Autism Spectrum Disorder: Etiological Factors, Diagnosis, Prognosis And Interventions
Autism Spectrum DisorderAutism spectrum disorder (ASD) is a mental condition that is associated with behavioural challenges among children. Chiefly, there is nothing about people with ASD that is different from other people except their means of communication, as well as how they interact with others. The frequency of ASD is significantly greater in boys than in girls. Autism is also more prevalent in white children than in children from other races (Centers for Disease Control and Prevention [CDC], 2019). According to the American Psychiatry Association (2013), there is not one but multiple types of autism. The different types of autism are affected by a mixture of inherited and ecological factors. According to the CDC (2019), each child with autism has a distinctive set of strengths as well as weaknesses. For example, a manner in which a child with autism learns or deals with their problems may range from skilled to severely challenged. Some children with ASD may require daily support; others may need minimal assistance, while some children do not require any help. According to the CDC (2019), the indicators of ASD mainly appear at the age of 2-3 years, however; other signs may appear as early as 18 months. CDC (2019) also estimates that 1 in 59 children has autism in the U.S. today. ASD affects the day to day activities of a child as well as their parents
Etiological Factors of ASD
Autism has no known cause, but some factors are associated with the disorder. ASD is mainly diagnosed through behavioural symptoms and not via the use of etiological factors. The etiological factors are grouped into genetic, neurobiological factors as well as cultural and environmental factors. Different researchers agree that the leading cause of ASD is genetic mutations in human DNA. According to American Speech-Language-Hearing Association [ASHA] (2020), ASD is more common in boys than girls. The affects may be as a result of the disorder being related to the hereditary alterations connected to the X chromosome. Additionally, twins are more likely to suffer from ASD compared to siblings who are not twins. Notably, twins share the same genes compared to non-twin siblings who might not share the same genetic material. It is estimated that 20% of infants whose older biological siblings with autism are at a higher threat of being diagnosed with ASD and the risk is higher if the sibling with ASD is more than one (CDC, 2019). The sperm mutates throughout a man’s life; therefore, increased paternal age is a factor for ASD. The genetic factors are associated with the genetic factors by the fact that neurological mutations may affect the way the human brain functions Irregularities in the genetic material may result in abnormal brain growth. Primarily, these irregularities may affect the behaviour and cognition of the person. There are structural and functional abnormalities of the brain that pose risks to the development of autism in children. First, there is an increase in the amount of grey matter in the temporal lobes, which makes it hard for social interactions (CDC, 2019). Secondly, the synaptic deficits are affecting neural circuity, which results in altered communication between the neurons hence slow cognition. Some brain developments may affect the child’s behaviour hence the symptoms of ASD. These factors may include the reduction of neural sensitivity in infancy and the disruption of standard patterns of brain development that result in decreased attention (ASHA, 2020). For example, mutated brain development occurs in an abnormally shaped brain, which is a factor that results in autism. Gene mutations result in neurons forming a lot of channels in children. To scientists, the environmental risk factor for autism involves anything that is beyond the genetic material. Primarily, some studies have reported that advanced parental age and preterm birth as risk factors. Mainly preterm births may be a result of air pollution, which may be associated with maternal smoking. For instance, maternal smoking is associated with retarded brain development in their babies (Karahmadi, Karimi, Kamali, & Mousavi, 2017). The child may suffer from brain damage hence neurological disorders such as Down’s syndrome and ASD, which affect the normal life for the child. Besides, things like endocrine disruptors interfere with the normal hormonal pathways hence hindering normal brain development. Research has associated air pollution to different types of neurotoxicants, which may be inhaled by pregnant women and neonates. Studies have concluded that there is an association between air pollution and the development of ASD. According to Karahmadi et al. (2017), in a survey, pregnant women who lived 1.5 kilometres within an agricultural field sprayed with organophosphates had a 60% risk of having a child with ASD. Also, cultural practices such as female genital mutilation increase the duration of childbirth hence neurological disorders.
Diagnosis for ASD
Diagnosing ASD is a difficult task as there are no specific medical tests to diagnose this condition. Chiefly, different illnesses have different tests, such as blood tests that determine their presence in the human body. As a result, physicians consider at the child’s developmental performance to make a verdict. Also, ASD can have an early onset in the child in which it may be spotted at 18 months. According to the autism society (2020), at the age of two years, a conclusion made by a skilled medical expert is trustworthy. Conversely, countless children do not receive a test for autism until they are a few years older since parents tend to ignore the symptoms. The delay is bad for the child’s health as this child might not receive the much-needed help that is offered. According to the American Psychiatric Association (2014), a physician uses the DSM-5 to make a diagnosis for ASD. Therefore, when the child does not follow the typical developmental course, the parent should turn to experts for answers. Diagnosing ASD involves two steps. The first step involves developmental screening (Autism speaks, 2020). Primarily, developmental screening consists of a test that tells the physician if the child is learning the necessary skills at the required time. During this screening, the physician mainly plays with the child to see their development behaviour, for example, speech and later asks the parents questions regarding the child. A delay in the areas of development could be a problem for the child. According to the CDC (2019), children should be screened for growth delays and disabilities during their regular clinics or visits to the doctor. Children that should be well tested are those that are at high risk for autism, for example, preterm births. The second type of ASD diagnosis is a comprehensive diagnostic evaluation (Autism speaks, 2020). Besides, this type of screening involves different medical testing, such as neurological screening. In this type of screening, problems with the child’s genetics and the brain are identified and autism may be diagnosed.
ASD is a condition with no known cure. Chiefly, this condition makes it hard for a person diagnosed with the condition to like an independent life. The children suffering from this condition may grow up with a lack of employment and support required, which results in low self-esteem and anxiety disorders. Besides, some children with mild ASD disorder may improve with time if they received those interventions at an early age (Mandal, 2019). The children that progress might have improved social functions in which they interact well with their age mates. The educational policy of inclusion helps in supporting people with ASD disorder in schools. Also, results from studies have concluded that up to 49% of adults with ASD stay with their relatives, with only 12% having a permanent job (Mandal, 2019). It is impossible for a child that is diagnosed with severe ASD to live a normal life as they will always depend on someone’s support and help for normal activities. As a result of increased ASD awareness, more parent is no longer ignorant as the ones with high risk for the disorder are always rushing to have their children screened. Primarily, the prognosis of ASD may depend on mental retardation. According to Mandal, 25% to 75% of people who have ASD may encounter diverse amounts of mental deficiency (2019). Researchers conclude that cases of ASD increased between 1990 and 2000. The increase can be related to improved diagnostic criteria and increased public knowledge. Mandal (2019) also insists that ASD prognosis is dependent on diseases existing alongside ASD. An Example of diseases co-existing with autism is the downs syndrome. Some cases of autism have been identified alongside chromosomal abnormality. Children with ASD and Asperger’s syndrome may naturally be intellectually gifted or have a normal speech, but they normally have one or more symptoms of autism. Some organizations claim that with the variety of treatments available, there is a good chance of having interventions to live a normal life. Nevertheless, researchers agree that the interventions do not seek to reverse autism as autism has no cure.
There is no known cure for autism, so different interventions have to be considered. Primarily, some medications are known to help children diagnosed with ASD to function better in their daily lives. For instance, some medications might help with depression and the lack of focus (Autism Society, 2020). Besides, children are different, so drugs might not affect the children in the same way, thus the reason to collaborate with a physician experienced with the treatment of ASD. A parent needs to know that children with ASD are normal kids and they may get ill or get injured (Autism Society, 2020). Therefore, it is crucial for the child to undergo routine dental exams and treatment when they get sick. Monitoring a healthy child development includes paying attention to signs that are related to ASD and to the symptoms that are not associated with ASD (CDC, 2019). The parent should monitor the child’s physical and mental health to ensure their wellbeing. There are different approaches to help a child suffering from autism to get better. Chiefly, there are behavioural and communication approaches that help in therapy. For example, there is an intervention approach that encourages positive behaviour and discourages negative behaviour (Autism Society, 2020). In this, the child’s behaviour is monitored and they are motivated to learn new practices and social skills by initiating communication with others. Additionally, there is a relationship-based approach in which the child’s emotions are monitored to help in dealing with how they react to certain conditions. In these types of intervention approaches, children are taught new things, for example, dressing themselves or tying their shoes (CDC, 2019). Physicians may suggest the child undergo speech therapy to improve their communication skills. Furthermore, a child who has autism can undergo dietary treatments. However, this mode of therapy is not scientifically supported, but nutritional changes help in making a difference in a child’s emotions and behaviour. To relieve the symptoms of ASD, they may use complementary treatments such as the use of secretin. These modes of therapy are controversial, as up to 10% may end up using a form of treatment that is dangerous (CDC, 2019). Before starting treatment, the parent should consult their physician first.
Policy Concerns of ASD
When a parent discovers that their child has ASD, it is natural for them to seek help. Primarily, wealthy parents may seek assistance from private practitioners, while the poor may seek advice from public health practitioners. Notably, in some cases, private programs are supported by federal public policies (National Conference of State Legislature [NCSL], 2016). These policies were formulated by families with children with disabilities aiding parents and children with special needs. Additionally, the service provider, nature of the services and the conditions for service delivery are essential for children with ASD. Scarce resources and unlimited needs promise a continuous fight to obtain the necessary resources for children with ASD as well as their families (NCSL, 2016). Some states and communities had formerly developed policies for children with disabilities, but the resources were limited and scattered hence inefficient. The political leaders decided that it was necessary to come up with the required resources to prevent parents from running from state to state in search of the essential assistance.The federal policies for children with special needs are legislation and decisions passed by the court. Legislation can only set rules and it cannot guarantee whether the rules would be faithfully adhered to. The IDEA legislation has a set of policies such as disabled children act that regulate how a child with special needs should be treated. Moreover, it cannot be proved that congress has the intent to include children with ASD in the legislation (NCSL, 2016). Nonetheless, children with autism, including ASD, involves a group that is entitled to all provisions in the legislation. Furthermore, in the past years, the courts have played a significant role in protecting children with ASD and their families. The courts always side with the rights of the children as they are the future. However, it does not mean that the judiciary will always side with the children. For instance, in the Rowley case, the court denied the request of a deaf girl to having a classroom interpreter (NCSL, 2016). There have been different cases seeking adequacy of services for children with ASD.ConclusionASD is a disorder that affects a child’s life by modifying their behaviour. Primarily, studies have concluded that autism is more common in white children than those of other races. ASD development can be brought about by a mix of environmental, genetics and problems with normal brain development. There are no specific medical tests for autism; thus, it is difficult to diagnose the disorder. Also, autism has no known cure, which makes it difficult for children to live a normal life. Children with ASD should always attend yearly appointments with their PCP and dentist so that parents are watching all milestones and can get assistance if needed. Parents will also be able to help children more accurately if proper hence proper diet and regular medical checkups are routine. The government, in collaboration with advocates for children who have ASD, have come up with different policies to aid those who benefit from accommodations and services regarding autism.
- American Psychiatric Association. (2014). DSM-5. Home │ psychiatry.org. https://www.psychiatry.org/
- American Speech-Language-Hearing Association. (2020). Autism spectrum disorder. https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589935303§ion=Causes
- Autism Society. (2020). Autism spectrum disorder. https://www.autism-society.org/
- Autism Speaks. (2020). Autism diagnosis criteria: DSM-5. https://www.autismspeaks.org/autism-diagnosis-criteria-dsm-5
- Centres for Disease Control and Prevention. (2019). Basics About Autism Spectrum Disorder (ASD) | NCBDDD | CDC. https://www.cdc.gov/ncbddd/autism/facts.html
- Karahmadi, M., Karimi, P., Kamali, E., & Mousavi, S. (2017). Environmental factors influencing the risk of autism. Journal of Research in Medical Sciences, 22(1), 27. https://doi.org/10.4103/1735-1995.200272
- Mandal, A. (2019, February 26). Autism prognosis. News-Medical.net. https://www.news-medical.net/health/Autism-Prognosis.aspx
- National Conference of State Legislature. (2016). Autism policy issues overview. Legislative news, studies and analysis | National Conference of State Legislatures. https://www.ncsl.org/research/health/autism-policy-issues-overview.aspx