Clinical Development And Diagnoses
Leo Kannerearly infantile autism
The word autism first took its modern sense in 1938 when Hans Asperger of the Vienna University Hospital adopted Bleuler’s terminology autistic psychopaths in a lecture in German about child psychology. Asperger was investigating an ASD now known as Asperger syndrome, though for various reasons it was not widely recognized as a separate diagnosis until 1981.Leo Kanner of the Johns Hopkins Hospital first used autism in its modern sense in English when he introduced the label early infantile autism in a 1943 report of 11 children with striking behavioral similarities. Almost all the characteristics described in Kanner’s first paper on the subject, notably “autistic aloneness” and “insistence on sameness”, are still regarded as typical of the autistic spectrum of disorders. It is not known whether Kanner derived the term independently of Asperger.
Kanner’s reuse of autism led to decades of confused terminology like infantile schizophrenia, and child psychiatry’s focus on maternal deprivation led to misconceptions of autism as an infant’s response to “refrigerator mothers“. Starting in the late 1960s autism was established as a separate syndrome.
How Common Is Autism
Approximately 1 out of 59 children is diagnosed with an autism spectrum disorder. Autism is more common in boys than in girls , and its more common now than it was nearly two decades ago, when about 1 in 150 children were diagnosed with autism.
Why the jump? It could be partly because more moms know about the disorder and are spotting early signs of autism in their toddlers and informing their pediatricians. The increase in autism rates could also be due to the wider range of behaviors that are now being labeled as part of the autism spectrum. Environmental factors such as exposure to pesticides or chemicals in household products, as well as viruses, may also be contributing to the rise.
Social Communication And Interaction Skills
Social communication and interaction skills can be challenging for people with ASD.
Examples of social communication and social interaction characteristics related to ASD can include:
- Avoids or does not keep eye contact
- Does not respond to name by 9 months of age
- Does not show facial expressions like happy, sad, angry, and surprised by 9 months of age
- Does not play simple interactive games like pat-a-cake by 12 months of age
- Uses few or no gestures by 12 months of age
- Does not share interests with others
- Does not point or look at what you point to by 18 months of age
- Does not notice when others are hurt or sad by 24 months of age
- Does not pretend in play
- Shows little interest in peers
- Has trouble understanding other peoples feelings or talking about own feelings at 36 months of age or older
- Does not play games with turn taking by 60 months of age
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Signs And Symptoms Of Asd
People with ASD have difficulty with social communication and interaction, restricted interests, and repetitive behaviors. The list below gives some examples of the types of behaviors that are seen in people diagnosed with ASD. Not all people with ASD will show all behaviors, but most will show several.
What Are The Different Types Of Autism
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition is published by the American Psychiatric Association . Clinicians use it to diagnose a variety of psychiatric disorders.
The most recent fifth edition of the DSM was released in 2013. The DSM-5 currently recognizes five different ASD subtypes, or specifiers. They are:
- with or without accompanying intellectual impairment
- with or without accompanying language impairment
- associated with a known medical or genetic condition or environmental factor
- associated with another neurodevelopmental, mental, or behavioral disorder
Someone can receive a diagnosis of one or more specifiers.
Before the DSM-5, autistic people may have received a diagnosis of:
- autistic disorder
- pervasive development disorder-not otherwise specified
- childhood disintegrative disorder
Its important to note that a person who received one of these earlier diagnoses hasnt lost their diagnosis and wont need to be reevaluated.
Early symptoms may include a marked delay in language or social development.
The DSM-5 divides symptoms of ASD into two categories: problems with communication and social interaction, and restricted or repetitive patterns of behavior or activities.
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Treatment Of Mental Disorders
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Two large studies done by the Faculty of Health Sciences at Simon Fraser Universityindicates that both behaviour therapy and cognitive-behavioural therapy are equally effective for OCD. CBT has been shown to perform slightly better at treating co-occurring depression.
Considerable policy implications have been inspired by behavioural views of various forms of psychopathology. One form of behaviour therapy has been found to be highly effective for treating tics.
There has been a development towards combining techniques to treat psychiatric disorders. Cognitive interventions are used to enhance the effects of more established behavioural interventions based on operant and classical conditioning. An increased effort has also been placed to address the interpersonal context of behaviour.
Modelling has been used in dealing with fears and phobias. Modelling has been used in the treatment of fear of snakes as well as a fear of water.
Aversive therapy techniques have been used to treat sexual deviations as well as alcohol use disorder.
Contingency contracting has been used to deal with behaviour problems in delinquents and when dealing with on task behaviours in students.
Autistic People May Act In A Different Way To Other People
Autistic people may:
- find it hard to communicate and interact with other people
- find it hard to understand how other people think or feel
- find things like bright lights or loud noises overwhelming, stressful or uncomfortable
- get anxious or upset about unfamiliar situations and social events
- take longer to understand information
- do or think the same things over and over
If you think you or your child may be autistic, get advice about the signs of autism.
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What Research Is Being Conducted To Improve Communication In Children With Asd
The federal governments Autism CARES Act of 2014 brought attention to the need to expand research and improve coordination among all of the components of the National Institutes of Health that fund ASD research. These include the National Institute of Mental Health , along with the National Institute on Deafness and Other Communication Disorders , the Eunice Kennedy Shriver National Institute of Child Health and Human Development , the National Institute of Environmental Health Sciences , the National Institute of Neurological Disorders and Stroke , the National Institute of Nursing Research , and the National Center for Complementary and Integrative Health .
Together, five institutes within the NIH support the Autism Centers of Excellence , a program of research centers and networks at universities across the country. Here, scientists study a broad range of topics, from basic science investigations that explore the molecular and genetic components of ASD to translational research studies that test new types of behavioral therapies. Some of these studies involve children with ASD who have limited speech and language skills, and could lead to testing new treatments or therapies. You can visit the NIH Clinical Trials website and enter the search term autism for information about current trials, their locations, and who may participate.
Do Symptoms Of Autism Change Over Time
For many children, symptoms improve with age and behavioral treatment. During adolescence, some children with ASD may become depressed or experience behavioral problems, and their treatment may need some modification as they transition to adulthood. People with ASD usually continue to need services and supports as they get older, but depending on severity of the disorder, people with ASD may be able to work successfully and live independently or within a supportive environment.
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What’s It Like To Have Autism Spectrum Disorder
A kid with autism might have trouble:
- talking and learning the meaning of words
- making friends or fitting in
- dealing with changes
- dealing with loud noises, bright lights, or crowds
Kids also might move in an unusual way or do the same thing over and over .
A kid with autism may have a little trouble with these things, or a lot. Some kids need only a little bit of help, and others might need a lot of help with learning and doing everyday stuff.
Asd Symptoms In Children
The following are some signs and symptoms that can be noticed in children with ASD .
- Reduced eye contact and lack of facial expressions
- Inability to respond to their name
- Preference to stay alone
- Resistance to holding or cuddling
- Speech delays
- Problems starting conversations and interacting with others.
- Abnormal tone while speaking, such as speaking like a robot or speaking to the tune of a song
- Inability to express themselves and understand peoples expressions.
- Difficulty understanding simple words, phrases, sentences, and questions
- Repetition of movements, such as rocking, spinning, or hand flapping
- Problems with coordination, such as toe walking and stiff body
- Sensitivity to light touch or sounds
- Peculiar food preferences
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How Does Asd Affect Communication
The word autism has its origin in the Greek word autos, which means self. Children with ASD are often self-absorbed and seem to exist in a private world in which they have limited ability to successfully communicate and interact with others. Children with ASD may have difficulty developing language skills and understanding what others say to them. They also often have difficulty communicating nonverbally, such as through hand gestures, eye contact, and facial expressions.
The ability of children with ASD to communicate and use language depends on their intellectual and social development. Some children with ASD may not be able to communicate using speech or language, and some may have very limited speaking skills. Others may have rich vocabularies and be able to talk about specific subjects in great detail. Many have problems with the meaning and rhythm of words and sentences. They also may be unable to understand body language and the meanings of different vocal tones. Taken together, these difficulties affect the ability of children with ASD to interact with others, especially people their own age.
Below are some patterns of language use and behaviors that are often found in children with ASD.
Causes And Risk Factors For Asd In Children
The exact cause of autism spectrum disorder is not known. However, experts believe that it could be a combination of environmental and genetic factors. The following factors could put a child at a higher risk for ASD .
- Exposure to toxins before or after birth
- Infections before birth and low birth weight
- Having an older parent or a sibling with ASD
- Viral infections such as meningitis or encephalitis, which lead to brain damage.
- Various genetic conditions are said to be involved in autism spectrum disorder. For some children, autism spectrum disorder can be due to Rett syndrome or fragile X syndrome, and for others, it could be Down syndrome.
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Speech Disorders Delaying Speech Or Language
Childhood apraxia of speech is an example of a physical disorder that may cause a child to seem like they have a speech delay or dont know the words.
This disorder makes it difficult for them to speak even if they know exactly what they want to say because it makes it harder for your child to produce the correct sounds.
This type of disorder is typically handled by a speech-language pathologist, who can offer therapy in the field, to help your child learn to speak as quickly and effectively as possible.
What Are The Risk Factors For Autism
Risk factors for autism include:
- Low birth weight
- Being exposed to a medication called valproate during the mothers pregnancy
- Older parents
Boys are diagnosed with ASD more often than girls.
Studies have shown that there is no link between vaccines and autism. Learn more about vaccines and autism from theCDC.
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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.
Muscle Disorders Stemming From Neurological Issues
Neurological problems can lead to muscle disorders than can affect a childs ability to speak.
That is because certain disorders like muscular dystrophy and cerebral palsy affect the muscles used for speaking, making it seem like the child cant speak effectively.
Youll want to see a specialist as early as you can if this seems to be the problem so that you can get these determined as early as possible to get the disorder managed and under control.
Theories Of Causes Lead To Interventions
Over the years there have been many theories about the causes of autism. In the 1950s and 60s, it was believed that autism was caused by cold parenting. This led to the promotion of Holding Therapy, an approach where the mother holds their child for a prolonged time and forces eye-contact in order to remediate a presumed attachment disorder. Whilst children on the receiving end have reported terrible suffering as a result, the professionals involved overlooked the fact that the parents also had children who did not have autism.
Although this theory and intervention have long been debunked, Research Autism currently lists 123 different interventions for autism and nearly all of them are the result of a theory about a possible cause.
Over the years many theories have come and gone. One notable exception is EIBI . This approach applies ABA techniques to help children with autism. This treatment has the highest evidence base and is one of the few that was not developed from a theory of a cause. Find out more about ABA and autism.
Causes Of Autism Spectrum Disorder
Although the exact cause of autism spectrum disorder is not known, current research points to genetic changes that occur during a baby’s development in the womb. Autism spectrum disorder tends to run in families, and researchers are trying to identify genes that may be passed down through the generations. Special types of brain images taken of children with the condition show that certain areas of their brains develop and function differently from those of children without the condition. Autism spectrum disorder is not caused by bad parenting.
Restricted Or Repetitive Behaviors Or Interests
People with ASD have behaviors or interests that can seem unusual. These behaviors or interests set ASD apart from conditions defined by only problems with social communication and interaction.
Examples of restricted or repetitive interests and behaviors related to ASD can include:
- Lines up toys or other objects and gets upset when order is changed
- Repeats words or phrases over and over
- Plays with toys the same way every time
- Is focused on parts of objects
- Gets upset by minor changes
- Has obsessive interests
- Flaps hands, rocks body, or spins self in circles
- Has unusual reactions to the way things sound, smell, taste, look, or feel
How Is Autism Spectrum Disorder Treated
There is no cure for autism, but treatment can make a big difference. The younger kids are when they start treatment, the better.
Doctors, therapists, and special education teachers can help kids learn to talk, play, and learn. Therapists also help kids learn about making friends, taking turns, and getting along.
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What Causes Autism In A Child
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What causes autism in a child is a very difficult question. Unfortunately, no one knows what causes autism in a child.
Firstly, it is thought to be caused by genetics because it runs in families. Sometimes if a certain group of genes is mutated, a child is at a higher risk of developing autism. But, that does not mean he will have autism.
Secondly, certain environmental factors like pregnancy and labor complications can increase the risk. So, genetics and environmental factors play a role in what causes autism in a child.
What Is Autism Spectrum Disorder Previously Called Autism And Pervasive Developmental Disorders
Autism spectrum disorder is a neurodevelopmental disorder characterized by the following:
- Difficulties in social communication differences, including verbal and nonverbal communication.
- Deficits in social interactions.
- Restricted, repetitive patterns of behavior, interests or activities and sensory problems
Many of those with ASD can have delayed or absence of language development, intellectual disabilities, poor motor coordination and attention weaknesses.
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What Causes Autism: 6 Facts You Need To Know
There are lots of frightening rumors about what causes autism, a mysterious brain disorder, in children. We asked leading experts across the country to get you answers.
Nancy Wiseman had a feeling early on that something wasn’t quite right with her daughter. When Sarah was 6 months old, she stopped babbling, and by 10 months, she was silent. By 18 months, the increasingly aloof toddler no longer responded to her name, and she resisted being held, kissed, or touched. “I felt that I was losing my child a little more each day,” says Wiseman, of Merrimac, Massachusetts. When Sarah wasn’t saying any words or even making sounds that resembled words by 20 months, her grandmother, a school psychologist, suspected that the girl might actually be deaf. Instead, Wiseman was devastated to learn that her daughter had autism. “The diagnosis really knocked the wind out of me,” she recalls, “but I was relieved to finally know what was wrong.”
There are many unanswered questions,” says Alice Kau, Ph.D., an autism expert at the National Institutes of Health, which funded more than $74 million in autism research in 2002, as compared with only $22 million in 1997. Still, researchers are beginning to make progress in unraveling this baffling disorder, and the number of resources available for families is increasing. Here, six facts about autism that every parent should know.