World Autism Day, 2 April

Autism spectrum disorder (ASD) is a complex developmental condition involving persistent challenges with social communication, restricted interests and repetitive behavior. it is a neurodevelopmental disorder.

Risk Factors:

The current science suggests that several genetic factors may increase the risk of autism in a complex manner. People with certain specific genetic conditions such as Fragile X Syndrome and Tuberous Sclerosis are at increased risk for being diagnosed with autism.

Certain medications, such as valproic acid and thalidomide, when taken during pregnancy, have been linked with a higher risk of autism.

Having a sibling with autism also increases the likelihood of a child being diagnosed with autism.

Parents being older at the time of pregnancy is additionally linked with greater risk of autism.

Male children tend to be diagnosed with autism more often than those assigned female sex at birth. 

Diagnosis of Autism Spectrum Disorder:

Early signs of this condition can be noticed by parents/caregivers or pediatricians before a child reaches one year of age. However, the need for services and supports typically become more consistently visible by the time a child is 2 or 3 years old.In some cases, the problems related to autism may be mild and not apparent until the child starts school, after which their deficits may be pronounced when amongst their peers.

Social communication deficits may include:

  1. Decreased sharing of interests with others.
  2. Difficulty appreciating their own & others' emotions.
  3. Aversion to maintaining eye contact.
  4. Lack of use of non-verbal gestures.
  5. Difficulty making friends or keeping them.

Restricted interests and repetitive behaviors may include:

  1. Inflexibility of behavior, extreme difficulty coping with change.
  2. Expecting others to be equally interested in those subjects.
  3. Difficulty tolerating changes in routine and new experiences.
  4. Sensory hypersensitivity, e.g., aversion to loud noises.
  5. Stereotypical movements such as hand flapping, rocking, spinning.
  6. Arranging things, often toys, in a very particular manner.

Treatment:

There are several effective interventions that can help a child reach their full potential:

Applied behavioral analysis: Involves systematic study of the child's functional challenges, which is used to create a structured behavioral plan for improving their adaptive skills and decreasing inappropriate behavior.

Social skills training: Done in group or individual settings, this intervention helps children with autism improve their ability to navigate social situations.

Speech & language therapy: Can improve the child's speech patterns and understanding of language.

Occupational therapy: Can address adaptive skills deficits with activities of daily living, as well as problems with handwriting.

Parent management training: Parents learn effective ways of responding to problematic behavior and encouraging appropriate behavior in their child. Parent support groups help parents cope with the stressors of raising a child with autism.

Special education services: Are provided by schools under an Individual Education Plan and can include a range of services and accommodations for social communication deficits, restricted interests and repetitive behaviors. This can include special classes for very young children to address language, social skills and other needs.

Treating co-occurring conditions: Children with autism are more likely to experience insomnia, attention-deficit/hyperactivity disorder (ADHD), intellectual disability, anxiety, and depression than peers without autism. These conditional also need to be addressed. The impact of these conditions can be reduced with the proper services, which can include any of the above, as well as psychotherapy and/or medication.

Medication: A child psychiatrist can evaluate for other mental health conditions and prescribe medication if appropriate. For example, autism-related irritability that does not respond to behavioral interventions can be reduced by medications such as aripiprazole and risperidone.