There are about 2 million Brazilians with autism. The condition, due to chromosomal changes, is often identified as early as childhood.
But it is important to note that there may be levels of the disorder.
This means that people with mild degrees can delay the correct diagnosis, receiving it only in adulthood.
Autism, also known as Autistic Spectrum Disorder (ASD), is a condition that causes problems in language development , communication processes, interaction and social behavior of the child.
2017 data from the World Health Organization (WHO) reveal that 1 in 160 children has autism spectrum disorder (ASD).
A current survey conducted this year by the Center for Disease Control and Prevention (CDC) says that autism affects both genders and all ethnicities, but the number of occurrences is higher among males (about 4.5 times).
This disorder has no cure and its causes are still uncertain, but it can be worked, rehabilitated, modified and treated so that, thus, the patient can adapt to social life and academic activities as best as possible.
The sooner Autism is diagnosed the better, as the disorder affects not only the health of the individual, but also of their caregivers, who, in many cases, end up feeling unable to face the situation.
Nomenclatures for Autism
Over the years, Autism has received several names to be represented. Among them are:
- Autistic Spectrum Disorder;
- Condition of the Autism Spectrum;
- Classic Autism;
- Autism Kanner;
- Invasive Developmental Disorder;
- High functioning autism;
- Asperger syndrome;
- Pathological Demand Avoidance.
Currently, due to recent changes and the main diagnostic manuals, the term that covers all the others and that will be the most commonly at the time of diagnosis is the first on the list, that is, Autistic Spectrum Disorder.
A considerable proportion of patients are identified with autism between 1 and a half years and 3 years. This is because the signs start to become clearer at this stage. But it is possible that some signs can be noticed before 1 year.
The advantage of fathers and mothers being aware of the child is that the sooner the therapeutic approach is started, the better the results.
Although the most characteristic signs are related to verbal communication (such as difficulties in development), non-verbal communication plays an important role in these indications.
Not looking directly at the mother or father, or not focusing on objects, such as toys, can be an alert. In addition, young children often find it strange to be in contact with strangers.
However, children with autism tend to switch easily, without crying or reluctance. On the other hand, constant irritation, frequent crying and exacerbated agitation, with manifestations of aggression, can also be related.
According to the Center for Disease Control and Prevention (CDC), there are 3 types of Autism:
- Asperger syndrome;
- Invasive Developmental Disorder;
- Autistic Disorder.
Another 2 types are also attached to these, only this time by the Diagnostic and Statistical Manual of Mental Illnesses:
- Rett Syndrome;
- Childhood Disintegrative Disorder.
Better understand what each type is below.
Asperger’s syndrome is the mildest form of the autistic spectrum. Children who have it usually become extremely obsessive about a single object and are also overly interested in their favorite subject, being able to discuss it for hours on end, without stopping.
The syndrome affects three times more boys and those who develop it usually have above average intelligence. Because of this, some doctors call it “High-functioning Autism”.
Invasive Developmental Disorder
Children who have a type of autism that is slightly more severe than Asperger’s Syndrome and slightly milder than Autistic Disorder are diagnosed with Invasive Developmental Disorder.
Because the symptoms of this type of disorder vary widely, it can be said that the most common are:
- Impaired social interaction;
- Reasonable linguistic competence superior to Autistic Disorder, but inferior to Asperger’s Syndrome;
- Less repetitive behaviors.
All children who have more severe symptoms than those mentioned above have autistic disorder. The functioning of social, cognitive and linguistic capacity is greatly affected, in addition to having repetitive behaviors.
As much as children with this problem have behaviors very similar to those with autism, Rett Syndrome is not related to the autistic spectrum.
Experts say the mutation present in the syndrome happens at random rather than being inherited and it mostly affects female children.
The syndrome is characterized by some items and appears between the 6th and 18th month of the child:
- Stop responding socially;
- Twists your hands too much, which becomes a habit;
- Lose language skills;
- The growth of the head decreases significantly and, for 2 years, it is much below normal.
Childhood Disintegrative Disorder
This type of autism is the most serious of all present on the Autistic Spectrum, but it is also the least common about 2 children of 100 thousand are diagnosed with Childhood Disintegrative Disorder.
As for the symptoms, it can be said that after a period of normal development, usually between 2 and 4 years of age, the child with this type of disorder loses social, linguistic and intellectual skills very abruptly. In addition, these lost functions are no longer recovered.
In addition to these types presented, Autistic Spectrum Disorder is also divided into degrees:
Light (level 1)
In mild-grade autism, the characteristics are:
- Social communication : Children of this level tend to have difficulty initiating a social interaction with other people. In addition, they may also have little interest in these social interactions.
- Repetitive and restricted behaviors : The inflexibility of the behavior directly interferes with the functioning of one or more contexts. Children also have significant difficulties in changing activities and problems with organization and planning are obstacles to their independence.
Moderate (level 2)
In the moderate degree of autism, the characteristics are:
- Social communication : At this level, children have a serious deficit in their social skills, whether verbal or not. In addition, they also have social losses even when they receive support and limitations to initiate some type of interaction.
- Repetitive and restricted behaviors : Characterized by the inflexibility of the behavior, the child also has difficulty in dealing with changes, in addition to frequently presenting restricted / repetitive behaviors.
Severe (level 3)
The intense (severe) degree, the characteristics are:
- Social communication : Children with Autism at level 3 have severe deficits in verbal and non-verbal communication. He also has difficulty initiating a social interaction or opening up to one that comes from other people.
- Repetitive and restricted behaviors: As for behaviors, children at level 3 have the same behaviors as children at level 2.
Until today, the causes of Autism are inconclusive and, since the mid-1940s, medicine has tried to unravel them. Due to some research and studies on the subject – which have been present since the 1970s / 1980s -, it is believed that the disorder has links with genetic changes.
Today, with the gradual evolution of genetics and neuroscientific and neuropsychological advances, the results of several investigations on Autism have evolved.
They report that the disorder has associations with genetic mutations, syndromes, metabolic diseases, epilepsies and other developmental disorders.
Is there a relationship between vaccines and autism?
First of all, the answer is: no, there is no relationship whatsoever between the disorder and the fact of getting some kind of vaccine!
The idea of this relationship emerged in 1998 when a study suggested that the vaccine that fights Measles , Mumps and Rubella (MMR) can cause autism. Since then, numerous surveys have been conducted and each has found that there is no relationship between one thing and the other.
That done, the study was found to be false and the doctor who wrote it lost his license.
As much as there are several findings about the information being just a myth, several parents are still afraid when vaccinating their children, which is extremely risky, as these diseases are contagious and, when a child contracts them, it can quickly transmit to others.
As much as the causes of Autism are not known, scientists suggest that some factors play important roles in the development of the disorder. They are:
- Gender: Male children are more likely to have Autism. It is estimated that for every 8 autistic boys, 1 girl is also.
- Genetics: About 20% of children who have Autism also have other genetic conditions, such as Down syndrome, fragile X syndrome, tuberous sclerosis, among others.
- Older parents: Science says that the older someone has a child, the more risk children have of developing some kind of problem. And Autism is no different.
- Autistic relatives: If the family already has a history of Autism, the chances of someone also having it are greater.
All the symptoms of the disorder are due to some changes that the brain undergoes, but the exact way Autism happens is not yet known. Its mechanism can be divided into two major areas:
- The physio duck logy of brain structures and processes associated with autism;
- The neuropsychology of brain behaviors.
See below what characterizes each of these areas.
Unlike other disorders that affect the brain, such as Parkinson’s disease, Autism does not have a clear mechanism, be it at the molecular, cellular or system level.
Therefore, scholars still do not know if Autism is characterized by several disorders caused by mutations in the molecules or if it is a set of diseases that has different mechanisms.
Some studies indicate that the mechanism of the disorder has changes in the development of the brain soon after its conception, which ends up causing this organ of autistic children to grow faster than normal.
This excessive growth may be linked to some of these hypotheses:
- Too many neurons that cause too many connections in important brain locations;
- Neuronal migration disturbed during pregnancy;
- Unbalanced excitatory-inhibitory networks;
- Abnormal formation of synapses and dendritic spines.
With regard to the immune system, it is thought that it plays a super important role in autism. Inflammation in the peripheral and central immune systems has been found in some children who have the disorder.
This interaction between the immune and nervous systems still occurs in the child’s embryonic stage and it is believed that this happens due to the use of toxic substances or infections by the mother. As for neurotransmitters, it is still not very well understood.
It is assumed that serotonin , produced by these chemicals, has genetic differences in its transport, which ends up generating the fragile X syndrome, the most common cause of Autism.
Within this group, there are two major categories of cognitive theories that relate the brain to autistic behavior, the first of which is concerned with the deficit in socialization and the other with non-social transformations.
The Simon Baron-Cohen empathy systematization theory says that autistic people can develop internal rules of operation to manipulate events that happen to them, but are unable to develop empathy.
Studies point out that this ability to be empathetic to other people happens when it is necessary to understand more complex social emotions.
This category studies the functions of memory, planning and inhibition work.
Scholars claim that the failure of these functions to function directly interferes with people’s social and cognitive actions.
They also say that there is progress in these functions from late childhood to adolescence, but they do not reach the level of adults who do not have the problem.
The Autistic Spectrum is characterized by the person’s difficulty in communicating and also in interacting socially. In addition, the person suffering from the disorder has a tendency to practice some behaviors repeatedly.
Check below how each symptom interferes with the patient’s life.
Generally, children between 2 and 3 months old already look at nearby faces, turn to voices and smile.
In the case of autism, these actions do not happen and, when they are around 8 to 10 months old, these children start to show some symptoms such as lack of response when called and also of interest to the people around them.
In addition, many autistic children have difficulty participating in games that involve a group, preferring to play alone. They may also have difficulty interpreting each other’s gestures and facial expressions, which makes the world a disconcerting place for them.
In a child’s normal development, language learning – both verbal and gestural – takes place at an early age. One of a baby’s first means of communication is babbling speech and even in his first year, he already says a word or two.
In contrast, some children with Autism tend not to babble, speak and also do not learn to communicate with gestures. Others, in turn, have language delays and begin to speak just a few years later than would be normal.
When language begins to develop, the autistic child may use his or her voice in an unusual way, have difficulty combining words into sentences that have meaning, or even repeat the same phrase several times.
Unusual repetitive behaviors or a tendency to engage in just a few activities are other characteristic symptoms of Autism. Among the behaviors, there are actions such as hands hitting, body swaying, reorganizing objects and repeating sounds and words.
As for the characteristic of restricted activities, it can be identified, for example, when a child makes a line of toys in a very specific way instead of playing with them.
When the activity leaves the route that the child previously stipulated, it is usually stressed.
These extreme interests can turn into obsessions, generating adults who develop a great interest in numbers, symbols, dates or themes of science.
Symptoms due to other medical conditions
In addition to the symptoms already described, some others may also manifest, due to the association that Autism has with other conditions. Are they:
- Genetic diseases;
- Gastrointestinal diseases;
- Convulsive disorders;
- Sleep dysfunction;
- Sensory processing problems.
There is no specific exam for the diagnosis to be made. As Autism is a disorder that affects language and social interaction, the child who has it needs to be analyzed by a group of people and professionals who live with it – including pediatricians, psychologists, teachers and parents.
According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), of 2013, the criteria for identifying a case of Autism are:
- Persistent inability in communication and social interaction that manifests itself through 3 characteristics:
- Deficit in socioemotional reciprocity;
- Deficit in non-verbal behavior for social interaction;
- Deficit in the process of developing and maintaining a relationship.
- Restricted and repetitive patterns in behavior that are manifested by at least 2 of these items:
- Speech, motor movements or repetitive use of objects;
- Excessive adherence to routines, verbal or non-verbal rituals or excessive reluctance to change;
- Fixed and highly restricted interests that end up being abnormal for outsiders;
- Hyper or hyporeactivity to sensory perception of stimuli or excessive interest in sense-perceptual stimuli.
In addition to observing these criteria, a physical and a psychological examination may also be required, as well as a specific examination tool, such as:
- Autism Diagnostic Interview Revised (ADIR);
- Diagnostic observation program for autism (ADOS);
- Autism classification scale in children (CARS);
- Gilliam’s autism rating scale;
- Screening test for invasive developmental disorders.
It is important to remember that the symptoms of the disorder are heterogeneous, that is, each child has a very particular way of being. They vary greatly in the degree of impairment, whether or not they are associated with intellectual disabilities and whether or not they have speech.
These variations and the time of diagnosis influence – and a lot – in the definition of the response to treatments and whether their evolution is being favorable or not.
Diagnosis in older children and adolescents
When autism is noticed after school starts, it is often recognized by the school’s education team.
Among the communication problems that arise in children, the interpretation of the tone of voice and the difficulty in understanding facial expressions, figures of speech, humor or sarcasm can be found.
In addition, parents may also find that their child has difficulty making friends with peers.
Diagnosis in adults
In some cases, adults notice signs and symptoms of Autism in themselves. When this happens, they usually seek help from a psychologist or psychiatrist and the psychologist, in turn, will ask some questions regarding their concerns about social interaction and communication challenges.
This information and the person’s developmental history help with accurate diagnosis.
Although the condition of autism seems to have very explicit and easily identifiable signs, recently studies have pointed out that there may be more people with the disorder.
Considered cases of underreporting, mild autism is often diagnosed only in adulthood – when it is.
That’s because patients – mostly women – don’t have all the obvious or characteristic signs of autism spectrum disorder. There is a slight manifestation of communication and language difficulties, which means that they are often considered just shy or insecure people.
The signs are variable for each person. Despite this, some behaviors can be elevated as signs that deserve attention.
Adults who work better alone, have difficulty interacting, take more time to develop activities or reasoning, have difficulty concentrating and are sensitive to stimuli (such as visual information or sounds), in such a way that these signs cause discomfort or suffering, they should investigate the board.
Even with all the research related to Autism in progress, there is still no specific drug for its treatment, as well as a cure. However, there are several ways to treat the child’s cognitive and functional functions from the moment it was diagnosed.
For this, a multidisciplinary team is important, as each specialist will work on a certain type of development.
In the phase of 0 to 2 years, monitoring the child with a speech therapist is essential, as this will help him / her to develop non-verbal language. Stimulation can be done through games and play, storytelling and conversation.
Occupational and behavioral therapy are also relevant at the time of treatment, as this way the patient’s brain starts to perceive sensory stimuli.
There is no specific treatment rule, as each child has their own particularities. Therefore, the multidisciplinary team will decide what type of treatment should be addressed.
Among these forms of treatment, there are some types of intervention methods, scientifically proven, that professionals end up relying on.
Check out what they are:
TEACCH (Treatment and Education of Autistic and Relate Communication Handcapped Children)
Aiming at the child’s independence and learning, TEACCH is structured to combine several colors and visual materials in a single environment in order to organize the routine and the work system employed.
PECS (Picture Exchange Communication System)
This method of communication is carried out through the exchange of pictures and helps not only patients who have a problem and / or limitations in speech, but also those who have not even developed it.
ABA (Applied Behavior Analysis)
Literally, ABA is a behavioral analysis of the child that is based on the fundamental principles of the theory of learning. Within it, there are some teaching techniques and strategies that include:
- Discreet attempts;
- Task analysis;
- Incidental teaching;
- Functional analysis.
Some professionals indicate the use of certain medications so that the symptoms of the disorder are alleviated, but there is no specific medication for the treatment of Autism itself.
The patient’s behavioral and / or emotional problems that can be treated with medications are:
- Mood changes;
- Difficulty sleeping;
- Anger attacks.
NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained on this site is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.
Several experts do not agree with the fact that a restricted diet can help in the treatment of Autism.
However, if you still want to use this route as a form of assistance, it is important to consult a gastroenterologist and a nutritionist beforehand so that they can develop a correct diet for the patient.
Support for parents
It is important to note that it is not always just autistic children who need follow-up. As parents are usually intensely devoted to them, they are often frustrated and worn out by the fact that they cannot significantly help them.
Therefore, psychological counseling can be effective in reducing the anxiety and stress they face.
Unfortunately, for many experts on the subject, there is still no definitive cure for Autism. However, because the disorder is not progressive, there are several cases of autistic patients who have a very satisfactory level of recovery.
Contrary to what many people think, autistic children and adults can make eye contact with other people, in addition to showing affection when smiling / laughing and various other emotions.
Some still manage to maintain a job in a responsible manner, maintain a stable relationship with other people, marry and raise children.
But even in these cases, you cannot talk about a cure, because although the development is excellent, the autistic characteristics remain throughout life.
Caring for an autistic child can, in most cases, be exhausting not only physically but also emotionally. For this to not happen, some tips are valid:
Find a team of trusted professionals
Some decisions about your child’s education and treatment need to be made, and they are often not easy. Therefore, first of all, the multidisciplinary team that will be in constant contact with the child needs to be reliable and efficient.
Take time for yourself
So that burnout is avoided and your personal and family relationships are not affected, take time to relax and exercise.
Look for other families who also have children with autism
Sometimes seeking help from others who also face the challenges of the disorder can be effective, due to your advice. Try to see if there is any support group in your area.
Learn more about the disorder
There are several myths and misconceptions about Autism. Therefore, it is always good to find out about the issue so that you can help your child in the best possible way.
Keep records of visits
Your child may have visits from many people during his treatment, either with professionals or family members. In order for this to help in the development and monitoring of it, keep an organized file of all meetings and their respective reports.
Stay up to date on new therapy options
With each passing year, researchers seek to find new technologies and therapies so that new approaches to help be made in children who have Autism.
There are no ways to prevent Autism. However, as already explained, the disorder can be treated, causing children to improve their language and social skills.
If your child is diagnosed as autistic, talk to experts about effective ways of treatment.
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