What is Autism? Symptoms, Causes, Diagnosis, and Treatment Process

Autism

Autism Spectrum Disorder (ASD) is a neurodevelopmental difference that causes symptoms such as difficulties in communication and social interaction, and repetitive behaviors. Thought to be caused by the influence of genetic and environmental factors, autism can manifest in different ways. Although there is no definitive cure for autism, early diagnosis can improve children's communication and social interaction skills. Contrary to popular belief, ASD is not a disease but a neurological difference. In this context, rather than treating the disorder, it is important to focus on how the child can cope with the challenges they may encounter in life.

What is Autism?

Autism is a neurodevelopmental disorder characterized by deficits in social interaction and communication, repetitive behaviors, and restricted interests. At the root of the disorder lies the fact that the brain region responsible for determining the communication a child establishes with their environment functions differently than it should. An ASD diagnosis can sometimes be made in adulthood. A late diagnosis can lead to the perception that the disorder can be acquired later due to reasons such as poor parenting or psychological trauma experienced by children. However, people with the syndrome are neurodivergent; that is, the brains of people with ASD function differently from birth than they should. For this reason, children with autism may be more successful in different areas than their peers while needing help in other areas.

According to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), ASD is defined as differences in brain function that cause persistent deficits in multiple areas of social communication and interaction, currently or in the past. Research shows that 1 in every 100 children worldwide has ASD, and cases may be more prevalent in low- and middle-income countries.

ASD is characterized by social, communicative, and behavioral challenges. The developing challenges can be mild, moderate, or severe depending on the support the person needs. With the DSM-5, all different types of autism are addressed under the heading of ASD. Some types defined according to older classifications before the DSM-5 are as follows:

Asperger syndrome: Located at the milder end of the spectrum, Asperger syndrome usually manifests itself with high intelligence, advanced language skills, and the ability to carry out daily life activities independently. While Asperger was considered a standalone diagnosis before the DSM-5, it is now addressed under ASD. Although they may experience some difficulties in socialization, people with Asperger syndrome can have deep knowledge, especially in subjects that interest them, and can talk about these subjects for a long time.

Atypical autism: Also known as atypical pervasive developmental disorder, atypical autism is used to describe people who show symptoms that are more severe than Asperger syndrome but milder than autistic disorder. Although typical symptoms such as difficulty in social communication are seen among the symptoms of the syndrome, repetitive behaviors or restrictive interests may not be present.

Autistic disorder: Autistic disorder manifests with more severe symptoms compared to Asperger and atypical autism.

Childhood disintegrative disorder (CDD): Also known as Heller's syndrome, childhood disintegrative disorder is in the rarest and most severe part of the spectrum. This disorder can manifest itself with children who show normal development rapidly losing their social interaction, language, and mental skills when they reach the 2-4 age range. At the same time, neurological problems such as epilepsy can also develop in infants and children with CDD.

Today, all of the disorders listed above are addressed under the heading of ASD. However, because the World Health Organization diagnostic criteria are used in Turkey, families may sometimes encounter an atypical autism diagnosis in their children's health reports.

How Does Autism Occur?

Autism spectrum disorder is accepted as a difference that arises from the influence of both hereditary and environmental factors. Although the exact cause is not fully known, it is thought that various factors affecting brain development can lead to this disorder. For example, factors such as complications during pregnancy, parental age, and low birth weight can increase the risk of the disorder. Accordingly, the possible causes of ASD can be listed as follows:

Genetic factors: Genetic factors can play a role in the formation of ASD. There are various studies showing that some cases may be associated with specific genetic syndromes or mutations. However, it is difficult to say that there is a specific gene or mutation that causes this difference. ASD can arise from the influence of various genes. Genetic factors can affect brain development, communication between neurons in the brain, and the severity of symptoms. Some genetic disorders such as Rett syndrome or fragile X syndrome can cause neurodevelopmental differences.

Environmental Factors: Research suggests that factors such as viral infectious diseases, certain medications used during pregnancy, pregnancy complications, and exposure to environmental pollutants may increase the risk of ASD.

In addition to those listed, some factors may increase the risk of developing ASD. Accordingly, the main risk factors can be listed as follows:

Gender: According to research, boys carry four times the risk of ASD compared to girls.

Family history: The risk of the disorder may be higher in children who have any ASD diagnosis in their family.

Premature birth: Various studies show that the risk may increase in babies born before 26 weeks.

Age of mother and father: There are some studies showing that the risk increases depending on becoming a parent at an advanced age.

Additionally, various studies conducted in recent years show that there is no scientific basis for the claim that vaccines administered in childhood cause the disorder.

What Are the Symptoms of Autism?

The spectrum that gives autism spectrum disorder its name means diversity. For this reason, symptoms may vary according to age and the type of disorder. Symptoms of autism in infants include inability to establish eye contact, not responding to their name, and a dull facial expression. While symptoms of autism in a 6-month-old baby may not be clearly understood, symptoms may become more apparent as the baby grows. For example, failure to respond to sounds or lack of interest in the environment can be observed as symptoms of autism at 1 year of age, and speech delay and repetitive behaviors can be observed as symptoms of autism at 2 years of age. Accordingly, the main symptoms are as follows:

Deficits in social communication and interaction: Children with ASD may have difficulty establishing eye contact or understanding the facial expressions of the person they are talking to. They usually do not respond when called by their name and may remain uninterested in the people around them. In addition, they may have difficulty expressing their emotions and understanding the feelings of others.

Language and communication problems: Speech delay may be seen in some infants and children, and some children may not speak at all. Children who have the ability to speak may speak in a monotonous tone or in a robotic style. Even those with developed speech skills may have difficulty starting and maintaining a conversation and may prefer to communicate only when they need to. On the other hand, it can be observed that those with differences such as Asperger syndrome have quite developed speech and language skills.

Repetitive behaviors and adherence to routines: People with the difference may show the behavior of frequently repeating the same movement, such as clapping hands, spinning, or repeating certain sounds. Even the slightest change in daily routines can cause these individuals to experience intense stress and anxiety. Additionally, they may tend to show excessive interest in certain objects or topics.

Sensory sensitivity: Some individuals with the disorder may react unusually to sensory stimuli such as light, sound, or touch. For example, while some children may be hypersensitive to loud noises or bright lights, others may remain unresponsive to sensations such as pain or temperature.

The listed symptoms can appear at different levels in each person. With early diagnosis and appropriate treatment planning, the severity of symptoms can be mitigated, and the person's quality of life can be significantly improved.

How Is Autism Diagnosed?

There is no specific autism test that can be used for diagnosis today. However, experts can make a diagnosis by evaluating the person's social, communicative, and behavioral characteristics in detail. For this reason, experts recommend that children undergo ASD screening during childhood, especially when babies are 18-24 months old. The main diagnostic methods used by experts are as follows:

Developmental screening: The first step of diagnosis is to evaluate the child's developmental process. Children are screened for signs of developmental delay during routine check-ups. In the process where the child's cognitive, language, social, and motor skills are examined, if pediatricians suspect the presence of a neurodevelopmental difference in the child, they may refer families to specialists such as a developmental pediatrician, child neurologist, psychologist, and speech therapist.

Behavioral observation: Information obtained from the family about the child's early developmental characteristics, behaviors, and social interactions is important for experts. Having information about children's social interactions, ways of playing, and communication with their environment can help the diagnostic process.

Additional tests: In some cases, genetic tests or neurological scans may be performed to determine whether the symptoms are caused by another neurological or genetic disorder.

In the diagnosis of ASD, experts make an assessment according to DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) criteria. According to the DSM-5, ASD is defined as significant differences seen in social interaction, difficulties in language, and repetitive behaviors. The presence of one or more of these may cause experts to suspect ASD.

How Is Autism Treated?

Although there is no definitive cure for ASD today, supportive therapy and education applied from an early age can help improve individuals' social, communicative, and behavioral skills. Thus, the autism treatment process requires a multidisciplinary approach. The main methods frequently used by experts in the treatment process are as follows:

Behavioral therapies: Behavioral therapies such as applied behavior analysis therapy help people with the disorder gain social skills and reduce repetitive behaviors. Applied behavior analysis, which is based on the principle that children will repeat certain behaviors when they are rewarded, can help the child abandon repetitive behaviors. In addition, speech therapy and occupational therapy can contribute to the development of communication and motor skills.

Medication: Although there is no specific medication for ASD, in some cases, medications can be used to manage symptoms such as the individual's sleep problems, anxiety, attention deficit, or hyperactivity.

Family education and support programs: Families receiving training on managing their children's behaviors, communicating, and improving daily living skills can play an important role in the development of children with the disorder.

Social skills training: If symptoms of autism are observed in adults, special training programs aimed at increasing social skills can be applied. Programs can improve a person's ability to express themselves in communication, build friendships, and move more comfortably in society.

Sensory therapy: For some individuals, stimuli such as touch, sound, or light are quite disturbing. For those with symptoms related to stimuli, sensory integration therapies that help them become more compatible with stimuli can be applied.

These supportive treatment methods started at an early age are important for individuals with ASD to develop independent living skills and adapt to social life.

Frequently Asked Questions

Atypical autism, which is one of the subtypes of autism, is a type of ASD characterized by symptoms that are more severe than Asperger syndrome but milder than autistic disorder. While difficulties in social communication may be seen in these individuals, repetitive behaviors and restricted interests may not be seen. The risk of the disorder may be higher in people who have any ASD diagnosis in their family members. Also, some genetic diseases can increase the risk. However, genetic factors alone cannot explain neurodevelopmental differences. ASD is a neurodevelopmental difference that starts in childhood and lasts a lifetime, causing differences in social interaction, communication, and behavior. Although ASD types are defined under a single umbrella according to the DSM-5, according to old definitions, autism is divided into subcategories such as Asperger syndrome, atypical autism, autistic disorder, and childhood disintegrative disorder. The mildest ASD is generally considered to be Asperger syndrome. Although people with Asperger syndrome experience some difficulties in social life, they can usually live independently. Additionally, no significant deficit is seen in the language and cognitive skills of these people. The lifespan of people with ASD varies depending on their general health status and the degree to which they are dependent on others, similar to other people in society. Today, there is no treatment method that will allow children with ASD to return to completely normal. However, supportive therapies started at an early age can help children improve their skills and adapt to social life more easily. ASD is not a temporary difference. However, typical symptoms such as avoiding eye contact, speech delay, or social indifference can arise due to developmental delay or other reasons. Experts examine the child in detail before making a definitive diagnosis. Although genetic factors are important in the development of the disorder, it is not possible to talk about a gene known to cause autism today. As a result, it is also difficult to say who the ASD gene will be transmitted from. Severe autism symptoms include difficulty in speaking, in some cases not being able to speak at all, avoiding eye contact, intense repetitive behaviors, and reacting violently to stimuli such as sound and light.

When you think there are symptoms of autism, early evaluation makes a big difference.

You can make an appointment with our Child and Adolescent Psychology specialists for an accurate diagnosis and personalized support programs.