Autism – Risks, Symptoms, Diagnosis, ABA Therapy and Treatment

Five things to know about Autism

1. Autism Spectrum Disorder (ASD) is a neurological and developmental
   disorder influencing how individuals perceive things.
2. ASD comprises conditions like autism, Asperger’s syndrome, childhood
   disintegrative disorder, and an unspecified form of pervasive developmental
   disorder.
3. Difficulty in social communication and interaction is common in individuals
   with ASD, leading to distinct ways of expressing and understanding emotions.
4. Developmental screening using screening tools, like questionnaires, or
   comparing your child’s development to their peers, covering language,
   movement, thinking skills, behaviors, and emotions, is often used to evaluate
   ASD.
5. There is no biological marker or blood test to diagnose ASD.

Risk Factors of Autism

While the precise causes of ASD remain unclear, research has identified several risk factors that may contribute to the development of the disorder. Here are some risk factors associated with ASD:

1. Family History: Individuals with a family history of autism or other developmental
disorders are at a higher risk. Certain genetic mutations and variations may also
contribute to the hereditary nature of ASD. However, not everyone with autism has
changes in every identified gene.

2. Advanced Maternal Age: Older parents, particularly mothers, may have an
increased risk of having a child with ASD. Advanced paternal age has also been
linked to a higher likelihood of autism.

3. Prenatal and Perinatal Factors:

• Prenatal Exposure to Certain Drugs or Chemicals: Exposure to certain medications, drugs, or environmental toxins during pregnancy may pose a risk.
• Complications during Birth: Certain perinatal complications, such as low
  birth weight, premature birth, or other birth-related stressors, have been
  associated with an increased risk of ASD.

4. Biological Factors:

• Brain Development Abnormalities: Abnormalities in the development of
  the brain, including differences in the structure and function of the brain,
  have also been identified in individuals with ASD.
• Neurological Disorders: Conditions such as epilepsy or other neurological
  disorders have been speculated to increase the risk of autism.

5. Gender and Socioeconomic Factors:

• Gender: The reasons behind the gender difference are not fully
  understood. However, boys are found to have been diagnosed with ASD
  more than four times more frequently than girls, and thus, gender is considered a risk factor.
• Socioeconomic Status: Some studies suggest a potential link between
  lower socioeconomic status and an increased risk of ASD, although the relationship is complex and could be influenced by various factors.

Symptoms of Autism

A range of symptoms characterizes ASD, and the severity and combination of symptoms are
widely varied among individuals. Here are some key symptoms associated with Autism
Spectrum Disorder:

1. Social Challenges:

• Difficulty with Social Interaction: Children with ASD usually struggle with
  understanding and interpreting social cues, engaging in social interactions
  challenging.
• Limited Eye Contact: Many individuals with ASD may avoid or have limited
  eye contact during conversations, a common social difficulty.
• Delayed Speech Development: Some individuals with ASD experience
  delayed language development. Some of them speak later than their peers,
  while some of them have difficulty producing sounds as well.
• Difficulty with Nonverbal Communication: Your child may face challenges
  in using and understanding gestures, facial expressions, and body language.

2. Repetitive Behaviors:

• Stereotyped Movements: The autistic children may have repetitive
  movements, such as hand-flapping, rocking, or twirling objects. This is one of
  the common characteristics of ASD.
• Rigidity and Resistance to Change: They usually have a strong preference
  for routines and resistance to changes in daily activities or surroundings and
  usually have difficulty adapting to changes in routines or unexpected events.

3. Difficulty with Imaginative Play: These children usually have limited
engagement in imaginative or pretend play activities, as seen in typically
developing children.

4. Impaired Planning and Organization: They may struggle with planning,
organization, and time management tasks. Thus, they need help with doing bigger
chores or multiple tasks.

5. Intellectual Disabilities: Some individuals with ASD may have intellectual
disabilities, while others may have average or above-average intelligence.

Developmental Screening and Diagnosis of Autism

Developmental screening is a routine part of well-child visits at ages nine months, 18
months, 24 months, and 30 months. Your doctor may use screening tools, like
questionnaires, or compare your child’s development to their peers, covering language, movement, thinking skills, behaviors, and emotions.

For diagnosis, there are no biological markers to diagnose ASD. So, your doctor might use questionnaires to observe the behavior in two different settings, one of which can be your kid’s school.

When to see a Doctor?

Signs of ASD typically emerge early, with noticeable delays in language skills and social
interactions. You need to see your doctor if your child does not:

1. Smile or give a happy expression by six months.
2. Copy sounds or facial expressions by nine months
3. Babble or coo by 12 months
4. Say single words by 16 months
5. Play pretend games by 18 months
6. Say two-word phrases by 24 months

Treatment of Autism

The treatment of ASD involves a multidisciplinary approach that can address the unique needs and challenges of individuals with autism. Treatment options encompass a range of developmental, behavioral, and pharmacological interventions, often tailored to each person’s specific characteristics and strengths. Here’s an overview of these treatment options:

1. Applied Behavioral Analysis (ABA): ABA is a significant behavioral intervention for
   individuals diagnosed with ASD. It aims to enhance positive behaviors while discouraging undesirable ones to foster skill development across various domains. In ABA therapy, a systematic approach is used to instruct individuals on specific behaviors or responses. Lessons are broken down into digestible parts, and desired responses and behaviors are encouraged through the use of positive reinforcement. On the other hand, undesirable reactions and actions are deliberately ignored. ABA therapy can be used outside of clinical settings in natural settings. The main goal is to improve some “pivotal skills” that act as triggers for learning more diverse abilities.
2. Developmental Approach: This approach focuses on improving developmental skills such as language, speech, and physical skills that are often combined with a behavior approach for better outcomes. The most common developmental therapy that is instituted is speech and language therapy. This will help the person better communicate with others and understand how to deal with social situations. The other one is occupational therapy. It includes training to learn fine hand skills and the use of more extensive movements of the trunk and body. It helps the person to live an independent life.
3. Pharmacological approach: Currently, there is no medication to treat ASD. However, there are medications to treat the co-existing symptoms that can help alleviate the symptoms and help them function better. Your doctor might prescribe medication to manage self-harming behavior like head banging to alleviate anxiety or depression.

Questions to ask your doctor if you or your child have ASD

1. What challenges might I face as a parent on a day-to-day basis?
2. One of my children has autism; what is the chance that my other child might also have a
   similar condition?
3. What can I do to understand my child’s needs when they cannot communicate well?
4. How often should we schedule follow-up appointments to monitor progress and address
   concerns?
5. Can I and my child join any groups to understand the condition better and provide support
   to others needing the support?

References

http://What is Autism Spectrum Disorder? | CDC

http://pectrum Disorder? | CDC Autism (who.int)

http://What is Autism? – Autism Research Institute

http://Exposure and Sex Differences | Environmental Health Perspectives | Vol. 130, No. 1 (nih.gov)