6th year medical student (UTG)
Autism is a condition that affects how people communicate, behave, and experience the world. Autism Spectrum Disorder (ASD) is the complete medical term for autism. ASD describes a difference in brain function that influences how a person communicates and connects with others. For instance, an autistic individual might use eye contact or body language differently from someone who is neurotypical or may struggle with social interactions or find certain environments overwhelming; while others might have unique strengths, like strong memory skills or attention to detail.
Autism is called a “spectrum” disorder because the type and intensity of symptoms vary widely from person to person. It is also important to understand that autism is not a disease or illness so, there is no cure. However, early and intensive support can significantly improve outcomes for many children, helping them build important skills and navigate the world around them more comfortably.
This article provides a simple guide to understanding autism, including its signs, challenges, and strengths. With more awareness and compassion, we can create a community where autistic individuals feel valued and included.
How common is it?
Around 1 in 100 children worldwide are autistic. However, this figure represents an average, and prevalence rates can vary significantly between studies. While it may appear that autism is becoming more common, this increase is likely due to improved awareness, knowledge, and resources among healthcare providers. As a result, they are better equipped to identify and support autistic individuals, leading to more diagnoses and a rise in reported numbers. That being said, anyone, regardless of gender, race, ethnicity, or economic background, can be diagnosed with ASD.
What are some signs and symptoms of autism?
The signs and symptoms of autism vary widely from person to person, encompassing challenges with social communication and unusual repetitive behaviors. Some children display symptoms within their first year of life, while others may develop noticeable signs later in childhood.
Social communication/Interaction
Individuals with autism spectrum disorder (ASD) may face challenges in social communication and interaction, which can show up as one or more of the following signs:
· Does not respond to their name or seems not to hear at times
· Has limited eye contact and minimal facial expressions
· Resists physical affection like cuddling or holding, and often prefers playing or being alone.
· Experiences delayed speech, does not speak, or loses previously learned words or phrases.
· Struggles to start or maintain conversations, or only begins one to make requests or label items.
· Has trouble interpreting nonverbal cues, such as others’ facial expressions, body language, or tone of voice.
· Uses an unusual tone or rhythm, such as a singsong or robot-like voice.
· May not understand simple questions or directions.
· Shows limited emotional expression and may seem unaware of others’ emotions.
· Repeats phrases or words verbatim, without understanding their use.
· Does not point at or bring objects to share interest with others.
· Difficulties engaging in imaginative play or connecting with others to build friendships.
· Approaches social interactions in ways that can be passive, aggressive, or disruptive.
· Have difficulties with the back and forth of conversation.
· Talks about a narrow range of topics.
Repetitive/restrictive patterns
Children or adults with autism spectrum disorder may display restricted, repetitive patterns of behavior, interests, or activities. These can include:
· Establishing specific routines or rituals and becoming upset over small changes.
· Repetition of the same movement and/or sounds (stimming)
· Being overly sensitive to light, sound, or touch, but sometimes indifferent to pain or temperature
· Doing activities that might cause self-harm, such as biting or head-banging
· Showing coordination issues or unusual movement patterns, like clumsiness, toe-walking, or stiff body language
· Focusing intensely on small details of objects, like the spinning wheels of a toy, while missing their overall purpose
· Avoiding imitative or pretend play
· Fixating on objects or activities with abnormal intensity or focus
· Having selective eating habits, such as only eating certain foods or avoiding specific textures
· Reacts strongly to certain fabrics or other things on their skin.
· Engaging in repetitive movements like rocking or flapping their hands
What strengths do autistic individuals have?
Autistic individuals may have unique strengths that make them special. Some of these strengths can help them excel in various areas and they include:
· An ability to learn and retain detailed information for extended periods
· Strong skills in visual and auditory learning
· Exceptional abilities in areas such as math, science, music, or art
· Exceptional focus and concentration: They can immerse themselves deeply in tasks or areas of interest, often sustaining focus for long periods.
· Honesty and reliability: People with ASD are often known for their sincerity, straightforwardness, and honesty, as they tend to express thoughts openly and avoid hidden agendas.
· Great attention to small details
· Logical and analytical thinking: They may approach problems methodically and excel at logical reasoning, making them great problem solvers.
· Strong sense of fairness and sticking to rules.
· Excellent memory, especially for facts, figures, and past events, which can be helpful in academic and work settings.
· Passionate about their interests and often very knowledgeable
· High Standards for accuracy and quality.
What are the causes/risk factors for autism?
The exact causes of ASD are complex and not fully understood, but research points to a combination of genetic, environmental, and neurological factors. Below are some known causes and risk factors:
· Having a sibling or parent with autism increases the risk.
· Genetic changes affecting brain development are linked to autism.
· Genetic disorders like Fragile X syndrome or Rett syndrome are associated with autism.
· Advanced parental age at conception
· Complications like premature birth, low birth weight, or toxin exposure during pregnancy increase risk.
· Maternal health problems, such as diabetes or infections during pregnancy, may raise the risk.
· Exposure to air pollution, pesticides, or heavy metals during pregnancy can contribute to autism.
The causes of autism are very complicated and not tied to a single, specific cause or gene variation, unlike other conditions, where a particular gene mutation or cause can be clearly identified. Instead, autism involves multiple gene variations, each contributing to differences in brain development. Autistic individuals may have one or more of these variations, which interact with other factors to influence their unique traits and challenges.
Autism and vaccines?
One of the most debated topics regarding autism spectrum disorder (ASD) is whether childhood vaccines play a role in its development. Extensive research has found no reliable evidence linking vaccines to autism. The original study that fueled this misconception was retracted due to flawed methods and unreliable findings. Skipping childhood vaccinations does not protect against autism but instead increases the risk of dangerous diseases like measles, mumps etc, which can threaten both a child’s health and the wider community.
How is autism diagnosed?
Autism is typically diagnosed through a combination of:
· Developmental Screening: Healthcare providers evaluate a child’s early milestones and behavior. Delays in speech, eye contact, or social interactions may raise concerns.
· Comprehensive Evaluation: Specialists, such as pediatric neurologists or developmental psychologists, then conduct in-depth assessments. These include observing behavior, interviewing caregivers, and using standardized tools like the Autism Diagnostic Observation Schedule.
· Medical Tests: While there is no medical test specifically for autism, hearing tests, genetic testing, and neurological exams help rule out other conditions.
According to the DSM-5, the criteria for diagnosing autism include:
1. Persistent difficulties with social communication and interaction, such as challenges in:
· Using or interpreting verbal and nonverbal communication.
· Forming and maintaining relationships.
· Understanding social norms.
2. Restricted and repetitive behaviors, interests, or activities, such as:
· Repetitive movements or speech (e.g., hand flapping or repeating phrases).
· Insistence on routines or resistance to change.
· Intense focus on specific interests or sensory sensitivities (e.g., aversion to loud sounds or bright lights).
These symptoms must be present early in development, significantly affect daily functioning, and cannot be better explained by other conditions.
Most diagnoses occur by age 2, though some individuals may not be identified until later. Early diagnosis is crucial for effective intervention. The severity of autism may be difficult to assess due to the unique combination of symptoms in each child. It is typically determined by evaluating the extent of impairments and how they affect the individual’s ability to function in daily life.
How is autism treated?
While there is no cure for autism, personalized management plans can greatly improve quality of life:
· Applied Behavior Therapy: Focuses on improving social, communication, and daily living skills.
· Speech and Occupational Therapy: Helps with language development, sensory issues, and motor skills.
· Educational Support: Individualized education programs in schools provide tailored learning approaches.
· Medications: Used to address specific symptoms, such as anxiety, hyperactivity, or sleep problems.
· Family and Caregiver Support: Training and support groups help families better understand and care for their loved ones.
· Community and Social Integration: Programs that teach social skills and provide sensory-friendly environments encourage inclusion.
Summary
Autism is not a disease, which means it is not something to be “cured.” Instead, the focus is on helping individuals recognize and build on their strengths while addressing the challenges they may face. Autistic individuals are considered neurodivergent, meaning their brains function differently from the typical or expected way and this often allows them to excel in certain areas while requiring extra support in others, compared to their neurotypical peers. Autism also exists on a spectrum, highlighting the uniqueness of every individual, whether they are children or adults. And just like everyone else, autistic people have their own combination of personality traits, abilities, and challenges. By fostering understanding and inclusivity, we can ensure that autistic individuals have the support they need to thrive in their unique ways.
