What is Autism Spectrum Disorder (ASD)?

Autism spectrum disorder (ASD) refers to a developmental disability that involves communication, social interaction and behavioral difficulties. The terminology has recently changed, so ASD now includes the previous diagnoses of Autistic Disorder, Asperger's Disorder, and Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS).

Children with an ASD diagnosis show difficulties in two main areas:

  • Social communication and social interaction: Within the language and communication area, some children are nonverbal, some speak in single words or short phrases, while others have excellent verbal skills. Children's socialization styles may differ as well. Some children have limited social interest and tend to spend much of their time alone, while others are interested in being social but have difficulty doing so successfully.
  • Restricted interests and/or repetitive behaviors: Some children have interests in unusual items, such as elevators or street signs, or collecting unusual objects like pencil erasers. Children may have interests that are unusual in their intensity and that may or may not be age appropriate. For example, a child may know detailed facts about a particular topic or may be interested in only one toy that is played with exclusively and/or repetitively. Children may also do repetitive movements with their hands (e.g., hand flapping) or complex mannerisms with their entire body (i.e., jumping while flapping). In addition, difficulties with transitions or changes in routine and unusual responses to sensory experiences are common in children with ASD.

The term "spectrum" refers to the wide range of symptoms, skills, and levels of impairment, or disability, that children with ASD can have. Some children are mildly impaired by their symptoms, but others are severely disabled. Many different symptoms can manifest within each of these areas. Therefore, two children with the same diagnosis can have different abilities and behave in very different ways.

How common are autism spectrum disorders?

Once considered rare, the current understanding of autism is that it is in fact one of the more common developmental disabilities.

  • Prevalance of Autism: Between 1 in 500 (2/1,000) to 1 in 166 children (6/1,000) have an Autism Spectrum Disorder (Center for Disease Control).
  • Prevalance Rate: Approx. 1 in 500 or 0.20% or more than 2,160,000 people in India.
  • Incidence Rate: Approx. 1 in 90,666 or 11,914 people in India.
  • Incidence extrapolations for India for Autism: 11,914 per year, 250 per month, 57 per week, 8 per day, 1.4 per hour.

How to recognize your child may have ASD?

The following are a list of some behaviors that can be used to formulate questions which may be useful in reviewing the diagnostic criteria. The child with autism may:

  • Not respond to name and may on occasion appear to be deaf.
  • Appear to avoid gaze or show unusual eye contact.
  • Not seek comforting even when hurt or ill.
  • Have difficulty in mixing and playing with other children.
  • Not point to share or indicate interest, or not share in others interests.
  • Not look at a toy across room when adult points at it.
  • Not imitate adults' actions.
  • Not pretend to play house, talk on phone.
  • Have unusual or repetitive play, lack or have limited pretend play.
  • Have extreme unusual fears or have poor awareness of danger or not show fear.
  • Show delay or lack of language development or loss of early acquired language.
  • Echo words or phrases.
  • Have difficulty in initiating and sustaining conversation.
  • Enjoy rotating or spinning object, or lining up objects, twirl twigs, flap paper.
  • Be occupied with parts of objects like knobs, switches, wheels.
  • Like sameness in everyday routines; may show resistance to change in routines or surroundings.
  • Display repetitive actions and ask repetitive questions.
  • Display unusual behaviour or body movement such as spinning, hand flapping, head banging, or rocking.

What causes Autism?

Although no one specific cause for autism is known, current research links autism to biological or neurological differences in the brain. There is reason to believe that genes play a major role in the development of autism. It has been found that identical twins are more likely to both be affected than twins who are fraternal (not genetically identical). In a family with one autistic child, the chance of having another child with autism is about 5 percent - or one in 20 - much higher than in the normal population.

Sometimes, parents or other relatives of an autistic child have mild social impairments (such as repetitive behaviors and social or communication problems) that look very much like autism. Research also has found that some emotional disorders (such as manic depression) occur more often in families of a child with autism.

At least one group of researchers has found a link between an abnormal gene and autism. The gene may be just one of three to five or more genes that interact in some way to cause the condition. Scientists suspect that a faulty gene or genes might make a person more likely to develop autism when there are also other factors present, such as a chemical imbalance, viruses or chemicals, or a lack of oxygen at birth.

What are common interventions for children with ASD?

Because of the variety and combination of behaviors which may be present in a child with autism, no single approach is effective with all individuals who have the disorder. Hence, a multidisciplinary approach is best suited, which includes behavior modification, speech/language therapy, sensory integration training, medication, and others.

One of the most important aspects of an intervention program is that it is tailored to meet the child's and family's individual needs. It is coordinated by a team of specialists including a special education teacher, speech/language pathologist, clinical psychologist, occupational therapist and psychiatrist. The parents are also an essential part of this team.

Early intervention refers to doing things as early as possible to work on your child's autism spectrum disorder (ASD) characteristics. It is very important for young children with ASD to receive support as early as possible in life to assist their development.

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