Autism, In A Nutshell

April 2nd, 2021, the world celebrated World Autism Acceptance Day and April is now celebrated as NATIONAL AUTISM  ACCEPTANCE MONTH. Here at Verge Learning, we wanted to take a moment and share some general information on Autism to bring awareness to the those who may not be aware of Autism spectrum disorder. 

What is ASD? Autism spectrum disorder (ASD) is a neurodevelopmental disorder that can cause significant social, communication and behavioral challenges. 

A diagnosis of ASD now includes several conditions that used to be diagnosed separately: autistic disorder, pervasive developmental disorder not otherwise specified (PDD-NOS), and Asperger syndrome. These conditions now fall under the umbrella of autism spectrum disorder.

It is usually characterized by the following:

• Difficulties in social communication, including verbal and nonverbal communication.
• Deficits in social interactions.
• Restricted, repetitive patterns of behavior, interests or activities and 
• Sensory Concerns

Many individuals with ASD can have delayed or absence of language development, intellectual disabilities, poor motor coordination and cognitive difficulties like focus and sustaining attention.

The range and severity of symptoms can vary widely.

How is it diagnosed? Unfortunately, there are no specific medical tests to determine ASD. However, certain healthcare providers such as developmental pediatricians, child neurologists and child psychologists receive specific training and perform screenings and evaluations, a lot of which includes observations from parents, caregivers and teachers, which help them determine the diagnosis. The child’s behavior and development are key indicators. 

At what age can it be diagnosed? ASD can sometimes be detected at 18 months or younger. By age 2, a diagnosis by an experienced professional can be considered very reliable. However, many children do not receive a final diagnosis until much older, which may be either due to mild presentation of symptoms or lack of awareness on the families’ part.

While ASD is believed to be a disorder of very early brain development, the behavioral signs of autism characteristics surface between age 1 and ½ years of age and 3 years of age.

What causes autism spectrum disorder (ASD)?

• Research shows that there may be different factors that make a child more predisposed to having ASD, including environmental, genetic and biological factors.
• Environmental risk factors include advanced parental age, low birth weight, prematurity and other birth complications, among others.
• Specific genetic causes can only be identified in 10% to 20% of cases. These cases include specific genetic syndromes associated with ASD and rare changes in the genetic code.
• Individuals with certain genetic or chromosomal conditions, such as fragile X syndrome or tuberous sclerosis, can have a greater chance of having ASD.
• Ongoing research continues in this area.
  
  

Let’s look at the signs and symptoms of autism spectrum disorder (ASD). Signs of ASD range from mild to severely disabling, and every person is different. The following signs are considered to be red flags that indicate your young child may be at risk for autism.

• Not responding to their name being called at all or responding inconsistently.
• Absence of smiling widely or making warm, joyful expressions by the age of 6 months.
• Does not make sounds or make faces with you or other people by the age of 9 months.
• No babbling by 12 months.
• No back-and-forth gestures such as showing, pointing to objects of interest, reaching out for toys/people or waving by 12 months.
• Not looking at objects when others point to them.
• No meaningful words by 16 months, and two-word phrases (not including imitating or repeating) by 24 months.
• Trouble expressing their needs using typical words or motions.
• Appear to be unaware when people talk to them, but respond to other sounds.
• Inability to play “pretend” games (for example, not pretend to “feed” a doll).
• Repetitive actions.
• Difficulty adapting to changes in routine.
• Lose skills they once had (for example, stop saying words they were using).
• Have trouble relating to others or not have an interest in other people at all.
• Avoiding eye contact.
• Have trouble understanding other people’s feelings or talking about their own feelings.
• Prefer not to be held or cuddled, or might cuddle only when they want to.
• Sometimes show interest in people, but lack the ability to talk, play, or relate to them.
• Echolalia

Associated Medical & Mental Health Conditions

• Autism can affect the whole body.
• Attention Deficit Hyperactivity Disorder (ADHD) affects an estimated 30 to 61 percent of children with autism.
• More than half of children with autism have one or more chronic sleep problems.
• Anxiety disorders affect an estimated 11 to 40 percent of children and teens on the autism spectrum.
• Depression affects an estimated 7% of children and 26% of adults with autism.
• Children with autism are nearly eight times more likely to suffer from one or more chronic gastrointestinal disorders than are other children.
• As many as one-third of people with autism have epilepsy (seizure disorder).
• Studies suggest that schizophrenia affects between 4 and 35 percent of adults with autism. By contrast, schizophrenia affects an estimated 1.1 percent of the general population.
• Autism-associated health problems extend across the life span – from young children to senior citizens. Nearly a third (32 percent) of 2 to 5 year olds with autism are overweight and 16 percent are obese. By contrast, less than a quarter (23 percent) of 2 to 5 year olds in the general population are overweight and only 10 percent are medically obese.

Prevalence of Autism?

• In 2020, the CDC reported that approximately 1 in 54 children in the U.S. is diagnosed with an autism spectrum disorder (ASD), according to 2016 data.
  • 1 in 34 boys identified with autism
  • 1 in 144 girls identified with autism
• Boys are four times more likely to be diagnosed with autism than girls.
• Most children were still being diagnosed after age 4, though autism can be reliably diagnosed as early as age 2.
• 31% of children with ASD have an intellectual disability (intelligence quotient [IQ] <70), 25% are in the borderline range (IQ 71–85), and 44% have IQ scores in the average to above average range (i.e., IQ >85).
• Autism affects all ethnic and socioeconomic groups.
• Minority groups tend to be diagnosed later and less often.
• Early intervention affords the best opportunity to support healthy development and deliver benefits across the lifespan.
• There is no medical detection for autism.

Are siblings at greater risk for autism spectrum disorder (ASD)? Genetics do play a role in autism. When one child is diagnosed with ASD, the next child to come along has about a 20% greater risk of developing autism than normal. When the first two children in a family have both been diagnosed with ASD, the third child has about a 32% greater risk of developing ASD.

How is autism spectrum disorder (ASD) treated? There is no medicinal cure for ASD, and it is most often a life-long condition. Both children and adults with autism benefit from behavioral interventions or therapies that can teach them new skills to address the core deficits of autism and to reduce the intensity of the core symptoms. Every child and adult with autism is unique. For this reason, the treatment plan is individualized to meet specific needs. It is best to begin interventions as soon as possible, so the benefits of therapy can continue on throughout the course of life. Even if your child has not been diagnosed with an ASD, he or she may be eligible for early intervention treatment services.

Research shows that early intervention leads to positive outcomes later in life for people with autism. Children under the age of 3 years are eligible for early intervention services.

Many people with ASD often have additional medical conditions, such as gastrointestinal and feeding issues, seizures and sleep disturbances. Treatment can involve behavioral therapy, medications or both.

Early intensive behavioral treatments involve the entire family and possibly a team of professionals. As your child ages and develops, treatment may be modified to cater to their specific needs.

During adolescence, children benefit from transition services that promote skills of independence essential in adulthood. The focus at that point is on employment opportunities and job skill (vocational) training.

In addition, treatment for particular symptoms, such as speech therapy for language delays, often does not need to wait for a formal ASD diagnosis.

Services that are usually provided:

• Applied Behavior Analysis (ABA)
• Occupational Therapy
• Speech Therapy
• Physical Therapy
• Assistive Technology
• Developmental, Individual Differences, Relationship-Based Approach (also called “Floortime”)
• Treatment and Education of Autistic and related Communication-handicapped CHildren (TEACCH)
• Social Skills Training

What is the outlook for people with autism spectrum disorder (ASD)? People with ASD may go on to live typical lives, but there is often need for continued services and support as they age. The needs depend on the severity of the symptoms. For most, it’s a lifelong condition that may require ongoing support. In many cases, the symptoms of ASD become less pronounced as a child gets older, probably due to early detection and intervention, and regular therapy.

Careers For People With Autism People with autism perform best in positions that maximize their strengths and minimize their weaknesses. In general, they should seek jobs that provide structure, require attention to detail and avoid those that regularly involve intense interpersonal work or require a strong short-term memory. Here are eight types of occupations that may be a good fit for someone on the autism spectrum.

• Animal science. For those who enjoy working with pets, career options include veterinary technician, groomer, obedience trainer, dog walker or pet sitter. Individuals who are comfortable with large animals could also consider occupations such as equine trainer, livestock handler or zookeeper.
• Researcher. People with autism can leverage their interest in facts to pursue a career in research. In many of these positions, their tendency to be logical and unemotional is an advantage because it enables them to present the information they find without personal bias. Careers for people with autism exist in many different fields and require various levels of education. Possible jobs include reference librarian, title abstractor, fact-checker, genealogist or research assistant.
• Accounting. If your child excels in mathematics, a career that focuses on numbers may be a great fit. Like research, there are many related jobs at a variety of different skill and education levels. People with autism can excel in careers such as forensic accountant, CPA, tax preparation specialist, bookkeeper, billing specialist and accounts payable clerk.
• Shipping and logistics. The freight hauling and logistics industry offers many different types of jobs. For those who are confident drivers, there are driving jobs that range from operating a tractor-trailer to delivering mail on rural routes. Non-driving jobs that may be suitable for someone with ASD include package handler, load supervisor and mail processor.
• Art and design. As previously mentioned, many people with ASD are very visually oriented and excel at creating 2D or 3D images. These skills can be translated into a variety of creative or industrial careers including animator, CAD designer, photographer, architect, illustrator or artist.
• Manufacturing. Many people with autism perform best in a structured environment. These individuals may excel at jobs in manufacturing, a field that relies on consistent, routine processes. If your child enjoys tasks that involve assembling components, he or she may be interested in a career as a machinist, baker, fabricator, machine operator, woodworker, assembler or welder.
• Information technology. Many IT positions are very specialized and performed “behind the scenes,” which may be appealing to someone with autism. To identify appropriate roles, pay attention to the way the employer describes both the position and work environment. People with ASD can excel in roles like network engineer, web developer, web designer, software engineer and database administrator but would be wise to avoid positions that are described as “client-facing” or that operate in an “agile environment.”
• Engineering. Like IT, engineering offers many technical positions that are very attractive to detailed oriented individuals. If your child has strong math and science skills, he or she may want to consider a career in civil, chemical, electrical, biomedical or mechanical engineering.

REFERENCES
https://my.clevelandclinic.org/health/diseases/8855-autism
https://www.cdc.gov/ncbddd/autism/index.html    
https://lexingtonservices.com/career-paths-for-people-with-autism/    

RESOURCES FOR PARENTS
https://www.autismspeaks.org/what-autism