What are autism spectrum disorders
The word “spectrum” emphasizes that autism manifests itself in many different ways. Previously, childhood autism, atypical autism, and Asperger's syndrome were distinguished, but now they are increasingly being combined into one group and the level of support required is described. All children with ASD have difficulties in social communication: understanding emotions, maintaining dialogue, playing together. The second group of signs are limited, repetitive patterns of behavior and interests. ASD is often combined with speech delay, intellectual impairment, attention deficit hyperactivity disorder, epilepsy, and sleep disorders.
- Difficulties in social communication and interaction
- Repetitive movements, phrases, rituals
- Narrow, very intense interests
- Strong reactions to sounds, light, texture of food and clothing
- Varying levels of support - from minimal to very significant
Causes and risk factors
Autism is a disorder of brain development that begins very early. Genes play a major role: the likelihood of ASD is higher if a sibling has autism, as well as with some genetic syndromes, such as fragile X syndrome and tuberous sclerosis. Risk factors include extreme prematurity, older age of parents, and taking certain antiepileptic drugs by the mother during pregnancy. The connection between autism and vaccinations has been tested many times and has not been confirmed. Parental upbringing and emotional coldness are also not the cause of autism.
- Autism in a sibling
- Genetic syndromes
- Extreme prematurity
- Older age of parents
- Taking certain antiepileptic drugs during pregnancy
Early signs
Parents often notice features in the second year of life, sometimes earlier. The baby rarely makes eye contact, does not smile back, does not respond to names, although he hears well, does not point at interesting objects and does not bring them to share. Speech may be delayed or develop unusually: the child repeats phrases he hears, but does not use words to communicate. Monotonous games appear - arranging objects in a row, spinning wheels, repeating hand movements. Sometimes, after normal development, loss of words and skills occurs.
- Does not respond to name by 12 months
- No pointing and joint attention
- Rare eye contact
- No words by 16 months or phrases by 2 years
- Repeating someone else's phrases without understanding
- Monotonous game, lining up objects in a row
- Violent reactions to changes in routine
- Loss of speech or social skills
Diagnostics
There is no blood test or imaging test to confirm autism. The diagnosis is made by specialists - a child psychiatrist, a neurologist, a clinical psychologist - based on observation of the child, conversations with parents and standardized methods. During routine examinations, a pediatrician may use screening questionnaires for children 16–30 months old. Be sure to have your hearing checked to rule out hearing loss. For seizures, an EEG is prescribed; for signs of a genetic syndrome, a consultation with a geneticist and genetic studies are prescribed. Speech, intelligence, and motor skills are also assessed to create an individual plan of care.
- Screening questionnaires for parents
- Observation and standardized assessment by a specialist
- Hearing test
- Speech and intelligence assessment
- EEG - for seizures or regression
- Genetic testing according to indications
Help and treatment
There is no cure for autism itself, but early, intensive training is the mainstay of help. Behavioral programs have the greatest evidence base, including applied behavior analysis, developing communication, speech, and self-care skills. A speech therapist helps with speech and alternative methods of communication, such as flash cards, and an occupational therapist helps with everyday skills and motor skills. Parent training and predictable daily routines are important. Drugs are prescribed only by a doctor for the treatment of concomitant conditions: epilepsy, severe aggression, sleep disorders. Methods without proven effectiveness - “body cleansing”, diets without indications, stem cells - do not help and can be dangerous.
- Early Behavior Therapy
- Classes with a speech therapist and defectologist
- Alternative communication - cards, gestures
- Occupational therapy
- Parent training and support
- Predictable routine and visual schedule
- Treatment of concomitant sleep disorders and epilepsy