What is autism spectrum disorder?
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that starts in early childhood and progresses with inadequacy in social-communicative development, repetitive behaviors and interests. In various studies conducted in recent years, the prevalence of ASD has been found to be over 1%. In terms of gender, ASD is seen 3-4 times more in boys than in girls.
While the term ASD has been used for years as a category that includes autism, atypical autism and Asperger’s syndrome, it was in May 2013 that the definition of ASD was included in the official classification systems. The definition of ASD is now used for all disorders associated with Autism.
What are the causes?
An important factor in the development of ASD is genetic predisposition. It is accepted that the variables in the genes play the most important role among the causes of autism. It has been found that there are some differences in the brain imaging of children diagnosed with autism at an early age, and these differences change with age. Environmental factors in the etiology of ASD were also emphasized. Advanced parental age is one of the factors emphasized. Again, it has not been confirmed that factors such as diet, exposure to mercury and vaccination, which have been popularly accused recently, contribute to the development of autism. The most important view accepted today is that autism is a neurodevelopmental disease that develops in the early stages of the brain and arises due to gene-environment interaction.
What are the symptoms?
Autistic individuals, the symptoms that occur, and the severity of these symptoms vary widely.
In cases with autism, symptoms usually appear in the first or second year of life. Initial symptoms are typical, including delayed language development, social apathy, or unusual hypersensitivity to the environment. The parents of about a quarter of children with ASD stated that their children stopped speaking after saying a few meaningful words and their social skills regressed.
Babies diagnosed with ASD look for other individuals less and look after them less in the first six months of life. In addition, it was revealed that social smiles were less in these children during this period and that these babies made less noise. Not looking when their name is called helps to distinguish children with ASD from those without ASD starting from the eighth month. Features that distinguish ASD children from other children; eye contact, inadequacy in social interest and smiling, limitation in the use of gestures and signs, not looking when their name is called, inability to imitate, and delay in receptive and expressive language.
In the 2-3 age period, the most common symptoms in the social field are; Inadequate eye contact, decreased interest in social games and mutual social interaction, less reference to parents to regulate mood, and a tendency to be alone were reported.
In the 4-5 age group, differences from peers, limited gestures, reluctance to interact with others, not seeking peers, and inability to maintain relationships with peers become more evident. While the level of empathy approaches the adult level in normally developing individuals, there is no empathy in this group. Language development and communication problems constitute an important part of the problems of individuals with ASD. In cases where language skills are developed, language use is different from normal, including repetitive behaviors and repetitive language use, repetition of the other person’s speech, mixing personal pronouns, differentiation of normal sound volume, and problems in the use of language for social interaction. In the non-speaking group, making meaningless sounds is sometimes seen as making new words. Also in this period, motor stereotypes such as swaying, turning on its own axis, walking on tiptoe, strange hand movements, flapping wings are common; In addition, ritualistic behaviors such as arranging toys, playing with certain parts of toys are in question.
Individuals diagnosed with ASD with normal intelligence during adolescence often experience depression due to not belonging to the group and peer abuse. In the mentally retarded group, on the other hand, basic symptoms continue in this period, and anger, impulse control problems, limitations in self-care, resistance to change and destructive behaviors are common.
Again, from the early period, problems in academic skills, inability to benefit from special education and behavioral problems are more severe in the group with Attention Deficit Hyperactivity Disorder. Particular attention should be paid to Bipolar Disorder in the group whose autism symptoms intensify, obsessions increase, and sleep problems increase in certain periods or seasons. Along with autism, additional psychiatric problems both exacerbate autism symptoms and negatively affect its course.
In Asperger’s syndrome, individuals have a higher level of functionality, although they show signs of autism. Language skills are good from the first years of life. There is no delay in cognitive skills. It defines individuals with Asperger’s syndrome as individuals who have normal language development but show the same characteristics as those with autism, with their social interaction behaviors and repetitive ritualistic behaviors. These children have special interests in the preschool period, and these interests are sometimes related to daily life and sometimes to unfamiliar subjects. Again, they have obsessions and daily routines related to daily life or unfamiliar subjects. With age, the difficulties in social relationships that they begin to experience become more evident. With age, they start to spend time with their own interests, especially during adolescence, and they talk more about their interests. From the beginning, they may experience mobility, attention problems, anxiety, motor clumsiness, sleep and feeding problems.
How does the treatment process work?
Since there is no known cure for autism, clinicians develop intervention and treatment programs suitable for the individual’s functional level and problematic areas. They actively contribute to the coping of the child and the family. The basic approach is educational approaches. These educational approaches aim to develop in the social-communicative field, to reduce undesirable behaviors, and to gain new skills.
Although a drug that improves the basic symptoms in ASD has not been developed yet, it is common to use drugs for comorbid behavioral problems in this group. Medications are helpful in irritability, anger, insomnia, behavioral problems, repetitive movements, tics, social interaction, anxiety, fear, low mood, obsession, hyperactivity and attention problems.
How is it going?
Pre-treatment intelligence level, starting treatment at an early age, amount of treatment – duration of treatment, family characteristics, social avoidance were defined as important determinants of response to treatment. It has been stated that one-fifth of individuals with normal intelligence live on their own and nearly 40% can graduate from university. The majority of individuals diagnosed with autism at a more severe functional level continue their lives with support.
