Autism Spectrum Disorder (ASD)
Nature of ASD
Autism Spectrum Disorder (ASD) comprises a cluster of neurodevelopmental disorders that presents challenges in the way people behave, learn, and interact with others. ASD is characterized by atypical behavior, which involves impairments in social communication, and restricted recurrent behavior patterns (Masi, DeMayo, Glozier & Guastella, 2017, p. 183). ASD is categorized as a neurodevelopmental disorder. The modern research about ASD and its symptoms can be traced to Kanner and Asperger. In 1943, Kanner noted that girls and boys in his study were inherently unable to develop normal contact with other individuals (Park et al., 2016, p. 2). In 1944, Asperger developed the concept of “autistic psychopathy” to describe the condition where young individuals demonstrated impairments in their social skills and non-verbal communications (Masi et al., 2017, p. 184). This led to the development of a disorder called Asperger’s Syndrome. ASD includes multiple forms of neurodevelopmental diseases. There are several ASD comorbid conditions, such as obsessive-compulsive disorder, ADHD, and anxiety (Hodges et al., 2020, p. S60). The nature of the comorbidities varies from one individual to another.
ASD highly prevalent among children. According to Hodges, Fealko, and Soares (2020), the disorder affects about 1.68 percent of U.S. children at eight years (p. S58). The above figure represents an incident of 1 out of 59 children. Globally, autism affects about sixteen percent of all children. The disease is highly prevalent in males than females, with the ratio of occurrence being 3:1 (Hodges et al., 2020, p. S58). The disorder affects people from all socioeconomic and ethnic backgrounds.
ASD does not have any specific known cause. Both environment and genes play a crucial role in its development. According to Park et al. (2016), chromosomal anomalies and gene defects are some ASD risks. Mutations disrupt the neurological development of the embryo and children. Fragile X syndrome is a genetic disorder that may increase a person’s susceptibility (Park et al., 2016, p. 2). A broad range of environmental factors occurring in pre- and post-natal periods increase one’s risk of ASD. For instance, embryo exposure to medications, such as thalidomide and valproic acid, can cause ASD (Park et al., 2016, p. 3). Post-natal factors that may cause ASD include hypoxia, viral infections, and autoimmune diseases. Other risks include low birth weight and family history, especially a first-degree relative with the disorder (Park et al., 2016, p. 3). Overall, ASD results from the interaction of genetic and environmental elements.
Signs and Symptoms of ASD
ASD symptoms can be seen during childhood as early as 12 months (Park et al., 2016, p. 4). Nevertheless, the symptoms can occur later during the child’s development. Early signs of ASD include faulty language and social skills, lack of gesturing at the age of twelve months, difficulties in sharing and showing, and impaired eye contact (Hodges et al., 2020, p. S60). The symptoms that are used in the ASD diagnosis are mainly impairments in language or developmental delays. During diagnosis, clinicians should be aware of various red flags during the early stages of development.
The DSM-5 criteria for ASD diagnosis divide the core symptoms into two groups. The first category involves pervasive, faulty social interactions (Masi et al., 2017, p. 185). This encompasses the communication problems, including the lack of sharing of emotions and interests and atypical back-and-forth dialogue. The child fails to respond to interactions with other individuals. The category also involves nonverbal communication problems, where the child may have difficulties interpreting and using body language or maintaining eye contact. In furtherance, the above category may include complete failure of nonverbal cues, such as facial expressions. Another vital symptom in this category includes trouble forming and maintaining relationships. The individual with ASD will have challenges making friends, engaging in imaginative play, and modifying behaviors based on social situations (Masi et al., 2017, p. 185). Overall, the therapist should check impairments in social communication across various contexts.
The second category of ASD core symptoms in the DSM-5 includes the presence of restricted, recurrent activities or behaviors. The category includes repeating speech patterns, motion, and movements (Masi et al., 2017, p. 185). The individual may also rigidly follow certain verbal and non-verbal behaviors or routines. Additionally, the patient may show increased or decreased sensitivity to sensory input from the surroundings. For instance, the individual with ASD may respond negatively to a particular sound. Other symptoms in the second category include preoccupations and fixated interests, which are of abnormal intensity (Masi et al., 2017, p. 185). The therapist must identify signs in the two categories for an individual to be diagnosed as having ASD.
Treatment for ASD
Currently, no scientifically proven cure for ASD. The therapeutic approaches usually target core ASD features, such as irritability, aggression, and self-injury. The treatment of ASD includes medications, behavioral therapy, and educational interventions. Behavioral therapy has been used to effectively improve ASD symptoms, especially when applied early and intensively (Masi et al., 2017, p. 189). The above intervention helps in identifying and modifying unhealthy or self-destructive behaviors. The individuals with ASD can learn useful ways of repressing the behaviors. Behavioral and educational approaches teach individuals with ASD various ways of managing their self-destructive behaviors. Applied behavior analysis (ABA) is a technique used to teach persons with ASD new skills and reinforce the appropriate behavior. During ABA, the therapist identifies the problem behavior and its antecedents and consequences. The process provides information on the factors that are enhancing the problem behavior. Positive reinforcement is applied to help the individual modify his or her behavior (Brennan, 2019, para. 5). Learning trials are repeated to help the person with ASD change the problem behavior.
Other forms of interventions for ASD include play, speech, and occupational therapies. Occupational therapy (OT) involves activities that teach individuals with ASD daily living skills, emphasizing work issues. OT can assist children in performing their everyday activities related to play, work, and school better. Speech therapy can help children to better their interaction and communication skills. Young individuals can be taught how to express themselves, take turns in communication, as well as to use and understand gestures (Brennan, 2019, para. 4). The various forms of therapies do not work for all persons in the same manner. Therefore, therapists should tailor interventions to the needs of each individual.
Medications are applied to targeted symptoms instead of the general ASD characteristics. In furtherance, the medications may be used to treat some conditions comorbid to ASD. The first type of drug that is used to treat ASD is antipsychotics. Risperidone is one of the approved antipsychotics, and it is used to treat aggression, tantrums, and self-injurious behaviors in teens and children. Nevertheless, the drug can have side effects such as drowsiness and high appetite (Masi et al., 2017, p. 189). The second type of antipsychotic that has been used as a pharmacotherapeutic approach for ASD is aripiprazole. The drug treats irritability in youths with ASD (Masi et al., 2017, p. 189). The medications may not be responsive to all individuals with ASD. Therefore, health providers should consider the appropriate intervention for the disorder.
Group-based training can be conducted to teach children different social skills. The training can happen in the community, school, or at home. The social skills class aims to teach children with ASD how to interact and form relationships with other people. Practice and role-plays can be used to teach children the relevant social skills.
References
Brennan, D. (2019, March 12). What Therapies, Besides Play Therapy, Also Help with Autism? WebMD. Retrieved from https://www.webmd.com/brain/autism/therapies-to-help-with-autism
Hodges, H., Fealko, C., & Soares, N. (2020). Autism spectrum disorder: Definition, epidemiology, causes, and clinical evaluation. Translational Pediatrics, 9(Suppl 1), S55–S65. https://doi.org/10.21037/tp.2019.09.09
Masi, A., DeMayo, M. M., Glozier, N., & Guastella, A. J. (2017). An overview of autism spectrum disorder, heterogeneity, and treatment options. Neuroscience Bulletin, 33(2), 183–193. https://doi.org/10.1007/s12264-017-0100-y
Park, H. R., Lee, J. M., Moon, H. E., Lee, D. S., Kim, B. N., Kim, J., … & Paek, S. H. (2016). A short review on the current understanding of autism spectrum disorders. Experimental Neurobiology, 25(1), 1-13. https://doi.org/10.5607/en.2016.25.1.1