“If they can’t learn the way we teach, we teach the way they learn.”
Dr. O. Ivar Lovaas
The need for specialized care and management for patients with rare disorders has seen advancements with the recent expansion of technology and awareness. Autism Spectrum Disorder is a widespread condition that has progressed due to external and internal factors taking a toll on a substantial amount of people globally.
Around 1% of the World’s population has Autism Spectrum Disorder according to 2023 research statistics. To gain more insight into all aspects of ASD, including management and diagnosis, we have created a comprehensive article for your convenience below.
Autism Spectrum Disorder (ASD) is considered a complex neurodevelopmental condition. It is a disorder causing a broad range of conditions as referred to by the word ‘Spectrum’ in the term. It directly affects developmental characteristics such as social communication, behavior, interaction, and sensory processing.
The onset of ASD can begin in early childhood, but the symptoms can be more apparently observed as the child reaches 2–3 years of age. It causes restrictive and repetitive behaviors with varying degrees of impairment. It can range from mild to severe symptoms, along with facing a variety of challenges and displaying strengths in particular areas.
The exact origins of autism spectrum disorder (ASD) are unresolved, although researchers think that a combination of genetic and environmental factors influences this. ASD is identified by a child’s behavior and development, and its treatment and management are also individualized. They vary from person and person owing to the severity of their condition.
The symptoms that are visible for ASD differ in every individual. Medical professionals usually utilize an Autism Spectrum Disorder checklist, which helps diagnose every symptom separately. Discussing the symptoms of ASD can be determined by focusing on the characteristics individually:
- Lack social-awareness
- Difficulty making and maintaining eye contact
- Fail to read facial expressions and body language
- Delayed speech
- Verbal incoherence and confused speech
- Evident Echolalia (repeating words spoken by others)
- Strong aversion to cope with change
- Not flexible to adjust to new environments or situations
- Lack of creating age-appropriate relationships
- Inclination in expecting others to show shared interest towards their subjects of interest
- Limitations in sharing interests and emotions
- Abnormal Motor Movements
- Repetition in activities such as rocking, hand-flapping, etc.
- Hypersensitivity to factors such as bright lights, loud noises, strong taste, etc.
- Defensive actions towards heightened factors such as covering eyes against bright light etc.
Although in the Diagnostic and Statistical Manual of Mental Disorders (DSM), 4th Edition, autism was divided into 4 separate diagnostic categories, but in DSM 5 it differs. DSM 5 is considered the standard mental disorder diagnostic manual in the U.S.
Its release in 2023 led to determining autism under only one category, in which ASD was classified according to its level of severity. The DSM 5 autism spectrum disorder is characterized as follows.
The mildest form of ASD comes under Level 1. Children and Adult diagnosis is included in this. They require support to lead a normal life. These patients were generally previously diagnosed with Asperger’s Syndrome and also faced high-functioning autism (HFA) spectrum disorder.
HFA patients usually show intellectual disability but mostly communication challenges. The individuals who have this ASD Level 1 disorder have difficulty in maintaining friendships. Reading social cues and participating in activities is also challenging for them.
The middle level of ASD is under Level 2. Substantial support is required for them to lead a balanced life. Repetitive and restrictive behaviors are observed in these patients. This can hinder their daily activities and need treatment and support.
This type of autism spectrum disorder is considered the most severe of all. These patients might exhibit incoherent speech, lack of communication of basic needs, levels of aggression, and self-harm. Thus, they require very substantial support. This can develop rapidly from child stage to adolescence to being an adult.
The autism spectrum test is a diagnostic assessment administered by medical professionals to observe consistent ASD symptoms. Interviews, evaluations, and observations are involved in these tests to determine results. 3 tests that are prevalent in this regard are determined as follows.
This test includes play-based assessment. It is used for children or adults. Social communication fluency and interaction abilities are evaluated in ADOS-2.
- It has 5 modules which are used according to the patient’s age.
- These are TCM(12-30 Months), T(31-447 months), C(48-71 months), A (8-16 years), and M (17 years and older).
- The test takes 40–60 minutes to complete.
This type of test for ASD is a semi-structured test. It focuses on observing and testing social interaction, repetitive behaviors, restricted interest, and sensory sensitivity in patients.
- It is generally administered to children.
- This is considered the gold standard for ASD diagnosis.
Developed in the 1960s by Eric Schopler, Robert Reicher, and Barbara Rochen Renner , CARS is one of the most well-regarded ASD diagnostic tests worldwide. Communication, general intellect, restricted interests, and abnormal behavior are all observed in this test.
- It is among the oldest and most frequently employed ASD testing techniques.
- The CARS is a 15-item scale of rating that examines the child’s actions and progress across many domains.
Asia is the most affected area in regard to ASD in other parts of the world. Research published in 2014 in Nature Reviews Neurology indicated that the incidence of ASD in Asia was 1.6%, higher than the rates in North America (1.3%) and Europe (1%). To understand this more, we are discussing two countries that show a high rate of ASD along with their ways of management below.
The prevalence of ASD in Singapore is high. Owing to genetic mutation and disorders, environmental factors such as pesticides and age lead to a high number of ASD patients. More awareness and testing have led to more support coming out for these individuals to aid them in leading a balanced life.
- Leading to recent years, every 1 out of 150 children has been diagnosed with ASD. As per this, 0.67% of children in Singapore have ASD.
- According to Wisevoter studies, it is 561.99 per 100k of the population. This means 0.56% is affected according to this research.
- The Autism Resource Center (ARC), The Autism Association of Singapore (AAS), The National Autism Center (NAC) are all government-funded and research centers set up in Singapore. These are established to support children and adults with ASD within Singapore.
Another Asian country that is highly affected by ASD is China. Genetic disorders, environmental factors, lack of prenatal care, and lack of early childhood education are factors that affect the prevalence of autism spectrum disorder in Chinese.
- According to various research, in recent years, 1-2% of people in China have ASD.
- The autism rate in Chin according to Wisevoter studies is 350.53 per 100k of the population. It means 0.35% of China is affected by ASD.
- Intervention programs, educational support, and research centers are set up in China to aid patients with ASD to live a more balanced life.
There is generally no cure for ASD, but it is managed and controlled in a number of ways. Common ASD treatments are conducted by medical professionals, doctors, trained Autism Spectrum Therapists, and physicians. These treatments include the following.
It is a form of corrective therapy that focuses on positive reinforcement. Modifying behaviors through a systematic approach is applied in this.
In this therapy one-on-one teaching method, the medical professional is applied to the patient. It is designed to break down tasks into smaller units to release stress and improve technical and intellectual abilities.
Speech articulation, language expression, and perception abilities are focused on this. The use of AAC devices is common in this to help ASD patients expand their verbal skills.
To enhance motor skills and boost everyday activities, occupational therapy is used. Sensory hypersensitivity is managed through this to help conduct tasks with ease.
To help with anxiety, repetitive behaviors, and hyperactivity, medication is also utilized to control ASD. Respective healthcare professionals can only advise medication according to the patient’s condition.
Autism is a condition that affects a significant population globally. However, related to this is a subcategory. Autism Spectrum Disorder, which has diagnoses patients with retention in speech and impaired interaction and intellectual abilities.
Managing this situation in its entirety depends on its level of severity. Different management programs are available around the world for corrective therapy and other therapies to help individuals who have ASD lead a healthy and balanced life.
ASD is a neurological developmental disability that stems from innate brain abnormalities. It is a lifelong condition.
Although there are two distinct conditions, there may be some overlapping in some of their symptoms. Both ADHD and ASD may coexist in certain individuals. Research indicates that as many as 30% of those diagnosed with ADHD may also have ASD, which is called “comorbidity.” Both of them have communication difficulties and have repetitive behaviors. However, they also exhibit symptoms that are different.
Before the DSM-5, these were the five distinct forms of ASD, which are as follows.
- Autistic disorder
- Pervasive developmental disorder not otherwise specified (PDD-NOS)
- Asperger’s syndrome
- Rett syndrome
- Childhood disintegrative disorder
Because of their shared diagnostic criteria, the DSM-5 combined all five subtypes of ASD into a single disorder.