By: Mavis Yaa Konadu Agyemang.
Autism spectrum disorder (ASD) is a developmental disability that is caused by differences in how the brain functions (Community Report on Autism, 2016). ASD is a group of complex disorders of brain development (Autism Speaks, 2016). People with ASD may communicate, interact, behave, and learn in different ways (Community Report on Autism, 2016). These disorders are characterized, in varying degrees, by difficulties in social interaction, verbal and non-verbal communication and repetitive behaviors. All autism disorders were merged into one umbrella diagnosis of ASD. Signs of ASD begin during early childhood and usually last throughout a person’s life (Autism Speaks, 2016).
Previously, the term “ASD” collectively referred to the following three conditions that were diagnosed separately: Autistic Disorder, Pervasive Developmental Disorder not otherwise specified (PDD-NOS), and Asperger Disorder. ASD now encompasses a single diagnosis of “Autism Spectrum Disorder”. The term “spectrum” in ASD means that each person can be affected in different ways, and symptoms can range from mild to severe (Community Report on Autism, 2016).
American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders which is commonly known as DSM-5 is the main diagnostic reference used by mental health professionals and insurance providers to diagnose ASD. One may also hear the terms Classic Autism or Kanner’s Autism (named after the first psychiatrist to describe autism) used to describe the most severe form of the disorder (Autism Speaks, 2016). More specifically, people with ASD must demonstrate deficits in social-emotional reciprocity, deficits in non-verbal communicative behaviors used for social interaction and deficits in developing, maintaining and understanding relationships. In addition, they must show at least two types of repetitive patterns of behavior, including stereotyped or repetitive motor movements, insistence on sameness or inflexible adherence to routines, highly restricted, fixated interests, hyper or hypo reactivity to sensory input or unusual interest in sensory aspects of the environment (Autism Speaks, 2016).
In addition to the diagnosis, each person evaluated will also be described in terms of any known genetic cause (e.g. Fragile X syndrome, Rett syndrome), level of language and intellectual disability and presence of medical conditions such as seizures, anxiety, depression and/or gastrointestinal (GI) problems (Autism Speaks, 2016). Also, there is an additional category called Social Communication Disorder (SCD). This allows for a diagnosis of disabilities in social communication, without the presence of repetitive behavior. SCD is a new diagnosis and much more research and information is needed. There are currently few guidelines for the treatment of SCD. Until such guidelines become available, treatments that target social communication, including many autism-specific interventions, should be provided to individuals with SCD.
CAUSES OF AUTISM
ASD is a complex disorder, and most scientists who study ASD believe that there is no single cause. We have learned that there are likely many causes for multiple types of ASD. There may also be many different factors, including environmental and genetic factors, which make a child more likely to have ASD. (Community Report on Autism, 2016). We now know that there is no one cause of autism, just as there is no one type of autism. Over the last five years, scientists have identified a number of rare gene changes or mutations associated with autism. Research has identified more than 100 autism risk genes. In around 15% of cases, a specific genetic cause of a person’s autism can be identified (Autism Speaks, 2016). However, most cases involve a complex and variable combination of genetic risk and environmental factors that influence early brain development.
In other words, in the presence of a genetic predisposition to autism, a number of non-genetic or environmental influences further increase a child’s risk. The clearest evidence of these environmental risk factors involve events before and during birth (Autism Speaks, 2016). They include advanced parental age at time of conception (both male and female), maternal illness during pregnancy, extreme prematurity, very low birth weight and certain difficulties during birth, particularly those involving periods of oxygen deprivation to the baby’s brain. Mothers exposed to high levels of pesticides and air pollution may also be at higher risk of having a child with ASD (Autism Speaks, 2016). It is important to keep in mind that these factors, by themselves, do not cause autism. Rather, in combination with genetic risk factors, they appear to increase risk.