What to know about autism

Autism or autism spectrum disorder causes a person to develop repetitive behavioral patterns and often impairs their social interactions with others.

According to the American Autism Association, physicians usually diagnose autism spectrum disorder (ASD) in the childhood as symptoms can occur before age 3.

The Centers for Disease Control and Prevention (CDC) in the United States suggest 1 in 59 children has ASD.

The term “spectrum” refers to the wide range of ASD symptoms and severities. Many people with the disorder experience social problems debilitating while others may function more independently.

What is autism?

Distressed child
Autistic children may become distressed over breaks in their routine.

ASD is a paragliding term which represents a number of neurodevelopmental conditions.

The following conditions have been added to the ASD group in the newest edition of the American Psychiatric Association’s diagnostic guidelines, known as the Diagnostic and Statistical Manual of Mental Disorders (DSM-V),:

  • Asperger syndrome
  • childhood disintegrative disorder
  • pervasive developmental disorders not otherwise specified

Although there are different types of ASD, common experiences among people with the disorder include social impairment and the adoption of repetitive behaviors.

Some autistic children may tend to have symptoms from birth while others may show more noticeable signs as they get older.

Autism also has associations with other medical problems, such as complex epilepsy and tuberous sclerosis. According to the National Institute of Neurological Disorders and Stroke (NINDS), by the time they reach childhood an estimated 20-30 percent of autistic people develop epilepsy.

Characteristics and symptoms

ASD can affect a person’s social interaction and communication with a number of effects, including:

  • adoption of unusual speech patterns, such as using a robot-like tone
  • avoiding eye contact with others
  • not babbling or cooing to parents as an infant
  • not responding to their name
  • late development of speech skills
  • having difficulty with maintaining conversation
  • frequently repeating phrases
  • apparent difficulty in understanding feelings and expressing their own

An autistic person can also display repetitive or irregular behaviours, as well as impaired communication.

Examples of these include:

  • becoming so invested in a topic that it seems to consume them, such as cars, train timetables, or planes
  • becoming preoccupied with objects, such as a toy or household object
  • engaging in repetitive motions, such as rocking side to side
  • lining up or arranging toys or objects in very orderly ways

An autistic person may also experience motor or balance issues.

Around 1 in 10 autistic individuals show symptoms of savant syndrome, although this disorder can also occur in persons with other developmental disabilities or injuries to the nervous system.

Savant syndrome occurs when a person displays exceptional abilities in a particular field, such as playing a musical instrument, calculating extremely complex sums at high speed, reading two pages of a book at the same time, or being able to memorize vast amounts of knowledge.

Autistic individuals thrive on the routine and the ability to predict the outcomes of other actions and locations. A routine break or exposure to loud, over-stimulating environments can overwhelm an autistic person, resulting in anger outbursts, frustration, distress, or sadness.

No particular test could diagnose autism. Instead, doctors reach a diagnosis through parental reports of behavior, observation, and by ruling out other conditions.

For instance, if a child has undiagnosed hearing loss, the symptoms can resemble autism.

Causes

Currently, the causes of autism are not known, but there are significant numbers of studies under way to learn how it develops.

Researchers have identified several genes which appear to be related to ASD. Those genes also evolve by mutating spontaneously. People can inherit these in other cases.

Autism also presents a strong association between twins in twin studies. For example, if one twin has autism, according to the NINDS, the other is likely to have an estimated 36–95 percent of the time autism.

Autistic people may also undergo changes that affect their speech and behavior in key areas of their brains. Environmental factors may also play a role in ASD development although a link has not yet been confirmed by doctors.

Researchers do know, however, that other alleged causes, such as parenting practices, do not cause autism.

Do vaccines cause autism?

Another common misconception surrounding autism is that it may lead to autism by receiving vaccines, such as those for measles, mumps and rubella (MMR).

The CDC reports, however, that there is no known link between the vaccines and autism.

There is no link between vaccines and autism.

A 2013 study reported that in children who do and do not have ASD, the number of antibodies, or substances that cause the production of disease-fighting antibodies is same.

Some people say that thimerosal has ties to autism, a preservative that contains mercury and is in specific vaccines. Since 2003, though, at least nine different studies have provided evidence to counter that claim.

The Lancet journal published the initial paper that triggered the vaccine and autism controversy and withdrew it 12 years later, after evidence of data tampering, and research fraud became apparent. The author, Andrew Wakefield, was deprived of his qualifications and permission to practice by governing bodies.

Treatment

There is no uniform treatment for autism because each person with the condition presents differently.

There are treatments and approaches to address the health problems that frequently surround autism. These conditions can include epilepsy, depression, obsessive-compulsive disorder (OCD), and sleep disorders.

Although not all of these therapies would be successful for all autistic people, there are plenty of ways to consider that may help people cope. Autism specialists or psychologists may refer a person to a treatment which represents their autism presentation.

Interventions

Among the treatment interventions that may be beneficial are:

Applied Behavior Analysis (ABA): In ABA, an instructor should first try to learn about the autistic person’s particular behaviors. They’ll also want to know about their environment’s impact on this activity, and how the individual learns. Using positive reinforcement, ABA aims to increase beneficial habits and reduce negative or isolating ones.

ABA can help improve your memory and communication

Early Start Denver Model (ESDM): This form of behavioral therapy takes place during play, supporting children between the ages of 1 and 4.

A counselor, behavioral consultant, or occupational therapist may use collaborative games and play to help a child with a sense of fun develop healthy relationships. Parents and carers will then be able to continue the therapy at home.

ESDM promotes thinking abilities and communication skills.

Floortime: This includes parents joining children and creating relationships in the play area. ABA therapies can also use floortime for treatment support, and vice versa. Parents let the kids lead the game, allowing the children to grow their strengths.

Through this dedication, an autistic child will learn bidirectional and complex communication, emotional reasoning, and intimacy. They also learn to take the lead in controlling themselves and becoming involved with the environment.

Occupational therapy (OT): This helps an autistic person develop and learn communication skills for daily life.

These abilities include unassisted dressing, basic grooming and hygiene and fine motor skills. Then, autistic people should exercise these skills during the therapy sessions, which typically take 30–60 minutes.

Pivotal Response Treatment (PRT): This program helps to enhance optimism and the ability of autistic children to respond to motivational signals. It is a therapy focused on play, focusing on natural reinforcement.

A teacher teaching the class
Many therapies for autism revolve around helping caregivers and teachers provide support.

For instance, if a child wants a toy car and asks for it in a appropriate manner, they get the toy car, not an arbitrary reward, like candy. This often allows autistic children to initiate social interactions, rather than simply respond to them.

Relationship development intervention (RDI): This approach focuses on the value of creative thinking, or the ability to flexibly change thoughts and manage circumstances to help enhance quality of life in autistic people.

RDI’s focus is on knowing the experiences of others, processing change, and receiving information from many sources at once, including sight and sound, without feeling discomfort.

Speech therapy: This helps overcome the communication difficulties that autistic people can experience.

Assistance may involve matching facial expressions with feelings, learning how to interpret body language, and answering questions. Also, a speech therapist will seek to teach the complexities of vocal tone and help improve the individual’s voice and clarity.

TEACCH: This program helps to integrate autistic children’s needs into a classroom environment, with an emphasis on visual learning and support for the potential difficulties in attention and communication.

This program can be used by special education agencies and social workers as well as medical practitioners who offer other services — such as psychologists and speech therapists — to help autistic children.

Verbal behavior therapy (VBT): This helps to relate language and sense to autistic children. VBT practitioners focus not on words but on the reasons to use them.

Medications

If a doctor prescribes medicine for an autistic child or adult, they will usually try to deal with seizures, depression or sleep disturbance.

Again, on a case-by-case basis, medications may or may not be right for an autistic person.

Click here for a helpful aid to break down which options are best for a specific set of symptoms.

Coping strategies and skills

Autistic children also acquire a number of strategies that can help them manage the condition’s isolating effects.

Such behaviors are the child’s attempts to protect themselves from stimuli that can confuse them and increase sensory input to enhance feeling. These actions can also be practiced to put some level of organization of reasoning into their everyday lives.

Although not all of the autism coping strategies are harmful, some may inhibit social interaction and contribute to isolation and distress.

These behaviors include:

  • isolating themselves and avoiding contact with others
  • repetitive patterns while playing and relying on familiar occurrences during the day
  • talking to themselves, humming, or whistling
  • becoming highly attached to preferred objects
  • choosing to seek out or avoid certain experiences to an extreme extent

The important factor in managing behaviors that are potentially isolated is not to discourage these behaviours, but to add other coping strategies that can facilitate a child’s journey through autism, such as:

  • seeking help
  • using language more openly
  • relaxing and taking breaks
  • making their needs clear
  • managing sensory input

The following are effective ways to achieve this:

  • understanding that speech processing may undergo delays and accounting for this when speaking to an autistic child
  • restricting noise, movement, and the presence of nearby objects to help a child concentrate when presenting information to them
  • helping a child structure activities by giving the order-based cues, such as “First, do this, then…” or “Get ready… get set … go!”
  • demonstrating appropriate adult socialization in front of the autistic child
  • clearly defining a play space by using visual markers, such as beanbags, to promote a feeling of safety around other children
  • making sure information about events is both clear and visible, in terms of routine activities and those that fall outside of routine and may cause distress
  • running through and practicing these coping strategies during play

Different individuals encounter ASD of different extent and a number of behaviours. However, these techniques and skills will enable each person with the condition to increase the resources available, and enhance their quality of life.

Research

Autism doesn’t get healed. Researchers are therefore researching almost every aspect of the disease, from its causes to possible treatments.

Drugs and mental health therapies may change the effects of the disorder in some autistic people and enable a person to work independently at adulthood.

The symptoms and coexisting conditions, such as epilepsy, may require further management and support for others.

Researchers in laboratory making their research
Research is helping to identify possible causes of and treatments for autism.

Some of the most notable developments in autism studies include:

A 2017 report in Proceedings of the United States National Academy of Sciences analyzed 32 children who received intranasal oxytocin or placebo as a treatment. The study showed that children taking oxytocin were exhibiting increased social functioning. Previously, the study leaders had found that low levels of oxytocin had linkages with lower social performance.

Research at the 2018 American Society of Human Genetics identified 43 previously unknown genetic sequences linked to developmental delays, including autism.

The ongoing research of Deciphering Developmental Disorders is currently looking at undiagnosed conditions in over 12,000 individuals in the UK and the Republic of Ireland.

The goal of the research is to try to understand these developmental disabilities and support those kids and adults who encounter them, plus scientists and clinicians.

A 2017 research in the journal Nature found that autistic children’s brain development has connections to the extent of the disease. The researchers have theorized that this knowledge could help doctors diagnose autism earlier than ever.

Such studies are only a few examples of ongoing initiatives that may aid in potential ASD diagnosis and care.

Outlook

In the United States, doctors treat a person with ASD every 11 minutes according to the American Autism Association.

A combination of ASD education and earlier recognition means people will get early care for the disorder. Ideally a person should undergo therapy and treatments as soon as possible to improve their quality of life.

Takeaway

Autism or ASD is a complex neurodevelopmental disorder, which causes social interaction problems and encourages strict adherence to routines and predictable patterns.

There are various types of ASD and its severities. Some autistic people will live independently while others require more sustained treatment and support.

The causes are unknown at present, but researchers have identified several genes that may have links to ASD growth. None of the vaccines cause autism.

Work is continuing, and interventions are underway which may enhance the quality of life for autistic people. Present treatments include occupational therapy, speech therapy, and communication assistance in different types.

Question:

As an adult, is it likely that I have undiagnosed autism? I demonstrate a lot of the symptoms.

Answer:

Yeah, there are times when people with mild autism symptoms are not treated until adulthood.

Autism symptoms can mimic symptoms of other conditions, such as attention deficit hyperactivity disorder or obsessive-compulsive disorder, leading to uncertainty about an accurate diagnosis.

Occasionally, after getting a child diagnosed with autism, physicians can label an person with autism, and the person experiences signs in themselves.

Answers represent our medical experts’ opinions. All material is purely informational and medical advice should not be considered.

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