AUTISM

 Autistic disorder constitute a diverse group of conditions

related to development of the brain. It impacts the nervous
.
system and affects the overall cognitive, emotional, social and
physical health of the affected individual –Neurodevelopment
disorder.
.

 The term autism ( from the Greek word ‘Autos’, meaning self)
was coined in 1911 by Swiss Psychiatrist Eugen Bleuler.

 About 1 in 100 children has autism.

• Until recently experts talk about different types of
autism such as Autistic disorder, Asperger’s
syndrome , Unspecified form of Pervasive
developmental disorder not otherwise specified
{PDD –NOS } also called atypical or subthreshold
autism, Rett syndrome and Childhood
disintegrative disorder.

• But now they are included within an umbrella term

of disorders commonly referred to as Autism
Spectrum Disorders (ASD), which is the clinical
definition of Autism.
  SYMPTOMS OF
AUTISM
The
Diagnostic and Statistical Manual of Mental Di
sorders, 5th edition, text revision (DSM-5-TR)
places autism symptoms into two main
categories:

•patterns of communication and social

interaction.

•patterns in behavior and interests.

  Social communication /
interaction may include:

•Making little or inconsistent eye contact.

•Doesn’t smile widely or make warm, joyful expressions by the age of
6 months.
• Difficulty understanding other people’s feelings.
•Doesn’t show facial expressions like happy, sad, angry and surprised;
and also show slow or no response to one’s name by 9 months of age.
•Doesn’t babble by 12 months of age.
•No back-and-forth gestures such as showing, pointing, reaching or
waving by 12 months.
•No words by 16 months.
•No meaningful , two-word phrases by 24 months.
contd...

•Anxiety before social interactions.

•Displaying facial expressions, movements, and
gestures that do not match what is being said.
•Having an unusual tone of voice that may sound
sing-song or flat and robot-like.
•Having trouble understanding another person’s
point of view or being unable to predict or
understand other people’s actions.
•Delayed language development.
 We can conclude that these
communication-related autism
symptoms impact:

o social skills and interaction.

o nonverbal communication.

o relationships and social connection.

 Restrictive / repetitive behaviors may include:

•Repeating certain behaviors (stimming) or having unusual behaviors,

such as repeating words or phrases (a behavior called echolalia).
•Having a lasting intense interest in specific topics, such as numbers,
details, or facts.
•Becoming upset by slight changes in a routine and having difficulty with
transitions.
•Being more sensitive or less sensitive than other people to sensory
input, such as light, sound, clothing, or temperature.
• People with ASD may also experience sleep problems and irritability.
• People on the autism spectrum also may have many strengths,
including:
Being able to learn things in detail and remember information for long
periods of time.
•Being strong visual and auditory learners.
•Excelling in math, science, music, or art.
 In short the behavioral patterns in
autism symptoms impact :

o stereotyped behaviors (repetitive

behavioral patterns).

o rigid routines and dislike of change

“narrowed,” or strong and specific
focus (restricted food intake).

o differences in responses to
surroundings.
  LEVELS OF AUTISM
• Each child with autism spectrum disorder is likely
to have a unique pattern of behavior and level of
severity — from low functioning to high
functioning.

• There are three levels of Autism Spectrum

Disorder (ASD), which are described in the
Diagnostic and Statistical Manual of Mental
Disorders, 5th edition :
o Level 1 (mild),
o Level 2(moderate), or
o Level 3 (severe), depending on how severe their
disorder is and how much support they need in
their daily life.
• These levels help doctors prescribe appropriate
therapy for the unique needs of their patients.
 LEVEL 1

• It is the mildest form of ASD, This is what most

people previously referred to when they used the
terms "Aspergers syndrome or high-functioning
autism”.

• People who qualify as level 1 ASD only require

minimal support to function in their daily lives. They
can communicate verbally and may be able to
establish relationships.
Level 1 social communication
characteristics may include:
•trouble understanding or complying
with social conventions
•the appearance of disinterest in
social interactions.
•some emotional or
sensory dysregulation .

Level 1 restricted interests and

repetitive behavior traits can
be:
•a need for additional personal
organization strategies.
•behavioral rigidity and inflexibility
•Stress during transitions.
•attention span differences.
 LEVEL 2
• An autistic person who meets the
level 2 criteria in either category
has similar characteristics as those
in level 1 but to a greater extent
i.e., they have more obvious
symptoms with verbal and social
communication than those
diagnosed with level 1.

• Compared to people with level 1

ASD those who qualify as having
level 2 ASD need substantial
support. Some social interaction
and change may be manageable for
autistic people at this level, but a
consistent level of support is
 Social communication traits at level
2 may include:
• using fewer words or noticeably
different speech.
•missing nonverbal communication
cues like facial expressions.
•exhibiting atypical social behavior,
like not responding or walking away
during a conversation.

 Restricted interests and repetitive

behavior traits at level 2 might
resemble:
•a high interest in specific topics.
•noticeable distress when dealing with
change or disruption.
 LEVEL 3
• Level 3 is the most severe form of autism
and therefore its often referred as severe
autism or low functioning autism or
profound autism or classic autism or
kanner’s autism (after the person who
described it).

• People with ASD 3 require very substantial

support. The individual may need to
depend on others to help them cope with
daily life.
 Level 3 social communication means the
person may:
•be nonspeaking or have echolalia (repeating
words or phrases they hear)
•prefer solitary activities
•interact with others only to meet an
immediate need.
•demonstrate a limited interest in friendships.
 For level 3 behavioral patterns might be:
•engage in repetitive physical behaviors like
rocking, blinking, or spinning in circles.
•express extreme distress when asked to
switch tasks or focus.

•In addition they have gastrointestinal

symptoms such as abdominal pain,
constipation and diarrhea.
  CAUSES AND
RISK FACTORS:
• Although the cause of ASD is still unknown ;yet researchers
suggest that it develops from a combination of genetic and non-
genetic , or environmental factors.

 GENETIC FACTORS-
• Many experts believe genes play the biggest role in causing
autism. A 2019 study estimated that about 80% of autistic people
have it due to genetics.
• More than 100 genes on different chromosomes may be involved
in causing ASD, to different degrees.
• Research suggests that many autistic people have small
mutations in a lot of their genes, it’s not always clear how big of a
role these mutations play. This means that different mutations
probably play different roles in causing autism.
 For example, some mutations or combinations of
mutations could:

•play a role in causing certain behaviors.

•contribute to whether someone needs minimal or
significant support.
•increase a person’s chances of having autism.

 Other genetic factors that could increase

someone’s chances of developing autism include:

•assigned male at birth {male to female ratio 3:1-

because girls need more genetic mutation to develop
them}.
•having an autistic sibling.
•a chromosomal condition like fragile X syndrome or
Down’s syndrome.
  ENVIRONMENTAL
FACTORS-
 So far, research suggests that the most influential factors
that increase a person’s chances of developing autism
are related to what happens before and during birth, like
if:
•the pregnant parent has diabetes or another immune
system disorder.
•the baby is born before 36 weeks old.
•there were birth complications like the baby was breech, in
fetal distress, or had a low birth weight.
•there were any issues during birth that caused a limited
amount of oxygen to the baby’s brain.
•Use of certain medications during pregnancy (like anti-
depressant drugs, etc) or exposure to harmful toxins or air
pollution.
•Advanced parent age.
•Pre-eclampsia (dangerous pregnancy complication
 Researchers have also looked into
other Biological factors
connected to autism. These factors
are involved with:

•growth or overgrowth in certain areas

of the brain (frontal cortex of brain
shows overgrowth shortly after birth).
•metabolism (how the body produces
energy).
• Some research links certain
immune system issues with autism.
•developing antibodies to a condition
they haven’t been exposed to.
  DIAGNOSIS
According to the
Diagnostic and Statistical Manual of Mental Disorders (DSM-
5)
, an autistic person must have both
social and behavioral patterns that meet the criteria for
autism spectrum disorder.
Someone might receive an autism diagnosis at 18 months or
younger, but it’s more common to get diagnosed around 2
years old.

• Some people don’t get a diagnosis until much older or

until adulthood (Asperger’s may not be diagnosed until
their teenage years or even adulthood as they do not
have obvious developmental delay & are sometimes be
 Diagnostic tools

o An ASD diagnosis involves :

 Several screenings {like Modified Checklist for
Autism in Toddlers (M-CHAT)}.
 Genetic tests.
 Behavioural evaluations.
 Visual and audio tests to rule out any issues with
vision and hearing that aren’t related to ASD.
 Occupational therapy screening.
 Developmental questionaries, such as the Autism
Diagnostic Observation Schedule, Second Edition
(ADOS-2).
  TREATMENT
• Since there is no cure for Autism but there are many
treatments that can help autistic people to improve
their symptoms.

• There are many autistic traits a person might have,

and everyone with autism is unique.

• Not only are needs different, but so is the level of

intervention .
  Treatment methods
include-
• Speech-language therapy: to help with both verbal and
non-verbal communication.
• Occupational therapy: to help with daily tasks of living.
• Social skills therapy: to teach conversation skills and social
emotional learning.
• Cognitive behavioral therapy (CBT): to help with social
situations and recognizing emotions.
• Physical therapy: help build motor skills and improve
strength, posture and balance.
• Art therapy: to help them express their inner thoughts and
emotional outlet.
• Animal-assisted therapy (AAT): involves a trained animal
therapist which help autistic children manage stress .
• Nutritional therapy: to avoid nutrient deficiency and
develop healthy eating habits.