What is Autism?
Autism, also known as autism spectrum disorder (ASD), is a disorder of development which can result in lifelong impairment as it affects various aspects of life. It affects the way an individual socialize and communicate with others, as well as behaviour. The severity of impairment varies from person to person, that is, in some people the symptoms may be mild while it can be severe in others.
With time, the number of children who has been diagnosed with ASD has increased since the 1970s. This might be related to the change in criteria used to make the diagnosis of the condition or it may be due to the condition becoming more common. Around 2-25 children per 1000 have ASD. It has also been observed that it is more common among males compared to females.
There are several other conditions that are often associated with ASD. Around 45% of children with ASD also have intellectual disability. 30% of children with ASD have seizures while around 25% are associated with another medical condition or syndromes.
What causes autism?
The exact cause of autism is unknown. What is known is that it is a disorder that affects the development of the brain, impairing skills such as socialization and communication. This explains the symptoms of ASD.
Some cases may be related to environmental factors including exposure to toxic substances prior to and after birth, obstetric complications (complications during childbirth) and certain infections before birth. In some cases, genetic factors have been identified. Some people claim that ASD is associated with vaccination, however, many scientific studies do not support this claim.
What are the risk factors of autism?
There are some factors that may increase the risk of having autism:
- Sex: Males are more likely to have ASD compared to females.
- Family history: If you have siblings with ASD, you are at increased risk of having the same disorder.
- Advanced parent’s age: Children born to old parents are at increased risk of having ASD.
- Other medical conditions: If you have other medical conditions or syndromes such as fragile X syndrome, tuberous sclerosis and Rett syndrome, you are at increased risk of having ASD.
What are the symptoms of Autism?
The symptoms of ASD are most likely to be observed around 2-3 years of age. The symptoms of ASD can be classified into 2 groups namely:
- Social interaction and communication
- Restricted and repetitive behaviour, activities and interests
Social interaction and communication
Most of the time, the main symptom that leads to parents seeking medical help is the lack of social interaction and communication. This may include the child being unable to speak or understand what is being said to him/her. The child may also not show interest in communicating with others.
- Social interaction: The main symptom of ASD is lack of interaction with people surrounding the child. They do not seem to be interested in building friendships. They usually play alone can completely ignore people trying to play along with them. With time, some older children may start showing interest in talking to others but do not understand the need of others. Children with ASD do not show any interest in sharing activities, interests and achievements.
- Nonverbal behaviours: Children with ASD are not able to use or interpret nonverbal cues such as eye contact, facial expression (anger, annoyance), gestures and body postures.
Restricted and repetitive behaviour, activities and interests
- Stereotyped behaviours: Repetitive body movements is a characteristic behavioural feature of autism. This includes hand or finger flapping, twisting, swaying, rocking and walking on tiptoe. These behaviours often persist their whole life.
- Insistence on sameness: Children with ASD often insist on having specific routines and rituals that have to be followed the exact same way each time they do them. Changes in the routine may lead to upset or frustration and children throwing tantrums.
- Restricted interests: People with ASD may be preoccupied with specific objects or experiences such as spinning objects, lights, odours, weather, dates, phone numbers or other items.
- Sensory perception: People with ASD may perceive sounds, tastes and touch in a different way compared to other people. They may be more sensitive to normal noise levels or show no response to excessively loud sound. Light touch may be perceived as painful while deep touch can calm down the child. Others may be completely indifferent to pain.
Other symptoms
Children with ASD often have problems with reasoning, interpretation and abstract thinking. Some children, however, may have special skills in memory, mathematics, music, art or puzzles despite being impaired in other aspects of their life.
Some children with ASD may have a delayed or absent speech. They may also not respond to their name.
How is the diagnosis of Autism made?
To make the diagnosis of autism, your child’s doctor will first start by asking a series of questions to know more about the symptoms and the development of your child. Your child will be evaluated by a child psychiatrist or psychologist, neurologist or developmental paediatrician.
There are no specific tests to make the diagnosis of ASD. A set of diagnostic criteria is used to make the diagnosis.
How is autism managed?
There is no cure for autism. However, your healthcare professional will discuss with you about the best treatment plan for your child depending on his/her particular needs. The main goal of the treatment is to help the child reach his/her full potential.
The treatment plan depends on the following factors: child’s age, associated medical conditions and other individual factors. With time, the treatment plan will have to be adapted according to your child’s response.
Treatment options include the following: behaviour and communication therapy, educational therapy, speech therapy, occupational therapy and physical therapy. Medications are not available for ASD. However, if your child is hyperactive for example, antipsychotic drugs may be prescribed.
Prognosis
The course of the condition depends on the level of intelligence of the person with ASD. Some people with low functioning may need permanent assistance and need residential care for their whole life. Others, who are high-functioning, may live on their own, work, marry and have children.
Source:
Hollander E. Autism Spectrum Disorders. Volume 24 of the Medical Psychiatry Series. New York, NY: Marcel Dekker; 2003
Brasic, J., n.d. Autism Spectrum Disorder
Augustyn, M., 2020. Autism spectrum disorder: Terminology, epidemiology, and pathogenesis
Augustyn, M., 2020. Autism spectrum disorder: Clinical features
Augustyn, M., 2020. Autism spectrum disorder: Evaluation and diagnosis
