Autism Spectrum Disorder: Difference between revisions
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* Assessment of children's symptoms can also be obtained from different scales: Social Responsiveness Scale ('''SRS'''), the Social Communication Questionnaire ('''SCQ''') and adaptive scales are also often used as measures of everyday functioning. | * Assessment of children's symptoms can also be obtained from different scales: Social Responsiveness Scale ('''SRS'''), the Social Communication Questionnaire ('''SCQ''') and adaptive scales are also often used as measures of everyday functioning. | ||
Diagnoses based on combined clinician observation and caregiver reports are consistently more reliable than those based on either observation or reports alone. Later diagnoses often occur in presence of co-occurring problems such as anxiety, hyperactivity, or mood disorders that might have triggered the ASD, along with the same factors that play a part in delayed diagnoses in younger children. <ref name=":5" /> There is a need for clinical follow-up and reassessments of children diagnosed with ASDs, especially during the preschool years<ref name=":2" />. | Diagnoses based on combined clinician observation and caregiver reports are consistently more reliable than those based on either observation or reports alone. Later diagnoses often occur in presence of co-occurring problems such as anxiety, hyperactivity, or mood disorders that might have triggered the ASD, along with the same factors that play a part in delayed diagnoses in younger children. <ref name=":5" /> There is a need for clinical follow-up and reassessments of children diagnosed with ASDs, especially during the preschool years<ref name=":2" />. | ||
ASD aims to describe autism early signs by considering five categories of symptoms at onset. These categories include: a) language, b) social interaction and relationships, c) stereotyped behavior and activities, d) motor skills, and e) regulation.<ref>'''''Hyman SL, Levy SE, Myers SM, Kuo D, Apkon S, Brei T, Davidson LF, Davis BE, Ellerbeck KA, Noritz GH, Leppert MO. Executive summary: identification, evaluation, and management of children with autism spectrum disorder. Pediatrics. 2020 Jan 1;145(1).''''' </ref> | |||
== References == | == References == | ||
Revision as of 17:37, 6 March 2022
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Introduction[edit | edit source]
Autism Spectrum Disorder is characterized by patterns of delay and deviance in the development of social, communicative, and cognitive skills that arise in the first years of life [1]. Autism Spectrum Disorder (ASD) refers to a group of neurodevelopmental disorders including autism, Asperger's Syndrome (AS) and pervasive developmental disorder-not otherwise specified (PDD-NOS) [2]. It is characterized by deficits in social communication and the presence of restricted interests and repetitive behaviors. ASD can also be defined as a neurobiological disorder predisposed by both genetic and environmental factors affecting the developing brain. [3]
The World Health Organization (WHO) estimates the international prevalence of ASD at 0.76%; however, this only accounts for approximately 16% of the global child population with an increase over the past two decades.
Causes[edit | edit source]
ASD is a neurobiological disorder influenced by both genetic and environmental factors affecting the developing brain. Currently, no single universal cause has been identified but researches are still ongoing to deepen our understanding of potential etiologic mechanisms in ASD [3].
Signs and Symptoms[edit | edit source]
Common morbidities associated with ASD include symptoms such as : [2], [4], [5],[6]
- Attention deficit in nearly 75% of patients
- Anxiety, irritability
- Bipolar disorder
- Depression
- Tourette Syndrome
- Insomnia
- Eating and digestive difficulties
- Decreased intellectual ability
- Deficiency in social communication
Risk Factors[edit | edit source]
The following factors have been linked to ASD:
- Hereditary factors, parental history of psychiatric disorders, pre-term births.
- Parental age ( advance maternal and paternal age)
- Maternal history of autoimmune disease such as diabetes, thyroid disease and psoriasis. [3]
- Prenatal exposure to psychotropic drugs or insecticides like thalidomide and valproic acid. [3]
- Some of the known genetic disorders such as fragile X, tuberous sclerosis, Down syndrome, Rett syndrome even though they represent a very small amount of overall ASD cases [3].
- Maternal infection or immune activation during pregnancy
- Obstetric factors like uterine bleeding, caesarian delivery, low birth weight, preterm delivery, and low Apgar scores are more consistently associated with autism[3].
Early Diagnosis & Diagnosis[edit | edit source]
ASD can be diagnosed by various professionals (pediatricians, psychiatrists, or psychologists), ideally with input from multiple disciplines[7]. ASD aims to describe autism early signs by considering five categories of symptoms at onset. These categories include: language, social interaction and relationships, stereotyped behavior and activities, motor skills, and regulation[8]. ASDs should be identified as soon as possible to allow an intervention to start as quick as possible too. However, the time of identification varies according to the diversity of autism etiology as well as the varying degrees of associated brain disorder[6]. The most common early signs involve joint attention, eye contact, orienting to verbal call, facial expression, social smile and deficit or poor quality of movements [8]. Many studies have pointed out the importance of the early identification of ASDs to allow parents and schools to set appropriate measures related to children behavior and underlying cognitive problems taking into consideration the child's development in all its aspects[6]. It has been demonstrated that early interventions provide the best returns in investment and better results in terms of developmental outcomes and improvement in daily functioning [5]. To identify early symptoms of ASDs and sometimes help make a definitive diagnosis, different approaches/tools are used in different countries. The following ones are used :[8]
- The CHAT : Checklist for Autism in Toddlers from 18 months to 24 months
- CARS: Childhood Autism Rating Scale
- ADOS : Autism Diagnostic Observation Schedule
There are also a number of early intervention programs available that are relatively specifically focused on autism:
- Screening Tool for Autism in Toddlers and Young Children: STAT
- For research or a more comprehensive developmental history, caregiver interviews such as the Autism Diagnostic Interview-Revised (ADI-R) or, particularly in the UK, the Diagnostic Instrument for Social Communication Disorders (DISCO), or the computer-generated Developmental, Dimensional, and Diagnostic Interview (3di) are used, with many clinicians relying on informal histories.
- Assessment of children's symptoms can also be obtained from different scales: Social Responsiveness Scale (SRS), the Social Communication Questionnaire (SCQ) and adaptive scales are also often used as measures of everyday functioning.
Diagnoses based on combined clinician observation and caregiver reports are consistently more reliable than those based on either observation or reports alone. Later diagnoses often occur in presence of co-occurring problems such as anxiety, hyperactivity, or mood disorders that might have triggered the ASD, along with the same factors that play a part in delayed diagnoses in younger children. [7] There is a need for clinical follow-up and reassessments of children diagnosed with ASDs, especially during the preschool years[6].
ASD aims to describe autism early signs by considering five categories of symptoms at onset. These categories include: a) language, b) social interaction and relationships, c) stereotyped behavior and activities, d) motor skills, and e) regulation.[9]
References[edit | edit source]
- ↑ Volkmar, F., Siegel, M., Woodbury-Smith, M., King, B., McCracken, J. and State, M., 2014. Practice parameter for the assessment and treatment of children and adolescents with autism spectrum disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 53(2), pp.237-257.
- ↑ 2.0 2.1 Sharma SR, Gonda X, Tarazi FI. Autism spectrum disorder: classification, diagnosis and therapy. Pharmacology & therapeutics. 2018 Oct 1;190:91-104.
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 Hodges H, Fealko C, Soares N. Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation. Translational pediatrics. 2020 Feb; 9(Suppl 1): S55.
- ↑ Hahler EM, Elsabbagh M. Autism: A global perspective. Current Developmental Disorders Reports. 2015 Mar;2(1):58-64.
- ↑ 5.0 5.1 World Health Organization. Autism spectrum disorders & other developmental disorders: From raising awareness to building capacity. Geneva: WHO Document Production Services. 2013 Sep.
- ↑ 6.0 6.1 6.2 6.3 Fernell E, Eriksson MA, Gillberg C. Early diagnosis of autism and impact on prognosis: a narrative review. Clinical epidemiology. 2013;5:33.
- ↑ 7.0 7.1 Lord C, Elsabbagh M, Baird G, Veenstra-Vanderweele J. Autism spectrum disorder. The lancet. 2018 Aug 11;392(10146):508-20.
- ↑ 8.0 8.1 8.2 Parmeggiani A, Corinaldesi A, Posar A. Early features of autism spectrum disorder: a cross-sectional study. Italian journal of pediatrics. 2019 Dec;45(1):1-8.
- ↑ Hyman SL, Levy SE, Myers SM, Kuo D, Apkon S, Brei T, Davidson LF, Davis BE, Ellerbeck KA, Noritz GH, Leppert MO. Executive summary: identification, evaluation, and management of children with autism spectrum disorder. Pediatrics. 2020 Jan 1;145(1).
