Autism Spectrum Disorder - Diagnosis and Treatment | GetWellGo

What is Autism?

Autism is also known as Autism Spectrum Disorder (ASD) – a lifelong developmental disability that impacts on social interaction, communication and behavior. That is why it is referred to as a spectrum: some people may require significant assistance in daily live as opposed to others who may have a relatively independent existence.

Some of the essential manifestations of autism are:

• Some of these are social interactions (such as certain aspects of language, intonation, gesture, etc).
• This goal includes compulsive or ritualistic actions (performing actions in a certain manner each time)
• A highly focused interests (being able to commit on a specific field of interest)
• Differences in sensory experiences (being extra sensitive to sounds, lights, textures, etc.)

Symptoms of Autism

Here’s a simple list of the common symptoms of Autism Spectrum Disorder (ASD):

1. Social Communication and Interaction Symptoms

• Difficulty making eye contact
• Difficulty fulfilling the social aspects of integration related to gestures, facial expressions and other body language.
• Challenges with back-and-forth conversations
• Difficulty forming and maintaining friendships
• Wanting to play alone or to be isolated or appear that they prefer to be alone or live in their own universe
• Failure to complete communication by using their names before the age of 12 months in children.

2. Repetitive Behaviors and Restricted Interests

• Repeating movements (hand-flapping, rocking, spinning)
• Repeating words or phrases (echolalia)
• Unwillingness to change and display of temper whenever slight changes are made
• Very strong and narrow specializations or special erasures which include memorizing facts about certain things like trains, dinosaurs or space for instance.
• Engaging in pretense atypical to child’s age (such as putting cars side by side instead of imitating driving them).

3. Sensory Symptoms

• Hypo- or hypersensitivity to some stimuli such as audio, light, texture, and smell
• For example, putting his/her hands on the ears to block any sounds that are normally heard or not flinching when pinched.
• In this state, this part of the brain is interested in seeking sensory stimulation such as spinning, touching various textures.

4. Other Possible Symptoms

• Delays in speech or language development
• Unusual tone of voice (sing-song, flat, or robotic)
• This has been formulated as a difficulty in comprehending other people’s emotions, or as a deficit in the capacity to feel emotions.
• Clumsiness or unusual posture/movement patterns

Signs of Autism in Children

Here’s a simple and clear list of signs of autism in children:

Social Communication Signs    

• This may accompany movements such as avoiding eye contact or only glancing towards the first person’s eyes on very few occasions.
• Does not respond to own name by a year
• Is not very expressive and hardly reciprocates an affectionate expression such as smiling at the other person.
• It can not point objects as a sign of interest such as pointing at an airplane.
• This narrative shows that the child prefers to act singly rather than with other children, this is because I
• Difficulties in the interpretation in or a deficit in the ability to experience emotion
• Lacks in pretend play (as an example feeding a doll)

Behavioral Signs

• The patient makes the same movements in a continuous manner such as hand flapping, rocking, spinning Automated;, Routinized;
• These people get easily frustrated if there are slight changes to anything they are usually used to; be it human, objects, place, and routine among others.
• Has obsessive and unique preoccupations (like the obsession with having to ride trains, maps, only numeracy or any such associated preoccupation).
• Able to play differently as in arranging the toys rather than pretending to use them

Communication Signs

• Speech delay or no speech by around 16–18 months
• Speaks repetitions of what has been said in a repetition termed as echolalia instead of speaking with normal sentences.
• Thus uses few or no non-verbal actions such as waving or nodding.
• Abnormal pitch — may be monotonous, robotic, robotic or have a sing-song quality

Sensory Signs

• Avoids certain noises, weight, lights, odours or even textures (example: covering their ears while there is a vacuum cleaner in operation).
• Is engaged in seeking sensory input which they get by spinning in circles, sometimes staring at spinning objects.
• Unusual sensitivity to pain (either very high or very low)

Autism Diagnosis

Observation of Behavior

A child (or an adult) should be observed closely by the doctors in the following ways:

• How they communicate
• How they interact with others
• How either in playing or the manner in which they move their body or engage in certain repetitive motions.
• They look for such features that may correspond to the existence of autism.

Developmental Screening

• Usually done at 18 and 24 months for young children.
• It is a brief evaluation (which may be in form of a questionnaire) that establishes whether a child is on the correct developmental phase and milestones that include talking, pointing and even making eye contact.
• You can use such tools as M-CHAT (Modified Checklist for Autism in Toddlers).

Comprehensive Diagnostic Evaluation

In case a screening program points to some issues, there is further testing done by other professionals including:

• Developmental Pediatricians
• Child psychologists or psychiatrists
• Neurologists
• Speech-language pathologists

This can include:

• Detailed interviews with parents about developmental history
• They include fully standardized autism-specific instruments such as the ADOS-2 and the CARS.
• Cognitive and language assessments

Criteria Used

Presently, practitioners refer to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) to diagnose C-PTSD.

A person must show:

• Persistent difficulties in social communication and interaction
• Obsessive-compulsive disorder This is characterized by restricted repetitive behaviors or interests that are impairing on one’s daily life.
• Signs must exist since childhood and although they may be identified later.

Autism Treatment

Main Types of Autism Treatments

1. Behavioral Therapies

Applied Behavior Analysis (ABA):

• On the positive reinforcement aspect, assists in the facilitation of social, communication as well as learning.
• Early Start Denver Model (ESDM):
• A play-based therapy for very young children with autism.

2. Speech and Language Therapy

Helps improve:

• Understanding and using spoken language
• Non-verbal communication (like gestures, pictures, sign language)
• Conversation skills

3. Occupational Therapy (OT)

Assists in the development of some of daily life skills such as:

• Dressing, eating, brushing teeth
• Writing and holding objects which should be reasonable and within a size that the infant can handle on his own.
• Managing sensory sensitivities

4. Social Skills Training

Teaches how to:

• Make friends
• Play and share
• Social manners (regardless of whether these are playing with others or in general interactions such as sharing etc).

5. Educational Support

• The government programs schools implement for persons with disabilities or the individualized education plan for the students.
• There are advantages of adopting individual teaching techniques that correspond to the child’s learning ability and her or his learning inability.

6. Medication (if needed)

Medications can provide aid in managing some of the symptoms of autism but they do not cure the condition itself — these include:

• Anxiety
• Hyperactivity
• Sleep problems
• Irritability

This must, however, be taken under the prescription of a doctor and administered under supervision of the same.

7. Parent and Family Training

The parents are empowered with the ways of helping their child to develop and cope with problems they are faced with at home.
Family is an important aspect that needs to be involved in the treatment process of the patient.

Autism Causes

1. Genetic Factors

• It has been observed that this condition of autism is hereditary.
• Some of these modifications (mutations) may make one vulnerable to the disease.
• There are certain genetic disorders that result in increased likelihood of autism such as Fragile X syndrome, Rett syndrome and even others.
• But, those with such genes will not necessarily have autism at any stage in their lives.    

2. Environmental Factors

In general, any risk factors that affect the mother and fetus before and during birth can be a cause of the disease, grouped into the following categories:

• Older parental age (especially older fathers)
• Specific conditions like pregnancy complications such as preterm delivery or low birth weight.
• Exposure to certain infections or environmental pollutants during pregnancy
• Some of these factors enhance risk but do not ‘promote’ autism.

3. Brain Development Differences

It has been determined that children with autism manifest some neurological abnormalities – initially, in the areas of the brain responsible for regulating social interactions.

Autism Spectrum Test

An Autism Spectrum Test (sometimes called an autism screening or assessment) is actually a questionnaire whose purpose is to determine if there are characteristics of autism present.

Common Autism Screening Tests

• M-CHAT-R/F (Modified Checklist for Autism in Toddlers): A parent questionnaire about early signs like eye contact, gestures, plays skills.
• ADOS-2 (Autism Diagnostic Observation Schedule): A detailed, play- or conversation-based assessment done by trained specialists.
• CARS (Childhood Autism Rating Scale): Assesses behavior in several aspects such as social relations, verbal and non-verbal communication, and mood.
• AQ (Autism Spectrum Quotient): It is a 50 item self-assessment test that is designed to measure the degree of autistic characteristics the individual possesses.
• SCQ (Social Communication Questionnaire): A parent questionnaire about communication and behavior patterns.

How It Works

• Students (or their parents or teachers) complete some comprehension questions about behaviour, communication and interpersonal skills.
• If one or more of these examinations indicate that the child may have Austism, the next step which is more objective is to consult with a specialist preferably a developmental pediatrician or a child psychologist, or neurologist.

Autism Therapies

1. Behavioral Therapy

Applied Behavior Analysis (ABA):

• Adopts use of positive reinforcement where skills are taught from one step to another when the child demonstrates desirable behavior.
• Centers on the use of language, practical activities, and the decrease of problematic actions.

2. Speech and Language Therapy

Helps with:

• Understanding and using language
• Expressing needs and feelings    
• Improving conversation skills
• Non-verbal communication (gestures, pictures, sign language)

3. Occupational Therapy (OT)

Focuses on:

• Daily skills (eating, dressing, handwriting)
• Improving fine motor skills
• Three of the largest areas that people who are on the spectrum tend to struggle most are managing sensory sensitivities such as noise or touch.

4. Social Skills Training

Teaches:

• Making friends
• Taking turns and sharing
• From his facial expression and body posture one can infer a lot about him.

5. Sensory Integration Therapy

• Assists the children with certain conditions such as sensory integration and those who do not respond to sensory features like sound, light touch.
• Interventions are meant to modify the kid’s responses of anxiety towards sensory stimuli.

6. Cognitive Behavioral Therapy (CBT)

• Best for older children, teens, and adults.

Helps manage:

• Anxiety
• Depression
• Emotional challenges
• Cognitive behavioral therapy aims at encompassing evaluation of thoughts and transformation of negative patterns of thinking.

7. Parent-Mediated Therapy

Therapists teach parents techniques to:

• Promote their child’s early development at home
• Handle behavior challenges
• When it comes to communication and social skills that are used in everyday life, improvement is necessary when at certain levels.

8. Educational Support

• Special education services (like Individualized Education Plans — IEPs) in schools.
• In other words, it is possible to say that it is necessary to apply methods and approaches to teach the child, which correspond to his individuality.

9. Play Therapy

• Needs to engage in play in order to manage feelings, learn the social norms, as well as rehearse the newly acquired behaviors spontaneously.

Autism vs ADHD

Features	ASD	ADHD
Main Challenges	Social interaction, communication, repetitive behaviors	Attention, hyperactivity, impulsiveness
Social Skills	Difficulty reading social cues, struggles with relationships	Wants to interact but may act impulsively or interrupt
Communication	May have delayed speech, unusual tone, or prefer nonverbal communication	Talks a lot, may interrupt, struggles to listen carefully
Behaviour Patterns	Likes routines, may have intense special interests, repetitive actions	Easily bored, seeks constant new activities, often switches focus
Flexibility	Dislikes change, prefers sameness and routines	Easily distracted by new things, seeks change and excitement
Sensory Sensitivity	Very sensitive (or under-sensitive) to sounds, lights, textures	May seek sensory stimulation but not as strongly tied to sensitivity
Focus	Very intense focus on specific topics or objects (special interests)	Difficulty focusing on one task; mind often jumps between tasks
Emotional Reactions	May struggle to express emotions, may have meltdowns with change or overload	Quick emotional reactions, frustration if tasks are boring or hard
Age of Diagnosis	Signs often noticed by 2–3 years old	Symptoms usually noticed between 3–7 years old