Category : World Autism Day

It is vital to understand, with empathy and knowledge what autism really is. Here is a detailed exposition of its various aspects…

The pervasive developmental disorders or early onset condition is characterised by delay and deviance in the development of social communication and other skills in contrast to the lack of interest in the social environment, unusual sensitivity to the inanimate environment is typical, and one of the pervasive developmental disorders is autism.
The studies of prevalence show that approximately one in every 1000 children may have autism. This large exhibiting ratio concludes the increasing chances of autism. According to many books, there are higher chances of autism in boys than in girls. The ratio is reportedly 3.5 or 4 to 1.

Aetiology

 1. Psychosocial factors: Many times, autism is due to household or childhood traumas and emotional burdens when the child’s emotional needs are not fulfilled.

2. Biological factors: The most modern theory says that autism is a behavioural syndrome caused by one or more factors acting on the central nervous system.

3. Genetic factors: earlier genetic factors were not regarded as a cause for autism. But later on, it was discovered that many times, among monozygotic same-sex twin pairs, one of the twins developed autistic symptoms. Statistics also show that approximately 2 to 7% of autism cases are among siblings. Although the role of genetic factors in autism is not well established, specific Modes of inheritance remain unclear.

4. Fragile X syndrome (FXS) is the most common inherited cause of intellectual disability (ID), as well as the most frequent monogenic cause of autism spectrum disorder (ASD). Autism can also be caused due to Tuberous sclerosis, Which includes symptoms like nine tumours that affect various organ systems, mental retardation and seizure disorder.

 5. Autism is also related to diseases like phenylketonuria and rubella. However, children with these conditions, initially thought to have autism, were followed, and over time, the autistic-like features tended to diminish.

 6. Autism is also related to various immune theories, as there has been a suggestion that maternal antibodies directed against the foetus may be produced in vivo. There also have been reports of autism associated with viral infections.

Out of all these, the main cause is lesions and dysfunctions of the brain’s cortical areas like the amygdala, hypothalamus, temporal sulcus, prefrontal cortex, etc. The social language and behaviour problems with autism suggest that the syndrome affects a functionally diverse and widely distributed set of neural systems. For example, those who emphasise difficulty with complex information have widespread cortical abnormalities, and those who focus on emotional deficits often highlight the limbic system in the pathogenesis of autism.

Signs and symptoms

Autistic signs and symptoms develop before the age of three. Parents are typically concerned as language fields develop; they also note that the child responds quite dramatically to sounds in the inanimate environment. Normally, developing infants are interested in social interaction and the social environment, but autistic children lack these qualities, such as joint attention attachment and other specific social interactions. They do not engage in the usual games of infancy, may have difficulties with imitation, and may lack usual play skills.

An autistic child has a very prominent sign of defective language skills. Usual patterns of language acquisition may be absent or infrequent. The children might ask the parent’s hand to obtain a desired object without making eye contact. Speech tends to be less flexible and non-reciprocal, and the syntax and morphology of language are relatedly spared, along with slow vocabulary learning.

Autistic children cannot tolerate any change or variation in the routine. Autistic children develop a keen interest in a repetitive activity, such as collecting strings, memorising numbers or repeating certain words or phrases. They may get attached to specific objects. Stereotype moments are also included, for example, walking, finger flicking, body walking, hand flapping, body rocking, finger twiddling or waving in front of the eyes, etc

One of the most fascinating cognitive phenomena is the presence of special abilities, which somehow develop from other deficits in cognitive function. These abilities are limited to a narrow range of capacities, such as music and drawing.

Some autistic children also imitate the movements of other people. Normative motor skills are usually preserved and related to the child’s intellectual level. However, this may differ with highly functioning children, who might need to be more clumsy or better coordinated.
In autism, sleeping and eating patterns are disturbed. When sleeping, the child experiences recurrent waking up throughout the night. The child may develop an aversion to specific foods due to their textures, colours, odour, etc.

Autistic children may have sudden mood swings from laughing and crying to themselves for no specific reason. They may develop anxiety in social situations and suffer from depression due to negative social experiences over the years.
Some children with autism may engage in self-injurious behaviours like headbanging and physical injuries to themselves, etc.

People with autism are more attractive, but this attractiveness diminishes over the years due to various disabilities and unusual behaviours.

Autism should be differentiated from other similar kinds of diseases like mental retardation, language disorders, Rett’s syndrome or Asperger’s syndrome. These diseases might be mistaken for autism.

Treatment :

1. Autistic children require intensive and highly structured special education from as early as the symptoms arise. The focus of speech-language therapy is one of the uses of words for meaningful communication. Children with autism may require a considerable vocabulary that is disassociated from the act of communication. Children should be engaged in programs focused on alternative forms of communication, including science communication boards or other forms of augmented communication. Positive actions in frequently troublesome situations may have to be rehearsed, and concrete social and communication skills, including IAS voice modulation, guestroom communication posture, proximity greeting behaviours, rules of conversation and social expectations may have to be taught.

2. Behavioural therapy is a treatment for autistic children. In this therapy, the patient is given specific behaviour modification techniques that help achieve the desired behaviours. This theory is mostly helpful in managing disruptive, self-injurious behaviours.

3. Psychotherapy is another and one of the common treatments given to autistic autistic children. Individual cell psychotherapy may be appropriate for higher-functioning individuals who were present with anxiety and depressive symptoms. Still, with autistic people, psychotherapy should focus on rather explicit problem-solving skills.
Lastly, psychopharmacology treatments are also given. Medications may be of benefit for specific symptoms as the target symptoms include self-injury, aggression or stereotype moments. The potential benefits and side effects should be considered. For example, with major tranquilisers, there is potential for over-sedation. Before beginning any drug, baseline laboratory studies are a must.

4. Autism is not a completely curable disease but can be improved to a much greater extent by proper care. Social interest may increase over time. There is often a developmental progression with younger and more impaired individuals being avoided or aloof from interaction. In contrast, somewhat older or more advanced individuals are willing to accept interaction passively. Among the most able individuals with autism, there’s often social interest, but a person has difficulty managing the complex cities of social interaction.

Reference :

Amiet C, Gourfinkel-An I, Bouzamondo A, et al.Epilepsy in autism is associated with intellectual disability and gender: evidence from a meta-analysis. Biol Psychiatry 2008;64:577-82. 10.1016/j.biopsych.2008.04.030 [PubMed] [CrossRef] [Google Scholar]

Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation [pubmed]

Kaplan & Sadock’s Comprehensive Textbook of Psychiatry [Chapter 38:Pervasive Developmental Disorders Pg:3164-3175]

8 Comments

  1. Batul Lokhandwala

    Very helpful and interesting article.????????

    Reply
    • Zakir Hussain

      جزاك الله خير

      Reply
    • Dr.M.A.Khalak.( pediatrician)

      Nice presentation..
      Helpful for common people to understand abt “Autism”.
      Let’s diagnose Autism as early as possible nd helps to the pt. On world Autism Day

      Reply
  2. Irfan Abdulrahman

    Very informative, meticulously and concisely written about autism. Mashallah

    Reply
    • Zakir Hussain

      الله جزاك خير

      Reply
    • Aliya Faseeh

      Thank you,need of the hour, useful for parents, teachers and empathisers

      Reply
  3. Zakir Hussain

    Masha Allaah
    Very well explained about Autism .
    My sweet bachcha.
    Allah always with you aameen.

    Reply
  4. Kausar Dudhmal

    Very informative for parenting a child
    Masha Allah

    Reply

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