asd

Autism Spectrum Disorder

Autism spectrum disorders (ASD) is a neurodevelopmental disorder.

The etiology is multicausal with genetic involvement and environmental factors. People with ASD may behave, communicate, interact, and learn in ways that are different from most people.

The abilities of people with ASD can vary significantly. For example, some people with ASD may have advanced conversation skills, while others may not express themselves verbally. Some people with ASD need a lot of help in their daily lives; Others can work and live with little or no help.
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ASD appears before the age of three and symptoms last throughout life. The first warning signs appear at 12 months. Some children with ASD may stop acquiring new skills or lose the ones they already had.
As children with ASD become adolescents and young adults, they may have difficulty forming and maintaining friendships, communicating with peers and adults, or understanding what behaviors are expected of them at school or work.

They may reach out to health care providers because they also have conditions, such as anxiety, depression, or attention-deficit/hyperactivity disorder, which occur more frequently in people with ASD than in people without ASD.

ASD in a snapshot

WHAT IS IT

Autism spectrum disorder (ASD) affects communication, behavior and socialization. It is a "spectrum" because of the wide range of symptoms.

SYMPTOMS

Difficulties in verbal and non-verbal communication.
Repetitive or stereotyped behaviors.
Problems understanding and expressing emotions.
Increased or decreased sensitivity to sensory stimuli.
There may be developmental delays, but not always.

CAUSES

Multicausal etiology.
Combination of genetic and environmental factors and neurobiological impairment.

STATISTICS

Approximately 1 in 59 children is diagnosed with ASD.
It is more common in boys than in girls.
No two people with autism are exactly the same.
Many adults with autism are undiagnosed.
Some people with ASD have special abilitieschosenin certain areas or are very talented in topics of interest.

TIPS

Be patient and understanding.
Avoid assumptions; each individual is unique.
Use clear and direct language, avoiding double meanings or jokes.
Anticipate, as far as possible, certain situations.
Keep in mind that they may have very limited interests.
Be aware of sensory sensitivities.
Foster an environment of acceptance and support.

Remember, autism is a broad spectrum, and each individual's experience with it may be different.

Signs and symptoms of autism spectrum disorders

Autism spectrum disorder (ASD) is a neurodevelopmental disorder who has problems in communication and social interaction and with restrictive or repetitive behaviors or interests.

People with ASD often have problems with social communication and interaction, and restrictive or repetitive behaviors or interests. People with ASD may also have different ways of learning, moving, or paying attention. It is important to note that some people without ASD may also have some of these symptoms. However, in people with ASD, these characteristics can make life very difficult.

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Social communication and interaction skills

Social communication and interaction skills can be challenging for people with ASD.Some examples of alterations in social communication and social interaction that people with ASD present are the following:

They may avoid looking another person in the eye or do not maintain eye contact.

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Risk indicators at 12 months

They may not respond when their name is called.
They do not show facial expressions such as happiness, sadness, anger and surprise.
They do not engage in simple interactive games such as patting their hands.
They use few or no gestures (do not wave goodbye).

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Risk indicators at 18 months.

Do not share interests with other people (for example, do not show an object that you like).

Don't point to something interesting to show it.

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Risk indicators at 24 months

Not noticing when other people are hurt or upset.

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Risk indicators at 36 months

Not noticing other children or playing with them.
Don't play at being something else, like a teacher or superhero.

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Restrictive or repetitive behaviors or interests

People with ASD have behaviors or interests that may seem unusual. These behaviors or interests distinguish ASD from conditions that are only defined by problems with social communication and interaction.

Examples of restrictive or repetitive behaviors and interests related to ASD may include:

Putting toys or other objects in a row and getting upset when the order is changed.
Repeating words or phrases over and over (this is called echolalia).
Playing with toys the same way all the time.
Focus on parts of objects (for example, wheels).
Get irritated with minimal changes.
Have obsessive interests.
Having to follow certain routines.
Flap your hands, rock your body, or spin in circles.
Reacting in unusual ways to the way things sound, smell, taste, look, or feel.

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Other features

Most people with ASD have other related characteristics. These could include:

Delay in language skills.
Delay in movement skills.
Delay in cognitive or learning skills.
Hyperactive, impulsive or distracted behavior.
Epilepsy or seizure disorders.
Unusual eating and sleeping habits.
Gastrointestinal problems (for example, constipation).
Unusual moods or emotional reactions.
Anxiety, stress or excessive worry.
Do not be afraid or fear more than normal.

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It is important to note that children with ASD may not have any of the behaviors mentioned as examples or they may have some.

There is no single cause of ASD. Many factors have been identified that could increase a child's chance of having ASD, including environmental, biological, and genetic factors.

You are at greater risk of developing ASD:

Having a brother or sister with ASD
Having certain genetic or chromosomal conditions, such as fragile X syndrome or tuberous sclerosis
Having complications at birth

Treatment and intervention services for autism spectrum disorder

Current treatments for autism spectrum disorder (ASD) seek to reduce symptoms that interfere with daily functioning and quality of life.

ASD affects each person differently, which means that people with ASD have unique strengths and challenges and different treatment needs.

Therefore, treatment plans usually include several professionals (pediatric neurologist, psychiatrist, clinical psychologist, speech therapist, occupational therapist, psychomotor therapist, special education teacher) and are adapted to the person.

Treatments can be given in education, health, community, home, or a combination of settings. It is important for providers to communicate with each other, and with the person with ASD and their family to ensure that treatment goals and progress are meeting expectations.

As people with ASD move out of high school and into adulthood, receiving additional services can help them improve their health and daily functioning, and facilitate their social and community participation. Some may need help continuing their education, completing job training, finding employment, and obtaining housing and transportation.

‍For the reasons explained above, personalized treatment and networking among all the professionals who intervene with the patient are essential, taking into account the environment of the person with ASD (family and school).

Types of treatment

There are many types of treatment available. These treatments can generally be divided into the following categories, although some involve more than one approach:

Behavioral
Development
Educational
Socio-relational
Pharmacological
Psychological
Complementary and alternative

Psychological approaches

Psychological approaches can help people with ASD cope with anxiety, depression, and other mental health problems.

The cognitive behavioral therapy (CBT) It has demonstrated scientific effectiveness and focuses mainly on working on the connections between thoughts, feelings and behaviors.

During this type of therapy, the therapist and the person work together to determine goals and then to change the way the person thinks about a situation in order to change the way they react to it.

In children, we work together with parents to obtain tools, understand their child's behavior and give them alternatives to act.

Behavioral approaches

Behavioral approaches focus on changing behaviors by understanding what happens before and after the behavior. Behavioral approaches have evidence for the treatment of ASD symptoms. They have been widely accepted among educators and healthcare professionals and are used in many schools and treatment centers. One notable behavioral treatment for people with ASD is called applied behavior analysis (ABA). This treatment encourages desired behaviors and discourages unwanted ones in order to improve a variety of skills. Progress is measured and tracked.

Two teaching styles that use ABA are discriminated task teaching (DTT) and the Pivotal Response Treatment (PRT).

Teaching discriminated tasks is based on step-by-step instructions for teaching a desired behavior. Lessons are broken down into their simplest parts, and desired responses and behaviors are rewarded. Unwanted responses and behaviors are ignored.
Pivotal response treatment is done in a natural setting rather than a healthcare setting. Its goal is to improve some “fundamental skills” that will help the person learn many other skills. An example of a fundamental skill is initiating communication with other people.

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The Denver Early Start Model (ESDM) is abroad approach to development that is based on the principles of applied behavior analysis. It is used with children 12 to 48 months of age. Parents and therapists use play, social exchanges, and shared attention in natural settings to improve language, social, and learning skills.

Development approaches

Developmental approaches focus on improving specific developmental skills, such as language or physical skills, or a broader range of interconnected developmental skills. These approaches are often combined with behavioral approaches.

The most common developmental therapy in people with ASD isspeech and language therapy. Speech and language therapy helps improve a person's understanding and use of language and speech. Some people with ASD communicate verbally. Others may communicate using signs, gestures, pictures, or an electronic communication device.

Theoccupational therapy teaches skills that help the person live as independently as possible. These skills include dressing, eating, bathing, and interacting with people. Occupational therapy may also include:

Sensory integration therapy to help improve response to sensory stimuli that may be restrictive or overwhelming.
Physiotherapy, which can help improve physical skills, such as fine finger movements or gross trunk and body movements.

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Educational approaches

At school, methodological or curricular adaptations must be made.

One type of educational approach that helps children in school isTreatment and Teaching of Children with Autism and Related Communication Disabilities (TEACCH) and carried out by teachers, with the supervision or support of the special education teacher or educational psychologist. The TEACCH approach is based on the idea that people with autism reach their full potential through consistency and visual learning. Provides teachers with ways to adapt classroom structure and improve academic and other outcomes. For example, daily routines can be written or drawn and posted. Boundaries can be set around learning stations. Verbal instructions can be supplemented with visual instructions or physical demonstrations.

Socio-relational approaches

Social-relational treatments focus on improving social skills and creating emotional bonds. Some of these approaches involve parents or peer mentors andThey are carried out by expert psychologists trained in this model..

He model based on development, individual differences and relationships (also called “Floortime“) encourages parents and therapists to follow the person's interests to expand opportunities for communication.
The kind of relationship development intervention (RDI) involves activities that increase motivation, interest, and the ability to engage in shared social interactions.
Thesocial stories They provide simple descriptions of what to expect in a social situation.

The social skills groups provide opportunities for people with ASD to practice social skills in a structured environment.

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Pharmacotherapy

Depending on the clinic, the medication may help treat the symptoms that affect and interfere with the patient's life.

Medication is often recommended to help manage high energy levels, inability to concentrate, or self-harming behaviors such as head banging or hand biting. Medications can also help manage co-occurring psychological conditions, such as anxiety or depression, in addition to medical conditions, such as seizures, sleeping problems, or stomach or gastrointestinal problems.

It is important to make periodic visits with the psychiatrist to monitor the medication, taking into account the information provided by the family and the school to adjust the dose and/or type of medication based on the symptoms and severity of the symptoms.

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Complementary and alternative treatments

It has been proven that there are treatments that help children with ASD to stimulate different cognitive functions or social aspects, such as aquatic stimulation, equine therapy, music therapy or psychomotor skills. These treatments should be complementary to traditional treatments.

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