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ASD includes a broad spectrum of disorders that affects social skills, speech, movement, learning, cognition, mood and behavior. Rates of autism are increasing dramatically because of increased awareness and screening, better access to healthcare and broadened diagnostic criteria.
Let us start by reiterating some facts about autism.
- Multiple large-scale studies have established, with adequate proof, that vaccines do not cause autism.
- Autism does not develop due to bad parenting choices.
- Autistic spectrum disorders are not contagious.
Although the number of children diagnosed with autism has steadily increased over the last few years, this is not because more children develop autism now than before.
Experts cite the following reasons to explain the rise in autism cases in recent years.
- Extensive screening: In 2006, the American Academy of Pediatrics recommended that all children between 18 and 24 months of age must be screened for autism during routine pediatrician visits. This meant that more children were now being screened for autism than before, leading to diagnosis of those children who would have otherwise slipped under the radar. This also meant mild cases of autism were picked up by doctors, which would have otherwise been missed.
- Increased awareness: There is increasing awareness among the general public about autism. Parents actively ask pediatricians to screen their kids if they suspect their kids are not following the normal developmental pattern.
- Better access to health care: Up until a few years ago, African American and Hispanic children had lower rates of diagnosis due to lack of access to quality health care. Improved access to healthcare facilities has improved the detection of autism in these groups and increased overall prevalence.
- Broadened criteria for diagnosis: The older version of the Diagnostic and Statistical Manual of Mental Disorders (DSM) did not allow children to be diagnosed with both autism and attention-deficit hyperactivity disorder (ADHD). The DSM-5 version, which is a more recent one, allows multiple diagnoses and we now use the term autism spectrum disorders (ASDs).
ASD includes a broad spectrum of disorders with following symptoms, thus accommodating more kids under the title of autism.
- Classic autism: No eye contact, socially withdrawn and focused on certain repetitive behaviors.
- Level 1 ASD (previously called Asperger’s syndrome): Children with normal or above-normal intelligence and strong verbal skills, but those who have challenges with social communication.
- Pervasive developmental disorder-not otherwise specified (PDD-NOS): Milder forms of autistic disorders where children experience delays in certain milestones such as speaking or walking. They do not have hypersensitivity to sights, smells or sounds and other signs of classical autism.
- Childhood disintegrative disorder (CDD): Children who are developing at a normal pace begin regressing around the age of two years old. They may also develop seizures.
- Environmental factors:
- Increasing age of parents is an important factor that increases the chances of autism in the baby. Given the higher incidence of late marriages and conception, this may be one of the reasons why there is a slight increase in the number of babies being born with autistic traits.
- Survival of very premature babies (prematurity is a risk factor) is more common now than before.
- Exposure to environmental toxins such as pesticides, consumption of certain drugs during pregnancy (antiepileptics and antidepressants), certain maternal infections during pregnancy and alcohol consumption in pregnancy may be other reasons why we have greater incidences of babies born with autism.
What is autism?
Autism, or autistic spectrum disorder (ASD), is a developmental disorder that affects the ability of a person to interact socially. The brain of a person with autism does not process sounds, sights and smells like an average person’s brain. People with autism often struggle with expression of emotions. They often have poor speech, anger issues and certain repetitive behaviors (picking skin, twirling and neck movements).
Autism is diagnosed in childhood at about two to three years of age. The main symptom is often delayed milestones.
- Not responding to their name even the mother’s tone
- Failure to direct parent’s attention to objects or self
- Failure to imitate simple adult movements such as cooing
- Lack of eye contact
- Lack of interest in social games
- Prefer to play alone
- Be preoccupied with certain toys, parts of objects or characters
- Become unreasonably upset with changes in routine
- Use repetitive language and repeat things out of context
- An absence of smiling
- Hypersensitivity to lights, sounds, smells, textures and tastes
- No babbling
- Regression of speech, babbling or social skills at any age
What are the available treatment options for patients with autism?
The goal of treatment of patients with autism is to reduce symptoms and rehabilitate them socially.
- Applied behavior analysis (ABA): This is usually followed in schools and clinics. It helps children learn about positive behaviors and reduces the negative ones.
- Developmental, individual differences, relationship-based approach (DIR): It is meant to support children’s emotional and intellectual growth by helping them learn how to exhibit social skills.
- Treatment and education of autistic and related communication-handicapped children (TEACCH): This involves the use of visual cues such as picture cards to help children learn everyday skills.
- Picture exchange communication system (PECS): Children learn to ask questions and communicate through special symbols.
- Physical and occupational therapy: This helps children stretch, develop fine motor skills, perform eye exercises and so on.
- Sensory integration therapy: If children are easily upset by things such as bright light, certain sounds or being touched, this therapy can help them learn to deal with sensory information.
- Medications: There is currently no medication to treat autism. Some medicines can help with related symptoms such as depression, seizures, insomnia and impulsiveness. These may be prescribed on an individual basis by the doctor after a thorough medical evaluation.