Autism is a spectrum disorder, meaning that it can present with a variety of symptoms with varying severity. Every person is different, which can present some challenges with treatment.
What is Autism?
Autism Spectrum Disorder (ASD) is a disorder in which people have difficulty processing sensory input and social interactions. Many syndromes and disorders that used to be classified as separate now belong to ASD. These include autistic disorder, Asperger, childhood disintegrative disorder, and pervasive developmental disorder-not otherwise specified.
Scientists have not found the exact cause of ASD. They believe it is in part genetic, but they also believe that it is related to some environmental factors. For example, there is some evidence that autism is related to immune system activation and inflammatory processes in the mother during pregnancy.
What are the symptoms of ASD?
ASD can present with a variety of symptoms. As stated above, it normally encompasses difficulties with social interaction and sensory processing in addition to stereotyped movements. Symptoms are usually present at 2-3 years of age, but they may not be recognized as symptoms of ASD until later. Boys are more frequently diagnosed than girls, but many argue that this is due to gendered expectations and bias rather than actual disorder incidence. Impairment in social interaction can take many forms. Some people have difficulty forming relationships. This could be for a variety of reasons. They may have reduced ability for empathy. They may also have difficulty adjusting their behavior in social situations. Poor eye contact is a common finding in ASD. As expected, many of these symptoms make it difficult to form relationships.
Another hallmark of ASD is stereotyped or repetitive movements or interests. Many people are familiar with the common theme for people with ASD that they may be obsessed with one thing. For example, some people with ASD will only eat beige foods. Others may be excessively interested in a specific topic, like bridges. Many people with ASD may have stereotyped behavior. These include hand flapping, excessive touching or smelling, counting things, and many more behaviors. At times, these repetitive behaviors can include self-injurious behavior like head-butting or hitting. Aggression can be a major issue for people with severe ASD.
An important and challenging symptom for many people with ASD is sensory overload. An estimated 45-96% of people with ASD demonstrate sensory difficulties. In particular, some people with ASD find some sensory input to be too stimulating. The input itself can vary. Some people are sensitive to visual stimulation, others auditory, and others tactile. This could include a noisy room, a particular type of noise, a particular texture, etc. Each sensory trigger is particular to the individual.
Some people with autism experience developmental challenges, although this is not true for everyone with ASD. Some of these developmental deficits include abnormal language development. Some people with ASD are not able to verbally communicate at all. There may be some intellectual deficits as well, although, again, this is not true for every person with ASD. This is referred to as ASD with Intellectual Disability (ID).
What is ASD associated with?
ASD is associated with other disorders as well. Some people with ASD also have other genetic disorders, like Rett Syndrome, tuberous sclerosis, and fragile X syndrome. Others have concurrent medical disorders like epilepsy. Others have neuropsychiatric disorders that may be concurrent with or caused by the ASD itself. These include anxiety and depression.
What are some challenges?
Given the wide variety of symptoms, an obvious challenge is how to approach diagnosis and treatment. When diagnosing ASD, it is important to check for other associated disorders. These could include the genetic disorders listed above. These also include visual and auditory deficits. For example, if a child is not making eye contact or shows signs of language delay, these could be due to visual deficits or difficulty hearing, not necessarily ASD. Additionally, it is important to diagnose neuropsychiatric disorders that are associated with ASD. These include Attention Deficit Hyperactivity Disorder (ADHD), anxiety, and depression. It is important to treat these disorders when formulating a treatment plan for ASD.
Treatment itself can be difficult. As mentioned previously, each person with ASD presents differently. There is much trial and error when approaching treatment. Treatment uses many modalities. These include behavioral management, patient and family education, family support and counseling, and medical treatment. Medical treatment includes Selective Serotonin Reuptake Inhibitors (SSRIs) to treat the repetitive stereotyped behavior and anxiety or depression, antipsychotic drugs for people who exhibit aggression and self-injury, and methylphenidate for people with ADHD. Like patients without ASD, people with ASD may respond well to one medication and not the other. It takes patience and time to find the best medication and overall treatment combination.
ASD is a spectrum disorder that can cause a variety of symptoms that are particular to the individual. These symptoms include persistent impairment in communication and social interactions in addition to stereotyped patterns of behavior, interests, and activities. These may also include difficulties with sensory processing and additional neuropsychiatric disorders, like depression and anxiety. There are challenges associated with both diagnosis and treatment. It is important to refine each treatment approach based on each individual person’s needs. Contact the Stem Cell Transplant Institute to learn more about ASD today.