Autism Spectrum Disorder
1.What is Autism Spectrum Disorder (ASD)?
ASD is a type of neurodevelopmental disorder that affects brain. Features of autism are categorized into primary and secondary features. It is important to note that all children with autism do not necessary to display all features, nor are they identical in the severity of their symptoms.
Primary Feature 1: Social Interaction and Communication
- Less visual responsive, less likely to respond to their names, more likely to show aversion to being touched by another person.
- Fail to track people visually
- Avoid eye contact
- Exhibit an ‘empty’ gaze
- Fail to respond with emotional expression
- Show little interest in being held / hugged
- Deficits in joint interaction (after 6 months) such as pointing and eye contact for learning.
- Fail to recognize face, matching emotional faces, memorizing faces
- Delayed verbal and language development
- Echolalia (echoes back what another has said)
- Pronoun reversal (may refer others as ‘I’ or ‘me’, refer self as ‘he’ or ‘she’ or‘them’ or ‘you’)
- Difficulties in syntax, comprehension and other structural forms of language (but not identical to specific language impairments)
Primary Feature 2: Restricted, Repetitive, Stereotyped Behavior and Interests (RRSBS)
- Repetitive sensory motor behaviors such as hand flapping, rocking, twirling, toe walking.
- Repetitive use of objects
- Self-injury behaviors
- High level of insistence on sameness (may obsess with numbers, compulsively collect articles, overly absorbed in hobbies)
- May adopt motor routines such as rearranging objects, insist on following rituals for eating and going to bed
- Unable to adapt with minor changes in environment such as rearrangement of furniture or schedules
Secondary Feature 1: Sensory/ Perceptual Impairments
- Oversensitivity (eg: disturbed by sound of vacuum cleaner, seams on clothing or light embrace)
- Undersensitivity (eg: failing to respond to voices, unaware of loud noise but fascinated by quiet ticking of a watch)
- Overselectivity (focus on a selected portion of stimulus, neglect other component)
Secondary Feature 2: Intellectual Performance
- Intellectual deficiency is more common for severe autistic symptoms
- Uneven cognitive development
- Weak in abstract and conceptual thinking, language, social understanding
- Strong in rote learning, rote memory, visual-spatial skills.
- Splinter skills (abilities much higher than expected general intelligence)
- Savant abilities (skills that are strikingly better than those seen in normal youth)
Secondary Feature 3: Adaptive Behavior
- Difficulties in dealing with the comings and goings of everyday life.
Secondary Feature 4: Theory of Mind (ToM)
- Unable to understand mental states such as intention, desire, beliefs, feelings that are connected to actions.
2. When will my child show symptoms of autism?
Children with autism show few symptoms as early as 6 months. However, many show subtle differences from typically developing infants before 12 months. Most autism cases were diagnose after age of 3.
It is important to bring your child for a professional diagnosis with psychologist or pediatrician when you notice some abnormalities, instead of doing self-diagnosis with google.
3. Are there different levels of functioning for ASD?
People often label different levels of ASD with high functioning and low functioning.However, this is not officially included as a medical term. In DSM V, ASD is categorized into 3 level of severity.
4. What are the main cause of ASD?
• Family history
Children who have an immediate family member with communication problem, repetitive behavior or autism are more likely to develop it.
• Prenatal exposure
Environmental toxins and exposure to heavy metals during pregnancy may play a role, such as maternal medication, gestational diabetes, uterine inflammation and abnormal maternal immune responses.
• Parental age
Children born to older parents may have a higher chance for developing autism.
• Genetic mutations and disorders
Fragile X syndrome and tuberous sclerosis are the two genetic conditions that are associated with autism. These conditions results in gene mutations and tumors development of brain and other organs.
• Premature birth
Children with a low birth weight may be more likely to develop the disorder.
• Chemical and metabolic imbalances
A disruption in hormones or chemicals may impede brain development which could lead to the changes in brain regions that are associated with autism.
• Environment and social interaction
Early brain abnormalities influence the interactions between the child and the environment such as lesser stimulation for brain development. The altered interactions may further lead to additional brain anomalies and autism.
5. What Makes Autism a Spectrum Disorder?
Under DSM V, the primary symptoms of ASD falls into two domains:
(1) Persistent deficits in social communication and interaction,
(2) Restrictive or repetitive patterns of behaviours, interest and activities. Over- or under-sensitivity to sensory input.
These domains greatly categorized the below disorders together:
• Autistic Disorder,
• Asperger’s Disorder,
• Childhood Disintegrative Disorder (CDD)
• Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS)
These disorders are varied to a certain degree. However, they shared the similar domains. Hence, they all fall into Autism Spectrum Disorder.
6.Does Having a history of sosial neglect causes ASD?
No. According to DSM V, children with ASD rarely has the history of social neglect, in which, social neglect includes fail to provide adequate basic needs to the child such as parental supervision, social communication, safety needs, education etc.
7. Are there any theatments for ASD?
Yes, the autistic symptoms can be improved but not cured. There is no one standard treatment for ASD. Each treatment is aimed to maximize abilities and minimize symptoms based on different conditions of each child with autism.
Below are different types of treatment provided to ASD. Parents are highly encouraged to seek for a professional health care specialist to tailor the treatment best suit for your child.
• Behavioral management therapy
• Cognitive behavior therapy
• Early intervention
• Educational and school-based therapies
• Nutritional therapy
• Occupational therapy
• Parent-mediated therapy
• Physical therapy
• Social skills training
• Speech-language therapy
• Joint attention therapy
• Medication treatment
8. Why ASD affects more boys than girls?
Autism spectrum disorder is diagnosed four times more often in males than in females.
In clinic samples, females tend to be more likely to show accompanying intellectual disability, suggesting that girls without accompanying intellectual impairments or language delays may go unrecognized, perhaps because of subtler manifestation of social and communication difficulties.
9. is there a way to prevent kids from getting ASD?
Prenatal care and improvement in environmental quality is the universal prevention as it is an apparent genetic and neurodevelopmental disorder.
However, early identification and intervention can help some young children to reduce autistic symptoms. Early intervention programs that are focusing on social skills such as joint attention and social engagement with others, imitation, and language are frequently employed. These programs can improve intelligence, language, and rate of overall development in some children.
10. how can one help kids with ASD?
Having empathy and patience is important to help them. We should always put ourselves in their shoes and keep in mind that they have difficulties in communicating.
Forcing them to talk and understand us is useless. Hence, we should try various ways to explain things to them to help them in understanding the situation.
11. What do you think the public is the public should know about ASD?
Many have misunderstood people with autism are people with introvert personality or people who always got bullied and neglected by parents.
ASD is a neurodevelopmental disorder that is caused by brain abnormality. It is largely due to genetic problems that happened during the prenatal stage. Also, people with ASD do not necessary to have intellectual and learning disability. The IQ level may varies from exceptional higher or lower than normal developing children. They are only weak in abstract and conceptual thinking, but not in all aspects of learning.
12. What do you think is the best way to get to the public in understanding ASD?
Firstly, accepting autism with openness is necessary before having any input of information on Autism. Next, people may follow and subscript to newsletter on Autism or Social Medias that promote actual knowledge on Autism would improve the public understanding.
Lastly, do follow our Facebook A+ for Autism and Instagram @aplusforautism to get daily info on Autism!
References
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA:American Psychiatric Association, 2013
Wicks-Nelson, R. & Israel, A. C. (2015). Abnormal Child and Adolescent Psychology (8th ed).London: Routledge, Taylor & Francis Group.