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  • Dr Sravani Bhavanam

Autism Spectrum Disorders

Once upon a time, there was a little boy named Aman, who was diagnosed with autism at a young age. Aman had a hard time making friends and communicating with people and often felt overwhelmed by loud noises and bright lights. Despite these challenges, Aman had a passion for painting. He loved to create colorful and intricate artwork that expressed the beauty he saw in the world around him. His paintings were full of vibrant colors and intricate details that were truly remarkable. One day, Aman’s school decided to hold an art competition, and Aman eagerly submitted his paintings. But when the judges announced the winners, Aman’s name was not among them. He was heartbroken and felt like he would never be able to share his talent with the world. However, Aman's mother encouraged him to keep painting and expressing himself, even if others didn't always appreciate it. She reminded him that art was about self-expression, not just winning prizes. Over time, Aman continued to create beautiful paintings and share them with his family and friends. Eventually, his work gained recognition and he even had his own art exhibition. The moral of this story is that everyone has unique talents and abilities, and it is essential to embrace and nurture them, even if others don't always understand or appreciate them. By staying true to ourselves and pursuing our passions, we can overcome challenges and find success in our own way. The human brain is a complex and mysterious organ that continues to intrigue and perplex us. Our brains are truly fascinating with over 100 billion neurons, each connected to 10,000 other neurons. Despite years of study, we have only just scratched the surface of what our brains are truly capable of. Every individual's brain is unique in how it perceives the world around us, forms biases, and interacts with others. As we learn more about the brain, we discover that the factors that shape our behavior and language are more complex than we previously thought. Imagine suddenly losing your ability to express yourself - how would that feel? Autism or Autism Spectrum Disorder (ASD) is one such condition that affects one’s learning, behavior, and communication. "Autism is not a disease, it's a different perspective on life." Did you know that autism is the fastest-growing developmental disability in the world? Autism, a developmental disorder that affects communication and social interaction, is becoming increasingly prevalent around the world. In the last two decades alone, there has been a staggering 178% rise in its incidence, highlighting the urgent need for better diagnosis, personalized care, and management. Even in India, a child under the age of 10 has a 1 in 100 chance of being diagnosed with autism, underscoring the need for action to combat this epidemic. With the right tools and interventions, we can ensure that individuals with autism receive the support they need to lead fulfilling lives. Why is it named Autism spectrum disorder? The spectrum model recognizes the unique experiences and needs of each person with autism and acknowledges that there is no "typical" or "normal" presentation of the condition. Instead, autism is understood as a complex and diverse condition that can affect people in many different ways. How do individuals with autism experience the world differently from neurotypical individuals? “Autism is like a rainbow. It has a bright side and a darker side. But every shade is important and beautiful”

1. Impairment in social interaction and communication

Sub criteria (impairment in all 3 required)

-social and emotional reciprocity

-nonverbal communication

-creating and maintaining relationships

2. Abnormal and repetitive behavior, interests, and activities

Sub criteria (2 of 4 required)

-stereotyped speech and behavior

-resistance to change

-fixated interests

-hypersensitivity or hyposensitivity to sensory input

3. Presentation in early childhood development

4. Limited and hindered everyday activities

DSM 5-Diagnostic and Statistical Manual of Mental Disorders, 5th edition

Data from the American Psychiatric Association

One of the primary features of ASD is difficulty with social interaction. Children with ASD may have trouble reading social cues, such as facial expressions, tone of voice, or body language. For example, they may not understand when someone is joking or may have difficulty recognizing when someone is upset or angry. Another feature of ASD is difficulty with communication. This can manifest in a few different ways. Some children with ASD may have delayed speech or language development, while others may have difficulties with the nuances of language, such as understanding sarcasm or irony. Many children with ASD exhibit repetitive behaviors or have an intense interest in specific topics. These can change over time or be lifelong and include art, music, gardening, animals, postcodes, or numbers. For example, they may line up toys in a certain order, repeat specific phrases or sounds, or become fixated on a particular subject, such as trains or dinosaurs. Overall, these features of ASD can make it challenging for children to interact with others, communicate effectively, and navigate the world around them. However, with the right interventions and support, children with ASD can lead fulfilling lives.

Did you know that there are environmental factors that may contribute to the development of autism? Air pollution – Researchers found that early-life exposure to air pollution may be a risk factor for autism. Children of mothers living near a freeway, and traffic-related pollution, during the third trimester of pregnancy, were twice as likely to develop ASD. Metals, pesticides, and other contaminants – Prenatal and early childhood exposure to heavy metals like mercury, lead, or arsenic, as well as altered levels of essential metals like zinc or manganese, may be risk factors for autism. Pesticides and other environmental contaminants have also been identified as potential contributors to the development of autism, though more research is needed in this area. What are the other factors contributing to autism? Advanced parental age particularly in fathers, has been linked to an increased risk of autism. Studies have found that children born to fathers over the age of 40 are more likely to develop autism than those born to fathers under the age of 30. This may be because older fathers have a higher rate of genetic mutations in their sperm, which can increase the risk of autism and other developmental disorders. Family history is also a significant risk factor for autism. Research has shown that if a child has a sibling with autism, their risk of developing the disorder is much higher than if they have no family history of autism. Similarly, if a parent has a genetic mutation that increases the risk of autism, their children are more likely to develop the disorder. Moreover, Studies have identified a large number of genes that are thought to be associated with an increased risk of developing autism. What are some common myths and misconceptions about autism? Although there is increasing awareness of autism, there is still a great deal of uncertainty regarding what autism actually is, its causes, and how it affects individuals in various and distinct manners. MYTH #1: Autism is caused by vaccines FACT: One of the most common myths about autism is that vaccines, particularly the MMR vaccine, cause it. However, numerous high-quality research studies involving large groups of people have consistently shown that vaccines are not the cause of autism. Vaccinations have been repeatedly tested for safety and the evidence overwhelmingly supports their safety.

MYTH #2: Autism can be cured. FACT: There is no cure for autism, but early intervention and therapy can help individuals with autism to improve their communication, social skills, and daily living skills.

MYTH #3: Only boys are autistic FACT: Autism appears to be more common in boys. However, girls are more likely to 'mask' their autism, by learning the skills to interact with the world, better than boys. This can mean that many autistic girls get diagnosed much later in life than boys.

MYTH #4: All individuals with autism have extraordinary talents or savant skills. FACT: While some individuals with autism have exceptional skills and extraordinary talents in certain areas, most do not. The savant skills are seen in only a small percentage of individuals with autism.

MYTH #5: Autism is caused by bad parenting. FACT: There is no evidence to suggest that different parenting styles cause autism. Autism is a neurodevelopmental disorder with a strong genetic component.

MYTH #6: Individuals with autism do not have feelings or empathy. FACT: Individuals with autism experience emotions and have empathy just like neurotypical individuals, but they may express them differently.

Do you know about the advantages that early intervention can have for children with autism? Early intervention for children with autism takes place before or during preschool years, typically around 2-3 years of age. This is an important time for a child’s brain development as it is still highly "plastic" or changeable. Therefore, interventions have a greater chance of being effective in the long run. Early interventions not only provide children with the best possible start but also the greatest potential for them to reach their full developmental potential. Recent guidelines recommend initiating an integrated developmental and behavioral intervention as soon as an autism spectrum disorder (ASD) is diagnosed or strongly suspected. Early intervention has shown that some children with autism make significant progress to the extent that they no longer fit the criteria for an autism diagnosis as they get older. Many of these children who no longer have ASD in later years have some things in common, such as receiving a diagnosis and treatment at a younger age, having a higher IQ than the average child with autism, and developing better language and motor skills.

Have you ever thought about the challenges faced by adults with autism as they navigate the workplace and social situations? It's important to recognize that each autistic individual is unique and may experience different challenges at work. However, here are some common issues that autistic adults may face:

  1. Difficulty with social communication: Autistic adults may have difficulty understanding the nuances of social communication and the unwritten rules of social interaction. They may have difficulty with small talk, understanding body language, and interpreting sarcasm or jokes.

  2. Sensory issues: Autistic adults may be sensitive to certain sounds, lights, or smells in the workplace. This can cause distraction and difficulty concentrating on work tasks.

  3. Routine and structure: Autistic adults may require structure and routine in the workplace to feel comfortable and focused. Changes in routine can cause anxiety and stress, which can affect work productivity.

  4. Multi-tasking: Autistic adults may have difficulty with multi-tasking and may prefer to focus on one task at a time. This can make it difficult to keep up with a fast-paced work environment.

  5. Difficulty with change: Autistic adults may struggle with change and may find it difficult to adapt to new procedures or changes in the workplace. This can cause anxiety and stress, which can affect work performance.

To help autistic adults succeed in the workplace, it's important to provide them with appropriate support and accommodations. This can include clear communication, a structured and routine work environment, and accommodations for sensory issues. With the right support, autistic adults can thrive in the workplace and make valuable contributions to their teams. Are there any treatments available for autism? There is no known cure for autism, but there are many treatments available that can help individuals manage the symptoms of the condition and improve their quality of life. Treatment plans for autism are usually tailored to the individual's specific needs and include:

  1. Behavioral and communication therapies: Therapies such as Applied Behavior Analysis (ABA), speech-language therapy, and family therapy can help autistic individuals with communication, and the development of social, and other behavioral skills.

  2. Medication: Certain medications such as antipsychotics, antidepressants, and stimulants, may be used to manage specific symptoms of autism, such as anxiety, hyperactivity, and aggression.

  3. Alternative therapies: Some individuals with autism may benefit from alternative therapies such as music therapy, animal-assisted therapy, and sensory integration therapy.

It is important to note that treatment plans for autism should be individualized and based on the specific needs and challenges of the individual. It is also important to work with a qualified healthcare professional to develop and implement a treatment plan. In conclusion, autism is a complex condition that affects individuals in different ways. While the challenges of autism can be significant, individuals with autism also have unique strengths and potential. Through early intervention, specialized support, and a better understanding of autism, individuals with autism can lead fulfilling and meaningful lives. It is important that we continue to work towards a world where individuals with autism are accepted and valued for who they are, and not defined by their condition. They are, "Different, not less." By recognizing and celebrating the diversity and unique perspectives of those with autism, we can create a more inclusive and compassionate society for all.

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