Autism: Causes, Epidemiology, Treatment and Prevention

Definition

Autism, or autism spectrum disorder, refers to a variety of conditions characterized by challenges with social skills, repetitive behaviors, speech and nonverbal communication, also as by unique strengths and differences. We now know that there's not one autism but many sorts , caused by different combinations of genetic and environmental influences. The term “spectrum” reflects the wide variation in challenges and strengths possessed by everyone with autism

Types of autism

There are four main sub-types of autism recognized within the Diagnostic and Statistical Manual of Mental Disorders

Autistic Disorder, also referred to as autism, childhood autism, early autism , Kanner’s syndrome or infantile psychosis. People with autistic disorder usually have significant language delays, social and communication challenges, and weird behaviors and interests. many of us with autistic disorder even have intellectual disability

Asperger Syndrome, also referred to as Asperger’s disorder or just Asperger’s. People with Asperger syndrome usually have some milder symptoms of autistic disorder. they could have social challenges and weird behaviors and interests. However, they typically don't have problems with language or intellectual disability

Childhood Disintegrative Disorder, also referred to as CDD, dementia infantalis, disintegrative psychosis or Heller’s syndrome. These children develop normally for a minimum of two years then lose some or most of their communication and social skills. this is often a particularly rare disorder and its existence as a separate condition may be a matter of debate among many psychological state professionals

Pervasive Developmental Disorder-Not otherwise Specified, also referred to as PDD (NOS) or atypical autism

  ?How common is Autism

Autism statistics from the U.S. Centers for Disease Control and Prevention (CDC) released in March 2014 identify around 1 in 68 American children as on the autism spectrum – a ten-fold increase in prevalence in 40 years. Careful research shows that this increase is merely partly explained by improved diagnosis and awareness. Studies also show that autism is four to 5 times more common among boys than girls. An estimated 1 out of 42 boys and 1 in 189 girls are diagnosed with autism within the us 

ASD affects over 2 million individuals within the U.S. and tens of millions worldwide. Moreover, government autism statistics suggest that prevalence rates have increased 10% to 17% annually in recent years. there's no established explanation for this continuing increase, although improved diagnosis and environmental influences are two reasons often considered

Historical background about ASDs

The term Autism comes from the Greek word “autos,” meaning “self”. Eugen Bleuler coined the word “autism” in 1908 among severely withdrawn schizophrenic patients

In 1943 American child psychiatrist Leo Kanner studied 11 children. the youngsters had features of difficulties in social interactions, difficulty in adapting to changes in routines, good memory, sensitivity to stimuli (especially sound), resistance and allergies to food, good intellectual potential, echolalia or propensity to repeat words of the speaker and difficulties in spontaneous activity

In 1944 Hans Asperger, working separately, studied a gaggle of youngsters . His children also resembled Kanner’s descriptions. the youngsters he studied, however, didn't have echolalia as a linguistic problem but spoke like grownups. He also mentioned that a lot of of the youngsters were clumsy and different from normal children in terms of fine motor skills

Next Bruno Bettelheim studied the effect of three therapy sessions with children who he called autistic. He claimed that the matter within the children was thanks to coldness of their mothers. He separated the youngsters from their parents. Kanner and Bettelheim both worked towards making hypothesis that showed autistic children had frigid mothers

Bernard Rimland was a psychologist and parent of a toddler with autism. He disagreed with Bettelheim. He didn't agree that the explanation for his son’s autism was thanks to either his or his wife’s parenting skills. In 1964, Bernard Rimland published, Infantile Autism: The Syndrome and its Implications for a Neural Theory of Behavior

Autism came to be better known within the 1970’s. The Erica Foundation started education and therapy for psychotic children within the beginning of the 80s. Many parents still confused autism with retardation and psychosis

It was in 1980’s that Asperger’s work was translated to English and published and came into knowledge

It was within the 1980’s that research on autism gained momentum. it had been increasingly believed that parenting had no role in causation of autism and there have been neurological disturbances and other genetic ailments like tuberous sclerosis, metabolic disturbances like PKU or chromosomal abnormalities like fragile X syndrome

Lorna Wing, along side Christopher Gillberg at BNK (Children’s Neuro-Psychiatric Clinic) in Sweden within the 1980’s found the Wing’s triad of disturbed mutual contact, disturbed mutual communication and limited imagination. within the 1990’s they added another factor making it a square. The factor was limited planning ability

Ole Ivar Lovaas studied and furthered behavioural analysis and treatment of youngsters with autism. Lovaas achieved limited success initially together with his experimental behaviour analysis. He developed it to focus on younger children (less than 5 years of age) and implemented treatment reception and increased the intensity (a measurement of the quantity of “therapy time”) to about 40 hours weekly. Lovaas wrote Teaching Developmentally Disabled Children: The Me Book in 1981. In 2002, Lovaas wrote, Teaching Individuals with Developmental Delays: Basic Intervention Techniques

Signs and symptoms of ASDs

People with ASDs may have problems with social, emotional, and communication skills. they could repeat certain behaviors and won't want change in their daily activities. many of us with ASDs even have alternative ways of learning, listening , or reacting to things. ASDs begin during  infancy and last throughout a person’s life

A child or adult with an ASD might have

Not play “pretend” games (pretend to “feed” a doll)

Not point at objects to point out interest (point at an airplane flying over)

Not check out objects when another person points at them

Have trouble concerning others or not have an interest in people in the least

Avoid eye contact and need to be alone

Have trouble understanding other people’s feelings or talking about their own feelings

Prefer to not be held or cuddled or might cuddle only they need to

Appear to be unaware when people ask them but answer other sounds

Be very curious about people, but not skills to speak , play, or relate to them

Repeat or echo words or phrases said to them, or repeat words or phrases in situ of normal language (echolalia)

Have trouble expressing their needs using typical words or motions

Repeat actions over and once again

Have trouble adapting when a routine changes

Have unusual reactions to the way things smell, taste, look, feel, or sound

Lose skills they once had (for instance, stop saying words they were using)

Causes of Autism

There’s nobody explanation for autism. Research suggests that autism develops from a mixture of genetic and non-genetic, or environmental, influences. These influences appear to extend the danger that a toddler will develop autism

Autism’s genetic risk factors: Changes in certain genes increase the danger that a toddler will develop autism. If a parent carries one or more of those gene changes, they'll get passed to a toddler (even if the parent doesn't have autism)

Autism’s environmental risk factors: certain environmental influences may further increase – or reduce – autism risk in people that are genetically predisposed to the disorder. Importantly, the rise or decrease in risk appears to be small for anybody of those risk factors

Advanced parent age (either parent)

Pregnancy and birth complications (e.g. extreme prematurity [before 26 weeks], low birth weight, multiple pregnancies [twin, triplet, etc.])

Use of alcohol

Maternal metabolic conditions like diabetes and obesity

Use of anti-seizure drugs during pregnancy

Untreated phenylketonuria (called PKU, an inborn disorder caused by the absence of an enzyme)

Rubella (German measles)

Diagnosis of ASDs

Diagnosing autism spectrum disorder (ASD) are often difficult, since there's no medical test, sort of a biopsy , to diagnose the disorders. Doctors check out the child’s behavior and development to form a diagnosis

ASD can sometimes be detected at 18 months or younger. By age 2, a diagnosis by an experienced professional are often considered very reliable. Diagnosing an ASD takes two steps

Developmental Screening

Comprehensive Diagnostic Evaluation

Developmental Screening

Developmental screening may be a short test to inform if children are learning basic skills once they should, or if they could have delays. During developmental screening the doctor might ask the parent some questions or talk and play with the kid during an exam to ascertain how she learns, speaks, behaves, and moves. A delay in any of those areas might be a symbol of a drag 

All children should be screened for developmental delays and disabilities during regular well-child doctor visits at

9 months

18 months

24 or 30 months

Additional screening could be needed if a toddler is at high risk for developmental problems thanks to preterm birth, low birth weight or other reasons. additionally , all children should be screened specifically for ASD during regular well-child doctor visits at

18 months

24 months

Other lab tests could also be done under specific circumstances. These tests include

Chromosomal analysis, which can be done if intellectual disability is present or there's a case history of intellectual disability. for instance , fragile X syndrome, which causes a variety of below-normal intelligence problems also as autistic-like behaviors, are often identified with a chromosomal analysis

An electroencephalograph (EEG), which is completed if there are symptoms of seizures

MRI, which can be done if there are signs of differences within the structure of the brain

Treatment of ASDs

Applied behavioral analysis (ABA

This intervention works by breaking down skills like communication and cognitive skills into smaller and simpler tasks. The tasks are then taught during a highly structured way. the straightforward tasks over time coalesce into more complex skills that help in development

Early start Denver model

This is yet one more behavioral intervention that mixes applied behavioral analysis with developmental and relationship based approaches. the kid is brought into interactive social relationships, using positive emotional exchanges and joint play activities. It improves cognitive, language and adaptive behavioral skills

Discrete Trial Training (DTT

This is a method of teaching that uses a series of trials and efforts to show each step of a desired behavior or response

Pivotal Response Training (PRT

This is intended to extend the child’s motivation to find out and monitor his or her own behaviour and start communication

Verbal Behavior Intervention (VBI

VBI may be a sort of ABA that focuses on teaching verbal skills

Speech and language Therapy (SLT

This therapy aims at improving communication and language skills. this will improve their ability to interact with others socially. This intervention may use visual aids, stories and toys and other aids to develop language skills

Occupational therapy

This focuses on development and maintenance of fine motor and adaptive skills

Stem cell therapy

Medicines

Medicines are most ordinarily wont to treat related conditions and problem behaviors, including depression, anxiety, hyperactivity, and obsessive-compulsive behaviors.

Prevention

Although the precise explanation for autism isn't known in most instances, some cases are linked to chemical exposure during pregnancy. Therefore, it's essential to avoid taking any drugs during pregnancy unless the doctor specifically prescribes them

It is also essential to avoid drinking alcoholic beverages of any kind during pregnancy. Being immunized against rubella (German measles) before becoming pregnant can prevent rubella-associated autism

Following delivery, there are certain measures which will be helpful in preventing autism. One is early diagnosis and treatment of phenylketonuria (PKU). this is often a genetic disease that's caused by the shortage of a liver enzyme required to digest the enzyme phenylalanine

Similarly, early diagnosis and treatment of disorder may reduce the danger of a toddler having autism