Autism Spectrum

A young girl playing alone with colored clayAutism, or ASD, is a neurological condition, the cause of which is still unknown. Impaired social behavior; difficulty communicating; and restricted, repetitive behavior patterns characterize the condition. The diagnosis is controversial, both because the incidence of the condition appears to have increased tremendously over the last few decades and because its criteria are widely debated. New behavioral treatments (especially if applied during childhood) have shown great success in improving the social behavior of individuals with autism, whereas in the past autism was seen as, at best, manageable with intensive support and structure.

Some clinicians believe that the ability to communicate verbally at a functional or near functional level rules out autism; others diagnose autism more readily, despite the American Psychiatric Association's Diagnostic and Statistical Manual's (DSM) guidelines. Several related conditions, such as Asperger's syndrome, a form of the condition in which children do not show the intellectual delays associated with autism, also appear on the spectrum.

What Causes Autism?

The causes of autism are essentially unknown, although it is thought to perhaps occur when an individual with a genetic predisposition for the condition is triggered by an environmental factor. There seems to be a strong genetic component: Family and twin studies show that there is a strong likelihood that some people are genetically predisposed to autism. The specific genetic factors have not yet been identified, though. The brain scans of children with autism show some differences in brain shape and structure to those of children without autism, indicating that an abnormality in brain structure or function is likely responsible for the condition. Some genetic conditions, such as fragile x syndrome, tuberous sclerosis, and (untreated) PKU may lead to a higher occurrence of autism, as might congenital rubella syndrome, which a developing fetus can contract from a mother who has rubella.

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Several advocacy groups have insisted that chemicals in childhood vaccines are responsible, but research and studies from leading medical groups such as the Institute of Medicine and Centers for Disease Control and Prevention have shown no links between vaccines and autism, though the theory is still popular among some. One reason for this theory is the rising number of cases diagnosed in the past few decades, but the increase in diagnoses may be due to the advancement of research on the condition, which has led to a wider definition of the condition and thus, an increase in identification of cases of autism.

Primary factors affecting the rise in cases of autism have yet to be identified, though research does seem to indicate that environmental toxins and other environmental factors may have some effect on the occurrence of autism. This research shows that said factors may potentially trigger autism in at-risk individuals, rather than actually cause the condition, but it is not yet definitive, and possible causes are still being explored.

How Is Autism Treated?

No cure has been discovered for autism, and in general the condition is treated with therapy and behavioral interventions that are specific to the needs of each particular child. The earlier autism is diagnosed and treated, the better chance that a child's condition will improve. Medication may help relieve some of the specific symptoms of autism, such as anxiety, obsessions and compulsions, behavioral problems, and seizures. Children who experience significant hyperactivity may also benefit from medications that treat ADHD.

Because the parents and siblings of a child with autism may find the condition a challenging one to cope with, family counseling might be of benefit.

Therapy for People on the Autism SpectrumA boy lying on a sofa uses a handheld device

Ordinary therapy is not usually indicated as a helpful treatment for autism itself; in fact, talk therapy might not be possible for some autistic children and may only prove useful to higher functioning adults or to individuals diagnosed with Asperger’s. Medical and mental health professionals can identify the signs of autism, help rule out other possible causes of the child’s behavior, and refer the child to a specialist in behavioral therapy, most commonly applied behavioral analysis, the approach with the most proven success.

Adults with autism, especially milder forms, and children and adults with Asperger’s may benefit from talking therapy in addressing social isolation, though they may be unlikely to seek such help as their condition may often affect their families more than it affects them. Children with Asperger's, who often develop an extreme interest in one or two areas of knowledge and tend to show off the information they have acquired indiscriminately, may benefit from therapy to develop their social skills.

Individuals with autism may experience various issues as a result of their condition, such as anger, grief, anxiety, or stress, that therapy can be helpful in addressing. People who have autism, especially high-functioning adults, may also seek therapy for issues that may or may not be related to autism, such as loneliness.

Case Examples:

  • Adolescent boy with autism: David, 12, was diagnosed with autism as an infant, but his intellectual skills indicate that he has Asperger’s. He wants to sit by his computer all day and cannot get along with other children at school. Even in a special school, he is isolated from others, and he constantly brags about his supposed intellectual superiority. He has a good, if odd, sense of humor, but struggles in his interactions with other people. His parents bring him to therapy in the hopes of “normalizing” his behavior “just a little bit”, and, thanks to David’s fair intelligence and his desire “to stop getting beat up,” his therapist is able to make some progress with him by helping David understand that he can choose to get along with others, that others may offer him something enjoyable, such as a joke or discussion about shared interests. With his therapist, David also begins to work on his social skills, learning social cues and how to speak appropriately with others. David's therapist also works with his parents to set realistic goals for him, and they continue to work on his social skills at a reasonable pace.
  • Autistic middle-aged woman in therapy: Jaycine, 39, is autistic and lives at home with her aging mother, who is beginning to experience difficulties handling Jaycine's dependency. The two enter therapy, but Jaycine cannot participate much, as she is almost completely nonverbal and uninterested in any relationship but the one with her mother, on whom she is entirely dependent. The therapist helps the mother identify her choices, and refers the family to a group home when the mother decides it is time for Jaycine to move out. She also helps Jaycine’s mother work through the feelings of guilt and grief that follow Jaycine's departure from her home.

References:

  1. About Autism: Causes. (n.d.). Retrieved from http://www.autism-society.org/what-is/causes.
  2. Asperger Syndrome Fact Sheet. (2012, October). Retrieved from http://www.ninds.nih.gov/disorders/asperger/detail_asperger.htm.
  3. Autism Fact Sheet. (2009, September). Retrieved from http://www.ninds.nih.gov/disorders/autism/detail_autism.htm#268313082.
  4. Vaccines Do Not Cause Autism. (2015, March 17). Retrieved from http://www.cdc.gov/vaccinesafety/Concerns/Autism/Index.html.

 

Last updated: 07-22-2015

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