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Understanding Autism

According to the World Health Organization, autism is usually detected in the early infancy, and one out of 160 children will have one of many types of autism.

They are all included on a broader term addressed to as autism spectrum disorder, and each patient develops a unique form of autism with their own strengths, opportunities and weaknesses.

Even though we live in the era of information, there’s much misunderstanding about what autism really is and how parents and families deal with it. Thus, we are covering the topic and providing a common ground to talk about this wide and complex topic that worries many parents worldwide.

What is autism?

The diagnosis of autism is often stigmatized because people do not really know what it is. It is also known as autism spectrum disorder, an umbrella term that includes a series of conditions that feature an alteration in the patient’s social behaviour, communication skills and language. It is also
characterized by patterns of behaviour, activities and interests that are not commonly found in the rest of the population.

Autism is a complex disorder with a genetic predisposition, but the exact causes and how the disease is triggered by the environment remains elusive. A series of genes and mutations have been identified as possible candidates, but many children who are genetically susceptible do not necessarily exhibit any behavioural change. Thus, it has been proposed that interaction with certain substances in the environment and certain infections may activate these genes to display the signs and symptoms we often see in autism spectrum disorder.

In all of these cases, the diagnosis of autism does not depend on the cognitive skills of the patient. It is possible to have autistic children with a severe cognitive impairment and patients with a high-functioning type of autism who display significantly high levels of cognitive ability and impressive technical or artistic skills, usually associated with a hobby or topic of interest.

Is something wrong with my child?

Living with an autistic child is not easy, and sooner or later, parents start noticing a series of behaviours and forms of interactions that differ dramatically from those found in children their age. However, to detect a case of autism earlier it is essential to know the exact signs and symptoms usually found in these children. They are usually enclosed in three different groups, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5):

Impairments in social interaction
  • A persistent difficulty to engage in social interactions regardless of their attempts.
  • A reduced social circle of friends.
  • A difficult to feel empathy towards the feelings and perceptions of others.
  • Speaking to others in monologues without leaving space for interaction.
Impairments in communication
  • A form of communication that feels awkward or not normal despite having proper grammar and vocabulary.
  •  A difficulty to display non-verbal communication.
  • Difficulty to keep eye contact.
Repetitive or restricted range of behaviors or interests
  • Interests are often restricted to a single topic.
  • They often become self-absorbed and spend excessive time in their restricted interests.
  • Adherence to inflexible routines
Other signs and symptoms
  • Motor difficulties or problems to coordinate movements.
  • A difficulty to understand sarcasm and non-literal messages, which includes figurative languages and idioms.
  •  They often become disturbed after listening to certain sounds, especially unexpected noises.
  • Repetitive and stereotyped movements.
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As mentioned before, autism is a very wide term that includes many types and subtypes. Each patient displays different characteristics or the same trait differently. Thus, if you’re suspecting that there’s something wrong with your child, it is imperative to ask for professional advice instead of trying to diagnose and treat your child by yourself.

Autism, comorbidity and treatment

One of the most critical features of autism that makes it even more complicated is that this condition is often accompanied by other mental health symptoms. This association is clinically known as a comorbidity. For example, it is common to have developmental problems along with autism, as in patients with a language delay or intellectual disability. It is also common to find symptoms of anxiety and depression in a patient with autism. It is strongly linked to Attention-deficit/hyperactivity disorder (ADHD), and it is also common to have other physical health problems as well, including cases of sleep disorders, epilepsy, and metabolic disease.

Depending on the symptoms and the diagnosis, there are many types of treatment to improve the quality of life of the affected children and their families. Also, depending on the comorbidities, there will also be an added treatment, either physical or psychological. According to the scientific literature, there are behaviorally based treatments, social skill interventions, cognitive-behavioural therapy and pharmacological interventions that the multidisciplinary team will likely try on your child. Each one of them is critical, as you will see next:

  • Behaviorally based treatments: This type of therapy is not only an attempt to change the child’s conduct. It seeks an understanding of how the environment and the events around children contributes and affects their behaviour. It is based on understanding the antecedents of a given behaviour, changing these antecedents and the motivational variables to change the conduct. It includes parent training interventions, a type of treatment that is effective in reducing the disruptive behaviour in children with autistic spectrum disorder.
  • Social skill interventions: There are many types of interventions that may significantly improve social skill in patients with autism. They include techniques such as video modelling, peer-mediated interventions, and programs that combine various modalities of treatment to achieve an improvement in social skills.
  • Cognitive-behavioural therapy: It is useful to treat symptoms of depression and anxiety in patients with autism
  •  Pharmacological interventions: They are equally important, and may be used according to each case and depending on the symptoms and the comorbidity of the patient. The most commonly used medications are risperidone, aripiprazole or serotonin reuptake inhibitors for aggressive and repetitive behaviours, stimulant medications to treat inattention symptoms, and melatonin in case of an alteration in the sleep pattern.

References:

Landrigan, P. J. (2010). What causes autism? Exploring the environmental contribution. Current opinion
in pediatrics, 22(2), 219-225.

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Hallmayer, J., Cleveland, S., Torres, A., Phillips, J., Cohen, B., Torigoe, T., … & Lotspeich, L. (2011).
Genetic heritability and shared environmental factors among twin pairs with autism. Archives of general
psychiatry, 68(11), 1095-1102.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-
5®). American Psychiatric Pub.

Klinger, L. G., Dawson, G., Burner, K., & Crisler, M. (2019). Autism spectrum disorder. Child
psychopathology.

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