Terminology And Distinction From Schizophrenia
As late as the mid-1970s there was little evidence of a genetic role in autism while in 2007 it was believed to be one of the most heritable psychiatric conditions. Although the rise of parent organizations and the destigmatization of childhood ASD have affected how ASD is viewed, parents continue to feel social stigma in situations where their child’s autistic behavior is perceived negatively, and many primary care physicians and medical specialists express some beliefs consistent with outdated autism research.
It took until 1980 for the DSM-III to differentiate autism from childhood schizophrenia. In 1987, the DSM-III-R provided a checklist for diagnosing autism. In May 2013, the DSM-5 was released, updating the classification for pervasive developmental disorders. The grouping of disorders, including PDD-NOS, autism, Asperger syndrome, Rett syndrome, and CDD, has been removed and replaced with the general term of Autism Spectrum Disorders. The two categories that exist are impaired social communication and/or interaction, and restricted and/or repetitive behaviors.
The Internet has helped autistic individuals bypass nonverbal cues and emotional sharing that they find difficult to deal with, and has given them a way to form online communities and work remotely.Societal and cultural aspects of autism have developed: some in the community seek a cure, while others believe that autism is simply another way of being.
Diagnosis In Young Children
Diagnosis in young children is often a two-stage process.
Stage 1: General Developmental Screening During Well-Child Checkups
Every child should receive well-child check-ups with a pediatrician or an early childhood health care provider. The American Academy of Pediatrics recommends that all children be screened for developmental delays at their 9-, 18-, and 24- or 30-month well-child visits and specifically for autism at their 18- and 24-month well-child visits. Additional screening might be needed if a child is at high risk for ASD or developmental problems. Those at high risk include children who have a family member with ASD, have some ASD behaviors, have older parents, have certain genetic conditions, or who were born at a very low birth weight.
Parents experiences and concerns are very important in the screening process for young children. Sometimes the doctor will ask parents questions about the childs behaviors and combine those answers with information from ASD screening tools, and with his or her observations of the child. Read more about screening instruments on the Centers for Disease Control and Prevention website.
Children who show developmental problems during this screening process will be referred for a second stage of evaluation.
Stage 2: Additional Evaluation
This second evaluation is with a team of doctors and other health professionals who are experienced in diagnosing ASD.
This team may include:
The evaluation may assess:
- Blood tests
Data Highlight Gaps In Autism Treatment
In the study, 12% of kids with autism spectrum disorder didn’t receive any of the suggested services. Less than half received the kind of behavioral therapies that are believed to be most helpful.
“There are many reasons children with autism are not receiving the interventions they need, including lack of insurance coverage and inadequate numbers of trained professionals,” Dawson says. “It is critical that we address the barriers that are preventing children from receiving early intervention. “
Daniel L. Coury, MD, agrees. He is a professor of clinical pediatrics and psychiatry at Ohio State University and Nationwide Children’s Hospital in Columbus, Ohio. He says that doctors need to do a better job of identifying autism earlier and getting these children into services at younger ages.
“If we can get more physicians to do that, it would be a start,” he says. This is not going to pick up every child, as those more mildly affected may not be identified until their school years.
Amy Keefer, PhD, is a clinical psychologist in the Kennedy Krieger Institute’s Center for Autism and Related Disorders in Baltimore, Md. She says that parents need to advocate for their children.
“Be involved with practitioners who are experts in autism at the first concern, and if a diagnosis isn’t given, ongoing monitoring, assessment, and checking in can help guide parents through the developmental stages,” she says.
Regression Can Be Real Or Apparent
Over the past few years, there have been some debates as to whether regression, in which there is a loss of acquired communication or social skills, is a real phenomenon or an apparent one. Some have wondered whether parent reports were exaggerated.
Video records, however, combined with studies, make it clear that at least some children do in fact regress into autism while others either show signs of autism in infancy or “plateau” in their development.
A relatively new set of studies looking at the younger siblings of children with autism in their earliest months are discovering that subtle regression is quite common. While parents may notice issues such as loss of language or eye contact, researchers are noticing small losses in the areas of motor skills and response to social cues.
Such regression typically occurs before age 3. According to researcher Lonnie Zwaigenbaum, “upwards of 20% to 30% recall a period when their children lost social and communication skills in the second year of life.”
At present, no one knows exactly what causes regression, but according to developmental-behavioral pediatrician Paul Wang, We understand now that regression is common. It starts early, and it can affect many different developmental skills.”
Early Signs Of Autism In Babies Aged 0
Shortly after they are born, babies begin to smile and coo at people around them. By the time they turn 2 months old, they are able to pay attention to faces.
If the child has autism spectrum disorder, this may not be the case. If a child doesnt smile, or smile as big, and is not showing any warm expression, it may be a sign of autism spectrum disorder.
The following signs can also be seen by the time the baby turns 3 months old:
- Doesnt respond to loud noises,
- Doesnt grasp objects,
- Doesnt follow objects with their eyes,
- Doesnt babble,
- Doesnt point to things,
- Doesnt respond to their names,
- Cant stand when supported,
- Doesnt babble
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Autism Signs By 3 Months
- They don’t follow moving objects with their eyes: “Babies at high risk for autism don’t follow caregivers as they move in the visual field,” says Dr. Frazier. “They may be more intrigued by something like a blanket.”
- They don’t respond to loud noises.
- They don’t grasp and hold objects.
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Is An Early Diagnosis More Likely To Be Incorrect
Multiple studies have confirmed that autism can be reliably diagnosed by age two with little risk of that diagnosis being invalidated later. Though early diagnoses may require a more definite diagnosis as the child grows older.
A 2006 study found that if children with autism were diagnosed at age two, that diagnosis was very likely to remain consistent by age nine.
However, the study noted that diagnostic stability was less reliable for children whose autism involved less severe presentations, meeting the older definition of PDD-NOS. This conclusion means that children with more typical presentations or who did not outwardly display multiple diagnostic criteria were more likely to affect how soon a child would be diagnosed with autism or have a missed diagnosis.
While medical knowledge has improved in the 14 years since that study was published, it is still possible for a child to delay presentation of ASD until age five or later.
One major factor that can prevent a missed diagnosis is input from parents. Because parents can observe some of the subtler signs or pervasive patterns that a single diagnostic test might miss, clinicians can perform a more thorough diagnosis or re-evaluate as the child ages.
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Late Recognition Of Symptoms
Next, it’s important to distinguish between a late recognition of symptoms and late onset of symptoms. According to the DSM-5 diagnostic criteria: “Symptoms must be present in the early developmental period .”
In the case of high-functioning autism, for example, it’s not unusual for a child to receive a diagnosis much later than most children are diagnosed with autismbut that’s not because symptoms suddenly developed. Rather, the symptoms are so subtle that it’s only with time that their impact becomes obvious.
“Masked” symptoms are particularly common among girls, who are more likely to, for example, follow others’ lead or become very passive in order to avoid being identified as “different.”
Earlier Diagnosis Of Autism Is Possible
Of the children in the study, about 9 of 10 received one or more therapies. Most commonly these included speech or language therapy and/or social skills training. More than half of these kids took at least one psychiatric medication, including stimulants, anti-anxiety drugs, or antidepressants.
“Our data indicate that many children with autism — the majority — are getting some sort of services such as speech or other individual-based interventions,” says researcher Lisa J. Colpe, PhD, MPH, of the National Institute of Mental Health in Bethesda, Md. “That is great news.”
Outside experts say there are still many gaps in the diagnosis and treatment of autism spectrum disorder among school-aged kids in the U.S.
“Research tells us that children who start intervention earlier do better in the long run,” says Geraldine Dawson, PhD, in an email. She is the chief science officer at Autism Speaks. “We can reliably diagnosis autism by 24 months, so professionals need to do a better job, including screening all children at 18 and 24 months.”
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When To Seek Medical Advice
Early intervention is very important in children with autism spectrum disorder. Services such as speech therapy and behavioral and skills training are more effective if begun when a child is young.
For this reason, it is helpful to receive a diagnosis as early as possible. However, many children remain undiagnosed until they are in school. Some people are not diagnosed until they are adults.
If you suspect someone has autism, including yourself, contact a medical professional as soon as possible.
Diagnosis In Older Children And Adolescents
ASD symptoms in older children and adolescents who attend school are often first recognized by parents and teachers and then evaluated by the schools special education team. The schools team may perform an initial evaluation and then recommend these children visit their primary health care doctor or doctors who specialize in ASD for additional testing.
Parents may talk with these specialists about their childs social difficulties including problems with subtle communication. These subtle communication issues may include problems understanding tone of voice, facial expressions, or body language. Older children and adolescents may have trouble understanding figures of speech, humor, or sarcasm. Parents may also find that their child has trouble forming friendships with peers.
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Types Of Support To Help People With Asd
ASD is a lifelong disorder. You cannot change the fact that a person has ASD. But support can significantly improve the ability of that person to be successful in all areas of their life. This support is referred to as intervention.
Intensive intervention and therapy can help a person
- learn new skills
- change some behaviours that interfere with their functioning.
Intervening as early as possible helps most people, so diagnosis in young children is important.
There are many programs and supports available for people diagnosed with ASD. Interventions for ASD can include:
- occupational therapy
- training for parents, families and caregivers
- behavioural therapy, like applied behaviour analysis
- education and school planning in the form of an individual education plan
What Disorders Are Related To Asd
Certain known genetic disorders are associated with an increased risk for autism, including Fragile X syndrome and tuberous sclerosis each of which results from a mutation in a single, but different, gene. Recently, researchers have discovered other genetic mutations in children diagnosed with autism, including some that have not yet been designated as named syndromes. While each of these disorders is rare, in aggregate, they may account for 20 percent or more of all autism cases.
People with ASD also have a higher than average risk of having epilepsy. Children whose language skills regress early in life before age 3 appear to have a risk of developing epilepsy or seizure-like brain activity. About 20 to 30 percent of children with ASD develop epilepsy by the time they reach adulthood. Additionally, people with both ASD and intellectual disability have the greatest risk of developing seizure disorder.
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Articles On Autism Diagnosis
Autism spectrum disorder is usually diagnosed in young children. But what if you think you may be on the spectrum, and it never got diagnosed?
Parents of very young children are on the lookout for classic symptoms like lack of eye contact, repetitive movements, and sensory issues. And all kids are screened for these signs at their 18- and 24-month pediatrician well-child visits, so most cases of autism spectrum disorder are diagnosed by age 2.
That wasnât always the case. Not too long ago, some kids who would be diagnosed with autism spectrum disorder today might have been labeled as âdifficultâ or âlearning disabled,â and may not have gotten the help they needed.
Now, those children are adults and they or their family members may wonder if they might have ASD.
What Are The Tell
Autism spectrum disorder is one of the most common neurodevelopmental disorders. It can be seen in all groups of age. The Centers for Disease Control states that the disorder does not discriminate between racial, ethnic and socioeconomic groups.
Oftentimes, certain severe forms of ASD are diagnosed before the child turns two. However, high-functioning individuals may not be recognized and diagnosed until later ages in their lives.
- The level of science,
- Knowledge on autism spectrum disorder itself at the time,
- Lack of social and economic means they had,
This happens because autistic adults were not diagnosed when they were children.
Since autism spectrum disorder is still, in part, a mystery, studies generally focus on where the disorder stems from to figure out how it occurs in the first place. This has caused the focus to be on children. The adults who have never been diagnosed in their lives were partially left out in the research sphere.
However, in recent years, awareness of autism spectrum disorder in adults has increased significantly. This is due to the fact that the public is now aware of the signs and understands that a diagnosis can be made even later in life of a person.
Autism spectrum disorder impacts three main areas in an individuals life: the social aspect, communication, and their behaviors.
Since we understand autism more and more every day, we are now able to differentiate and diagnose more adults with ASD.
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Autism Spectrum Disorder Definition And Facts
Autism is a complex developmental disorder that has the following three defining core features:
A number of other associated symptoms frequently coexist with autism.
- Most people with autism have problems using language, forming relationships, and appropriately interpreting and responding to the external world around them.
- Autism is a behaviorally defined developmental disorder that begins in early childhood.
- Although the diagnosis of autism may not be made until a child reaches preschool or school age, the signs and symptoms of autism may be apparent by the time the child is aged 12-18 months, and the behavioral characteristics of autism are almost always evident by the time the child is aged 3 years.
- Language delay in the preschool years is typically the presenting problem for more severely affected children with autism. Higher functioning children with autism are generally identified with behavioral problems when they are aged approximately 4-5 years or with social problems later in childhood.
- Autism disorder persists throughout the person’s lifetime, although many people are able to learn to control and modify their behavior to some extent.
All of these disorders are characterized by varying degrees of problems with communication, social interaction, and atypical, repetitive behaviors.
What Educational And Complementary Therapies Are Used To Treat Autism
The main principle of education is that each person with autism has his or her own strengths, abilities, and functional level and that his or her education should be tailored to meet his or her individual requirements. This is not only desirable for the child, it is required by federal law. The Individuals with Disabilities Education Act guarantees free and appropriate public education for every child with a disability. This law specifies that a written and explicit education plan be prepared by the local education authority in consultation with the child’s parents. When all parties agree on the plan, the plan must be put into place and the child’s progress documented. Preparation of the plan includes a comprehensive assessment of the child’s needs.
Many different options are available for educating children with autism. The basic assumption is that, whenever possible, children with disabilities should be educated with their nondisabled peers, who serve as models for appropriate language, social, and behavioral skills. Thus, some children with autism are educated in mainstream classrooms, others in special education classes within mainstream public schools, and others in specialized programs separate from mainstream public schools. Parents wanting to find the best possible program for their child are advised to work with the local education authority full cooperation and communication are essential for meeting this goal.
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How The Development Of Autism Works
If it is not possible for a teenager or an adult to develop autism, how does autism actually develop? A 2014 report in the New England Journal of Medicine suggests that brain changes that take place long before birth might be what causes the symptoms of autism spectrum disorder.
Looking at the brains of children with autism and those without, scientists discovered abnormalities in the brain regions that control language, social, and emotional control in 90% of the children with autism. And the abnormalities themselves were formed as the result of a process occurring long before birth.
In terms of timing, these changes occur in the cortex around the second trimester of pregnancy. Speaking to NPR, one of the authors of the study explained that something must have gone wrong at or before the second trimester.
Commenting on the study, the director of the National Autistic Society Centre for Autism in the United Kingdom stressed the importance of early detection. This is primarily because the earlier the intervention, the easier it will be for patients, parents, and therapists to compensate for the problematic developments in the brain.
Secondarily, it is for fear that undetected cases of autism will lead to more misconceptions that the disability develops as some people age. This misconception will affect how these people are treated.