Autism Spectrum Disorder (ASD)

 

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by challenges in social interaction, communication, and behavior. It often presents in early childhood and varies in severity. While most children with autism have normal to decreased intellectual abilities, the occurrence of extremely high skills or “savant” abilities is uncommon.

Key Features

i. Impaired Language and Communication
Children with ASD may struggle with language development, finding it difficult to start or maintain conversations.
They may use repetitive language or have trouble understanding non-verbal cues like facial expressions and body language.

ii. Impaired Social Relationships
Difficulty in forming relationships with others is a hallmark of ASD. Children might show little interest in playing or interacting with peers and may prefer to be alone.
They often struggle with understanding others’ feelings or emotions, making social interaction challenging.

iii. Compulsive and Repetitive Behaviours
Individuals with ASD may engage in repetitive actions or have a strong preference for routines. This includes repetitive movements, like hand-flapping or rocking, or repetitive interests, such as lining up toys or repeatedly building the same structures with blocks.

iv. Restricted Interests and Collecting Behaviours
It’s common for children with ASD to develop intense interests in specific subjects or objects. For example, a child might collect hundreds or even thousands of toy cars or have an obsession with a particular topic, such as trains or dinosaurs.

v. Excessive Mood Swings
Mood changes can be frequent, with children showing signs of frustration, anxiety, or even aggressive behaviour, especially when their routines are disrupted.

Intellectual Abilities
i. While ASD affects individuals across all levels of intelligence, most children exhibit decreased IQ levels. However, a small subset of individuals may demonstrate exceptional skills in specific areas, such as mathematics, music, or art. This phenomenon is referred to as “savant” abilities, but it is rare.

Common Triggers for Presentation
i. Children with ASD may not exhibit all symptoms until there is a significant change in their environment or routine. Common triggers that lead to noticeable symptoms include:
. Starting a new school
. Moving to a new home
. The death or absence of a loved one
. Changes in daily routines

Diagnosis
. Recognition: Diagnosis involves identifying traits related to social interaction, communication, and behaviour. Key indicators include difficulty with social responsiveness, challenges in interpreting non-verbal cues, and repetitive interests or behaviours.
. Diagnosis Process: This requires a comprehensive history from family or caregivers, focusing on current presentation, neurodevelopmental history, and any previous assessments.
. Assessment: A multidisciplinary approach is used to evaluate strengths, skills, and impairments, forming the basis for individualized management plans.

Management

General Management: Emphasizes education, training, and social support to help individuals live independently, with adaptations to meet their specific needs.

Psychiatric Management:
Medication: Not routinely used for core autism features, but may be considered for co-occurring conditions like ADHD or epilepsy, with careful monitoring.
Psychological Interventions: Focus on reducing anxiety, improving social understanding, and managing co-occurring psychiatric issues.