Autism

Autism

Autism Spectrum Disorder (ASD), formerly known solely as autism, is a neurodevelopmental disorder. ASD is characterized by its effect on an individual’s developmental growth, social interaction, and communication skills. Those living with ASD may present repetitive, restricted, and stereotyped patterns of behaviors. ASD tends to be more prevalent in boys than girls by a 4 to 1 ratio.

Symptoms can typically appear within the first two years of life, though an individual will not be diagnosed until later in development. Symptoms and diagnosis are not the same. Even with the presence of symptoms, an individual may still not be experiencing the qualifying characteristics. ASD is classified and diagnosed on a spectrum, which altered and renamed the diagnosis. With the addition of the spectrum, providers have emphasised the concept of inclusivity most likely due to the increased presence of diverse sets of symptoms in treatment.

Here are some common experiences of those living with ASD:

✅ hypersensitive to touch, light and sound
✅ flap arms, rock back and forth to cope
✅ constant pacing
✅ fixation on certain object or activities
✅ upset when routine or ritual aren’t upheld
✅ don’t respond to their name
✅ avoid eye contact
✅ don’t understand emotions

ASD is not limited to any specific race, gender, sexual orientation, or economic group. Receiving an ASD diagnosis may bring on many new changes and challenges in the family, signifying the importance to receiving adequate treatment and services. Even though ASD  does not have a cure, treatment can help improve the quality of life.  By facilitating the development of routines and daily functions, individuals can function independently in the world.

Causes of Autism

There is no specific cause for ASD though research suggests ASD can possibly develop from a combination of genetic and nongenetic influences, such as the environment. Taking prenatal vitamins containing folic acid before and during pregnancy have shown to decrease risk. Below are certain risk factors for receiving an ASD diagnoses and what is not a cause of ASD:

💡 genetic factors                                               ❌ vaccines 
💡 siblings diagnosed with ASD                       ❌ contiguous 
💡 other genetic conditions                              ❌ baby allowed to cry / self soothe
💡 parents being an older age                        ❌ poor nutrition 
💡 pregnancy and birth complications         ❌ cable television
💡 premature birth                                              ❌ cell phones 
💡 low birth weight                                              ❌ discipline   
💡 multiple pregnancies / twins                       
💡 pregnancies less than one year apart

💡 genetic factors
💡 siblings diagnosed with ASD 
💡 other genetic conditions 
💡 parents being an older age 
💡 pregnancy and birth complications
💡 premature birth  
💡 low birth weight 
💡 multiple pregnancies / twins
💡 pregnancies less than one year apart
❌ vaccines 
❌ contiguous 
❌ baby allowed to cry / self soothe
❌ poor nutrition 
❌ bad parenting
❌ cable television
❌ cell phones 
❌ discipline

Misconceptions About Autism

There are plenty of misconceptions surrounding ASD. Many common help belief just aren’t true. Misconceptions cause stigmas and stigmas limit individuals to seeking support. Misconceptions also make individuals feel isolated, alienated, and alone. Below are some common misconceptions:

🚫 savant skills
🚫 experience a full range of emotions
🚫 intellectually disabled
🚫 outgrown or cured
🚫 caused by vaccinations
🚫 live independently 
🚫 want to make friends
🚫 aggressive / violent
🚫 able to learn
🚫 an epidemic
🚫 caused by bad parenting
🚫 can be cured
🚫 uncommunicative / do not speak

Signs and Symptoms of Autism

Be mindful that ASD is on a spectrum and varies from one person to the next. One person may have all symptoms while some may only have a few. Severities of the diagnosis are case-by-case basis. Just because these are major symptoms, this does not conclude a diagnosis. It is important to see a specialist that can correctly assess an individual for ASD. The earlier a person gets intervention the better they will be able to manage their life with ASD. Here are the signs and symptoms associated with ASD:

🗣 Social and communication/ interaction behaviors: 
🚩 little to no eye contact
🚩 lacking focus / attention 
🚩 rarely showing enjoyment or interest in objects
🚩 failing to or delay in response when called
🚩 difficulty keeping conversations
🚩 talking at length about subjects that bring pleasure
🚩 unmatching facial expressions or gestures
🚩 difficulty understanding others point of view, emotions, or actions

🔁 Restrictive/ Repetitive Behaviors
🚩 repeating certain behaviors
🚩 stimming behaviors to self soothe
🚩 lasting interest numbers, details, and/or facts
🚩 overly focused behavior in hobbies enjoyed 
🚩 escalated behavioral due to changes in routine
🚩 sensitivity to sensory input

Diagnosing Autism

ASD is diagnosed on a spectrum- meaning symptoms are evaluated across a continuum scaled by type, servivity, and experience. ASD supports the case of how different one individual’s experience is to another. Each diagnosis is based on a description of an individual’s behavior and development causing the diagnoses in children, adolescents and adults all look different. Below is a description of how ASD is typically diagnosed for each age group:

⚠️ Diagnosis in young children (two stage process):

Stage one: Children should be screened for developmental delays at 9, 18 and 24 months wellness checkups. If a child is high risk for ASD, additional tests may be indicated. Children who fall under the high risk category include: 

      • has family member diagnosed with ASD
      • show associated behaviors 
      • born at low birth weight

Stage two: If concerns at stage one, children will be further evaluated and assessed for the following:

      • cognitive level or thinking skills
      • language abilities
      • age appropriate life skills 
      • blood test 
      • hearing test

​⚠️ Diagnosis in older children / adolescent:

ASD in older children and adolescents may be recognized by parents and/or teachers. After evaluation from a team at school, they may be recommended to a primary health care provider specializing in ASD. Behaviors discussed may include: 

      • social difficulties 
      • depressive symptoms
      • understanding tones of voice (angry, sad, mad, happy)
      • recognition of facial expressions 
      • recognition of body language 
      • understanding figures of speech, humor, and sarcasm
      • difficulty forming friendships 
      • self-harming behaviors

​⚠️ Diagnosis in Adults:

ASD has proven to be more difficult to diagnose in adulthood. ASD symptoms may mimic other mental health disorders. Evaluation may include a discussion of the following:

      • history of any developmental delays 
      • social or communication difficulties
      • sensory issues
      • repetitive behaviors
      • restricted interest
      • self-harming behaviors

There are also 4 main types of ASD:

🧩Asperger’s syndrome-A neurodevelopmental disability that affects the ability to effectively interact and communicate with people.

🧩Childhood disintegrative disorder- characterized by the loss of a previous motor, language or social skill or having a delay in onset of these skills.

🧩Kanner’s Syndrome or Classic Autistic Disorder- a brain abnormality that affects the way the brain transmits information. Shows a decrease in communication and social function.

🧩Pervasive Developmental Disorder- A group of disorders characterized by  a delay in development in multiple functions including socialization and communication, there are multiple disorders that fall under this category including those above ( Asperger’s syndrome and Childhood disintegrative disorder.)

Conditions Commonly Mistaken for Autism

There are many disorders that are often mistaken for ASD. It is very important to be evaluated and diagnosed correctly. Individuals can exhibit certain behaviors similar thoughts may not be ASD related. Conditions and behaviors often mistaken for ASD are listed below.

✳️ speech delays
✳️ avoidant personality disorder
✳️ hearing impairments
✳️ obsessive compulsive disorder
✳️ visual impairments
✳️ reactive attachment disorder
✳️ developmental delays
✳️ social communication disorder
✳️ narrowed interest
✳️ attention deficit hyperactivity disorder
✳️ high intelligence
✳️ schizophrenia
✳️ sensory processing issues
✳️ deletion syndrome

Treating Autism

There are no specific treatments for ASD instead there is a wide range of therapy options for individuals to learn to manage and live with ASD. Therapies are specialized for each person’s needs and are adjusted with progress. Treatment can be provided to individuals of all ages. People with ASD can learn to use everyday skills and reduce symptoms through the following therapy and intervention programs:

🧬 behavioral management therapy
🧬 occupational therapy 
🧬 cognitive behavioral therapy
🧬 parent-mediated therapy 
🧬 early intervention
🧬 physical therapy
🧬 educational and school-based therapy
🧬 social skills training
🧬 medication treatment
🧬 speech-language therapy 
🧬 nutritional therapy
🧬 applied behavior analysis

Healthcare Professionals Who Treat Autism

For the best results in a successful treatment of ASD  seek providers that have specialities in the assessment, treatment, diagnosis, and continuing support of patients diagnosed with ASD

Many medical and mental health providers are familiar with the diagnosis of ASD.  However if your chosen provider is not, they should always provide a knowledgeable referral source. Specialized providers will have the capabilities to diagnose using various testing methods to decrease the likelihood of misdiagnoses and unnecessary treatments. 

If you choose to utilize medication, psychotherapy should always be incorporated in treatment planning. 

The following are professionals involved in the treatment of ASD:

🧠 pediatricians- are a great place to start to assess developmental milestones
🧠 psychiatrist- may be a great place to start for individuals living with ASD
🧠 applied behavior analysis therapist- Using certain behavioral principles of learning, to improve socially significant behaviors by increasing or decreasing behaviors
🧠 speech therapist- helps improve language and speech related issues
🧠 occupational therapist – helps individuals fulfill daily routines
🧠 sensory therapist- assesses the sensory and motor components of the child and plans intervention accordingly

Recognizing Immediate Need for Autism Treatment

As soon as an individual believes they or another person may be exhibiting symptoms related to ASD, it is important to reach out to a healthcare provider as soon as possible. If a person is exhibiting any symptoms and it becomes alarming, reach out to a pediatrician and/or physician to be evaluated. Early intervention is known for more successful treatment outcomes. Below are the most common early signs and any concerns should be brought to a provider’s attention:

🚨lack of expression in a wide range of emotions
🚨reflecting an understanding in topics
🚨lack of understanding in native language
🚨lack of visual cues and corresponding behavior

Autism Professional Organizations

Provided are some resources to help the start of seeking support for Autism:

8 Things That Don’t Cause Autism. (n.d.). Verywell Health. Retrieved April 12, 2021, from https://www.verywellhealth.com/dont-worry-these-things-do-not-cause-autism-260608

Common Misconceptions. (n.d.). Autism Association of Western Australia. https://www.autism.org.au/what-is-autism/common-misconceptions/

Conditions & Disorders with Symptoms Similar to Autism. (n.d.). WebMD. https://www.webmd.com/brain/autism/autism-similar-conditions

Healthcare Providers Who Treat Autism. (2015, April 23). Healthgrades. https://www.healthgrades.com/right-care/autism/healthcare-providers-who-treat-autism

iprovadmin. (n.d.). What are the 5 Different Types of Autism? %%sitename%%. https://www.integrityinc.org/what-are-the-5-different-types-of-autism/

Maddox, B. B., Trubanova, A., & White, S. W. (2016). Untended wounds: Non-suicidal self-injury in adults with autism spectrum disorder. Autism, 21(4), 412–422. https://doi.org/10.1177/1362361316644731

National Institute of Mental Health. (2018, December 3). Autism Spectrum Disorder. Nih.gov. https://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd/index.shtml

Schmidt, R. J., Hansen, R. L., Hartiala, J., Allayee, H., Schmidt, L. C., Tancredi, D. J., Tassone, F., & Hertz-Picciotto, I. (2011). Prenatal Vitamins, One-carbon Metabolism Gene Variants, and Risk for Autism. Epidemiology, 22(4), 476–485. https://doi.org/10.1097/ede.0b013e31821d0e30

Soke, G. N., Rosenberg, S. A., Hamman, R. F., Fingerlin, T., Robinson, C., Carpenter, L., Giarelli, E., Lee, L.-C., Wiggins, L. D., Durkin, M. S., & DiGuiseppi, C. (2016). Brief Report: Prevalence of Self-injurious Behaviors among Children with Autism Spectrum Disorder—A Population-Based Study. Journal of Autism and Developmental Disorders, 46(11), 3607–3614. https://doi.org/10.1007/s10803-016-2879-1

Takara, K., & Kondo, T. (2014). Comorbid atypical autistic traits as a potential risk factor for suicide attempts among adult depressed patients: a case–control study. Annals of General Psychiatry, 13(1). https://doi.org/10.1186/s12991-014-0033-z

Vaccine Safety: Examine the Evidence. (2019). HealthyChildren.org. https://www.healthychildren.org/English/safety-prevention/immunizations/Pages/Vaccine-Studies-Examine-the-Evidence.aspx

What are the Early Signs of Autism? (2016). HealthyChildren.org. https://www.healthychildren.org/English/health-issues/conditions/Autism/Pages/Early-Signs-of-Autism-Spectrum-Disorders.aspx

What are the treatments for autism? (2017, January 31). Http://Www.nichd.nih.gov/. https://www.nichd.nih.gov/health/topics/autism/conditioninfo/treatments

What Causes Autism? | Autism Speaks. (2019). Autism Speaks. https://www.autismspeaks.org/what-causes-autism