A look at ASD

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By Shani Asokan

For the last 15 years, 2 April has been internationally recognised as World Autism Awareness Day. Initiated by a United Nations General Assembly resolution that was passed and adopted in the latter half of 2007, this day encourages member states of the United Nations (UN) to take measures to raise awareness about people with Autism Spectrum Disorder around the world. Being one of seven official health-specific UN Days, World Autism Awareness Day further aims to bring together organisations from around the world to research, diagnose, treat and promote acceptance for those on the autism spectrum.

To mark this year’s World Autism Awareness Day, let’s take a look at Autism Spectrum Disorder (ASD), its risk factors and the importance of diagnosis. 

What is ASD?

The term Autism was changed to Autism Spectrum Disorder (ASD) in 2013 by the American Psychiatric Association. ASD is now an umbrella term used in clinical diagnosis for a broad range of conditions characterised by challenges with social skills, repetitive behaviours, speech, and nonverbal communication. 

It is important to note that Autism is a highly variable neurodevelopmental disorder, which means that there is not just one type of autism, but a number of subtypes influenced by both genetics and environmental factors. It also means that each person with autism has a distinct set of strengths and challenges. The ways in which people on the autism spectrum learn, think and problem-solve can range from highly skilled to severely challenged. While some people with ASD may require a lot of assistance in their daily lives, others may require little to no assistance. 

What causes ASD?

Though there have been presumptions over the years that there is a common cause for autism at a genetic, cognitive and neural level, there is now an increasing school of thought that autism is a complex disorder whose core aspects have distinct causes that often occur at the same time. 

ASD has a strong genetic basis, but research on the disorder is still ongoing, and it remains unclear if it is caused by rare genetic mutations or rare multi-gene interactions of common genetic variants. That is, there’s no one known cause for autism. Existing research suggests that autism develops from a combination of genetic and environmental influences. 

Something to keep in mind however, is that while these influences increase the risk that a child will develop autism, they are not the same as a cause. For example, some genetic mutations associated with autism can also be found in people who do not have ASD. Similarly, not everyone who is exposed to an environmental influence associated with autism will develop ASD. It is likely that most people will not develop ASD.

Some research suggests that autism runs in families: that is, if a parent carries one or more of the genetic mutations, there is a risk of the child developing ASD. This could be the case even if the parent has the mutations but is not a person with autism themselves. Some other risk factors include a parent’s advanced age, pregnancy and birth complications like prematurity, birth weight, and multiple pregnancies (twins, triplets and so on), and pregnancies spaced less than a year apart. There is some research to indicate that prenatal vitamins like folic acid taken throughout the pregnancy can decrease the risk of the child developing ASD.

Signs of ASD and diagnosis

There is no set age for an autism diagnosis. The occurrence and intensity of early signs can vary widely from child to child. Some infants may show signs in the early months, while in others, behaviours may only become obvious by age two or three. Some children with autism may show no signs at all, while others without autism may display some behaviours associated with ASD. These varied results underscore the importance of a professional evaluation and diagnosis. 

There are some signs that could indicate a child is at risk for ASD. Examples of such signs all ages of young children include: little or no babbling, speech or social skills; loss of previously acquired babbling, speech or social skills; avoidance of eye contact; persistent preference of solitude; delayed language development; difficulty understanding other people’s feelings; persistent repetition of words or phrases; resistance to minor changes in routine or immediate environment; repetitive behaviours like rocking or spinning; and unusual and intense reactions to sounds, colours, smells, textures, and lights.

If parents notice their child exhibiting these behaviours, it is important that they get their child evaluated by a medical professional. Though ASD is generally diagnosed in infancy or toddlerhood, adult diagnoses are also possible and not uncommon. Autism is a disorder that is lifelong, but a diagnosis can often be a turning point for those with autism, and their parents.

Treatment and therapy

As each person with autism has their own strengths and challenges, there is no one size fits all treatment or intervention for ASD. Some people with autism have accompanying medical conditions like sleep disturbance, seizures and anxiety – treating these conditions could improve attention, learning and other related behaviours. Further, many people with autism benefit from therapies for communication, social skills, and motor skills and so on. 

Thus, each autism intervention or therapy will and must be tailored to the individual with autism to benefit them best.

Understanding and acceptance

Being aware of autism or ASD is not the same as acceptance. For a long time now, autism advocates have strived to create an understanding that communities must help people with autism lead more fulfilling lives rather than treating them like invalids. This includes improved support for educational opportunities, employment, affordable healthcare and more. Further, this movement challenges non-autistic people to address their own biases (both explicit and implicit) they may have about autism. 

By addressing any biases, misinformation and outdated perspectives on autism, we can move towards ensuring that people with autism are accepted, understood and appreciated in our communities. 

While 2 April is World Autism Awareness Day, April is considered Autism Acceptance Month. So this April, we should all strive to find a way to spread autism awareness, amplify autistic voices and participate in community-based activities that promote autism acceptance.