Autism Spectrum Disorder

Autism Spectrum Disorder

Autistic disorder (sometimes called autism or classical ASD) is the most common condition in a group of developmental disorders known as the autism spectrum disorders (ASDs).

Autistic children have difficulties with social interaction, display problems with verbal and nonverbal communication, and exhibit repetitive behaviors or narrow, obsessive interests. These behaviors can range in impact from mild to disabling. Autism varies widely in its severity and symptoms and may go unrecognized, especially in mildly affected children or when more debilitating handicaps mask it. Scientists aren’t certain what causes autism, but it’s likely that both genetics and environment play a role.

Types of autism spectrum disorders

The autism spectrum disorders belong to an “umbrella” category of five childhood-onset conditions known as pervasive developmental disorders (PDD). Some autism specialists use the terms pervasive developmental disorder and autism spectrum disorder interchangeably. However, when most people talk about the autism spectrum disorders, they are referring to the three most common PDDs:

• Autism
• Asperger's Syndrome
• Pervasive Developmental Disorder - Not Otherwise Specified (PDD-NOS)

Childhood disintegrative disorder and Rett Syndrome are the other pervasive developmental disorders. Because both are extremely rare genetic diseases, they are usually considered to be separate medical conditions that don't truly belong on the autism spectrum.

Signs and symptoms of autism spectrum disorders

In both children and adults, the signs and symptoms of the autism spectrum disorders include problems with social skills, speech and language, and restricted activities and interests. However, there are enormous differences when it comes to the severity of the symptoms, their combinations, and the patterns of behavior.

Keep in mind that just because your child has a few autism-like symptoms, it doesn’t mean he or she has an autism spectrum disorder. The autism spectrum disorders are diagnosed based on the presence of multiple symptoms that disrupt your child’s ability to communicate, form relationships, explore, play, and learn.

Social skills

Basic social interaction can be difficult for children with autism spectrum disorders. Symptoms may include:

• Unusual or inappropriate body language, gestures, and facial expressions (e.g. avoiding eye contact or using facial expressions that don’t match what he or she is saying)
• Lack of interest in other people or in sharing interests or achievements (e.g. showing you a drawing, pointing to a bird)
• Unlikely to approach others or to pursue social interaction; comes across as aloof and detached; prefers to be alone
• Difficulty understanding other people’s feelings, reactions, and nonverbal cues
• Resistance to being touched
• Difficulty or failure to make friends with children the same age

Speech and language

Problems with speech and language comprehension are a telltale sign of the autism spectrum disorders. Symptoms may include:

• Delay in learning how to speak (after the age of two) or doesn’t talk at all
• Speaking in an abnormal tone of voice, or with an odd rhythm or pitch
• Repeating words or phrases over and over without communicative intent
• Trouble starting a conversation or keeping it going
• Difficulty communicating needs or desires
• Doesn’t understand simple statements or questions
• Taking what is said too literally, missing humor, irony, and sarcasm

Restricted behavior and play

Children with autism spectrum disorders are often restricted, rigid, and even obsessive in their behaviors, activities, and interests. Symptoms may include:

• Repetitive body movements (hand flapping, rocking, spinning); moving constantly
• Obsessive attachment to unusual objects (rubber bands, keys, light switches)
• Preoccupation with a specific topic of interest, often involving numbers or symbols (maps, license plates, sports statistics)
• A strong need for sameness, order, and routines (e.g. lines up toys, follows a rigid schedule). Gets upset by change in their routine or environment.
• Clumsiness, abnormal posture, or odd ways of moving
• Fascinated by spinning objects, moving pieces, or parts of toys (e.g. spinning the wheels on a race car, instead of playing with the whole car)

Diagnosing autism spectrum disorders

In order to determine whether your child has autism, a related autism spectrum disorder, or another developmental condition, clinicians look carefully at the way your child socializes, communicates, and behaves. Diagnosis is based on the patterns of behavior that are revealed.

If you are concerned that your child has an autism spectrum disorder and developmental screening confirms the risk, ask your family doctor or pediatrician to refer you immediately to an autism specialist or team of specialists for a comprehensive evaluation. Since the diagnosis of an autism spectrum disorder is complicated, it is essential that you meet with experts who have training and experience in this highly specialized area.

The team of specialists involved in diagnosing your child may include:

• Child psychologists
• Child psychiatrists
• Speech pathologists
• Developmental pediatricians
• Pediatric neurologists
• Audiologists
• Physical therapists
• Special education teachers

Diagnosing an autism spectrum disorder is not a brief process. There is no single medical test that can diagnose it definitively; instead, in order to accurately pinpoint your child's problem, multiple evaluations and tests are necessary.

Getting Evaluated for an Autism Spectrum Disorder
Parent interview – In the first phase of the diagnostic evaluation, you will give your doctor background information about your child’s medical, developmental, and behavioral history. If you have been keeping a journal or taking notes on anything that concerned you, turn over that information. The doctor will also want to know about your family’s medical and mental health history.
Medical exam – The medical evaluation includes a general physical, a neurological exam, lab tests, and genetic testing. Your child will undergo this full screening to determine the cause of his or her developmental problems and to identify any co-existing conditions.
Hearing test – Since hearing problems can result in social and language delays, they need to be excluded before an autism spectrum disorder can be diagnosed. Your child will undergo a formal audiological assessment where he or she is tested for any hearing impairments, as well as any other hearing issues or sound sensitivities that sometimes co-occur with autism.
Observation – Developmental specialists will observe your child in a variety of settings to look for unusual behavior associated with the autism spectrum disorders. They may watch your child playing or interacting with other people.
Lead screening – Because lead poisoning can cause autistic-like symptoms, the National Center for Environmental Health recommends that all children with developmental delays be screened for lead poisoning.

Depending on your child's & symptoms and their severity, the diagnostic assessment may also include speech, intelligence, social, sensory processing, and motor skills testing. These tests can be helpful not only in diagnosing autism, but also for determining what type of treatment your child needs:

• Speech and language evaluation – A speech pathologist will evaluate your child's speech and communication abilities for signs of autism, as well as looking for any indicators of specific language impairments or disorders.
• Cognitive testing – Your child may be given a standardized intelligence test or an informal cognitive assessment. Cognitive testing can help differentiate autism from other disabilities.
• Adaptive functioning assessment – Your child may be evaluated for their ability to function, problem-solve, and adapt in real life situations. This may include testing social, nonverbal, and verbal skills, as well as the ability to perform daily tasks such as dressing and feeding him or herself.
• Sensory-motor evaluation – Since sensory integration dysfunction often co-occurs with autism, and can even be confused with it, a physical therapist or occupational therapist may assess your child's fine motor, gross motor, and sensory processing skills.

Treatment

There is no cure for autism.  Therapies and behavioral interventions are designed to remedy specific symptoms and can bring about substantial improvement.  The ideal treatment plan coordinates therapies and interventions that meet the specific needs of individual children.  Treatment options include educational/bahavioral interventions, medications, and other therapies.  Most professionals agree that the earlier the intervention, the better.

Prognosis

For many children, autism symptoms improve with treatment and with age. Some children with autism grow up to lead normal or near-normal lives. Children whose language skills regress early in life, usually before the age of 3, appear to be at risk of developing epilepsy or seizure-like brain activity. During adolescence, some children with autism may become depressed or experience behavioral problems. Parents of these children should be ready to adjust treatment for their child as needed.  People with an ASD usually continue to need services and support as they get older but many are able to work successfully and live independently or within a supportive environment.

Reference link:

·         http://www.helpguide.org/articles/autism/autism-spectrum-disorders.htm

·         http://www.ninds.nih.gov/disorders/disorder_index.htm