Autism spectrum disorder

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Even though everyone develops at slightly different paces, almost everyone hits the same general developmental milestones and learns the same sets of skills at about the same time, more or less.
These are things like language and communication, socializing, cognitive skills like problem solving, and physical milestones like walking, crawling, and fine motor skills, all of which all progress as the brain develops.
If one of these doesn’t develop as scheduled, depending on the severity, it may be described as a type of neurodevelopmental disorder, neuro referring to the brain.
Especially when certain skills related to socializing and communicating don’t proceed as normally, it can result in isolation, which is where the name autism originated, since “auto” means “self”, so autism refers to a condition where somebody might be removed from social interaction and communication, leaving them alone or isolated.
Before 2013, the diagnostic and statistical manual for mental disorders, the fourth edition, or the DSM-IV, described autism as one of several pervasive developmental disorders—which also includes Asperger syndrome, childhood disintegrative disorder, and those not otherwise specified, or PDD-NOS.
Asperger syndrome was used for children that appeared to have characteristics of autism, like difficulties with social interactions or non-verbal communication, but don’t generally have significant delays in language or cognitive development, and are therefore Asperger’s syndrome was sometimes referred to as a “high-functioning” form of autism.
Childhood disintegrative disorder was used to describe late onset of developmental delays, so these children develop normally for their age, but then they seem to lose the acquired social and communication skills sometime between age 2 and 10.
Pervasive developmental disorder - not otherwise specified is essentially a catch-all category in which patients meet some, but not all features of autism, Asperger’s syndrome, or childhood disintegrative disorder.
Researchers found, however, that separate diagnoses of these pervasive developmental disorders weren’t consistent across different clinics, since they tend to have similar signs and symptoms.
As of 2013, the DSM-V, a new revised edition, removed these terms and replaced them with autism spectrum disorder or ASD, which encompasses all the previous pervasive developmental disorders, but uses a scale, or a spectrum, that differentiates based on severity of two major areas—social communication and interaction deficits, and restrictive or repetitive behavior, interests, and activities.
For the social and communication area, there are four subcategories that clinicians look for deficits. The first is social reciprocity, which refers to how children respond or reciprocate in social interactions.
So like how the behavior of one person influences the other, and vice versa. An example impairment in this area might be preferring to be alone and not taking a role in social games.
A second area of potential deficit is joint attention, which is the state of wanting to share an interest with someone else, so it’s like “hey!
Check out this awesome thing I found”. So an example of impairment might be a child not sharing their interests or amusement in an object a parent.
Next there’s nonverbal communication, which refers to difficulties either using nonverbal communication themselves or interpreting nonverbal cues from someone else.
So maybe the child won’t put their arms out when they want to be picked up, or they won’t be able to tell when a parent’s upset, even if the parent’s frowning and crossing their arms.
The last subcategory of communication deficits is in social relationships, so children have trouble developing and maintaining relationships.
So maybe the child has a hard time making friends, or they’re able to make friends but their behavior tends to drive them away.
The other major area of deficit is called restricted and repetitive behaviors—and this category’s pretty broad and can include a whole bunch of behaviors, some being more well-known or characterized than others, like lining up toys in a ritualistic sort of way, or flapping one’s hands, or imitating words or phrases.
The child might be fixed on certain routines, like taking the same route every day to school, or they might have restricted patterns of interest, like having a very specific and in-depth knowledge of the Titanic, or vacuum cleaners.
Children with autism spectrum disorder might exhibit one or more of these deficits, and vary in how severe the deficit is.
With that in mind, it’s important to remember that each child with autism spectrum disorder is going to have a different spectrum of symptoms and deficits.
Typically clinicians will try to observe these behaviors in the child, looking for these possible deficits. Since these behaviors are often are often well-known by the child’s caretakers than they are by the clinicians, like their parents or their teachers, a meaningful diagnosis of autism spectrum disorder relies heavily on listening to what other’s are observing at home or in school.
They might be given severity scores in each area, which can help determine how much support the child’s going to need. For example, a severity level 1 would indicate the child needs some support.
For social communication, they might speak in full sentences and engage in communication, but normal back and forth conversation with others just doesn’t seem to work.
For repetitive and restrictive behaviors, they might have difficulties switching between activities. On the side of the spectrum, a level 3 severity means the child needs very substantial support, and on the social communication side, they might display few words of intelligible speech and rarely initiate in interaction with others.
For repetitive behaviors, they might be extremely resistant to change, and their behaviors seriously interfere with daily life.
It’s thought that using this scale of symptoms, as opposed to differentiating between pervasive developmental disorders, will help give a more accurate and medically useful way to diagnose individuals, for example, those with what was previously described as Asperger’s syndrome would likely fall closer to severity level one than severity level three.
Generally speaking, ASD’s thought to have a genetic cause, which ultimately affects brain development, specifically areas that affect social and communication behaviors.
Which genes or combination of genes that are affected in ASD, though, is still very much a mystery. In addition, there are many environmental triggers that have been explored, but at the moment, there are no clear risk factors that have been identified.
With that said, there’s also no cure for ASD, and treatment or management has to be specifically and carefully tailored to each child, and this includes things like specialized educational programs and behavior therapy, that all seek to maximize quality of life and functional independence.