What is Autism?

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Autism is a developmental disorder characterized by difficulties with social interaction and communication and by restricted and repetitive behavior. Parents often notice signs during the first three years of their child’s life. These signs often develop gradually, though some children with autism experience worsening in their communication and social skills after reaching developmental milestones at a normal pace.

Autism is associated with a combination of genetic and environmental factors. Risk factors during pregnancy include certain infections, such as rubella, toxins including valproic acid, alcohol, cocaine, pesticides, lead, and air pollution, fetal growth restriction, and autoimmune diseases. Controversies surround other proposed environmental causes; for example, the vaccine hypothesis, which has been disproven. Autism affects information processing in the brain and how nerve cells and their synapses connect and organize; how this occurs is not well understood. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), combines autism and less severe forms of the condition, including Asperger syndrome and pervasive developmental disorder not otherwise specified (PDD-NOS) into the diagnosis of autism spectrum disorder (ASD).

Early behavioral interventions or speech therapy can help children with autism gain self-care, and social, and communication skills. Although there is no known cure, there have been cases of children who recovered. Not many autistic adults are able to live independently, though some are successful. An autistic culture has developed, with some individuals seeking a cure and others believing autism should be accepted as a difference to be accommodated instead of cured.

Globally, autism is estimated to affect 24.8 million people as of 2015. In the 2000s, the number of people affected was estimated at 1–2 per 1,000 people worldwide. In developed countries, about 1.5% of children are diagnosed with ASD as of 2017, from 0.7% in 2000 in the United States. It occurs four to five times more often in males than females. The number of people diagnosed has increased dramatically since the 1960s, which may be partly due to changes in diagnostic practice. The question of whether actual rates have increased is unresolved.

Some of us may remember the movie, “Forest Gump”, starring Tom Hank. In this movie, we saw him grow up with autism.

What are the symptoms of autism?

Autism symptoms typically become clearly evident during early childhood, between 12 and 24 months of age. However, symptoms may also appear earlier or later.

Early symptoms may include a marked delay in language or social development.

The DSM-5 divides symptoms of autism into two categories: problems with communication and social interaction, and restricted or repetitive patterns of behavior or activities.

Problems with communication and social interaction include:

• issues with communication, including difficulties sharing emotions, sharing interests, or maintaining a back-and-forth conversation
• issues with nonverbal communication, such as trouble maintaining eye contact or reading body language
• difficulties developing and maintaining relationships

Restricted or repetitive patterns of behavior or activities include:

• repetitive movements, motions, or speech patterns
• rigid adherence to specific routines or behaviors
• an increase or decrease in sensitivity to specific sensory information from their surroundings, such as a negative reaction to a specific sound
• fixated interests or preoccupations

Individuals are evaluated within each category and the severity of their symptoms is noted.

ASD: Autism Spectrum Disorder

In order to receive an ASD diagnosis, a person must display all three symptoms in the first category and at least two symptoms in the second category.

What causes autism?

The exact cause of ASD is unknown. The most current research demonstrates that there’s no single cause.

Some of the suspected risk factors for autism include:

• Having an immediate family member with autism
• genetic mutations
• Fragile X syndrome and other genetic disorders
• being born to older parents
• low birth weight
• metabolic imbalances
• exposure to heavy metals and environmental toxins
• a history of viral infections
• Fetal exposure to the medications valproic acid (Depakene) or thalidomide (Thalomid)

According to the National Institute of Neurological Disorders and Stroke (NINDS), both genetics and environment may determine whether a person develops autism.

Multiple sources, old and new, have concluded that the disorder isn’t caused by vaccines, however.

A controversial 1998 study proposed a link between autism and the measles, mumps, and rubella (MMR) vaccine. However, that study has been debunked by other research and was eventually retracted in 2010.

What tests are used to diagnose autism?

An ASD diagnosis involves several different screenings, genetic tests, and evaluations.

Developmental screenings

The American Academy of Pediatrics (AAP) recommends that all children undergo screening for ASD at the ages of 18 and 24 months.

Screening can help with the early identification of children who could have ASD. These children may benefit from early diagnosis and intervention.

The Modified Checklist for Autism in Toddlers (M-CHAT) is a common screening tool used by many pediatric offices. This 23-question survey is filled out by parents. Pediatricians can then use the responses provided to identify children who may be at risk of having ASD.

It’s important to note that screening isn’t a diagnosis. Children who screen positively for ASD don’t necessarily have the disorder. Additionally, screenings sometimes don’t detect every child that has ASD.

Other screenings and tests

Your child’s physician may recommend a combination of tests for autism, including:

• DNA testing for genetic diseases
• behavioral evaluation
• Visual and audio tests to rule out any issues with vision and hearing that aren’t related to autism
• occupational therapy screening
• developmental questionnaires, such as the Autism Diagnostic Observation Schedule (ADOS)

Diagnoses are typically made by a team of specialists. This team may include child psychologists, occupational therapists, or speech and language pathologists.

How is autism treated?

There are no “cures” for autism, but therapies and other treatment considerations can help people feel better or alleviate their symptoms.

Many treatment approaches involve therapies such as:

• behavioral therapy
• play therapy
• occupational therapy
• physical therapy
• speech therapy

Massages, weighted blankets and clothing, and meditation techniques may also induce relaxing effects. However, treatment results will vary.

Some people on the spectrum may respond well to certain approaches, while others may not.

Alternative treatments

Alternative treatments for managing autism may include:

• high-dose vitamins
• Chelation therapy, which involves flushing metals from the body
• hyperbaric oxygen therapy
• melatonin to address sleep issues

Research on alternative treatments is mixed, and some of these treatments can be dangerous.

Before investing in any of them, parents and caregivers should weigh the research and financial costs against any possible benefits.

Can diet have an impact on autism?

There’s no specific diet designed for people with ASD. Nevertheless, some autism advocates are exploring dietary changes as a way to help minimize behavioral issues and increase the overall quality of life.

A foundation of the autism diet is the avoidance of artificial additives. These include preservatives, colors, and sweeteners.

An autism diet may instead focus on whole foods, such as:

• fresh fruits and vegetables
• lean poultry
• fish
• unsaturated fats
• lots of water

Some autism advocates also endorse a gluten-free diet. The protein gluten is found in wheat, barley, and other grains.

Those advocates believe that gluten creates inflammation and adverse bodily reactions in certain people with ASD. However, scientific research is inconclusive on the relationship between autism, gluten, and another protein known as casein.

Some studies, and anecdotal evidence, have suggested that diet can help improve symptoms of attention-deficit hyperactivity disorder (ADHD), a condition similar to autism.

How does autism affect kids?

Children with autism may not reach the same developmental milestones as their peers, or they may demonstrate a loss of social or language skills previously developed.

For instance, a 2-year-old without autism may show interest in simple games of make-believe. A 4-year-old without autism may enjoy engaging in activities with other children. A child with autism may have trouble interacting with others or dislike it altogether.

Children with autism may also engage in repetitive behaviors, have difficulty sleeping, or compulsively eat non-food items. They may find it hard to thrive without a structured environment or a consistent routine.

If your child has autism, you may have to work closely with their teachers to ensure they succeed in the classroom.

Many resources are available to help children with autism as well as their loved ones.

Local support groups can be found through the national nonprofit The Autism Society. The organization Autism Speaks also provides targeted toolkits intended for the parents, siblings, grandparents, and friends of children with autism.

Autism and exercise

Children with autism may find that certain exercises can play a role in alleviating frustrations and promoting overall well-being.

Any type of exercise that your child enjoys can be beneficial. Walking and simply having fun on the playground are both ideal.

Swimming and being in water can serve as both exercise and sensory play activity. Sensory play activities can help people with autism who may have trouble processing signals from their senses.

Sometimes contact sports can be difficult for children with autism. You can instead encourage other forms of challenging yet strengthening exercises.

How does autism affect girls?

Because of its gender-specific prevalence, autism is often stereotyped as a boys’ disease. According to the CDC, ASDs are about 4 times more common in boys than in girls.

However, this doesn’t mean that autism doesn’t occur in girls. In fact, the CDC estimates that 0.66 percent, or around 1 in every 152 girls, have autism. Autism may even present differently in women.

In comparison to recent decades, autism is being tested earlier and more often now. This leads to higher reported rates in both boys and girls.

How does autism affect adults?

Families who have loved ones with ASD may worry about what life with autism looks like for an adult.

A minority of adults with ASD may go on to live or work independently. However, many adults with ASD require continued aid or intervention throughout their lives.

Introducing therapies and other treatments early in life can help lead to more independence and a better quality of life.

Sometimes people who are on the spectrum aren’t diagnosed until much later in life. This is due, in part, to a previous lack of awareness among medical practitioners.

Seek help if you suspect you have adult autism. It’s not too late to be diagnosed.

Why is autism awareness important?

April is World Autism Month. It’s also been deemed National Autism Awareness Month in the United States. However, many advocates have rightly called for the need to increase awareness about ASDs year-round, and not just for 30 select days.

Autism awareness also requires empathy and an understanding that ASDs are different for everyone.

Certain treatments and therapies can work for some people but not others. Parents and caregivers can also have differing opinions on the best way to advocate for a child with autism.

Understanding autism and people who are on the spectrum starts with awareness, but it doesn’t end there. Check out one father’s story on his “frustrations” with autism awareness.

What’s the difference between autism and ADHD?

Autism and ADHD are sometimes confused with one another.

Children diagnosed with ADHD consistently have issues with fidgeting, concentrating, and maintaining eye contact with others. These symptoms are also seen in some people on the spectrum.

Despite some similarities, ADHD isn’t considered a spectrum disorder. One major difference between the two is that people with ADHD don’t tend to lack socio-communicative skills.

If you think your child has symptoms of hyperactivity, talk to their doctor about possible ADHD testing. Getting a clear diagnosis is essential to ensure that your child is receiving the correct treatment.

It’s also possible for a person to have both autism and ADHD.

What’s the outlook for people with autism?

There are no cures for ASDs. The most effective treatments involve early and intensive behavioral interventions. The earlier a child is enrolled in these programs, the better their outlook will be.

Remember that autism is complex and that it takes time for a person with ASD to find the program best suited for them.

• High-Functioning Autism
• Understanding Autism in Women
• Autism Treatment Guide
  

What are the different types of autism?

The DSM (Diagnostic and Statistical Manual of Mental Disorders) is published by the American Psychiatric Association (APA) and is used by clinicians to diagnose a variety of psychiatric disorders.

The fifth and most recent edition of the DSM was released in 2013. The DSM-5 currently recognizes five different ASD subtypes or specifiers. They are:

• with or without accompanying intellectual impairment
• with or without accompanying language impairment
• associated with a known medical or genetic condition or environmental factor
• associated with another neurodevelopmental, mental, or behavioral disorder
• with catatonia

Someone can be diagnosed with one or more specifiers.

Prior to the DSM-5, people on the autism spectrum may have been diagnosed with one of the following disorders:

• autistic disorder
• Asperger’s syndrome
• pervasive development disorder-not otherwise specified (PDD-NOS)
• childhood disintegrative disorder

It’s important to note that a person who received one of these earlier diagnoses hasn’t lost their diagnosis and won’t need to be reevaluated.

• Understanding the 3 Levels of Autism

Autism Prevalence

April is World Autism Month.

Why are the numbers rising?

Michael.

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