Experts & Centers (120)

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Summary


Autism is a neurodevelopmental disorder that affects Social Interaction, Verbal/non-verbal communication, and Behavior. Many children also present repetitive behavior. It affects how people communicate, behave, and learn. Diagnosis typically occurs at the ages of 2 - 3 years old, however, some children are only diagnosed at an older age.

Autism is not a medical condition with treatments or a cure. Some people require different levels of support throughout their lives with certain things, some require help with everything. This is why Autism is referred to as a spectrum, everyone on the spectrum is different and needs different levels of support.

It is not clear what causes autism, and as such a lot of misconceptions have come up. One common misconception is that vaccines cause Autism, which is wholly incorrect and can have serious effects on the child if they are to miss their vaccines. Autism can also be accompanied by other disorders, such as ADHD, anxiety, and epilepsy.

In some cases, around 10% of individuals with autism may show exceptional skills and abilities, these can be involved in memorization, art, music, and mathematics.

Diagnosis is given by a trained professional who will be conducting a series of tests and taking notes of their behavior, as well as family reports. This is done due to the varying nature of the symptoms, and severity.

The prevalence of autism spectrum disorder worldwide is estimated to be 62 cases per 10,000 people according to studies by Dubai Healthcare Authority, with a higher prevalence in males than females. There is also a clear trend of an increase in the diagnosis of ASD since the 1980s. Therefore the number of people being diagnosed with ASD is on the rise.

Types


As of 2013, the American Psychiatric Association has merged all of the types of diagnosis for ASD under one diagnosis, therefore the types of autism that existed before are now classified as ASD only. It is however important to these types as many of these terms are still in use today by professionals and people alike. The reasons that were done was to ensure a more accurate diagnosis, determine treatment or support services, and assess the severity level

The types that used to be in use are:

  • Autistic disorder
  • Asperger’s
  • Pervasive Developmental Disorder - not otherwise specified

Causes


There is no direct cause of autism, research suggests that autism may develop from a combination of genetic, and environmental factors and influences. Some associated risk factors include:

  • Family history or an immediate family member who has autism
  • Genetic disorders such as Fragile X Syndrome
  • Low birth weight
  • Preterm birth
  • A child being born to older parents
  • Exposure to environmental toxins

There is an ongoing controversy over whether mandatory vaccinations given to children cause vaccines. The research however is very clear, Vaccines do not cause Autism. The studies that started the controversy have been thoroughly debunked many times. While having worries about what a vaccine might contain and how it affects one’s child is natural and important, however missing vaccines can have adverse effects on children growing up and puts them at extreme risk of disease and weakened immune system

There are a range of co-existing conditions that come with ASD, some of which are:

  • Anxiety
  • Depression
  • Fragile X syndrome
  • Sensory issues
  • Epilepsy
  • Obsessive-Compulsive disorder
  • Sleep disorders
  • Learning difficulties
  • Intellectual disabilities
  • ADHD

Symptoms


Symptoms and signs of autism may not be the same for everyone, however, some of the prevailing symptoms are:

  • Communication difficulties
  • Emotional connection with others
  • Difficulty processing sensory information (sounds, smells, touch)
  • Completely missing or delayed developmental milestones
  • Avoiding eye contact
  • Reliance on routines
  • Tantrums
  • DIfficulty processing other people’s emotions
  • Repetitive behavior (flapping hands)
  • Not responding to their names
  • A narrow range of interests
  • Lack of interest in playing with others
  • No or reduced imitation skills
  • Repeating words/phrases they heard

Challenging Behaviors

Around 50% of individuals with autism engage in challenging behaviors, some of these behaviors include:

  • Self-harm
  • Harming others
  • Biting
  • Throwing objects
  • Scratching or picking on their skin
  • Meltdown or tantrum
  • Destroying objects

Diagnosis


Autism may be detected by 18 months or younger, and by age 2 a diagnosis from a qualified mental health care provider can be very reliable. Some children do not receive a diagnosis until they are older.

There are developmental screenings that need to be done in order to determine if a child has hit their developmental milestones. This is done should some of the symptoms of Autism are apparent in the child growing up.

A comprehensive evaluation must then be taken using multiple different screen tools and evaluations. While these evaluations do not provide a direct diagnosis, this formal evaluation is a more in-depth look at a child’s development. The specialist will observe the child, give them tests, ask parents and caregivers questions and fill out questionnaires. The combined result of these tests will determine if they get a diagnosis of being on the Autism Spectrum.

The diagnostic criteria for ASD are broken up as follows:

  • A persistent deficit in social communication and interaction in multiple settings, includes emotional social interactions, responding to emotions, initiating social interactions
  • Repetitive and restricted patterns of behavior, interests, or activities. This includes repetitive actions like hand flapping, insisting on the same routine and ritual patterns, highly restricted interests, and an unusually high interest in specific sensory stimuli such as specific sounds, textures, smells, lights, and movement
  • Presence of symptoms and signs from early ages (signs can be noticed a little bit before the ages of 2)
  • Symptoms cause significant effects on a person’s overall life
  • Ruling out all possible other conditions that may explain the symptoms

Treatments


Due to the nature of Autism Spectrum Disorder, treatment methods typically entail different types of therapies depending on the individual’s needs.

Treatment for Autism must include receiving therapy from a mental health professional with experience in the disorder/ This will help an individual better control their mood swings, learn new skills, and avoid having frequent meltdowns.

Depending on the level of the individual and severity of their negative symptoms, different combinations of treatments may be provided such as:

Applied Behavior Analysis (ABA) - A form of behavioral therapy also called behavior modification.

This form of therapy focuses on improving specific behaviors. Depending on the needs of the individual, these behaviors could be specific skills that they could not do or something that they would consider aversive. ABA helps individuals improve and learn skills such as basic and advanced language skills, gross motor skills, fine motor skills, imitation skills, hygiene, social skills, adaptive skills, and many more. An ABA therapist teaches an individual these skills through the use of reinforcement and reducing unwanted behaviors by not reinforcing them, or by “punishing”, thereby reducing them.

In educational settings for children, Behavior therapy (and many other forms of therapy) can be combined alongside educational goals with the use of therapy tools.

Therapy tools are important as they help successfully teach students with psychiatric disorders or learning conditions. Examples of these therapy tools can be:

  • Visual Support: The use of visual items/pictures to communicate a message to a child who may have difficulty receiving instructions or using language. They come in many forms such as photographs, drawings, objects, or words. Research evidence has shown that visual support helps children by removing barriers to learning both at home and at school. An important type of visual support is Visual Schedules. These are images that represent a schedule of tasks, or activities. For schoolwork, visual schedules help with establishing goals of what needs to be completed in order to access a break or a reward. These schedules can also establish a basic home routine such as getting ready for school, or when study time and playtime are during the day. A visual timer is another great example, which is used to show exactly how much time is left to complete or engage in an activity before they are able to move on to something else.
  • Social Skills Training: This intervention is used to improve social skills and teach how to display acceptable and functional social skills in different scenarios. Using different teaching methods, an individual can learn to act appropriately in the correct social situations, or target specific issues such as social awkwardness and shyness
  • Emotional and Self Regulation skills: These skills refer to one’s ability to regulate their emotions in an appropriate and functional manner. Individuals with many conditions can display low tolerance to frustrating circumstances, difficulties transitioning from one activity (or place) to another, impulsivity, unable to accept “no” as an answer, difficulties waiting to receive a desired activity, item, or person. Intervention methods vary depending on the environment and situation it is occurring in, and each of these situations is taught as skills to be learned and attained. The teacher in this case must be aware of how to teach each situation effectively, and slowly build up the child to be able to tolerate a situation, and teach them replacement behaviors that they can engage in so they can access what they need without having any problems.
  • Sensory tools: These are helpful tools that aim to improve focus, reduce impulsive behavior (such as leaving one’s seat in a classroom), and help one’s ability to self-regulate. These tools (many are toys) stimulate one’s senses and make many environments more appealing tolerable. A good example is classroom-friendly fidget toys, designed to keep distraction to others to a minimum and increase the focus of the individual

Assistive Technology - also known as augmented and alternative communication. Technology that is used to communicate with others, using a Tablet, which can either generate speech or show pictures/videos of what they want to communicate

Occupational Therapy - Teach skills that help with independence, such as eating, bathing, dressing, etc.

Speech Therapy - Improve their communication skills using sign language, gestures, pictures, or assistive technology

Medication: Some medications can be used to help with some symptoms of autism or other comorbid disorders. These are given when the trained professional is sure the benefits outweigh any side effects the medication can have. There are different classes of medications that work for Autism. A person should never take any kind of medication unless under the supervision of a trained mental health service provider. They should also ensure that they take it exactly according to the instructions and dosage gave to them. Medications for Autism work best in combination with an appropriate and individualized therapy plan, and may not be suitable to everyone on the Autism spectrum.

Healthy diet and lifestyle: Research suggests that developing a consistently healthy diet, adequate sleep, and exercise plan can play a big factor in mitigating symptoms and improving over the quality of life

Resources

References