What is Autism Spectrum Disorder (ASD)?
Autism Spectrum Disorder (ASD) refers to a spectrum of several lifelong neurodevelopmental difficulties in children, ranging from reduced social communication, restricted interests in activities and a desire for repetition in behavior and actions. A child diagnosed as being representative of neurodevelopmental difficulties, is observed to display resistance to the presentation of unexpected incidents in life and show a strong preference for routines and similar activities on a daily basis. One of the most prominent reactions to presentation of unexpected events is reflected under sensory hypersensitivity displayed by children.
Although, it has been characteristically deduced that autism is a neuro-developmental condition that has been observed closely in 1-2% of the population, its persistence keeps on increasing in the remaining population. Autism can be understood as a neurodevelopmental condition affecting the overall development and behavioral tendencies of individuals in a cumulative observation of symptoms and their overall intelligence, measured via the scales of the intelligence quotient (IQ). It has been observed on an overall basis, that 45% of the children under the autism spectrum disorder populations are observed to be non-verbal in nature and/or represent intellectual disabilities (ID). Consequently, the remaining 55% of the children diagnosed as being autistic, fall into the above average or higher range of IQ. Although, several alternative research findings indicate that the above conclusions might not be significantly reliable, since new research findings indicate that the co-occurring conditions of a persistence of symptoms of autism and intelligence observed via the intelligence quotient scales, are merely observed in 20-30% of the population, as opposed to the earlier findings of the entire population observing a condition implying persistence of symptoms and average to above average intelligence ratings. Therefore, it is necessarily evident to state that the field of research in autism is largely situational and therefore largely individualistic and thereby any finding cannot be considered with utmost certainty. As newer findings keep on arising, there is a deeper insight onto the functioning and development of the neurodevelopmental conditions characterized by autism, and gives one an increased level of motivation to continue questioning the technicalities and intricacies of the prevailing condition.
It is essential to understand that there are increasing gender differences involved in the diagnosis, screening and treatment of males and females in regard to observance and subsequent interventions made to provide them with the necessary treatment and therapy involved. For instance, males are prominently diagnosed as being autistic on a priority basis, while on the other hand, females are not easily diagnosed as being autistic, since they receive delayed treatment and later diagnosis as opposed to their male counterparts. At present, the ratio of autistic men in relation to autistic women, stands at 3:1. These increasing gender differences in diagnosis and treatment of females in opposition to men, is also largely due to difference in presentation of symptoms and camouflaging or covering up of symptoms.
What are the biological causes associated with autism?
There is no specific unidimensional cause associated with autism, since it involves functioning of a variety of genetic factors. It has been observed in 4-5% of the population, that the neuro-developmental conditions are suggestive of arousal from a specific gene mutation. For instance, individuals with 15q11.2 duplication syndrome show a tendency to hypotonia, motor delays, intellectual disability, autism and epilepsy. However, in most cases autism is polygenic, meaning that many genes contribute to its development.
Autistic individuals showing symptoms such as a constellation of subtle language, cognitive, social and personality characteristics including a higher-than average amount of autistic traits without even meeting the criteria for formal diagnosis. Such individuals are necessarily born with genes including characteristics of autism, as observed in 20% of parents of these children by possessing the ‘broader autism phenotype’.
Underlying Characteristics of Symptoms
The symptoms presented by autistic individuals can be largely classified as operating under two broad spectrums/categories which can be underlined under cognitive and non-clinical categories. Under the cognitive categories, there is an inherent tendency in individuals to prefer factual, logical and precise information and particularly a strong liking towards predictability of situations and therefore the subsequent approach to display stress over changes and unacceptance of unanticipated situations and events. But, at the same time it is necessary to understand that the cognitive impairments observed in individuals differ from case to case and therefore some individuals are in persistent requirement of round-the-clock care by medical professionals as well as frequent institutional interventions under the supervision of their general practitioners and personal child therapists and there are some individuals who are exceptionally gifted and therefore can lead individual lives by pursuing professional careers and independent performance of daily tasks.
Is there any specificity involved amongst the cognitive impairments observed among individuals who are diagnosed as autistic or are all cognitive impairments categorized under one large domain of general cognitive impairments observed amongst all autistic individuals?
The symptoms observed among individuals diagnosed as inhibiting the autism spectrum disorders can be observed under a variety of cognitive domains such as difficulties in processing of information related to emotional identification as well as in possessing a multitude of perceptions, in regard to a situation one encounters in their lives. Other commonly observed symptoms include reduced abilities to process a piece of information and difficulties in acquiring skills of verbal recall of learnt information which is also necessarily observed due to reduced memory to encode information from the environment. At times when there is a severity of such cognitive impairments involved, parents as well as close familial relatives are recommended to approach the general practitioner associated with treating their family and approach mental health professionals such as therapists and consulting clinical psychologists for screening their child to understand the cause of the initiation of certain cognitive impairments at a specific age and therefore begin the necessary treatment required in either forms of therapeutic interventions, medication and/or institutionalization.
Typical cognitive impairments associated with autism spectrum disorders include theory of mind or in other words, a difficulty observed in predicting others’ behavior based on their thoughts and feelings and problems encountered in regulating and controlling their behavior also known as executive function. It is also associated with an ability to detect minute and disengaged parts of an object, and difficulties observed in perceiving the entire object, also known as weak central object coherence.
What are the traits and characteristics involved amongst the social communication disabilities observed amongst autistic individuals?
A typical characteristic associated with social communication disabilities observed among autistic individuals is that of restricted interests in engaging in socializing and interacting with new individuals in a public context. Autistic individuals are observed to be accustomed to engaging in long-term conversations with familiar individuals such as family members including parents as well as a few friends who they are acquainted to over a period of time of a few years. They exhibit traits of social anxiety and alienation upon observing new individuals in their environments.
An autistic individual is also observed to experience difficulties in social communication, as they are used to expressing their desires, thoughts and emotions via limited gestures and facial expressions. The primary difference observed amongst shy individuals and autistic individuals is that the former manages to get into shorter or longer individuals at any particular point of time in their life and does not have specific mechanisms to resist or abstain from doing so and therefore their disengagement from new individuals is largely out of their personal choice and will and is not inherently encoded in their genetic make-up.
On the other hand, autistic individuals alienate themselves from interacting with new individuals since they are inherently instructed by specific psychological mechanisms in either cognitive or social domains of impairments. They also reflect difficulties in expressing their emotions by using hands as an instrument of instruction. They might also enter the external environment for recreational purposes such as playing in a park, but with the presence of a familiar individual such as a parent or other close relative.
What are the other kind of various ailments and health conditions children diagnosed with autism spectrum disorder, might be experiencing?
Autism spectrum disorder is often associated with several other co-occurring health conditions such as epilepsy, depression, anxiety, OCD, diabetes, sleep disorders, gastrointestinal conditions and ADHD. Several stimulants such as methylphenidate are prescribed by consulting general practitioners in order to specifically regulate symptoms of ADHD in autism, and yet relatively little evidence of improvement exists while a significant risk of adverse effects has been reported frequently.
It is essential to understand that several individuals diagnosed with the autism spectrum disorder are in possession of intellectual and/or learning disabilities. Therefore, it is important to understand that there should be a conscious monitoring and regulation of the various symptoms experienced by different individuals experiencing co-morbidities in the spectrum of both physical and mental disorders.
What are the various kinds of psycho-therapies and drugs that are prescribed by general practitioners for individuals diagnosed with autism spectrum disorder?
Autism is understood as a condition lead by ‘neurodiversity’, in which the neurological wirings of the brain are established in different structures than the existing forms. There are no specific pharmacological treatments or medical drugs associated with treating autism and therefore their administration does not resolve social communication difficulties. Although, there are no constructive pharmacological treatments designed to ‘cure’ autism but at the same time, it is important to understand that several research studies suggest prescription of antipsychotic drugs such as risperidone, aripiprazole and SSRIs such as citalopram, escitalopram, fluoxetine, which have been used to regulate repetitive behaviors resulting in autistic individuals. But, such drugs involve severe side-effects including adverse reactions observed in consequence of consuming such drugs. Therefore, several alternative behavioral therapies, initiated to treat some of the milder symptoms which include cognitive behavioral therapy (CBT), particularly introduced to treat symptoms of anxiety, depression and OCD which are common in autism as well as environmental adjustments such as finding an autism friendly school, work, home and/or leisure environments, in order to create a management plan and should always precede discussions about medication.
How to effectively deal with your autistic child on emotional, social and developmental levels?
It might appear a rather daunting task both physically as well as emotionally to deal in a normal sense with your recently diagnosed autistic child and one might even feel like reversing the situation, in order to see the child suffer less. But, at the same time it is essential to understand that autism is a specific neurodevelopmental disorder and needs to be treated medically under the correct supervision of a certified psychologist or psychiatrist. One might panic and experience extreme stress and anxiety when it comes to trusting medical practitioners and psychologists with children of tender ages between 0-6 years in particular.
Here are a few steps in order to plan your child’s autistic disorder diagnosis and treatment in an effective manner:
- Consult a trusted family medical practitioner to whom you go for regular check-ups and medical advice.
- Get in touch with psychologists and psychiatrists recommended by your family medical practitioner.
- Follow the treatment procedure and diagnosis in an effective manner
- Follow up with the practitioner on a weekly or monthly basis
- Make your child exercise regularly by attempting physiotherapy sessions with a suggested physiotherapist or therapist
- Be specific with their diet plan and ensure that they do not attempt to eat anything outside of it.
- Be highly patient with them and do not lose emotional well-being in the process of managing their daily responsibilities
- Do not easily hand them over to any given adult who is not aware of their sensitive situation.
- Do not hire babysitters or nannies for a condition so prolonged and serious. Manage them within the family by training trusted family members.
- Do not lose hope and stay strong.
Therefore, it can be inferred that the field of psychological disorders and diagnostics is an ambiguous and highly multi-faceted. In particular, if one considers the autism spectrum disorder (ASD) and its specific development among young children, it is variable from one individual to another. Therefore, the levels and specificity of cognitive impairments as well as remarked social-communication difficulties observed amongst different autistic individuals should be monitored on a regular basis and any minute change or alteration should be immediately conveyed to the general practitioner as well as the consulting therapist.
Undiagnosed individuals displaying symptoms similar to autism spectrum disorder at a young age, should be effectively observed by parents and shared with the general practitioner, to understand the severity of the cause and the subsequent steps to be followed in order to detect the persisting factors contributing to the development of the observed symptoms.