Paediatrics
Autism
Autism Spectrum Disorder (ASD), constitutes a diverse group of conditions related to the development of the brain.
What is Autism
Autism Spectrum Disorder (ASD), previously known as Pervasive Developmental Disorder, constitutes a diverse group of conditions related to the development of the brain. It consists of a wide range of impairments in social communication and restricted and repetitive behaviors. ASD is typically evident during the second year of life, and in severe cases, a lack of developmentally appropriate interest in social interactions may be noted even in the first year. Children with autism spectrum disorder often exhibit intense, peculiar interest in a narrow range of activities, resist change, and typically do not respond to their social environment per their peers.
Incidence
Autism is 4 times more common among boys than among girls. It is estimated that worldwide, about 1 in 100 children has autism.2 Available epidemiological data concludes that there is no evidence of a causal association between the Mumps, Measles, and Rubella vaccine and Autism. Likewise, there is also no evidence to suggest that any other childhood vaccines may increase the risk of autism.
What are the symptoms of Autism
- Persistent deficits in social interaction:
- Poor reciprocal social skills
- Poor eye contact and lack of social smile
- Poor attachment to parents and others
- Difficulty in making friends
- Restricted/repetitive behaviors or interests:
- Repetitive plays with rigid daily routines
- If routines are disturbed, may have an excessive reaction
- Stereotyped movements like hand wringing, spinning, head banging, etc
- Lack of imagination
- Impairment of Communication and Language:
- Delayed language milestones (Motor milestones are normal)
- Abnormal sentences, pronoun reversal
- Other symptoms:
- Abnormal response to stimuli
- Higher threshold for pain
- Less/no sensation for spinning movements
- Extreme interest in certain sounds like the ticking of clocks
- Abnormal fingerprints
- Self-destructive behaviors (Biting, scratching, head banging)
- Precocious Skills of high proficiency, such as extremely impressive memories or calculating abilities.
Diagnosis
According to the DSM-5, the diagnostic criteria for autism spectrum disorder include deficits in social communication and restricted interests, which are present in the early developmental period. However, when subtle, the child’s caregivers may not identify the symptoms until several years later. Approximately one-third of children who meet the DSM-5 criteria for autism spectrum disorder show intellectual disability.
Treatment
The goals of treatment for children with autism spectrum disorder are to target core behaviors to improve social interactions, and communication, broaden strategies to integrate into schools, develop meaningful peer relationships, and increase long-term skills in independent living. Psychosocial treatment interventions aim to help children with autism spectrum disorder develop skills in social conventions, increase socially acceptable and prosocial behavior with peers, and to decrease odd behavioral symptoms. In many cases, a child may require language and academic remediation.
- The helpful treatment protocols are:
- Structured classroom teaching
- Early Intensive Behavioral and Developmental Interventions
- Low-dose Antipsychotics like Reserpine and Aripiprazole may be used specifically used to reduce Aggression and Deliberate self-harm