Autism Spectrum Disorder


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What is autism?

One such condition is autism—these days often called autism-spectrum disorder ASD. ASD is characterised by repetitive, stereotypical and often restricted behaviour such as head-nodding, and by the difficulties those with it have in reading the emotions of, and communicating with, other people. These symptoms are noticeable in children from the age of two onwards. Currently, in America, about one child in 59 is diagnosed with ASD. What causes ASD has baffled psychiatrists and neurologists since the syndrome was first described, in the midth century, by Hans Asperger and Leo Kanner.

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But the evidence is pointing towards the bacteria of the gut. That suggestion has been reinforced by two recently published studies—one on human beings and one on laboratory rodents. The human study, the latest results of which came out a few weeks ago in Scientific Reports , is being conducted by Rosa Krajmalnik-Brown of Arizona State University and her associates.

It was prompted by earlier work in which Dr Krajmalnik-Brown and James Adams, a colleague at Arizona State, sequenced the DNA of gut bacteria from 20 autistic children to discover which species were present. One notable absence was Prevotella. This bug, which makes its living by fermenting otherwise-indigestible carbohydrate polymers in dietary fibre, is abundant in the alimentary canals of farmers and hunter-gatherers in places like Africa, rare in western Europeans and Americans, and nearly nonexistent in children with ASD.

Two years ago they tested a process called microbiota transfer therapy MTT on 18 autistic children aged between seven and MTT is a prolonged version of a process already used to treat infection by a bug called Clostridium difficile , which causes life-threatening diarrhoea. It involves transplanting carefully prepared doses of faecal bacteria from a healthy individual to a patient. The researchers gave the children, first, an oral antibiotic, a bowel cleanse and an oral antacid to ensure that microbes administered by mouth would survive their passage through the stomach.

They followed this up with either an oral or a rectal dose of gut bacteria, and then, for seven to eight weeks, a daily antacid-assisted oral dose. In addition, those of another species, Bifidobacterium , had quadrupled. Now, two years later, although levels of Prevotella have fallen back somewhat, they are still 84 times higher than they were before the experiment started. Levels of Bifidobacterium , meanwhile, have gone up still further—being five times higher than they had been at the beginning of the study. Crucially, these changes in gut bacteria have translated into behavioural changes.

Even 18 weeks after treatment started the children had begun showing reduced symptoms of autism. After two years, only three of them still rated as severe, while eight fell below the diagnostic cut-off point for ASD altogether. These eight thus now count as neurotypical. Exactly how gut bacteria might contribute to autism is a puzzle. But light has been shed on the matter by the second study, published this week in Cell by a team led by Sarkis Mazmanian of the California Institute of Technology.

They collected bacteria from the faeces of both neurotypical and autistic people who ranged in their symptoms from mild to severe and transplanted these into hundreds of mice. They then interbred the recipient mice and studied the offspring of these crosses—animals that had picked up the transplanted bacteria from their mothers at birth. They were looking for the rodent equivalent of ASD.

And they found it. Most of the young mice harbouring gut bacteria from autistic human donors showed features of autism themselves. These included repetitive behaviours, reduced social and vocal communication with other mice, and restricted movement. In contrast, none of the mice colonised with bacteria from neurotypical people ended up autistic. One long-held suspicion is that a molecule called gamma-aminobutyric acid GABA is involved. GABA is a neurotransmitter, meaning that it carries signals between nerve cells.

Understanding autism spectrum disorders

Sometimes, these genes arise by spontaneously mutate. In other cases, people may inherit them. In studies of twins, autism often has a strong correlation between twins. For example, if one twin has autism, the other is likely to have autism an estimated 36 to 95 percent of the time, according to the NINDS.

Those with autism may also undergo changes in key areas of their brains that impact their speech and behavior. Environmental factors might also play a role in the development of ASD, although doctors have not yet confirmed a link. However, researchers do know that some rumored causes, such as parenting practices, do not cause autism.

Another common misconception surrounding autism is that receiving vaccines, such as those for measles , mumps, and rubella MMR , can contribute to autism. However, the CDC report that there is no known connection between vaccines and autism. A study confirmed that the number of antigens, or substances that trigger the production of disease-fighting antibodies are the same in children who do and do not have ASD. Some people claim that thimerosal, a preservative that contains mercury and is in specific vaccines, has links to autism.

However, at least nine different studies since have provided evidence that counters this claim. The Lancet journal published the initial paper that triggered the controversy around vaccines and autism and retracted it 12 years later after evidence of data tampering, and research fraud became clear. Governing bodies stripped the author, Andrew Wakefield, of his credentials and permission to practice. There is no uniform treatment for autism, as every person with the condition presents differently. Therapies and strategies are available for managing the health issues that often accompany autism.

These issues can include epilepsy, depression , obsessive-compulsive disorder OCD , and sleep disturbances. While not all of these treatments will be effective for all people with ASD, there are many options to consider that may help people cope. Autism specialists or psychologists can refer a person for a treatment that reflects their presentation of autism.

They will also want to know about the effects of their environment on this behavior, and how the person learns. ABA aims to increase desirable behaviors and reduce harmful or isolating ones by using positive reinforcement. ABA can help improve communication, memory, focus, and academic performance.

By analyzing current behaviors and teaching new actions step-by-step, an instructor can provide both a person with ASD and the people around them with tools for support. A psychologist, behavioral specialist, or occupational therapist uses joint activities and play to help a child with autism build positive relationships with a sense of fun.

Parents can then continue the therapy at home. Floortime: This involves parents joining children in the play area and building relationships. ABA therapies might also use floortime to support treatment and vice versa.


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Parents let the children lead the game, allowing the child's strengths to develop. Through this engagement, a child with ASD learns two-way and complex communication, emotional thought, and intimacy. They also learn to take the lead of regulating themselves and engaging with their environment.

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Autism spectrum

Occupational therapy OT : This helps a person with autism develop the skills for everyday living and learn independence. These skills include dressing without assistance, grooming and hygiene, and fine motor skills. People with ASD then practice these skills outside of the therapy sessions, which are usually between 30 and 60 minutes long. Pivotal response treatment PRT : This therapy aims to support motivation and the ability to respond to motivational cues in children with ASD. It is a play-based therapy that focuses on natural reinforcement. For example, if a child wants a toy car and asks in an appropriate way, they get the toy car, not an unrelated reward, such as candy.

This also encourages children with ASD to start social interactions, as well as merely responding to them. Relationship development intervention RDI : This treatment revolves around the importance of dynamic thinking, or the ability to adapt thoughts and process situations flexibly, to help improve quality of life in people with autism. The focus of RDI includes understanding other people's perspectives, processing change, and absorbing information from several sources at once, such as sight and sound, without experiencing distress.

Speech therapy: This helps to address the challenges in communication that people with autism might experience. Assistance might include matching emotions with facial expressions, learning how to interpret body language, and responding to questions. A speech therapist might also try to teach the nuances of vocal tone and help the individual strengthen their speech and clarity.

Autism spectrum disorder - Symptoms and causes - Mayo Clinic

TEACCH: This program helps to integrate the needs of children with autism into a classroom environment, with an emphasis on visual learning and support for the attention and communication difficulties that might arise. Special education providers and social workers, as well as medical professionals providing other treatments, such as psychologists and speech therapists, can use this system to support children with ASD.

Practitioners of VBT focus not on words, but the reasons for using them. If a doctor prescribes medicine for a child or adult with ASD, they will usually be trying to address seizures, depression, or disturbed sleep.


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  7. Again, medications may or may not be right for an individual with autism on a case by case basis. Click here for a helpful aid that can break down which options will be best for a particular set of symptoms. Children with ASD often develop a range of behaviors that help them process the isolating effects of the condition.

    These behaviors are attempts by the child to protect themselves from stimuli that may overwhelm them and increase sensory input to enhance feeling. They may also enact these behaviors to bring some level or organization or logic to their everyday lives. While not all coping strategies for autism are harmful, some can inhibit social interaction and lead to isolation and distress.

    The important factor in managing potentially isolating behaviors is not to discourage these behaviors, but to add other coping strategies that can make a child's journey through autism easier, such as:. Different people experience ASD to varying extents and with a range of behaviors. However, these strategies and skills can help increase the tools available to each person with the condition and improve their quality of life. There is no cure for autism. However, researchers are studying nearly every aspect of the condition, from its causes to potential treatments.

    In some people with ASD, medications and behavioral health interventions can improve the effects of the condition to enable a person to function independently in adulthood. For others, the symptoms and co-existing conditions, such as epilepsy, may require further management and assistance. A study in Proceedings of the National Academy of Sciences of the United States of America examined 32 children who received intranasal oxytocin or a placebo as a treatment. The research found that children who took oxytocin demonstrated improved social functioning. The study leaders had previously found that low oxytocin levels had links with lower social performance.

    Research at the American Society of Human Genetics conference identified 43 previously unknown genetic sequences associated with developmental delays, including autism. The ongoing Deciphering Developmental Disorders study is currently looking at undiagnosed conditions in more than 12, people in the United Kingdom and the Republic of Ireland. The study aims to try and understand these developmental disorders to help those children and adults who experience them plus scientists and clinicians. A study published in the journal Nature found that brain growth in children with ASD has links to the severity of the condition.

    The researchers theorized that this knowledge may help doctors diagnose autism at earlier stages than ever before. These studies are a few examples of ongoing efforts that may assist in the future diagnosis and treatment of ASD. A combination of education about ASD and earlier recognition means that people with autism can receive early assistance for the condition. Ideally, a person should receive treatments and therapies as early as possible to enhance their quality of life.

    Autism or ASD is a complex neurodevelopmental condition that causes difficulties with social interaction and favors strict adherence to routines and predictable patterns. There are different types and severities of ASD, including Asperger syndrome. Some people with ASD can live independently while others require more sustained care and support. The causes are currently unknown, but researchers have identified several genes that may have links to the development of ASD. Vaccines do not cause autism. Research is ongoing, and treatments are under development that might improve quality of life for people with autism, moving forward.

    Current therapies include occupational therapy, speech therapy, and various forms of communication support. As an adult, is it likely that I have undiagnosed autism? I demonstrate a lot of the symptoms. Symptoms of autism can mimic symptoms of other disorders, such as attention deficit hyperactivity disorder or obsessive-compulsive disorder, causing confusion regarding an exact diagnosis.

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    Occasionally, doctors will diagnose an adult with autism after they have a child who is diagnosed with autism and the adult notices symptoms in themselves. Article last reviewed by Tue 20 November Visit our Autism category page for the latest news on this subject, or sign up to our newsletter to receive the latest updates on Autism. All references are available in the References tab.


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    Autism quick facts. Autism spectrum disorder ASD. Autism spectrum disorder fact sheet. Behavioral treatments and interventions. DeStefano, F. Increasing exposure to antibody-stimulating proteins and polysaccharides in vaccines is not associated with risk of autism. The Journal of Pediatrics, 2 , — Developing appropriate coping skills in children with autism.

    Do vaccines cause autism spectrum disorder ASD? Godlee, F. BMJ, ,

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