Autism Spectrum Disorder

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Autism Spectrum Disorder

 

Autism

 

Autism is a neurodevelopmental disorder with difficulties in two areas – social communication, and social interaction and restricted, repetitive behavior or interest.

According to DSM 5, the difficulty in Social Communication are defined in terms of:

  1. Deficits in social-emotional reciprocity
  2. Deficits in nonverbal communicative behaviors
  3. Deficits in developing, maintaining, and understanding relationships,

 

The difficulty in Restricted, Repetitive Patterns of Behavior, Interests, or Activities, as manifested by:

  1. repetitive or Stereotyped motor movements, Speech and objects usage
  2. Insistence on inflexible adherence, a sameness to routines, or of verbal or nonverbal behavior ritualized patterns.
  3. Fixated interests and abnormal in focus and intensity
  4. Sensory input, Hyper or unusual interest in sensory aspects of the environment

Severity Specifiers

Autism severity is based on three levels based on the support required for social communication and interaction and restricted repetitive behaviors

  • Required support
  • Required substantial support
  • Required very substantial support

Age of diagnosis: symptoms must present within neurodevelopmental age. Symptoms are recognized during 12-24 months of age. but may be seen earlier as well

Myths:

  • Autism is a degenerative disorder
  • Without therapy one can manage symptoms

 

Autism as a different ability

 

One of the epidemics among all neurodevelopmental disorders is Autism spectrum disorder. 1 in 68 children has been diagnosed with autism and the number is increasing day by day. Considering this epidemic, the question that arises now a day is that whether the number is really increasing or it’s just that the psychiatrist/ psychologist is sensitive enough to diagnose it at a quicker ratio.

Etiology:

  • Genetics and physiological
  • Environmental
  • Epigenetics

DSM IV TR and DSM 5 Difference

Autism is a different ability, therefore there are a lot of modifications in the diagnositic criteria of Autism from DSM IV-TR to DSM 5

 

DSM 5

DSM IV TR

Diagnostic subcategories

None

Rather they give it a name Autism Spectrum Disorder, covering the whole range of disorder category

5 categories for diagnosing autism

1. Autistic Disorder

2. Asperger’s Disorder

3. Pervasive Developmental Disorder, Not Otherwise Specified (PDD-NOS)

4. Rett’s Disorder

5. Childhood Disintegrative Disorder (CDD)

Symptoms description

two deficit areas: 1) social communication and interaction, and 2) restrictive, repetitive patterns of behavior, interests, or activities.

three deficit areas: 1) communication 2) Social, and 3) behaviors/routines

Age of Onset

Symptoms must be present in the early developmental period

Delays or abnormal functioning in at least one of the 3 behavioral must be present prior to age 3 years

Level of impairment

Based on clinical significant impairment. in occupational, social, or other functioning areas

Based on the support required to the child

Based on Global assessment of functioning (0-100)

 

Intervention: The earliest the intervention the better the results

  • Medication
  • Behavior therapy
  • Applied Behavior therapy (a lot of literature evidence is available for applied behavior therapy and
  • its therapeutic efficacy)
  • Speech therapy
  • Sensory integration therapy
  • Neurofeedback

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