What Is Autistic Spectrum Disorder/condition
Autistic Spectrum Disorder , or autism, is a developmental disability which affects how a person communicates with others and experiences the world around them. Autistic children and adults will experiences difficulties with social communication and interactions. Typically, they will have some form of restricted and repetitive patterns of behaviours, activities or interests. Differences in sensory responses were included in the 2013 update of the DMS-5, a manual used by clinicians to make an autism diagnosis.
Whilst it was well known prior to this that sensory processing differences and autism/ASD often occurred together, this is the first time it had been formally recognised. The DSM-5 states that the patterns of behaviours, activities or interests may be due to Hyper or hypo reactivity to sensory input or unusual interests in sensory aspects of the environment . This means that autistic children or adults are likely to process sensory information in the environment differently to others.
Connections Between Sensory Processing Disorder And Autism Spectrum Disorder
Some experts have found that over 80% of children with autism also have sensory processing disorder, and the DSM-5 includes hyper or hypo reactivity to sensory input, listing this as one of the behaviors associated with ASD.
The STAR Institute for Sensory Processing in Colorado has conducted studies finding that at least three quarters of children with autistic spectrum disorders have significant symptoms of sensory processing disorder, and probably more depending on how significant symptoms are defined. Yet, many studies show that the reciprocal of this discovery is not a fact. Most children who have SPD do not have ASD.
Roya Ostovar, PhD, is the Director of McLean Hospitals Pathways Academy in Belmont, Massachusetts and an Assistant Professor of Psychology, Department of Psychiatry at Harvard Medical School. Dr. Ostovar noted that people with SPD dont show the traits of someone with autism, such as difficulties with social and communication skills or stimming behaviors such as repetitive sounds or movement.
Signs Of Nonverbal Communication Difficulties
- Avoids eye contact.
- Uses facial expressions that dont match what they are saying
- Doesnt pick up on other peoples facial expressions, tone of voice, and gestures.
- Makes very few gestures . May come across as cold or robot-like.
- Reacts unusually to sights, smells, textures, and sounds. May be especially sensitive to loud noises. Can also be unresponsive to people entering/leaving, as well as efforts by others to attract the childs attention.
- Atypical posture, clumsiness, or eccentric ways of moving .
Children with autism spectrum disorder have trouble picking up on subtle nonverbal cues and using body language. This makes the give-and-take of social interaction very difficult.
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Autistic Children And Developmental Milestones
Steven Gans, MD, is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.
A developmental milestone is a sign of typical child development. Children reach dozens of developmental milestones between birth and adulthood. Early milestones include social smiles, rolling over, and sitting up. Later milestones involve the acquisition of language, social, physical, and emotional skills, and intellectual abilities.
Children with autism tend not to reach all of their developmental milestones at the appropriate times. But that statement is a huge oversimplification of the reality because:
- Many autistic children reach early developmental milestones on time or early, but then lose ground.
- Most autistic children reach some of their developmental milestones on time or early, but reach others late or not at all.
- Some autistic children reach some of their developmental milestones extraordinarily early but reach others extraordinarily late.
- Children with autism can appear to gain important skillsbut in fact, be unable to use those skills in real-world situations.
- Many children with autism have so-called “splinter” skills, which can be very advanced but which are not useful in daily life.
- Autistic children, particularly girls who are high-functioning, are sometimes able to hide or overcome some developmental delays.
Getting An Autism Spectrum Disorder Diagnosis
The road to an ASD diagnosis can be difficult and time-consuming. In fact, it is often two to three years after the first symptoms of ASD are noticed before an official diagnosis is made. This is due in large part to concerns about labeling or incorrectly diagnosing the child. However, an ASD diagnosis can also be delayed if the doctor doesnt take a parents concerns seriously or if the family isnt referred to health care professionals who specialize in developmental disorders.
If youre worried that your child has ASD, its important to seek out a clinical diagnosis. But dont wait for that diagnosis to get your child into treatment. Early intervention during the preschool years will improve your childs chances for overcoming their developmental delays. So look into treatment options and try not to worry if youre still waiting on a definitive diagnosis. Putting a potential label on your kids problem is far less important than treating the symptoms.
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Losing An Autism Diagnosis
Its rare, but some children with autism spectrum disorder lose their symptoms. Psychologists are exploring why, and how these children fare long term.
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As a young psychologist in the 1970s, Deborah Fein, PhD, became fascinated by a clinical mystery: A few of her patients with autism spectrum disorder who at age 2 had exhibited classic signs of the disorderhand flapping, repetitive behaviors and lack of direct eye gaze, for examplewere symptom-free by age 7.
As time went on, she saw more of these cases, and in 2014, she was the first to demonstrate empirically that young people who had lost the diagnosiswho no longer exhibited basic clinical markers of the disordertested about the same as typically developing young people on socialization, communication, face recognition and most aspects of language .
Some of these kids just did better and better, particularly those who had received intensive treatment starting at an early age, says Fein, a professor of psychology at the University of Connecticut.
Now, Fein and others are discovering more about this phenomenon: How might these young people lose the diagnosis? Do they continue to be symptom-free over time? The answers are of keen interest not just to researchers but also to parents who wish the same for their own children.
How Parents Can Spot The Warning Signs
As a parent, youre in the best position to spot the earliest warning signs of autism. You know your child better than anyone and observe behaviors and quirks that a pediatrician, in a quick fifteen-minute visit, might not have the chance to see. Your childs pediatrician can be a valuable partner, but dont discount the importance of your own observations and experience. The key is to educate yourself so you know whats typical and whats not.
Monitor your childs development. Autism involves a variety of developmental delays, so keeping a close eye on whenor ifyour child is hitting the key social, emotional, and cognitive milestones is an effective way to spot the problem early on. While developmental delays dont automatically point to autism, they may indicate a heightened risk.
Take action if youre concerned. Every child develops at a different pace, so you dont need to panic if your child is a little late to talk or walk. When it comes to healthy development, theres a wide range of typical. But if your child is not meeting the milestones for his or her age, or you suspect a problem, share your concerns with your childs doctor immediately. Dont wait.
Regression of any kind is a serious autism warning sign
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Key Points To Remember About Autism
- autism – takiwtanga is a difference in development that affects communication , social skills and behaviour
- children with autism – takiwtanga can have a wide range of challenges and strengths, and these can vary with age and over time in an individual
- if your child does have autism – takiwtanga, there are services available to support your child, you and your whnau
Why Monitoring Developmental Milestones For Autism Can Be Misleading
Sometimes, children with autism miss multiple milestones and have clear and obvious developmental delays. Often, however, missed milestones can be masked or even invisible. This is because children with autism aren’t simply delayed they learn and behave differently from their typical peers.
In addition, autism is rarely obvious from birth. Many children with autism develop normally for a period of time and then either slow down, develop idiosyncratically, or actually regress. Because of these issues, it can be tough to spot autism just by watching for missed developmental milestones.
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Sensory Health & Wellness
Sensory processing is the neurology of how we feel. The sensory messages we receive from our bodies and the world around us are responded to in everything we do in life whether its the comfort we feel from a warm hug from a loved one, the joy from the music we listen to, the feeling of satiation after eating, the ability to stay upright on moving bus or the act of learning / mastering a sport. In each instance, our sensory systems contribute vital information that we use to be successful. We couldnt do these things without our sensory systems.
Our ability to process sensory data does not usually require conscious thought or cognitive effort. It provides emotional stability, a platform for social interaction, a sense of self, well-being, satisfaction, and/or accomplishment. Sensory processing can also influence every area of living including our preferences in diet, exercise, relationships, career, and hobbies.
The sensory domain is where the brain and body connect and thrive. It is through robust sensory processing that we develop resilience, and establish a tolerance for stressful situations, learn to be calm under pressure, and process experiences that are challenging or upsetting. With well-integrated sensory processing comes a wealth of daily sensory-affective and sensory-motor experiences that cultivates the development of autonomy, competence, interest in learning, goal orientation, sense of purpose, resilience, social engagement, and agency.
Not Your Typical Talk
Language and speech development is complicated with many variables but, when it comes to language and speech delays for those on the spectrum, research often points to differences in brain circuitry, reward systems, motivation, and brain activitya combination which would explain a completely different language trajectory.
This may be even more relevant for nonverbal children with autism. A study recorded electrical activity in the brains of nonverbal children with autism and revealed that the typical wave of brain activity involved in linking objects with their names did not show up.
Even when children with autism are verbal, they may not converse in a neurotypical manner. Instead we often observe behavior like:
- Echolalia: This happens when a child repeats or imitates words and phrases uttered by someone else. For example, when asking a child whether they need to go to the bathroom, theyll answer by saying bathroom instead of answering in the affirmative or negative
- : Apraxia of speech is a condition often associated with autism . The child may have problems coordinating the complicated oral movements necessary for speech. This is evident when kids look like they know what they want to say but they just cant seem to get the words out
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Can Diet Have An Impact On Autism
Theres no specific diet designed for autistic people. Nevertheless, some autism advocates are exploring dietary changes as a way to help minimize behavioral issues and increase overall quality of life.
An autism diet may instead focus on whole foods, such as:
Those advocates believe that gluten creates inflammation and adverse bodily reactions in certain autistic people. However, scientific research is inconclusive on the relationship between autism, gluten, and another protein known as casein.
Restricted Behavior And Play
Children with Autism Spectrum Disorder are often restricted, rigid, and even obsessive in their behaviors, activities, and interests. Symptoms may include:
- Repetitive body movements moving constantly.
- Obsessive attachment to unusual objects .
- Preoccupation with a narrow topic of interest, sometimes involving numbers or symbols .
- A strong need for sameness, order, and routines . Gets upset by change in their routine or environment.
- Clumsiness, atypical posture, or odd ways of moving.
- Fascinated by spinning objects, moving pieces, or parts of toys .
- Hyper- or hypo-reactive to sensory input .
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Language And Communication Development And Autism
According to the American Speech-Language-Hearing Association , many children with autism spectrum disorders exhibit some type of language delay or challenge involving communication. In some cases, this may mean that a child talks on time but that she does not use language to communicate her needs or share information. In other cases, a child may be completely non-verbal. Occasionally, a typically-developing toddler may begin to lose language skills he previously had. Depending on the severity of the delay, this may be one of the first signs of autism that parents and pediatricians recognize.
How Autistic Delays Can Be Masked Or Hidden
Some children with autism have severe cognitive delays, behavioral challenges, or physical “stims” that make it obvious that something is wrong. But many autistic children have few or mild delays, challenges, or stims. When that’s the case, developmental delays may be hard to spot.
Here are a few groups of children whose developmental delays may not be obvious until social, emotional, or communication demands increase :
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White Matter Brain Connectivity
On the basis of diffusion tensor imaging tractography, HR-ASD infants have been reported to have abnormalities in white matter organizational structure as early as 6 months of age in multiple fiber tracts across the brain., Aberrant WM integrity has been observed by 6 months in the genu of the corpus callosum, and WM integrity in the genu and cerebellar peduncles is significantly associated with abnormal sensory responsiveness at 24 months, a clinical domain particularly affected in individuals with ASD. These reports of reduced WM organization in HR-AD infants are consistent with studies of toddlers with ASD.,
What To Do If Youre Worried
If your child is developmentally delayed, or if youve observed other red flags for autism, schedule an appointment with your pediatrician right away. In fact, its a good idea to have your child screened by a doctor even if he or she is hitting the developmental milestones on schedule. The American Academy of Pediatrics recommends that all children receive routine developmental screenings, as well as specific screenings for autism at 9, 18, and 30 months of age.
Schedule an autism screening. A number of specialized screening tools have been developed to identify children at risk for autism. Most of these screening tools are quick and straightforward, consisting of yes-or-no questions or a checklist of symptoms. Your pediatrician should also get your feedback regarding your childs behavior.
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Restricted Or Repetitive Patterns Of Behavior Or Activities
These can include:
- an increase or decrease in sensitivity to specific sensory information from their surroundings, such as a negative reaction to a specific sound
- fixated interests or preoccupations
Autistic people are evaluated within each category, and the intensity of their symptoms is noted.
To receive an autism diagnosis, a person must display all three symptoms in the first category and at least two symptoms in the second category. Get more information on symptoms and how they may manifest in kids.
The exact cause of ASD is unknown. The most current research demonstrates theres no single cause.
Some suspected risk factors for ASD include:
- having an immediate family member whos autistic
- genetic mutations
An ASD diagnosis involves several screenings, genetic tests, and evaluations.
Signs And Symptoms Of Autism In Babies And Toddlers
If autism is caught in infancy, treatment can take full advantage of the young brains remarkable plasticity. Although autism is hard to diagnose before 24 months, symptoms often surface between 12 and 18 months. If signs are detected by 18 months of age, intensive treatment may help to rewire the brain and reverse the symptoms.
The earliest signs of autism involve the absence of typical behaviorsnot the presence of atypical onesso they can be tough to spot. In some cases, the earliest symptoms of autism are even misinterpreted as signs of a good baby, since the infant may seem quiet, independent, and undemanding. However, you can catch warning signs early if you know what to look for.
Some autistic infants dont respond to cuddling, reach out to be picked up, or look at their mothers when being fed.
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What Are The Developmental Milestones
The CDC divides developmental milestones into groups: movement/physical, cognitive, language/communication, social/emotional. They list specific levels of achievement for each age, starting with 1 month and moving through adolescence. While they make it clear that children may not reach any given milestone at the precise age described, they also suggest that parents keep an eye out to be sure their child is at or close to normal.
Most children with autism are diagnosed at a relatively young ageoften by the age of 3. Here is a simplified list of milestones for 3-year-olds from the CDC:
Finding Help And Hope
Paul Adolescence was a good time for Paul. He seemed to relax and become more social. He became more affectionate. When approached, he would converse with people. For several months, drugs were used to help him control his aggression, but they were stopped because they caused unwanted side effects. Even so, he now rarely throws or breaks things.
Two years ago, Pauls parents were able to take advantage of new scientific understanding about autism, and they enrolled him in an innovative program that provides full-time support, enabling him to live and work within the community. Today, at age 20, he has a closely supervised job assembling booklets for a publishing company. He lives in an attractive apartment with another man who has autism and a residence supervisor. Paul loves picnics and outings to the library to check out books and cassettes. He also enjoys going home each week to visit his family. But he still demands familiarity and order. As soon as he arrives home, he moves every piece of furniture back to the location that is familiar to him.
Alan The summer Alan was 6, after years with no apparent progress, his language began to flow. Although he reversed the meaning of pronouns, he began talking in sentences that other people could understand.
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