Autism Spectrum Disorder: Etiology and Diagnosis

Scientifically, Autism commonly referred to as (ASD) is a term used when making reference to certain disorders that occur during brain development. There is a variation in the disorders and they are characterized separately considering the different levels of difficulties in, social interaction, repetitive gestures, and communication - whether verbal or nonverbal. The American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders (commonly referred to as the DSM-5) that was published on May characterizes and groups all forms of autism into one general Autism Spectrum Disorder (ASD). The term spectrum is usually used because autism affects each child differently and involves late or delays in the development of a lot of primary skills mostly associated with the abilities to form relationships, speak, and communicate effectively with others. Behavioral changes as well as intellectual disabilities are major characteristic children with autism.

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Before the May 2013 publication, these disorders were recognized separately and included the Childhood Disintegrative Disorder, Asperger Syndrome, and Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS). Diagnostic and Statistical Manual of Mental Disorders (DSM) remains the major reference for diagnosis of autism. DSM comprises of insurance providers and mental health professional in the United States. The updated DSM-5 requires that a minimum of six behavioral and developmental characteristics be put under strict observation in the diagnosis of autism and that problems are noted not after three years, and a lack of manifestation of certain other similar conditions.

The diagnostic process for every individual is different as there are no two or more people with autism that are identical regarding characteristics. A wide range of symptoms are usually exhibited by children with autism and may include the inability to engage in a conversation and experiencing difficulties in verbal and nonverbal communication such as problems in understanding and using language, facial expressions and gesticulations, respectively. The child may also have difficulties with general social interaction including warming up to people and making friends. This leads to the child preferring to play alone. Peculiar ways of playing with toys while experiencing difficulties in adjusting to changes in normal routines, or insistence on following certain routines in detail. A unique form of autism - autism savantism results into people with exceptional skills in areas such as music, art and arithmetic is present, and allows the autistics perform these skills without practice or lessons.

There are warning signs that a child may have autism and they include; if the child does not coo or babble at the age of 12 months. Another sign is if the child cannot perform basic gestures, e.g., indicating, waving or pointing at 12 months or if the child does not say single words or two words phrases on his/her own by 16 and 24 months respectively. A child that cannot establish and maintain eye contact may be suffering from autism, and lastly if the child cannot create, maintain or respond to your facial expressions.

Up to date, there is no single known case for autism spectrum disorder but a general acceptance that abnormalities in the structure or functioning of the brain may be the cause. There exists a difference in the brain scans of neurotypical children and those with autism. Researchers have not come up with the exact cause of autism, but investigations on some theories including the links among genetics, and general medical-related problems are ongoing. Due to the complexity of autism, some researchers have alluded to the fact that its occurrence may be attributed to a natural tendency called genetic predisposition. Other known factors may be environmental or factors yet to be known.

In families with autism patterns or related disabilities, the theory that autism stems from genetic factors and basis is supported. Although not one particular gene has been attributed to having caused autism, medical research is ongoing to establish the irregular segments of the different genetic codes that autistic children might have inherited from their parents. The probability of a cluster of unstable genes interfering with the development of brain under certain conditions is still under investigation, and this includes problems during expectancy or delivery, environmental factors e.g. metabolism imbalances, viral infections and constant exposure to harmful chemicals.

Treatment and Prognosis

Research shows that early behavioral intervention makes communication, learning, and social skills better in kids with autism. The child gets structured therapy for a minimum of 25 hours in a week. Very skilled therapists together with teachers are tasked to give the intervention. A professional may give the hand in the response as the treatment is regulated by specific learning objectives. The kids development in achieving the objectives is evaluated and recorded regularly. The intervention aims at the major areas impacted on by autism. These are communication, social skills and language imitation, play skills and motor skills. The program gives the child the opportunities to mingle with other developing peers. The program also involves parents when it comes to intervention, in both the delivery of treatment and decision making. The program includes a team of several disciplines team that includes a physician, occupational therapist, and speech-language.

Speech-language and Occupational Therapy

Its primary purpose is to coordinate the functionality of speech, social value and meaning of language. Treatment may be conducted for an individual or group. However, goals differ from individual to individual. This procedure collects the motor skills as well as physical and cognitive skills. The goals of this treatment include self-grooming, dressing and feeding. Occupationally certified therapists are charged with according this treatment

Sensory integration and Physical Therapy

The sensory integration is meant to evaluate disruptions in the processes of the brain, smell, touch, sound and sight. This treatment enhances the ability if the sensory system to process. It is mainly used to assist calm the kid, help in the exchange between activities and to promote desired behavior in the child. Physical therapy is primarily given to help in correcting difficulties in movements that might hinder bodily functions. It fixes problems with coordination, improper muscle tone, and balance.

Social skills and Auditory- integration therapy

This treatment aims at improving ones ability to relate with the others especially peers. The training provided in this case include eye contact focusing and inviting friends for a date to play. Parents are taught to help deliver this training to their children to assist in improving social skills both at home or outside the home. Auditory integration is a sound therapy used to help children with autism to help manage the problem with processing sounds. Treatment is giving the patient music using headsets to listen to in scheduled sessions.

Picture exchange communication system

It enhances the ability of a child to communicate using pictures. The therapist assists the child to build emotions, observations, vocabulary and desires. The individual is taught to differentiate between symbols and images and how to use them to make sentences. Verbal communication, however, is encouraged to help enhance the effectiveness of this treatment.

Gluten free, casein free diet

Getting rid of gluten and casein significantly helps in minimizing the symptoms of autism. Children who gain from this diet experience behavioral and physical symptoms when they take in casein or gluten. This treatment regulates habitual behaviors, bowel activity, and sleep habits.

Effect of drugs on the brain

The drugs used together with the above-discussed therapies might affect the brain in one way or another. They impair the ability of the brain to process thus leading to involuntary body movements and drowsiness as a result of lack of coordination that is to be facilitated by the brain. The drugs also hinder the receptors of the brain for serotonin and dopamine.

Prognosis and Recovery

Very few individuals get to achieve the best outcome from the interventions of managing autism. Several factors contribute to the outcome of treatment of a patient in the long run. These factors include:

Cognitive ability and Age of individual during treatment

Different learning abilities vary from one person to another. Some children can learn fast while others are slow in learning. Other children may find it challenging to understand and learn abstract concepts whereas others may find it easier. The cognitive ability thus determines how long the treatment results take before manifesting. Treatment in the early years of a child leads to optimum progress. As the children grow, ability to develop gets slower thus leading to a slow realization of intervention outcome.

Quality treatment and Treatment intensity

Parents are usually advised to ensure that their children get the best quality treatment. Qualified and professional treatment therapists should consistently go to workshops and seminars and be monitored by experts in the field to enhance top quality. It is vital that areas of challenge are addressed systematically and intensively. A high number of hours during intervention leads to excellent learning progress.

REFERENCES

Benayed, R., Gharani, N., Rossman, I., Mancuso, V., Lazar, G., & Kamdar, S. et al. (2005). Support for the Homeobox Transcription Factor Gene ENGRAILED 2 as an Autism Spectrum Disorder Susceptibility Locus. The American Journal Of Human Genetics, 77(5), 851-868. http://dx.doi.org/10.1086/497705

Diagnostic and statistical manual of mental disorders. (2000). Washington, DC.

Doyle, B. & Iland, E. (2004). Autism spectrum disorders from A to Z. Arlington, TX: Future Horizons.

GILLBERG, C. (2008). Autistic Children Growing Up: Problems during Puberty and Adolescence. Developmental Medicine & Child Neurology, 26(1), 125-129. http://dx.doi.org/10.1111/j.1469-8749.1984.tb04418.xHuerta, M., Bishop, S., Duncan, A., Hus, V., & Lord, C. (2012). Application of DSM-5 Criteria for Autism Spectrum Disorder to Three Samples of Children With DSM-IV Diagnoses of Pervasive Developmental Disorders. American Journal Of Psychiatry, 169(10), 1056-1064. http://dx.doi.org/10.1176/appi.ajp.2012.12020276

What Is Autism?. (2016). Autism Speaks. Retrieved 23 April 2016, from https://www.autismspeaks.org/what-autism