Autism Spectrum disorder

Overview

Autism spectrum disorder is a disability that affects a person’s brain and inhibits development and growth. The disability affects the person’s mental health and will have problems with social interaction.

Children affected by autism spectrum disorder become very sensitive and stressed to minimal changes in their environment.

People living with ASD might require help from others to perform their daily activities. According to the Centre for Disease Control and Prevention, there are various reasons for ASD which is still under research.

The way people affected with ASD differs from others. Apart from mental health, physical growth is usually normal. The disability differs from one person to another. For example, some people may require support to carry out their daily activities, whereas others are self-sufficient.

The symptoms of ASD manifest at the age of 3, and the disability can last till their lifetime. However, some reports suggest the onset of the symptoms can be seen as early as one year after birth.

Children affected with ASD have difficulty communicating with others, and their development can be delayed till 24 months after birth. Once the children reach this milestone, they might stop gaining new skills or lose the skills they gained during their growth. The onset of the symptoms may vary between each person.

Types of ASD 

According to data published in the journal National Library of Medicine, titled “Autism spectrum disorders”, boys are more prone to ASD than girls in a ratio of 4:1.

When the autism occurs with other medical conditions like fragile X syndrome, tuberous sclerosis, phenylketonuria and congenital infections, it is termed secondary autism.

Pervasive developmental disorder (PDD)

The pervasive developmental disorder is characterised by impairment in social interaction, communication, imaginative activity and restricted repetition of movements.

Atypical autism is formerly called a pervasive developmental disorder. Children aged 3-4 exhibit full symptoms of atypical autism. Some of the common social and emotional symptoms are listed below.

• Shy to make eye contact.
• Poor social skills or communication.
• Difficulty in engaging with communication.
• Lack of desire to share activities with other people in the group.
• Difficulty in understanding others’ opinions.
• Have the desire to mingle with others and make friends but will not know how to do it.
• Difficulty in sharing things with others.
• Does not have the skill to differentiate between familiar and unfamiliar things.
• Poor self-esteem.

Language and communication difficulties are listed below.

• Difficulty understanding others’ facial expressions, gestures, tone of voice and verbal communication.
• Lack of regular communication or limited communicative gestures.
• Children have the habit of repeating words or phrases called echolalia.
• They cannot communicate their wants and fears and answer questions reliably.
• They receive the words said by the other person as it is and cannot differentiate a person being sarcastic.

Some of the sensory difficulties are mentioned below.

• They will have difficulty processing the information received from their senses.
• Being over-sensitive to the environment.
• May tend to explore by smelling and mouthing objects.

They find it extremely difficult to adapt to changes.

Childhood disintegrative disorder

Childhood disintegrative disorder is also called Heller’s syndrome. Childhood disintegrative disorder develops in children at the age of three or four. Over the years of development, they forget all the skills and knowledge they gained.  

The cause of the disorder is unknown. Children affected by childhood disintegrative disorder tend to get irritated when someone touches them and react to loud noise. These are the common symptoms of childhood disintegrative disorder.

They prefer to play alone or only with one person, they feel comfortable. They will feel shy to have any eye contact. They like to be quiet and not talk to anyone.

Autistic children may have various symptoms. Some exhibit aggressive symptoms, and others tend to remain silent.

Research has suggested that atypical antipsychotics have improved the condition of anxiety and depression in children affected with childhood disintegrative disorder.

Symptoms of Autism Spectrum Disorder

People affected with autism spectrum disorder find their life very challenging. They think so many times about carrying out even a small activity like communicating with others.

If they miss their routine, they become restless. For example, if they brush at 9 am every day and miss the time, they tend to become very restless. Even a five minutes delay might upset them a lot.

Problems with communication and social interaction

Children affected with ASD have issues in communication and social interaction.

During the toddler age, they develop symptoms like communication. Some children might find it difficult to speak and find the right word at the right moment.

Social interactions might make them upset. They prefer to be left alone than with a group of people. Sometimes, they might feel uncomfortable with the people they are familiar with.

Restricted or repetitive patterns of behaviour or activities 

It is one of the core symptoms of autism spectrum disorder. People with autistic spectrum disorder tend to find the repetitive pattern of behaviour soothing.

For example, they find it good to take the same route while going to school. Some children, when they are tensed, they play with a widget spinner. These activities calm them down and make them comfortable.

Causes of Autism Spectrum Disorder

The cause of Autistic Spectrum Disorder is unknown. There is no single underlying cause for autism, and there are many reasons. Some significant causes of ASD are listed below.

Having an immediate family member who’s autistic

Autism can run in families. Families affected by any kind of neurological condition risk passing on their autism to their children.

Children whose parents or a first-degree relative are affected by any brain condition or even with autism are at an increased risk of having an autistic baby.

A decreased genetic distance between the child and the affected family member increases the risk of autism.

Certain genetic mutations

There are studies linked to genetic mutations that cause autism spectrum disorder.

When the mutation comes from both the parents, the mutated gene becomes dominant and is said to express autism spectrum disorder in the child. If it comes from only one parent, the mutated gene remains recessive.

The other mutations that are not inherited are called de novo or spontaneous mutations.

Actin-like protein 6B (ACTL6B) is a protein that encodes for the gene in humans. If there is a mutation in the gene, it can cause various genetic disorders, including autism spectrum disorder.

Fragile X syndrome

Fragile X syndrome is caused by a gene mutation in the gene FMR1. Fragile X Messenger Ribonucleoprotein 1 (FMR1) gene is responsible for producing a protein called FMRP.

The FMRP protein plays a vital role in the development of the brain. People affected by this syndrome will have a mutated FMR1 gene. However, their body will make a small amount of protein.

The syndrome affects both males and females, but females have mild symptoms compared to males. Children affected with the syndrome will have symptoms like delay in development, face problems in socialising and learning disabilities.  

Being born to older parents

Much research supports that child born to older parents are highly susceptible to autism.

Low birth weight

Complications during birth can affect the infant. Abnormal positioning of the child, severe oxygen deprivation in the womb and low birth weight can cause autism spectrum disorder.

Metabolic imbalances

Metabolic imbalances like amino acid metabolism and disorders in transporting vital nutrients can cause autism spectrum disorder. The autism spectrum disorder is also associated with a behavioural developmental disorder.

Exposure to heavy metals

Exposure to heavy metals can increase the risk of autism spectrum disorder. The body takes time to process all the heavy metals. These heavy metals present in our body can cause genetic changes and induce a mutation.

Maternal history of viral infections

Maternal history of viral infections can increase the risk of autism spectrum disorder.

Some animal studies were conducted in this regard, showing increased production of a cytokine called interleukin-17a. The interleukin-17a is a subset of helper T cells (Th17). It increases the mother’s inflammatory response, leading to the offspring’s mouse versions of ASD symptoms.  

The production of inflammatory response in the mother affects the offspring, leading to a defect in social approach behaviour, abnormal communication and increases in repetitive behaviour.

Successfully blocking the function of Th17 cells and IL-17a in the womb with the help of antibodies can restore normal behaviour and brain structure in the affected offspring.

Treatment of ASD

There are many treatments available for autism spectrum disorder. However, there is no standard cure for autism spectrum disorder.  

There are many therapies available to cope with the disorder and reduce its severity of the disorder. Some of the treatments to cope with the disorder are briefed below.

Behavioural management therapy

Behavioural management therapy will help to reduce all unwanted behaviour and will help to develop the desired behaviour of the child.

Behavioural therapy mainly focuses on applied behavioural analysis, and this therapy is widely accepted to track a child’s progress in improving their skills.

There are many types of applied behavioural analysis and are listed below.

• Positive behaviour and support
• Pivotal response training
• Early intensive behavioural intervention
• Discrete trial teaching

Cognitive behaviour therapy

Cognitive behavioural therapy works better for children who have other mental health conditions like anxiety, depression and attention deficit hyperactivity disorder.

It will help a child to avoid all types of negative thoughts and alter their beliefs. Cognitive therapy will help children to change their perspective of a situation.

Cognitive therapy is short-term and problem-focused. It aims to teach parents and children to cope with the disorder and handle their challenges in life in a better way.

Early intervention

Early interventions and diagnosis of autism will have fewer or no symptoms. In some cases, autism can be diagnosed in children below the age of 2. This will help them to develop better skills later in their life.

Children at the age of two, when diagnosed with autism, can be treated better. At the age of 2 or 3, their brain will still be in the developmental stage. So, when treatment is given, it might be efficient, and their brain might accept it.

When early diagnosis and treatment are given, it might help the children with their condition. Some cases make good progress, and later in life, they live a life free of autism.

Educational and school-based therapies

School-based therapy is given to children who have a disability. This therapy will provide an environment that school gives them and helps to prepare them for the real world.

It also focuses on the child’s safety and to carry themself as an individual. It also teaches them adaptive equipment to carry out their day-to-day task without any difficulty.

Joint attention therapy

Children or people affected by autism will have issues concentrating on a particular thing or person.

Joint attention therapy will help the child focus and improve their communication and language. These treatments significantly improve their day-to-day life, and they last a lifetime.

Medication treatment

Medication will improve the child’s health. When medication is combined with other therapies, it will significantly affect the child. They can develop skills in a short span of time.

However, there are no direct drugs available to treat autism. It can be used to mitigate the effects of their symptoms.

These medications will help calm the child’s aggressive behaviour and reduce anxiety and depression.

Nutritional therapy

There are many therapies and medications available for autism. Still, nutrition for the brain is essential to keep them healthy and accept the treatment given.

Children with autism will be particular about their food and will not eat certain foods. Feeding children with the right food will be challenging.

Children with autism will have thin bones and underdeveloped brains. So, nutrition is essential for kids. You can get help from a certified dietician to provide them with good food.

Occupational therapy

Occupational therapists help people improve their cognitive, social, physical and motor skills. The therapy aims to improve their social skills and make them independent.

Occupation therapy teaches the importance of self-care. Occupational therapy concentrates on goals like

• Eating
• Independent dressing
• Using a washroom
• Motor skills like writing, colouring and speaking.

Diagnosis of ASD

The diagnosis of ASD is suggested when there are impairments in your child’s communication and social interaction. The diagnostic methods are briefed below.

Several screenings

Screening at an early age can help diagnose autism. Usually, children under the age of do not exhibit any symptoms, and a diagnosis can be made at the age of three.

There are rare cases where people will be undiagnosed till their adolescent age. The delay in screening and diagnosis will not help people with the disorder and may worsen the condition.

Genetic tests

A commonly used genetic test for autism spectrum disorder is a chromosomal microarray. The test will look for any mutation or if there is any substitution or deletion of genes.

There are specific markers and whole-exome sequencing recommended for autism spectrum disorder diagnosis.

Developmental screenings and evaluations

Diagnosis of autism spectrum disorder can be challenging at times. There is no blood test like other diseases.

Developmental screening will help to detect any change in the brain.

When to see a doctor?

As a parent, you would always wish to give your child the best environment for them to nurture. Watch your child’s symptoms closely and if you have any doubts, contact your doctor.

The developmental paediatrician may help your child with social interactions and anxiety.

Children neurologist would help your child with brain development and nerves. And finally, a psychiatrist would help your child with mental health.

Conclusion

Autism is a genetic disorder that has nothing to do with the child. Be empathetic with your child and make them comfortable.

Always make them feel included and allow them to do their activities on their own. You can help them if they ask for help otherwise, respect their privacy and treat them like they are self-sufficient.

This will help them to improve their self-esteem. When they exhibit aggressive behaviour, try to calm them down and do not react. After they have calmed down, teach them coping strategies.

Living with autism can be challenging. Let us all help to build a healthy and safe environment for our children.  

Autism Spectrum disorder

Autism Spectrum disorder (ASD) affects children’s development, including their speech, gestural, non-verbal and social interaction with their peers.

Children with Autism can be active participants in the areas of community life, including social and recreational activities. They could also exhibit amazing mental progress as an adult with consistent care, therapy and support; thereby becoming contributing members of future society. 

Taking care of autistic kids is expensive as, along with regular visits to a paediatrician, they would need assistance from a psychiatrist, a counsellor, a special educator, a speech therapist and an occupational therapist. 

In order to manage such treatment expenses, a special Health Insurance cover for Autism is needed.

Star Special Care is an indemnity-based health plan for children diagnosed with Autism Spectrum Disorder. This plan caters to the specific needs of autistic children. This is an affordable plan where the parents may give their autistic child the greatest medical care available without worrying about the cost. The significant coverage of the Star Special Care are

• In-patient hospitalisation expenses
• Emergency ambulance charges
• Post-hospitalisation expenses
• Coverage for modern treatments
• Co-payment is applicable for every claim amount up to the limits mentioned in the policy
• Coverage for expenses incurred on specific ailment/treatment upto the limits listed in the policy

and so on. Read the policy clause and wording for more details on the inclusions and exclusions of the policy.

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