An Appraisal of Autism and Other Autistic Spectral Disorders

An Appraisal of Autism and Other Autistic Spectral Disorders

Background

Autism is a clinical disorder associated by life-long neurodevelopment disabilities. The common features of autism include impaired social interaction, repetition of behavioral actions and difficulties with verbal and non-verbal expressions. Such disorder has its onset in early childhood (within 36 months of birth), and persists in the entire life span of an individual. Autism may lead to various neuropsychiatric disorders if supportive treatment is inadequate. Autism is grouped together with autism spectral disorders. Autism occurs due to an impaired brain development that might be caused due to various genetic or organic causes. The present article will review the features and causes of autistic disorders with a primary focus on autism.

Classification and Features of Autism Spectrum Disorders
Autistic Disorder or Autism: This refers to the classical childhood autism, which is normally used to specify autism. The disorder is marked by impairments in social interactions, impairments in communication, restricted or repetitive interests in certain activities and other associated features. The impairments in social interaction includes a failure to develop relationship with others, exhibits help-seeking behavior but does not reciprocate with others, exhibits indifferent eye contacts , lack of understanding of societal norms, impaired use of non-verbal behaviors and lack of spontaneity in sharing enjoyment with others (Carona, Milunsky, Tager-Flushberg, 2008).

Communication impairments include delayed development of speech without the development of non-verbal alternatives, difficulty in initiation and sustenance of a conversion, stereotyped use of speech. The restriction of interests include difficulty in venturing unknown environments, exhibits narrow interests or focuses on something that is highly insignificant to the presence of other cues, and stereotype in exhibiting motor or postural gestures. The other features include impairment in intellectual disability, with unusual sensory responses, may develop angriness or intentions of causing self-injury and might be accompanied with epilepsy (Carona et al., 2008).

ii. Asperger’s Disorder: This is another autism spectral disorder and is often confused with classical autism due to the common features it shares with childhood autism. However, speech is not delayed in this type of disorder; however, social usage of appropriate communication is impaired. This might lead such individuals to become socially isolated. The intellectual disability is lesser than classical autism and verbal, and non-verbal gestures are higher than classical autism (Carona et al., 2008).

iii. Atypical Autism: This is often referred to as an autistic condition when the features of autistic behaviors are present, but cannot be defined under classical autism or Asperger’s Disorder (Carona et al., 2008).

Epidemiology and Burden of Disease

Classical autism is prevalent in 1-2 individuals per 1000 individuals while the prevalence rate of Asperger’s Syndrome is 6 individuals out of 00 individuals. The prevalence of atypical autism is higher than both these forms of autistic spectral disorders. Around 21.7 million of people across the globe were affected by autism at the end of 2013. In the similar period, people affected by Asperger’s Disorder were estimated to be 31.1 million (Rutter, 2005).

Diagnosis

Diagnosis of autism or other autistic spectral disorders depends upon the clinical features exhibited as discussed. However, the onset of such disorders should be stringently noted in home settings by the parents or care providers of affected children, to ensure correct diagnosis. Often the above features may present as obsessions and compulsions, which must be immediately brought under the attention of a psychiatrist or physician. This would improve the prognosis of autism and other autistic spectral disorders. The impairments in impairments in social interactions, impairments in communication, restricted or repetitive interests are systematically represented and assessed through the DSM-V guidelines and no symptoms are interpreted or associated independently for diagnosing autism (Landa, 2007). The Autism Diagnostic Interview –Revised (ADI-R) and the Autism Diagnostic Observation Schedule are the most used interviewing instruments used to assess the extent of autism (Lam & Aman, 2007).

Pathophysiology

Autism is highly correlated with a genetic cause. Such genetic causes may include mutation of a gene that leads to neurodevelopment impairments. Under certain circumstances, synaptic plasticity is considered as a causative factor for autism (Schmitz & Rezaie, 2008). Cell adhesion and cell signaling may be impaired due to lack of such cytoskeleton components. Whether it is a mutation or underdevelopment of cytoskeleton components the major anatomical location of such dysfunctions is the brain stem (Schmitz & Rezaie, 2008). The major changes that are noted include excess of neurons leading to increased inter-neuronal connectivity, abnormal neuronal connectivity may lead to unequal distribution of excitation and inhibition needed to ensure cognitive functionality. Apart from neurological basis autism may have a sociological basis too. It is speculated that autistic individuals may interpret and associate social cues but cannot react to such cues due to difficulties in appropriate expression or reaction (Schmitz & Rezaie, 2008).

Management of Autism

Management of autistic spectral disorders including autism is done by medications and non-pharmacologic interventions. The major pharmacological interventions are aimed to reduce the co-morbid conditions associated with autistic disorders. These include psychoactive agents and anti-epileptics or anticonvulsants. The use of such drugs reduces the aggression, irritability and obsessive-compulsive behavior associated with autism. Nonpharmacological interventions through psychotherapy and alternative medications have produced little evidence in alleviating the disorder (Schmitz & Rezaie, 2008).

References

Caronna EB, Milunsky JM, & Tager-Flusberg H (2008). “Autism spectrum disorders: clinical
and research frontiers”. Arch Dis Child 93 (6): 518–23
Lam K, & Aman M. (2007). “The Repetitive Behavior Scale-Revised: independent validation
in individuals with autism spectrum disorders”. J Autism Dev Disord 37 (5): 855–66.
Landa, R. (2007). “Early communication development and intervention for children with
autism”. Ment Retard Dev Disabil Res Rev 13 (1): 16–25
Rutter M. (2005). “Incidence of autism spectrum disorders: changes over time and their
meaning”. Acta Paediatr 94 (1): 2–15
Schmitz C, & Rezaie P (2008). “The neuropathology of autism: where do we stand?”.
Neuropathol Appl Neurobiol 34 (1): 4–11