, or economic background can be diagnosed with ASD. Although ASD can be a lifelong condition, treatments and services can improve a person’s symptoms and daily functioning.

People on the autism spectrum may exhibit many strengths, including:

• Remembering information for long periods of time and being able to learn things in detail
• Strong visual and auditory learning abilities
• Excelling in specific areas like math, science, music, or art

History Behind Autism

Eugen Bleuler, a psychiatrist, coined the term autism in 1908 to describe a schizophrenic patient who had withdrawn into his own world. The Greek word ”autós” meant self and the word “autism” was used by Bleuler to mean withdrawal within the self.

Hans Asperger and Leo Kanner were the pioneers in research into autism and were working separately in the 1940s. While Asperger focused on very able children, Kanner studied children who were severely affected. The DSM-II edition, published in 1968, defined autism as a psychiatric condition — a form of childhood schizophrenia marked by a detachment from reality. 

During the 1950s and 1960s, autism was thought to be the result of cold and unemotional mothers, whom Bruno Bettelheim dubbed ‘refrigerator mothers’. In the 1960s to 1970s, the concept of ‘refrigerator mother’ was disproved, as a growing body of research showed that autism has biological underpinnings and is rooted in brain development.

Later on, autism was described as a set of related developmental disorders. It was first categorized as a spectrum condition with wide-ranging degrees of impairment in the DSM-IV, released in 1994, and later revised in 2000. Its diagnostic criteria have changed along with these shifting views.

What Are the Signs and Symptoms of Autism

While some kids show signs of autism spectrum disorder such as limited eye contact, poor name-call response, or indifference to caregivers in early infancy, some children may develop normally for the first few months or years of life, and then suddenly become withdrawn or lose language skills they’ve already acquired. The signs of autism in this latter group are usually observed by age 2 years.

A checklist of typical behavioral patterns in people with ASD is listed below. Though not everyone with ASD will exhibit all of the behaviors, a majority will exhibit some of them.

Social communication/interaction behaviors may include:

• Having little or inconsistent eye contact 
• Appearing not to listen or look at people who are speaking 
• Rarely sharing interest, emotion, or enjoyment of objects or activities with others
• Poor name call response 
• Having difficulties engaging in back-and-forth conversation 
• Tendency to talk about a favourite subject without noticing that others are not interested or without giving others a chance to respond
• Exhibiting facial expressions and gestures that don’t match with what is being said 
• Having an unusual tone of voice that may sound flat and robot-like 

Restrictive/repetitive behaviors may include:

• Repeating specific behaviors or having unusual behaviors such as repeating words or phrases (a behavior called echolalia)
• Showing a lasting intense interest in specific topics such as numbers, details, or facts 
• Showing overly focused interests in specific objects such as any moving objects or parts of objects
• Difficulty in slight changes in daily routine and having difficulty with transitions
• Being more sensitive or less sensitive to sensory input, such as light, sound, texture, or temperature
• Sleep problems and irritability are also experienced by a majority of people with ASD.

Types of Autism Spectrum Disorders

There is not one but different subtypes in autism, most influenced by a combination of genetic and environmental factors. As autism is a spectrum disorder, each person with autism has a distinct set of strengths and challenges. The ways in which an autistic child thinks, learns, and problem-solves can range from highly skilled to severely challenged depending on the individual condition. Some with ASD may require significant support in their daily lives, while others may only need less support and, in some cases, live entirely independently.

The majority of the misconception surrounding ASD comes from terminology that was used before 2013. In this previous classification system, children fell into one of the following three categories:

• Autistic Disorder – In the past, more severe cases of ASD were classified as autistic disorders. The condition was often defined by communication difficulties, repetitive behaviors, and social challenges among other symptoms. 
• Asperger’s Syndrome – On the other end of the spectrum was Asperger’s syndrome which was characterized by milder symptoms that may impact an individual’s communication or social skills. 
• Pervasive Development Disorder, Not Otherwise Specified (PDD-NOS) – This diagnosis was often given to children who fell in the middle and didn’t fully meet the requirements for either autistic disorder or Asperger’s diagnosis.

Different Levels of Autism

Autism spectrum disorder (ASD) is now categorized into three different levels indicating what level of support a patient may need, such as, 

ASD Level 1 – Currently Level 1 ASD belongs to the lowest classification. Individuals on this level will require some support to help with problems such as inhibited social interaction and lack of organization and planning skills.

ASD Level 2 – Level 2 lies in the mid-range of ASD. In this category, they show problems that are more obvious to others and these individuals require additional support. The difficulties may include trouble with verbal communication, exhibiting frequent, repetitive behaviors, and very restricted interests.

ASD Level 3 –Individuals who require substantial care and support lie in the most severe end of the spectrum i.e., Level 3. In this category, signs of both Level 1 and Level 2 are still present but are far more severe and accompanied by other complications as well. Those at this level will have limited ability to communicate and interact socially with people around them.

What Causes Autism?

The primary causes of ASD are still unknown, but studies suggest that a person’s genes can act together with aspects of their environment to affect development in ways that lead to ASD.

Certain factors that increase a child’s risk may include:

• Gender: The risk of developing autism spectrum disorder is almost four times higher in boys than in girls.
• Family History: Families already having one child with ASD have more risk of having another child with the disorder. These include Fragile X syndrome, a hereditary disorder that causes intellectual problems; tuberous sclerosis, where benign tumors develop in the brain; and Rett syndrome, a genetic condition that is exclusively seen in girls.
• Extremely Preterm Infants: Children born before 26 weeks of pregnancy may have a greater risk of autism spectrum disorder.
• Parents’ Age: There may be a connection between ASD and parents’ age of conception. The older the parents at the time of conception, the greater will be the risk of their children developing autism.

How Is Autism Diagnosed?

Medical professionals assess the behavior and development of a patient to make an ASD diagnosis. By the age of two, ASD can be reliably diagnosed. The earlier the diagnosis, the sooner the child will get interventions.

Usually, the ASD diagnosis in young children follows a two-stage process.

Stage 1: General Developmental Screening During Well-Child Checkups

Every child should have regular check-ups with a pediatrician or an early childhood health care provider. The American Academy of Pediatrics advises that all children should be screened for developmental delays at their 9-, 18-, and 24- or 30-month child visits, and have specific autism screenings at their 18- and 24-month well-child visits.

Stage 2:  Additional Diagnostic Evaluation

It is crucial to accurately detect and diagnose children with ASD as early as possible, as this will help identify their unique strengths and challenges early. The diagnostic examination will be carried out by a team of medical professionals who have experience conducting diagnostic evaluations and diagnosing ASD. This team may consist of developmental pediatricians, speech-language pathologists, child psychologists and psychiatrists, educational specialists, and occupational therapists.

The diagnostic evaluation may include: 

• Medical and neurological examinations 
• Assessment of child’s cognitive abilities 
• Assessment of child’s language abilities
• Observation of child’s behavior 
• A detailed conversation with the child’s parents/caregivers about the child’s behavior and development 
• Evaluation of age-appropriate skills needed to perform everyday activities independently, such as eating, dressing, and toileting
• As autism is a complex disorder that sometimes occurs with other illnesses or learning disorders, the comprehensive evaluation may include:
• Blood tests
• Hearing test

How Is Autism Treated?

Depending on their specific individual needs, your child’s autism spectrum condition treatment will vary. There is no specific treatment or cure for autism. Because ASD is a spectrum disorder (meaning some children have mild symptoms and others have severe symptoms), treatment plans are tailored according to their unique needs.

The treatments that help your child the most will depend on their needs and situation, but the end goal will always be the same – to lessen their symptoms and enhance their learning and development.

Applied behavior analysis (ABA)

ABA applies interventions that are based on the principles of learning. ABA techniques are used to increase and maintain desirable adaptive behaviors, reduce interfering maladaptive behaviors or lessen the conditions under which they occur. Applied behavior analysis (ABA) can help kids generalize the new skills learned to multiple situations and environments through a reward-based motivation system.

Occupational Therapy 

Occupational therapy focuses on promoting the development of self-care skills (eg, dressing, using utensils, eating, personal hygiene) and academic skills (eg, cutting with scissors, writing). Occupational therapists may also help with prevocational training, promoting the development of play skills, and modifying classroom materials and routines to improve attention and organization.

Sensory Integration (SI) Therapy 

SI often is used alone or as part of a broader program of occupational therapy for children with ASD. Teaching specific skills or behaviors is not the goal of SI therapy; instead, sensory integration therapy works to remediate deficits in neurological processing and enhance the integration of sensory information to allow the child to interact with the environment more adaptively.

Speech-Language Therapy 

Speech-language therapy can help people with ASD improve their abilities to communicate and interact with others. They mainly work in two areas:

• Verbal Skills to improve their spoken or verbal skills, such as correctly naming people and things, using words and sentences better, and improving the rate and rhythm of speech.
• Nonverbal Skills to teach nonverbal communication skills, using unaided communication systems such as hand signals, gestures, facial expressions, sign language, and using augmentative and alternative communication systems such as picture symbols to communicate (Picture Exchange Communication System), and speech generating devices.

Medications

There is no specific medicine to ‘cure’ autism. However, medications can help control certain behaviors or difficulties that some autistic children experience such as aggressive behavior, anxiety, hyperactivity, obsessive behavior, etc. Before you decide whether medication is right for your child, it is essential to seek professional advice.

Family Therapies and Therapy at Home

Home programs are important as it helps to accelerate the improvements gained from therapy sessions. Parents and other family members can learn how to play and interact with their children in order to promote social interaction skills, manage problem behaviors, and teach daily living skills and communication.

Autism Compared To Other Disorders

Autism compared to Attention Deficit Hyperactivity Disorder (ADHD)

• ADHD is characterized by a persistent pattern of inattention, difficulty remembering things, difficulties with time management, organizational tasks, hyperactivity, and/or impulsivity that interfere with learning and daily life. 
• ADHD can be extremely challenging to distinguish from ASD since the core symptoms of ASD can look like attention problems or hyperactivity (lack of eye contact, repetitive behaviors, not appearing to listen when others speak, interrupting or invading other people’s personal space, etc.). Many autistic children display behavior that’s very similar to ADHD.

Autism Compared To Down Syndrome

• Down syndrome is a genetic disorder. While most people have 23 pairs of chromosomes, people with Down syndrome (also called Trisomy 21) have an extra 21st chromosome. These individuals show characteristic facial features, intellectual disability, developmental delays, poor muscle tone, congenital heart defects, and potential hearing and vision problems.
• Autism is quite common in children who have Down syndrome. Up to 40% of individuals with Down syndrome are also autistic.

Autism and Co-occurring Conditions

• Sleep Disorders 

Chronic sleep problems affect around 50% to 80% of children with autism. The difficulties can include trouble falling asleep, frequent waking up, or extremely early rising.

• Anxiety and Depression

Depression and anxiety are the most commonly diagnosed co-occurring conditions that are particularly important to watch for in older children, as they become more self-aware as they grow up.

• Intellectual Disability with Autism

It is estimated that 31% of children with ASD have intellectual disability ( [IQ] <70) with significant challenges in daily functioning and  25% are in the borderline range (IQ 71–85).

• High intelligence

Among autistic children, 59 percent have an average or higher IQ score. High functioning autism refers to individuals with IQ above 70 and no intellectual disability. The term high-functioning autism refers to autistic people who can function with minimal support. They may be able to read, write, handle basic tasks, or live independently. Their relationships, career, or education are not significantly affected, although they have autism.

• ADHD (Attention Deficit Hyperactivity Disorder)

ADHD and autism can occur together. According to the studies, the prevalence of ADHD in people with autism ranges from 50 to 70%.

• Chronic Gastrointestinal Disorders

Children with autism are nearly eight times more likely to suffer from one or more chronic gastrointestinal disorders than other children. Symptoms include abdominal pain, diarrhoea, chronic constipation, etc.

Is it Possible to Recover From Autism?

According to the field experts, the answer is no; unfortunately, it is not possible to outgrow autism. In the last 20 years, the prevalence of autism has increased by 178%. 1 in every 100 children under the age of ten in India has autism. The epidemic highlights the critical need for improved diagnostic techniques, individualized therapy, and ASD management. Even though autism is a lifelong condition, they may learn to function well and manage the symptoms if early interventions are given. 

How Can You Find Autism Treatment Centres

As a parent, to know more about your child and his/her developmental milestones, contact your kid’s doctor if you suspect that your child has ASD or if you have any other concerns about the way your child reacts, plays, learns, speaks, or behaves.

You can also ask the doctor to recommend a specialist who can perform a more detailed evaluation of your child. The professionals who can do a more in-depth evaluation and reach a diagnosis include

• Developmental pediatricians (doctors with special training in child development and special needs children)
• Clinical psychologists or psychiatrists 
• Occupational therapists
• Speech-language pathologists

Choosing Autism Treatments

There are many different approaches and options to ASD treatment, including behavior therapy, speech-language therapy, physical therapy, occupational therapy, and medications.

Treatment should be initiated focusing on your child’s most severe symptoms and pressing needs.

It is a proven fact that early intervention services can greatly improve a child’s development. It is important to initiate treatment as early as possible to ensure that your child reaches their full potential. If your child is diagnosed with ASD, talk to experts about creating a treatment plan and build a team of professionals to meet your child’s needs to ensure early intervention. 

Should you have any queries about the treatment process or feel confused, contact our team for guidance. Prayatna has a team of multi-functional professionals who work together to identify each child’s strengths and needs and help them develop skills for an independent life. 

Conclusion

Autism is a complex condition characterized by communication and behavioral difficulties. The disorder manifests itself very early in childhood, varies in severity, and is characterized by impaired social skills, communication difficulties, and repetitive behaviors. Hope this blog has helped you get a brief overview of autism, its symptoms, and the facts to consider when you have a child with autism.

The best thing you can do as a parent of a kid with ASD or associated developmental delays is to begin therapy as early as possible. As soon as you suspect a problem, seek guidance and get assistance. Don’t wait to see if your child will eventually catch up or outgrow the issue. You have to keep in mind that the earlier children get help, the greater their chances of treatment success. The most effective way you can help to support your child’s development and decrease the symptoms of autism is by providing early intervention.

Move Ahead Most Positively – Few Tips for Coping

There is no doubt that raising a child with autism spectrum disorder can be emotionally draining and physically exhausting. Here are a few suggestions to help you wade through all the difficulties you face along the way and cope with the situation most positively:

• Learn about the disorder. You can come across many myths and misconceptions about autism spectrum disorder. Getting to know more about the condition from competent authorities can help you better understand your child and their attempts to communicate.
• Find a team of trusted professionals including psychologists, occupational therapists, speech therapists, social workers, and teachers.
• Keep records of visits to the professional team. Your child may have many people involved in his or her care, starting from evaluations, therapies, education, and medication. So always record these meetings and reports in a file to help you monitor progress.
• Take time for yourself and other family members. Caring for a child with autism spectrum disorder can affect your relationships and family life. Take time out to relax, exercise, or enjoy your favourite activities to avoid burnout. 
• Keeping in touch with families of children with an autism spectrum disorder. You might get some useful tips and advice from families struggling with the challenges of ASD. Some communities even have support groups for parents and siblings of children with the disorder.

Interested to know more about autism? Stay connected with our blog content. 

References

1. Wiggins, L. D., Baio, J., Schieve, L., Lee, L. C., Nicholas, J., & Rice, C. E. (2012). Retention of autism spectrum diagnoses by community professionals: Findings from the autism and developmental disabilities monitoring network, 2000 and 2006. Journal of Developmental and Behavioral Pediatrics, 33(5), 387-395. doi:10.1097/DBP.0b013e3182560b2f [doi]

2. Blumberg, S. J., Zablotsky, B., Avila, R. M., Colpe, L. J., Pringle, B. A., & Kogan, M. D. (2015). Diagnosis lost: Differences between children who had and who currently have an autism spectrum disorder diagnosis. Autism: Che International Journal of Research and Practice, doi:1362361315607724 [pii]