AUTISM SPECTRUM DISORDER

Autism spectrum disorder (ASD) is a developmental disability caused by differences in the brain. People with ASD often have problems with social communication and interaction, and restricted or repetitive behaviors or interests. People with ASD may also have different ways of learning, moving, or paying attention. It is important to note that some people without ASD might also have some of these symptoms. But for people with ASD, these characteristics can make life very challenging.

Autism spectrum disorder begins in early childhood and eventually causes problems functioning in society — socially, in school and at work, for example. Often children show symptoms of autism within the first year. A small number of children appear to develop normally in the first year, and then go through a period of regression between 18 and 24 months of age when they develop autism symptoms.

SYMPTOMS OF AUTISM SPECTRUM DISORDER

SOCIAL COMMUNICATION AND INTERACTION SKILLS

Social communication and interaction skills can be challenging for people with ASD.

Examples of social communication and social interaction characteristics related to ASD can include

• Avoids or does not keep eye contact
• Does not respond to name by 9 months of age
• Does not show facial expressions like happy, sad, angry, and surprised by 9 months of age
• Does not play simple interactive games like pat-a-cake by 12 months of age
• Uses few or no gestures by 12 months of age (for example, does not wave goodbye)
• Does not share interests with others by 15 months of age (for example, shows you an object that they like)
• Does not point to show you something interesting by 18 months of age
• Does not notice when others are hurt or upset by 24 months of age
• Does not notice other children and join them in play by 36 months of age
• Does not pretend to be something else, like a teacher or superhero, during play by 48 months of age
• Does not sing, dance, or act for you by 60 months of age

RESTRICTED OR REPETITIVE BEHAVIORS OR INTERESTS

People with ASD have behaviors or interests that can seem unusual. These behaviors or interests set ASD apart from conditions defined by problems with social communication and interaction only.

Examples of restricted or repetitive behaviors and interests related to ASD can include

• Lines up toys or other objects and gets upset when order is changed
• Repeats words or phrases over and over (called echolalia)
• Plays with toys the same way every time
• Is focused on parts of objects (for example, wheels)
• Gets upset by minor changes
• Has obsessive interests
• Must follow certain routines
• Flaps hands, rocks body, or spins self in circles
• Has unusual reactions to the way things sound, smell, taste, look, or feel

OTHER CHARACTERISTICS

Most people with ASD have other related characteristics. These might include

• Delayed language skills
• Delayed movement skills
• Delayed cognitive or learning skills
• Hyperactive, impulsive, and/or inattentive behavior
• Epilepsy or seizure disorder
• Unusual eating and sleeping habits
• Gastrointestinal issues (for example, constipation)
• Unusual mood or emotional reactions
• Anxiety, stress, or excessive worry
• Lack of fear or more fear than expected

CAUSES OF AUTISM SPECTRUM DISORDER

Autism spectrum disorder has no single known cause. Given the complexity of the disorder, and the fact that symptoms and severity vary, there are probably many causes. Both genetics and environment may play a role.

• Several different genes appear to be involved in autism spectrum disorder. For some children, autism spectrum disorder can be associated with a genetic disorder, such as Rett syndrome or fragile X syndrome. For other children, genetic changes (mutations) may increase the risk of autism spectrum disorder. Still other genes may affect brain development or the way that brain cells communicate, or they may determine the severity of symptoms. Some genetic mutations seem to be inherited, while others occur spontaneously.
• Environmental factors.Researchers are currently exploring whether factors such as viral infections, medications or complications during pregnancy, or air pollutants play a role in triggering autism spectrum disorder.

RISK FACTORS OF AUTISM SPECTRUM DISORDER

The number of children diagnosed with autism spectrum disorder is rising. It's not clear whether this is due to better detection and reporting or a real increase in the number of cases, or both.

Autism spectrum disorder affects children of all races and nationalities, but certain factors increase a child's risk. These may include:

• Your child's sex.Boys are about four times more likely to develop autism spectrum disorder than girls are.
• Family history.Families who have one child with autism spectrum disorder have an increased risk of having another child with the disorder. It's also not uncommon for parents or relatives of a child with autism spectrum disorder to have minor problems with social or communication skills themselves or to engage in certain behaviors typical of the disorder.
• Other disorders.Children with certain medical conditions have a higher than normal risk of autism spectrum disorder or autism-like symptoms. Examples include fragile X syndrome, an inherited disorder that causes intellectual problems; tuberous sclerosis, a condition in which benign tumors develop in the brain; and Rett syndrome, a genetic condition occurring almost exclusively in girls, which causes slowing of head growth, intellectual disability and loss of purposeful hand use.
• Extremely preterm babies.Babies born before 26 weeks of gestation may have a greater risk of autism spectrum disorder.
• Parents' ages.There may be a connection between children born to older parents and autism spectrum disorder, but more research is necessary to establish this link.

COMPLICATIONS OF AUTISM SPECTRUM DISORDER

Problems with social interactions, communication and behavior can lead to:

• Problems in school and with successful learning
• Employment problems
• Inability to live independently
• Social isolation
• Stress within the family
• Victimization and being bullied

PREVENTION OF AUTISM SPECTRUM DISORDER

There's no way to prevent autism spectrum disorder, but there are treatment options. Early diagnosis and intervention is most helpful and can improve behavior, skills and language development. However, intervention is helpful at any age. Though children usually don't outgrow autism spectrum disorder symptoms, they may learn to function well.

MANAGEMENT OF AUTISM SPECTRUM DISORDER

There are many types of treatments available. These treatments generally can be broken down into the following categories, although some treatments involve more than one approach:

• Behavioral
• Developmental
• Educational
• Social-Relational
• Pharmacological
• Psychological
• Complementary and Alternative

BEHAVIORAL APPROACHES OF AUTISM SPECTRUM DISORDER

Behavioral approaches focus on changing behaviors by understanding what happens before and after the behavior. Behavioral approaches have the most evidence for treating symptoms of ASD. They have become widely accepted among educators and healthcare professionals and are used in many schools and treatment clinics. A notable behavioral treatment for people with ASD is called Applied Behavior Analysis (ABA). ABA encourages desired behaviors and discourages undesired behaviors to improve a variety of skills. Progress is tracked and measured.

Two ABA teaching styles are Discrete Trial Training (DTT) and Pivotal Response Training (PRT).

• DTT uses step-by-step instructions to teach a desired behavior or response. Lessons are broken down into their simplest parts, and desired answers and behaviors are rewarded. Undesired answers and behaviors are ignored.
• PRT takes place in a natural setting rather than clinic setting. The goal of PRT is to improve a few “pivotal skills” that will help the person learn many other skills. One example of a pivotal skill is to initiate communication with others.

DEVELOPMENTAL APPROACHES OF AUTISM SPECTRUM DISORDER

Developmental approaches focus on improving specific developmental skills, such as language skills or physical skills, or a broader range of interconnected developmental abilities. Developmental approaches are often combined with behavioral approaches.

The most common developmental therapy for people with ASD is Speech and Language Therapy. Speech and Language Therapy helps to improve the person’s understanding and use of speech and language. Some people with ASD communicate verbally. Others may communicate through the use of signs, gestures, pictures, or an electronic communication device.

Occupational Therapy teaches skills that help the person live as independently as possible. Skills may include dressing, eating, bathing, and relating to people. Occupational therapy can also include:

• Sensory Integration Therapy to help improve responses to sensory input that may be restrictive or overwhelming.
• Physical Therapy can help improve physical skills, such as fine movements of the fingers or larger movements of the trunk and body.

The Early Start Denver Model (ESDM) is a broad developmental approach based on the principles of Applied Behavior Analysis. It is used with children 12-48 months of age. Parents and therapists use play, social exchanges, and shared attention in natural settings to improve language, social, and learning skills.

EDUCATIONAL APPROACHES

Educational treatments are given in a classroom setting. One type of educational approach is the Treatment and Education of Autistic and Related Communication-Handicapped Children (TEACCH) approach. TEACCH is based on the idea that people with autism thrive on consistency and visual learning. It provides teachers with ways to adjust the classroom structure and improve academic and other outcomes. For example, daily routines can be written or drawn and placed in clear sight. Boundaries can be set around learning stations. Verbal instructions can be complimented with visual instructions or physical demonstrations.

Social-Relational Approaches

Social-relational treatments focus on improving social skills and building emotional bonds. Some social-relational approaches involve parents or peer mentors.

• The Developmental, Individual Differences, Relationship-Based model (also called “Floor time”) encourages parents and therapists to follow the interests of the individual to expand opportunities for communication.
• The Relationship Development Intervention (RDI) model involves activities that increase motivation, interest, and abilities to participate in shared social interactions.
• Social Stories provide simple descriptions of what to expect in a social situation.
• Social Skills Groups provide opportunities for people with ASD to practice social skills in a structured environment.

PSYCHOLOGICAL APPROACHES

Psychological approaches can help people with ASD cope with anxiety, depression, and other mental health issues. Cognitive-Behavior Therapy (CBT) is one psychological approach that focuses on learning the connections between thoughts, feelings, and behaviors. During CBT, a therapist and the individual work together to identify goals and then change how the person thinks about a situation to change how they react to the situation.

TIPS FOR PARENTS

Things that can help you and your family

Don’t

do not feel guilty for taking time for yourself when you can – even just going for a walk on your own can help give you a break

Talking to your child about autism

It's your choice when you want to tell your child about their autism.

Some parents do it straight away, while others wait until their child's a bit older. There's no right or wrong time.

When you tell your child, it may help to:

• do it when they're feeling calm or relaxed
• talk to them in a place where they feel comfortable, with no distractions
• explain they do not have an illness, but they might need extra support to help them with some things
• explain they might find some things harder than other people, and some things easier
• bring them to a support group to meet other autistic children

DIET TIPS

Food plays an important role in development of human beings. Following food may be of help-

• Omega-3 fatty acids- Deficiency in proper intake of omega- 3 fatty acids may lead to speech development delay in children. It can also affect speech quality. Include fish like salmon, flaxseeds, walnuts, soybeans, tofu etc for ample supply of omega -3 fatty acids.
• Vitamin D- It is important for brain development in foetus. Hence during pregnancy consume more of fish, eggs, liver etc. Expose to early morning sunshine.
• Folic Acid- Foods rich in folic acid or Vitamin B9 helps in prevention of nerve defects. Include leafy dark green vegetables and food fortified with folic acids like breads, wheat flour in your diet.
• Vitamin E- This acts as antioxidants and kills free radicals which can damage our nerves resulting in speech problems. Include more fruits, vegetables, nuts, sunflower seeds, pumpkin seeds, etc in diet.
• Include food containing zinc, phosphorus, magnesiumin diet for better overall development of child. Include dairy foods, fish, rice, nuts, chocolates, spinach, tomatoes, ginger, cumin, cloves, eggs, beans, peas, yogurt etc.
• Avoid foods that cause allergies to you since allergic reactions are an important cause of hearing loss which can simultaneously contribute to speech disorders.
• Avoid food preservatives, canned foods, additives in artificial foods, glutamates, excess coffee and alcohol.
• Avoid smoking and alcohol during pregnancy

HOMOEOPATHIC APPROACH FOR AUTISM SPECTRUM DISORDER

Few of the homoeopathic listed below are helpful to prevent blindness or to treat autism spectrum disorder with favourable result, if taken according to the totality of symptoms. They are:

CARCINOSIN: History of cancer in the family. Desire for milk. Sweat on head. Desire for salty things. Restlessness. Talented , but are obsessive , compulsive , stubborn . Sleep related issues. Mental retardation. Hyperactivity. Attention deficit syndrome. Aversion to reprimand or contradiction. Fastidious. Loves the excitement of thunderstorms.

BARYTA CARBONICUM: Poor socialization, communication and language skills. Shyness is another leading symptom. Shy of strangers. Bashful. Timid. Cowardly. Hides behind the furniture and keeps the hands over the face , peeping through the fingers. Weak memory. Forgets her errand or word in her mouth.Childish and thoughtless behavior. Slow mental grasp and backward.

BELLADONNA: Hyperactivity, poor communication, echolalia . Self injurious behavior, biting, jumping etc. Constant moaning. Starts in fright at the approach of others. Spits on faces of other persons. Quarrelsome.

BUFO RANA: Handling of genitals and nervous agitation. The mind remains childish, only the body grows. Talks nonsense , then angry, if not understood. Propensity to bite. Howling , impatient, nervous, imbecility.

CALCAREA PHOSPHORICUM: Hyperactivity behavior with stereotypy. Excitable nervous and sleepless. Talks rapidly and easily angered.

COFFEA: Sleep dysfunction, especially late sleeping. Nervous agitation. Cry and laugh easily.

HYOSCYAMUS NIGER: Eating or drinking dysfunction, escaping , running , jumping , foolish laughter . Inclined to laugh at everything. Very suspicious. Plays with fingers. 

KALI BROMATUM: Hyperactivity and short attention span. Fidgety, busy hands, fumbles. Moves arms about widely. Omits or mixes up words in talking and writing.

KALI PHOSPHORICUM: Nervous agitation leading to sleep deprivation. Children cry and screams. Shy. Indisposition to meet people.

PHOSPHORUS: Audio visual sensitivities . Unnatural fears , especially dark, desire to be hugged, pressurized ,flapping of fingers. Oversensitive to external impressions. Desires ice creams and cold drinks.

SILICEA : Pica.  Difficulty for eye to eye contact. Nervous, excitable. Sensitive to all impressions. Screaming violently. Starts from slight noise.

SULPHUR: Poor bowel control, lack of communication, lethargy, laziness. Dull, difficult, thinking , misplaces or cannot find proper words when talking or writing. Aversion to being washed. Restless, kick off the clothes at night. Stoop shouldered.

VERATRUM ALB.: Hyperactivity and produce vague humming sound. Howling all night.