Autism: Symptoms, Causes, Risk Factors, Diagnosis And Treatment

Every year on 18 June, Autistic Pride Day is celebrated to raise awareness on autism, a neurodevelopmental disorder that affects 1 out of every 59 children. The day gives an opportunity to celebrate the uniqueness of people with autism, support and understand them and increase the awareness for the early detection of the condition.

Autism or Autism Spectrum Disorder (ASD) is an umbrella term for 4 different types of developmental disorders - autism, childhood disintegrative disorder, Asperger's syndrome, and pervasive development disorder-not otherwise specified (PDD-NOS). It is a neurodevelopmental disease in which a person lacks social communication and interaction. People with these disorders usually demonstrate a repetitive, restricted and stereotyped pattern of behaviour. These impairments include challenges in verbal and nonverbal communication, repetitive speech, hand flapping, object use, restricted interests, restricted motor movements and hyper/hyposensitivity ^[1] .

According to the Centers for Disease Control and Prevention, 1 out of every 59 children have autism and the condition is common among boys in compared to girls. The disorder begins in early childhood and causes trouble as they age, like during functioning socially or in school. Experts say that children develop autism normally during the first year but the symptoms are developed within 18-24 months ^[2] .

The word 'spectrum' in autism spectrum disorder describes several symptoms and severity of the condition. The DSM-5 - American Psychiatric Association divided ASD among the two levels; social communication and Restricted and Repetitive Behaviors.

Symptoms Of Autism

In children, the symptoms of autism start developing at a very early stage and differ in every child by a different pattern of behaviour. They have a mixture of symptoms as some have high levels of intelligence but feels trouble while communicating and some have lower levels of intelligence with a bit more capability of verbal communication ^[3] .

The common symptoms of autism are divided into 2 categories which are as follows:

1. Social communication and language cognitive skills

• Difficulty in talking to people in a social environment ^[4]
• Limitations in knowing someone's intention
• Poor eye contact
• Delayed speech ^[5]
• Difficulty in starting a conversation
• Repeated phrases or words
• Speaking in an abnormal tone ^[6]
• Difficulty in understanding direction
• Difficulty in expressing emotions ^[7]
• Unable to understand another person's facial expression or voice tones

2. Behaviour and emotional regulation

• Problem during sleeping ^[8]
• Uncommon attachment to certain objects
• Difficulty when there's a routine change
• Laughing or crying for no reasons at inappropriate times ^[9]
• Social withdrawal
• Limited taste ^[10]
• Sensory difficulties with environmental light, sounds, voices, touch or other social stimuli ^[11]
• Using tantrums, aggressions or other emotional expressions
• Difficulty in self-management ^[12]

Causes Of Autism

There are several causes of autism. Also, there are a few medical conditions in which autism is the main symptom. The conditions are fragile X syndrome, cerebral dysgenesis tuberous sclerosis and Rett syndrome. Therefore, autism is usually considered as the result of several diseases related to the development of the brain. Common causes of autism spectrum disorder include the following:

1. Genetic: One of the foremost cause of ASD is a mutation or genetic differences. Though the genetic linkage between the child and family members is a question of discussion among medical experts, there are sufficient proofs which say that genes are involved in the ASD. In most cases, ASD in children is associated with genetic disorders like fragile X syndrome and Rett syndrome while in others, ASD develops due to mutation of the genes and affect the brain development in different ways which are determined by their symptoms ^[13] .

2. Environmental factors: Several environmental factors like infection, drugs, dietary factors and exposure to pollution like hydrocarbons, lead and insecticides may cause a genetic variation in a person and lead them to ASD. However, this is yet a topic of study and scientists are finding out more environmental factors that may result in the variation of genes ^[14] .

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Risk Factors Of Autism

Though ASD can affect people of all nationalities and race, factors that add more to the risk are as follows:

• Genes: According to medical experts, if one child of a parent has ASD, there's a maximum chance that another child from the same parent may get the disorder ^[13] .

• Gender: Experts say that boys are four times more prone to ASD than girls.

• Other genetic diseases: Certain genetic or chromosomal disorders like Rett syndrome [15], tuberous sclerosis and fragile X syndrome can lead a person to ASD.

• Age of parents: Some research reveals that child born to older parents are more prone to ASD. However, the condition requires more proof to establish the link.

• Preterm babies: There is some evidence in which babies who are born before 26 weeks of gestation are likely to get ASD after birth ^[16] .

• Medications: Some medications like valproic acid and thalidomide when taken during pregnancy can cause a higher risk ASD in the child.

Complications Of Autism

• Social isolation ^[4]
• Less access to good educational institutes and problem in seeking employment
• Problem in living independently
• Stress in people suffering ASD as well as to their family members ^[17]
• Bullied by other people which may result in low self-esteem
• Unable to develop social and emotional relationships at a later stage of life ^[9]

Diagnosis Of Autism

The diagnosis of ASD is very difficult as there are no medical tests to diagnose it. Doctors diagnose the condition by observing a person and their symptoms. For diagnosing ASD in children, the process is carried out by identifying the following aspects ^[18] :

• The child does not respond to his/her name by age 1
• The child does not show interest in playing games by 18 months
• The child does not point at any object out of curiosity by 14 months.
• The child does not make eye contact.
• Flapping hands
• The child gets upset suddenly.
• The child prefers staying alone.
• Tests for diagnosing other genetic disorders are also suggested by doctors to identify the cause of ASD.

Also read:

Auto-Brewery Syndrome (ABS): Causes, Symptoms, Risk Factors, Diagnosis And Treatment

Treatment Of Autism

The only way to treat people with ASD is to encourage and support them for learning and improving their abilities. If a child is trained with social, behavioural and communications skills at an early stage, there are chances of decrease in the symptoms. However, some of the treatment therapies include the following:

• Helping them in initiating communication and interactions in a social gathering ^[4]
• Using multimodal communication like sign language, gestures and communication with images
• Teaching personal values, culture and linguistic

• Teaching the value of family
• Using a certain process or framework for language development in them ^[19]
• Coming out with multiple approaches to enhance their communication skills and behaviour
• Using technologies like speech-generating devices as a supplement in aiding their communication ^[20]
• Using visuals or videos to make them understand
• Auditory integration therapy to treat sensory dysfunction like massaging the middle ear muscles
• Cognitive behaviour therapy to teach them the control of emotions ^[9]
• Teaching peer interaction techniques so that they are not left behind in the corporate world

Other treatment methods include medications when people with ASD face problems like epilepsy, stomach problems, anxiety and sleep disorders. Also, medications are provided when they face problems in the transition to adulthood.