Autism Spectrum Disorder

February 7, 2017

Autism Spectrum Disorder is a developmental disability in children that creates a significant social, communication and behavioral challenges. Individuals with this condition have restricted, repetitive pattern of behavior, activities and interests. The term Autism Spectrum Disorder means that there is a wide range of variation that it affects people. The word spectrum refers to the variation of symptoms, skills, levels of impairment and disabilities that children with ASD can have. The considerable overlap among the different forms of autism has led to the concept of Autism Spectrum Disorder.

ASD affects about 1 in 68 children. Boys are affected with ASD 5 times more than girls. It belongs to an ‘umbrella’ category of 5 childhood-onset conditions called Pervasive Development Disorder (PDD). However, when we use the term ASD, we are basically referring to three most common types.

  • Autistic Disorder – Children who generate more rigid criteria for a diagnosis of autism have autistic disorder. These children portray more severe impairments including social and language functioning, as well as, repetitive behaviors. In this condition, children may also have mental retardation and seizures. 
  • Aspergers’ Syndrome – The mildest form of ASD is Asperger’s Syndrome and affects boys three times more than girls. Children with Asperger’s Syndrome are obsessively interested in one topic or object. Although, their social skills are markedly impaired and are often awkward and uncoordinated. It is also known as high functioning autism, as children with this condition frequently have normal to above average intelligence. As these children enter adulthood, they are at a high risk of anxiety and/or depression. 
  • Pervasive Development Disorder – not otherwise specifies (PDD-NOS) – Children whose autism is more severe than Asperger’s syndrome, but milder than Autistic disorder, are diagnosed with PDD-NOS.

 Childhood Disintegrative Disorder and Rett Syndrome are the other PDD, but as both being the extremely rare genetic diseases, they are usually considered to be separate medical conditions and truly do not belong to ASD.

 Causes

Although, there is no dingle known cause for ASD, but, based on the complexity of disorders and the variety of symptoms and severity, both genetic and environmental factors may play a key role.

  • Genetic Factors

A variety of genes appear to be involved in autism spectrum disorder. In identical twins that share same genetic code, if once have ASD, the chances of the other child to get this condition in 9 out of 10 cases are very high. It appears that there is no single gene involved in the causing of autism; instead there is an involvement of multiple genes, each being the risk factor of the different part of ASD.

  • Environmental Factors

The term “environment” in medical, means anything outside of the body that can affect health, which includes air, water, food, medicines and many other things that our body may come in contact with. Environment also refers to our surroundings in the womb, where our mother’s health directly affects our development. This also include premature birth and exposure to alcohol or certain medications during pregnancy such as sodium valproate

  • Neurological Factors

Problems related to the development of brain and nervous system contributes to the symptoms of ASD. Studies suggest that the connection between parts of the brain called the cerebral cortex, the amygdale and the limbic system may have become damaged or scrambled in children with ASD.

The causes of ASD can be describer in two ways, namely:

  • Primary ASD also known as idiopathic ASD – where no underlying Factors are identified to explain the cause of ASD.
  • Secondary ASD – where underlying medical conditions or environmental factors are responsible to increase the risk of ASD.

About 90% of ASD cases are primary and about 10% are secondary.

Gut Micro biome and ASD

In Autism Spectrum Disorder, there are hints that the gut micro biome may play a role. The human gut shelters a complex community of microbes that deeply influences a variety of aspects related to growth and development, including that of the nervous system. A large sub group of individuals with ASD show abnormalities in mitochondrial functions and in gastrointestinal symptoms. Studies show that, fecal DNA extracts have Clostridium or Desulfovibrio clusters over represented in children with ASD who have gastrointestinal (GI) complaints, than in children with GI but typical neuro-behavioral development. A study shows that if the gastrointestinal problem is blocked, the behavioral symptoms can be treated. Studies of humans have shown tantalizing observations on potential differences in the composition of gut micro biota associated with the behavioral disorder like ASD.

Symptom

Many children with ASD may reflect developmental differences when they are babies – especially their social and language skills. As they sit and crawl on time less obvious differences like development of gestures, pretend play and social language are left unnoticed.

Symptoms of Social Differences

  • Difficulty in maintaining eye contact or very little eye contact
  • Doesn’t look at objects, parent is pointing to.
  • Portray empathy issues
  • No response to parent’s smile or expressions
  • Often have inappropriate expressions
  • Unable to make friends
  • Not pointing at objects to show interest (for example. Not pointing at the flying airplane)

Communication Differences

  • Fail or slow in responding to their name or other verbal attempt to gain their attention
  • Babble in the first year of life, and later stop to do so
  • Repeats exactly what others say without understanding the meaning
  • Fail or slow in developing gestures
  • Speak only in single word, unable to make sentences o combine words into meaningful sentences.

Repetitive or Stereotyped Behaviors

  • Rocks, spins, sways, twirls fingers, walks on toes for a long time or flaps hands
  • Habituated to certain routines, unable to manage with change
  • Doesn’t seem to feel pain
  • May be over sensitive or not sensitive at all to sounds, smells, lights, textures and touch.
  • Unusual use of vision or gaze

Difference between children with ASD and typical developing children

 A child with typical developmentAn child with ASD
At 12 months

 

Will turn his head when the name is called outMight not respond, even if called several times, might respond to other sound
At 18 monthsWill point, gesture, or use facial expressions to communicateMight not even attempt to compensate for delayed development of speech.
At 24 monthsBrings objects to show his mother and expresses joyMight bring an object like a bottle to open to his mother, but won’t look at her face, when she does so or share the pleasure of playing together.

Problems faced by ASD children

Research has shown that children with ASD face following issues:

  • Sleep Problems- Children with ASD tend to suffer from sleep problems like falling asleep or staying asleep extensively.
  • Intellectual Disability- In this condition, children have some degree of intellectual disability. This may include cognitive or language disability.
  • Seizures- 1 out of 4 children with ASD has seizures – the changes in behavior that occur after an episode of abnormal electrical activity in the brain. Sometimes high fever can trigger seizure.
  • Sensory Problems- Children with ASD either overreact or under react to certain sights, sounds, smells, textures, and tastes.
  • Fragile X- Syndrome- It is a genetic disorder and is the most common of inherited disability with symptoms similar to ASD.
  • Tuberous Sclerosis- This condition occurs in 1 out 4 ASD patients in which numerous non-cancerous tumors grow in the brain and other vital organs.
  • Gastro Intestinal Problems – The children in ASD suffer from severe GI issues.

Treatment

  • Early Interventions – This includes an intensive behavioral therapy during the early years, significantly improves cognitive and language skills in children with ASD. This therapy focuses on: language and communication, social skills, cognitive skills etc
  • Applied Behavioral Analysis (ABA)- One of the widely used treatment for ASD is ABA which includes- Verbal Behavior and Pivotal Response Training
  • Developmental, Individual Difference, Relationship based (DIR): This type of therapy is carried out in natural settings such as home and pre-school. It aims at improvements in communication skills, thinking and social skills.
  • Interpersonal Synchrony- It focuses on social development and imitation skills and teaches children how to establish and maintain engagement with others.
  • Medications- Medications help improve the symptoms. The medications include –
  • Antipsychotic Medicines – Commonly used to treat serious mental illness
  • Anti-Depressant Medicines – Like Prozac or Zoloft are prescribed.
  • Stimulant Medicines – like Ritalin, but in most ASD cases children do not respond to it.

All medications carry a risk of side effects when consumed.

Alternative Treatments for ASD

  • Creative Therapies – Some parents of ASD children choose to go for art therapy which includes art or music therapy, which aims at reducing child’s sensitivity towards touch or sound.
  • Yoga Therapies – Yoga is a mind-body approach which helps to control anxiety in ASD patients.
  • Chelation Therapy- This type of treatment is used to remove mercury and other heavy metals from the body.
  • Acupuncture- This therapy is used as a tool to improve ASD symptoms.

Natural Treatment

  • Melatonin – Melatonin is a naturally occurring hormone that regulates the sleep-wake cycle in ASD children, as they suffer from sleeping problems.
  • Omega-3 Fatty Acids – Fatty acids are very important in the development and function of the brain. Several studies have proven that omega3 fatty acids reduce the symptoms of ASD.
  • Nutritional Supplements- Studies show that children with ASD tend to be deficient in various nutrients. Multi vitamin supplements are highly suggested.
  • Gluten-free, Casein-free and Soy-free diet
  • Probiotic Intake – It helps in improving the gastrointestinal issues that ASD children suffer from.

How we treat ASD-

At our center, we perform a comprehensive diagnostic workup, which helps us to study the entire history of the child. This includes the following:

  • Allergy Testing- to determine food triggers and inhalant allergy.
  • Structured food elimination diet- to yield vital information about gastrointestinal functioned food tolerance
  • Urine Tests- to determine abnormal peptides from wheat or dairy products to see if gluten-free or casein-free diet should be implemented for the child.
  • Hair Analysis- to examine toxic metal and essential minerals for its toxicity or deficiency and suggests us the safest forms of detoxification or supplementation.
  • Hidden sources of toxic pollutants are examined
  • Neuropeptide Levels, the biomarkers of brain chemistry and function are tested to uncover certain imbalances that can be treated with individualized amino acid programs.
  • Organic Acid Analysis –to determine the metabolites of yeast and some bacteria species.

With the above way of treatment, we have successfully unlocked the mysteries behind altered brain function and resulted in providing comprehensive treatment that helps us to reach out to these children and help them to reach out to the world…