Autism is a neurodevelopmental disorder that primarily affects social skills, verbal communication, and abnormal behavior. This is a condition that is happening more and more often, 2 out of every 1000 children will have autism. Early detection and treatment can help limit the progression of the disease.
What is autism?
Autism is also known as Autism Spectrum Disorder (ASD). It is a developmental disorder with symptoms appearing within the first 3 years of life. Most children with ASD look like other children, but they act and interact in ways that are different from typical children’s behavior. When interacting with others, they may object in unexpected ways. Or they may not interact at all.
Autism is a spectrum disorder, which means it comes in many different forms and degrees of severity. Some individuals develop typical abilities in speech and language. They may develop special skills but struggle with behavioral and social differences throughout their lives.
Meanwhile, others may experience communication difficulties, sensory sensitivities, and behavioral problems. Such as repetitive behavior, excessive tantrums, aggression, and self-harm.
For many years, diagnoses of autism were rare, occurring in only 1 in 2,000 children. Since the 1980s, however, the incidence of ASD has increased dramatically around the world.
In March 2020, the US Federal Centers for Disease Control announced that 1 in 54 children in the United States will be affected by ASD. Autism is more likely to affect boys than girls. However, ASD tends to be more severe in women.
In Vietnam today, the prevalence of autism has increased by about 50 times compared to the period 2000 – 2007. Especially in Ho Chi Minh City, this rate has increased to 160 times. This is a major challenge for medicine and society. If optimal methods are not found soon, ASD will seriously affect the patients themselves and become a burden on the whole society.
Signs of autism
The range of autism symptoms varies widely. Some children may develop ASD symptoms in infancy. Examples include reduced eye contact, unresponsiveness when called by name, or indifference to caregivers.
Meanwhile, other children may develop normally during the first few months or years of life. Then suddenly they become withdrawn, aggressive, or lose the language skills they already have. These signs are usually seen when the child is about 2 years old.
Each child with autism is likely to have a unique pattern of behavior and severity. Usually from low activity to high activity. Some children with ASD have learning difficulties and have lower-than-normal intelligence.
However, other children with this disorder may also have normal to high intelligence. They learn quickly but have difficulty communicating. At the same time, it is difficult to apply the ways they know in everyday life and adapt to social situations.
Because of the mixture of symptoms that are unique to each child, it can sometimes be difficult to determine the severity of ASD. It is often based on the extent of the impairment as well as its impact on the child’s ability to function.
Here are some common signs that help identify autism:
1. Social communication and interaction
Children or adults with autism spectrum disorder may experience problems with communication skills and social interactions. Signs may include:
- Does not respond when called by name or may not be heard at times.
- Resists cuddling and seems to prefer playing alone. Always wanted to retreat into her own world.
- Poor eye contact, lack of facial expressions.
- Unable to speak, has a speech delay, or loses the ability to speak previously known words or sentences.
- Unable to start or continue a conversation. Or sometimes just start a conversation to make a request.
- Speaks with an irregular rhythm, possibly using a robot-like voice.
- Repeating words or phrases verbatim without understanding how to use them.
- Can’t seem to understand simple questions or instructions.
- Doesn’t show emotions and doesn’t seem to understand other people’s feelings.
- Approach social interaction in a passive, inappropriate, aggressive, or disruptive manner.
- Difficulty recognizing nonverbal cues such as body posture, interpreting facial expressions or the voice of others.
2. Behavioral signs
Children and adults with ASD may have restricted, repetitive patterns of behavior, interests, or activities. Common signs include:
- Repeating the same behavior over and over. This may include clapping, spinning, rocking, finger snapping, etc. Also they may play with objects in unusual ways. Such as spinning coins, spinning discs tirelessly, constantly turning on light switches.
- Develop specific routines or rituals. They are often upset or disturbed by even the slightest change.
- Have problems with coordination or have some strange movement patterns. For example, being clumsy, walking on tiptoe, having odd, exaggerated or rigid body language.
- Be mesmerized by the details of a particular object. For example, the spinning wheel of a toy car. However, they do not understand the purpose and overall function of that object.
- Unusual sensitivity to sound, light, or touch. But may be indifferent to pain and temperature.
- Do not engage in imitation or imitation games.
- Have specific preferences about food. For example, eating only certain foods or refusing foods with certain textures.
Injuring yourself by hitting your head, biting your hand, or excessively rubbing or scratching your skin.
As adults, some children with autism may be more sociable with others. At the same time, there are fewer manifestations of behavioral disorders. People with the least severe problems can eventually lead normal or near-normal lives.
However, others will continue to have difficulty with language and social skills. In it, the teen years can bring about worse emotional and behavioral problems.
3. Other problems that come with it
Several medical conditions may be associated with autism. These are often referred to as comorbidities or co-occurring conditions. They may include:
- Sleep disorders
- Dysregulation of the gastrointestinal tract
- Metabolism and immunity
- Classification of autism
Autism is classified into many different types, depending on specific criteria. Consists of:
– According to the time of autism:
- Typical Autism (Congenital ASD): ASD symptoms appear gradually over the first 3 years of life.
- Atypical Autism (Acquired ASD): Children develop normally in language and communication during the first 3 years.
- After that, ASD symptoms appear gradually and there is a decline in language-communication.
According to intelligence index:
- Autism has a high IQ and can speak: Children do not have negative behaviors but are very passive and behave abnormally in the social context. Early reading (2-3 years old), good visual skills, tendency to obsess, and better awareness of behaviors in adulthood.
- Autism has a high IQ and does not speak: Children have a difference between speaking skills and motor, motor, and performance skills. Children may be overly sensitive to auditory stimuli. Behavior may be mildly abnormal. Good vision skills (child can look at objects attentively). Usually quiet or self-isolating, can be stubborn. Children who like to communicate or can communicate alternately.
- Autism with low IQ and speaking: Child behavior is the worst of all forms of autism. Children may often scream loudly and become aggressive as they get older. Self-stimulating behavior, poor memory. Children often repeat speech (speech does not make complete sense) and have poor concentration.
- Autism has a low IQ and cannot speak: Children are often silent, use only a few words or gestures. Have a special interest in machines. Sensitive to sounds/noises. The child has inappropriate social skills and does not have relationships with others,
– By level:
- Mild Autism: The child still has relatively normal eye contact. However, communication with outsiders is a bit limited. Children learn simple activities, play skills and speak are still at a relatively normal level.
- Moderate Autism: Child has limited eye contact and communication with outsiders. Children are also able to speak but limited.
- Severe autism: Children do not know how to make eye contact, at the same time do not communicate with outsiders and cannot speak.
Causes of autism
Although many studies have been done, the exact cause of autism is still unknown. Several causes and factors are thought to be involved in the pathogenesis including:
Brain damage or underdevelopment of the brain due to:
- Premature birth less than 37 weeks
- Low birth weight less than 2,500g
- Traumatic brain injury due to obstetric intervention
- Asphyxiation or cerebral hypoxia at birth
- Cerebral hypoxia due to severe respiratory failure
- Neonatal kernicterus
- Cerebral hemorrhage – neonatal meninges
- Neurological infections such as meningitis, encephalitis
- Mercury poisoning
- Traumatic brain injury
– Genetic factors:
- Chromosome abnormalities
- Diseases inherited by genes or by groups of genes
– Environmental factors:
- The living environment has little stimulation to the child’s development in the first 24 months. For example, it is mainly for children to watch television, music, advertising, etc., instead of the care and teaching of parents and families.
- Certain chemicals or heavy metals can cause brain damage.
Effects of autism
Autism is a serious neurodevelopmental disorder. This disease affects the functioning of the brain, causing defects in many aspects. Due to its early onset, autism greatly affects children’s health, intellectual development as well as quality of life.
Impairments in language, reasoning, thinking, and behavior make it difficult for people with autism to lead a normal life. Patients are almost unable to make friends due to limited communication ability and difficulty expressing thoughts through words. They tend to live in seclusion and isolation.
Studies show that both children and adults with ASD are more likely to develop other mental illnesses. Such as depression, anxiety disorders, obsessive-compulsive disorder. Adults with autism are not able to have sex and get married even if they have feelings for a man and a woman.
Due to many disabilities, it is very difficult for people with ASD to study and work as usual. This will gradually cause pessimism, self-hatred. Patients can become a burden on their families and society. Some cases of autism combined with depression also lead to self-destructive and suicidal behavior.
Examination and diagnosis of autism
Screening for autism is usually done by a pediatrician during a child’s routine physical exam. The doctor may observe the child or ask the parent questions about the child’s behavior at home and when interacting with other children.
The purpose of screening is to identify common early signs of autism. These signs may include:
- Slow to communicate with others, including words and gestures
- Do not answer your own name
- Annoyed by small changes in routine
- Avoid all forms of physical contact
- Show little interest in things or people
Doctors can use a variety of tools to screen for autism. They can range from simple observations to formal assessments. Some of the commonly used tools are:
- M-CHAT (Revised Checklist for Toddler Autism): This is a common 20-question test designed for toddlers aged 16 to 30 months.
- ASQ (Age and Stage Questionnaire): This is a general developmental screening tool that looks at developmental challenges at specific ages.
- STAT (ASD Screening Tool for Toddlers and Young Children): An interactive screening tool that includes 12 activities that assess children’s play, communication, and imitation.
- PEDS (Parents’ Assessment of Developmental Status): This is a joint developmental interview for parents designed to identify developmental delays in motor, language, and autonomy. force and more.
Diagnosis of autism is usually based on clinical presentation. Specialists often base themselves on the criteria described in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) produced by the American Psychiatric Association.
The DSM-5 recognizes two broad diagnostic criteria for autism:
- Persistent deficits in communication and social interaction
- Restricted and repetitive patterns of behavior, interests or activities
These symptoms often appear early in life. It can disrupt a child’s social, emotional, and cognitive development. After being diagnosed with ASD, children need to receive the right treatment intervention to limit the problems affecting.
How to treat autism
Until now, the treatment of autism is still facing many difficulties. The disease cannot be completely cured, but only partially improved. However, early intervention will help limit the risk of severe disease progression.
Statistics show that only about 1-2% of patients are able to normalize their lives and have a job to support themselves. Two-thirds of adults with autism live in a hospital or are completely dependent on their family.
Treatment of autism requires a combination of many different approaches. In addition, the patient needs to receive support from the family to normalize life. Commonly recommended therapies for autism include:
1.Communication, speech and language
Developing communication, speech, and language skills is an important part of autism. Regardless of the language level of a person with autism, they all have some degree of social-communication difficulty. Speech and language therapy can begin as early as 18 months of age.
A speech-language pathologist (SLP) is trained to handle language, speech, communication, and sometimes eating problems. They can help with many problems including:
- Ask for appropriate help and objections
- Conversation skills help build relationships
- Actively initiate and maintain play activity
- Recognize verbal and nonverbal clues
- Learn the right times for specific communication purposes
- Assessment of augmentative and alternative communication skills
2. Therapeutic activities
People with ASD are likely to benefit from activity therapy (OT). An occupational therapist will work with the patient. The aim is to strengthen their skills in living activities. Such as play and learning for children.
The specialist will help the person identify factors that prevent them from fully participating in typical activities of daily living. Usually eating, cleaning, playing, writing, going to school or working, etc.
Many people with ASD may have difficulty processing sensory information. Or they can take in the information around them in an efficient way. This can make it difficult for them to regulate their behavior, attention, and emotions. Sensory Integrative (SI) therapy will help with these issues. Meanwhile, occupational therapy (OT) is the main specialty involved in treatment planning.
Some of the benefits that therapists offer to autistic patients:
- Plan games to improve hand-eye coordination
- Adjusting sensory signals to improve processing ability
- Change the environment with technology or use different devices
- Apply different ways to integrate physical movement for children
3. Physiotherapy for autism
Motor skills affect the way a person moves his or her body to perform a task. Sometimes people with autism have less developed motor skills. If this is the case, physical therapy (PT) can help.
A physical therapist will work with physical limitations to help a person develop the muscles, balance, and coordination needed for daily activities.
4. Behavioral Therapy
Behavioral therapy for autism may include:
Applied Behavior Analysis (ABA):
According to research, ABA is the most effective supported intervention for people with ASD. This therapy uses principles of behavior based on scientific evidence in everyday situations.
ABA therapy aims to increase/decrease various behaviors. All ABA programs share similar components. Includes professional instruction, parental involvement, teaching skills that can be used at home, at school or in other settings. ABA should always be fun and encouraging for children.
– Cognitive behavioral therapy (CBT):
Cognitive-behavioral therapy (CBT) is a well-researched group of skills that are effective in treating problems experienced by both children and adults. CBT is effective with anxiety disorders, depression, teaches stress management, anger management and improves related skills.
The goal of CBT is to help the person understand how emotions, thoughts, and behaviors are related. CBT teaches how to identify unhelpful beliefs and how to develop more positive behavioral patterns.
CBT is useful for people with autism who still have adequate speaking skills and the ability to think about their emotions, perceptions, and behaviors. CBT can be done for individuals or in groups. CBT will help patients improve communication skills and social thinking.
5. Other supportive therapies and interventions
There are many under-researched therapies for ASD that can be beneficial. Such as:
- Music therapy
- Art therapy
- Chelation therapy
- Adaptive exercise
- Therapy animals
These therapies can support social skills, boost self-esteem, and build confidence. This helps develop motor skills and improves quality of life for people with autism.
6. Prescription drugs
There are currently no prescription drugs specifically designed to treat autism. However, some medications can effectively improve associated symptoms. Such as aggression, hyperactivity, attention deficit, sleep disturbance, depression or mood swings.
Medications that may be taken include:
- The neuroleptic/antipsychotic Haloperidol (Haldol)
- Selective serotonin reuptake inhibitors (SSRIs)
- The antipsychotic drug Risperidone (Risperdal)
- Naltrexone (opioid antagonist)
Medication is often used in conjunction with behavioral therapy. The goal is to shape and control social behaviors. The most typical is self-injurious, aggressive, or destructive behavior.
Any behavior changes should be discussed with your doctor. Also tell your doctor about all medications you are taking (including over-the-counter medications, vitamins or herbal supplements) to monitor for interactions or related side effects.
7. Diet for autistic people
Some people report an improvement in function after changing the diet. The two most commonly used diets by families with members of ASD are the gluten-free, casein-free, and yeast-free diets.
It is best to build a special diet, away from foods that are easy to cause allergies. Eat foods rich in vitamins (especially B vitamins), minerals and healthy fatty acids.
8. Family support
Family support is considered an important factor in autism treatment. Especially for children who have the ability to perceive the difference between themselves and those around them. Ignorance about the condition can create anxiety, confusion and awkwardness in children.
Along with individual treatment, family members also need to be equipped with knowledge to understand and accept the child’s behavior. In addition, relatives also need to master the skills to deal with and cope with the difficulties that their children face.
The support from the family will help the child to be able to live on his own. At the same time learn to integrate and gradually adapt to the people around.
Prevention of autism
There is no complete cure for autism, experts say. However, taking the following steps well can significantly reduce your risk:
- Routine antenatal check-ups can detect early maternal diseases and fetal abnormalities that cause brain damage to the baby.
- Routine physical examination of children (especially high-risk infants) quarterly during the first 24 months of life can help detect early developmental disorders, including autism.
- Pregnant women need nutritional counseling and vaccinations to limit nutrient deficiencies. It also reduces the risk of contracting infectious diseases during pregnancy. In addition, pregnant women need to limit their exposure to mercury as well as heavy metals.
- Choose a reputable medical facility to give birth. This helps minimize brain damage in babies.
Autism is an increasingly common neurodevelopmental disorder. Early detection and proper treatment are needed to improve the disease. Parents should be equipped with more knowledge about this disease to help their children when they unfortunately have autism.