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Autism (or, correctly speaking, autism spectrum disorder) is a concern that many parents of young children fear. What are autism-related disorders of communication, interaction with other people, and abnormal behavior? What symptoms may make you suspect autism? What are the treatment options for a patient diagnosed with autism spectrum disorder?

Autismis a term that derives from the Greek word "autos", translated as itself. Basically, it reflects the essence of autistic disorders - people who have such disorders live in their own world and functioning in the surrounding reality can be simply difficult for them.

More and more people say that autism is a neurodevelopmental disorder that you don't have, but you just have.

Autism started to be mentioned in the first half of the last century - then, in 1943, early childhood autism was described by Leo Kanner.

At the same time, another researcher, Hans Asperger, was working on similar problems in parallel. In the first diagnostic classifications, autism was classified alongside such disorders as childhood schizophrenia.

Over time, however, the view on this type of disorder has changed - they have been distinguished as a completely separate problem.

Autism is still a rather mysterious problem, therefore not only is there constant research into its potential causes, but also views regarding its recognition or classification are changing.

Basically, it can be said that autism has actually come a long way - initially placed alongside various psychotic disorders, nowadays it is not even considered a disease by many.

Types of Autism and Autism Spectrum Disorder

Autism in adults: what the life of an adult autistic looks like

Types of autism spectrum disorders and differences in the classification

There are basically two classifications in psychiatry: the ICD developed by the World He alth Organization (currently its 10th version is in force) and the DSM classification prepared by the American Psychiatric Association (its fifth version is currently in use).

Basically in both classifications similar problems are describedHowever, the diagnostic criteria and the categorization of various disorders are often completely separate.

In Poland, doctors mainly use the ICD-10 classification. In her case,autismbelongs to the category of overall development disorders (F84), in which several different problems are distinguished, such as :

  • early childhood autism (in its case, the first problems appear before the child is 3 years old)
  • atypical autism (symptoms begin here after the child turns three)
  • Rett syndrome
  • other childhood disintegrative disorders
  • hyperkinetic disorder with accompanying mental retardation and stereotypical movements
  • Asperger's syndrome
  • other pervasive developmental disorders
  • unspecified pervasive developmental disorder.

The problem in the DSM-V classification is completely different: in the case ofautism , many changes took place in the last version of the classification.

Well, DSM-V basically ceases to distinguish particular typesautism , preferring to replace them with the term autistic disorder spectrum.

In the case of this classification, much more emphasis than the possible categorization of the patient's disorders as one of the formsof autism , is put on the intensity of the deviations occurring in him.

Autism - epidemiology

It is difficult to say with what exact frequency of autism spectrum disorders. The reason for this is both the fact that different research uses different diagnostic criteria and the fact that the prevalence of autism seems to be completely different in different regions of the world.

For example, in the United States, according to statistics, the autism spectrum disorder can be diagnosed in one in 68 children. On the other hand, European data suggest that one type of autism can be found in 1 in 150 children. Still other statistics show that autism affects 1% of the population, but just as it is difficult to accurately estimate the number of people with autism, the situation is different when it comes to gender and the prevalence of the problem. Here the differences are clearly noticeable - boys are diagnosed with autism spectrum disorders much more often, even four times.

Autism - Symptoms

The basic symptoms of autism are disorders related to three aspects: communication, social interactions, and also specific behavior.

In each of these spheres there may be characteristic deviations, emphasizehowever, one thing should be done: each child with autism spectrum disorders is different and in fact, one will be dominated by communication problems, and in another, exhibiting atypical, stereotypical behavior.

Autism is in fact a compilation of many different problems, not a unit in which specific disorders must occur.

Autism Symptoms - Communication

One of the worrying signs most likely to be associated with the possibility of autism in a child is delayed speech development.

It really is: speech development disorders may be one of the first symptoms of autism spectrum disorders, additionally, when a child starts to speak, his or her speech is different from that of his peers. A child with autism may:

  • repeat the same sentences or words over and over again
  • answer his question with exactly the same question (phenomenon known as echolalia)
  • find it difficult to clearly define your needs
  • not in accordance with the rules of grammar - he may not inflect words or use the correct grammatical forms, it is also characteristic that children with autism do not call themselves "I ate", but "Dorota ate"
  • speak in an unusual way, e.g. chant each utterance as if it were a question.

Communication disorders, which are a symptom of autism, concern not only the verbal sphere. Problems are also noticeable in non-verbal communication.

The person withautismis unlikely to make eye contact. She also has a hard time reading the body language (both facial expressions and gestures) presented by other people.

Understanding what a person with ASD is sayingautismcan be difficult, because he or she may display facial expressions completely unsuited to what he is talking about at the moment.

Autism symptoms - social interactions

Another problem related to the autistic spectrum disorder is the abnormalities in functioning among other people.

A patient withautismmay be perceived as an extremely strange, unusual person, but he simply functions in a different way. In terms of social interactions, the symptoms ofautismare:

  • difficulties with initiating contact, making new friends
  • reluctance to be touched by other people (even by their parents)
  • difficulties in talking about feelings - both your own and other people's feelings
  • problems while playing: a child withwith autism, it can be difficult to take on a role (for example while playing in a shop or at home) - usually his games are stereotypical, in addition, a child can still play with the same toy and still in the same, one way,
  • apparent indifference to contacts with other people: a patient with autism may seem completely indifferent to other people, additionally, he rarely boasts of his achievements (even success in composing complicated puzzles) - he may seem exceptionally locked in his world.

Autism symptoms - specific, stereotypical behavior

Yet another area in which symptoms of autism may present are the child's behavior.

Characteristic for autism spectrum disorders is, inter alia, exceptional behavioral rigidity. An autistic child simply doesn't like any changes in their daily routine: if they first dress, eat breakfast, and then go out for a walk, any change in the sequence of these activities can lead to an outburst of anger and even aggressive behavior.

Other symptoms of autism on this axis could be:

  • the child's great interest in items that others do not arouse curiosity at all: e.g. a spinning drum of a washing machine or light switches
  • obsessive arranging various items (e.g. toys, clothes) in the order set by the child
  • repeating unusual movements many times, e.g. spinning around its own axis
  • a high degree of interest in one specific field of knowledge, e.g. numbers.

Can the symptoms of autism be found in infancy?

Autism spectrum disorders in some children show up quickly, within several months of birth, while in other patients the first problems appear only a few years after they are born.

Different researchers have different theories about what behaviors - at the earliest stages of life - may suggest that the child is at risk of developingautism .

Returns, inter alia, attention to how the infant reacts to the mother - it would be disturbing, for example, that the child does not smile at the sight of the mother or that he does not make eye contact with her.

Another sign that could raise anxiety for parents would be the sensitivity of a young child to sounds. Well, there are theories according to which the characteristic ofautismwould be the response of an infant to very quiet sounds (such as the rustling of paper) with the simultaneousignoring much louder stimuli, such as the slam of a door.

  • Find out what characterizes childhood autism
  • Find out about autism in adults

Autism - causes

The causes of autism can vary widely, but they are certainly not vaccines.

The causes of autism are asked by many parents of autistic children, as well as many doctors, but nowadays no one is able to answer them with 100% certainty.

Even the best specialists have theories about the causes of autism rather than scientific facts. Potential factors causing autism include: gene mutations, infections or perinatal problems.

1. Genes

By analyzing the causes ofautism , scientists focus the most attention on various genetic disorders. Theoretically, mutations in certain genes could be responsible for the appearance of this disease, but so far no specific mutations causing it have been detected. So why is the role of genes in the emergence of autism still interesting for so many researchers?

The fact that genetic disorders can cause autism is supported by the results of studies that were conducted on twins.

In the case of identical twins (i.e. those who have the same genetic material), if one of them suffers from autism, according to some studies the risk that the other twin will develop the disease is up to 90%.

On the other hand, in the case of fraternal twins - who have separate genetic material - the autism incidence rate is approximately 30%.

Another indication that mutations can cause autism is that it sometimes coexists with other diseases caused by genetic disorders. This is the case, for example, in the case of fragile X chromosome syndrome or Rett syndrome.

In the latest research on the relationship between autism and genes, scientists from the Harvard University analyzed the genomes of 31,269 autistic people from around the world. While 65 genes related to autism were known so far, after the largest analysis in the history of autism research, their number increased to 102. Among them 47 were more strongly associated with intellectual and developmental delays, 52 more strongly with autism, and 3 genes conditioned both disorders. The analysis of such a huge number of genes was considered an important step towards the effective differentiation of genes into those related to the autism spectrum and those that cause other developmental disorders.

2. Ailmentsneurological

In children with autism, there are noticeable deviations in the morphology of their brain (which can be found, for example, in imaging tests).

It is for this reason that some scientists believe that the causes of autism may also include pathologies of the nervous system. Problems that could increase the risk of autism include :

  • macrocephaly
  • microcephaly
  • encephalopathies
  • meningitis.

It is also important that autism is more often observed in those children in whose families someone had previously suffered from this disease or other autism spectrum disorders.

3. Complications in pregnancy and the perinatal period

The phenomena that can cause autism are also various complications related to the course of pregnancy and childbirth.

A potential cause of autism may be medical conditions that occur in a pregnant woman, such as gestational diabetes and thyroid dysfunction.

The risk of pervasive developmental disorders may also be increased by intrauterine infections - especially infections with rubella virus or cytomegalovirus.

Other problems that are believed to cause autism are perinatal complications. An increased incidence of this disease is observed in babies born prematurely and in those born with reduced body weight.

The experience of perinatal hypoxia in the newborn may also contribute to the perinatal hypoxia.

4. Harmful substances

Among the hypotheses concerning the causes of autism, there are also those concerning the relationship between the child's exposure to toxic substances and the risk of developing pervasive development disorders. In this case, the greatest attention is paid to poisoning with heavy metals, such as lead or mercury.

Harmful substances that theoretically may increase the risk of autism in a child are also ingested by pregnant medications.

The potentially dangerous preparations taken by the expectant mother include valproic acid (an anti-epileptic drug), paracetamol (a painkiller and antipyretic drug) or misoprostol (an agent used to treat stomach ulcers).

The attention of researchers investigating the causes of autism is also directed at the relationship between the mother's alcohol consumption or smoking during pregnancy and the risk of overall development disorders in her child.

5. Unconfirmed theories -vaccinations

In recent years, the so-called anti-vaccine movement. Vaccination opponents argue their position, among others that vaccines can cause autism.

Indeed, some time ago there were suggestions that vaccination would lead to autism (measles vaccination in particular). Proponents of the theory also suggested that the mercury-containing preservative in vaccines promotes pervasive developmental disorders.

There have even been scientific publications that allegedly supported the link between vaccines and autism. Eventually, after a few years, other researchers refuted these theories - it turned out that research suggesting autism was caused by vaccines was incorrectly conducted.

Vaccination opponents remain true to their position anyway, and at the same time doctors are sounding the alarm - avoiding vaccinating children is already leading to dangerous consequences, such as the increasing number of measles cases (complications of which in unvaccinated children may be even fatal).

6. Other factors

The above-mentioned aspects are a lot in terms of what can potentially be the cause of autism.

In reality, however, these are not all the factors that, according to scientists, may lead to a comprehensive development disorder.

Other risk factors for their occurrence include: Vitamin D deficiency, gastrointestinal disorders in children or the use of SSRI antidepressants (serotonin reuptake inhibitors) by pregnant women.

As you can see, there are many theories about the causes of autism, but it will probably be a long time before it is finally established, which leads to its occurrence.

For this reason, it is impossible to effectively prevent autism. So it remains for the researchers to focus on what to do when the disorder occurs in the child. Currently, it seems more important to search for effective methods of therapy for autistic people than to discover what causes this disease.

Worth knowing

The mother's behavior has NO influence on the onset of autism in the child

Another theory about the causes of autism that has also been disproved is the influence of mother's behavior on the risk of this disorder in the child. Hypotheses have emerged that children who are brought up without maternal warmth and tenderness, by women who show emotional coldness, are at increased risk of developing pervasive developmental disorders.This hypothesis has nothing to do with the truth.

Autism - diagnosis

It is not easy to make a diagnosis of autism - after all, not all the disorders that are characteristic of this individual appear simultaneously. Concerned parents usually direct their steps to the pediatrician at first.

The specialist is of course able to confirm or rule out the parents' concerns, although the pediatrician will not diagnose autism on his own - for this purpose he will most likely refer the parents to a specialized facility, e.g. a psychological and pedagogical clinic.

Autism diagnostics is usually handled by an entire team, including child psychiatrist, psychologist, educator and speech therapist. The diagnosis is preceded by collecting a detailed interview with the parents (concerning both the child's behavior and individual, from the very birth, stages of its development, as well as the course of pregnancy).

It is also very important to observe the behavior of the little patient himself. Special officers, such as ADOS-2 (Autism Diagnosis Observation Schedule-2), are helpful in making a diagnosis.

However, before parents see a specialist, they may sometimes have doubts: is the child's development really going wrong or is it a matter of caregivers' oversensitivity?

This is where the Synapsis Foundation comes with help, running Badabada, the Autism Early Detection Program. On the website badabada.pl, a test is available, thanks to which parents can at least initially check if they really have any reasons to worry about their child.

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Autism - not treatment, but therapy

Self-diagnosis of autism is the beginning of a long path of therapy. Basically, the use of this term - therapy - is postulated by specialists dealing with autism spectrum disorders. This is because, since autism is increasingly not considered a disease, it would be difficult to talk about any kind of treatment for it. Therapeutic interventions that are offered to children with autism may be of various kinds. Behavioral techniques are used as well as dogotherapy or hippotherapy.

  • DOGOTHERAPY - therapeutic use of contact with a DOG
  • HYPOTHERAPY - rehabilitation with the help of a horse

Logotherapy is also used, but also music therapy, sensory integration exercises and biofeedback.

Classes also play a significant role in children with autismearly development support. All of these therapies for autism are aimed at improving the patient's functioning in everyday life - it is expected that they will improve, among others, the patient's communication skills, visual-spatial coordination or better development of the perception of the environment.

Sometimes pharmacotherapy is recommended for a patient with an autistic spectrum disorder, but one thing needs to be emphasized right away. There is no cure for autism - pharmacological treatment is recommended only in justified cases and only as an auxiliary.

Pharmacotherapy can be recommended, for example, to children struggling with anxiety, significant mood disorders or frequent aggressive behavior.

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Category:

Neurology