Definition

 Autism Spectrum Disorder (ASD) is a Neurodevelopmental disorder.

 It involves a wide range of problematic behaviors, including deficits in language and

perceptual and motor development, also includes limited and repetitive patterns of
behavior and impairments in social communication.

 The word "spectrum" refers to the broad range of symptoms and severity.
Usually starting in early childhood, ASD can lead to challenges in social functioning,
education, and employment.

 A common indicator is when a child appears apart or aloof from other people, including
their mothers.

 Within the first year, the majority of kids exhibit symptoms. Between the ages of 18 and
24 months, some children may regress after initially developing properly.

 Although there is no cure, many children's prognosis can be significantly improved with
early interventions

Etiology
 Genetic Factors:
Gene Mutations
Twin and sibling studies suggest a strong heritability, with 2-14% recurrence and ~20%
exhibiting symptoms.
• Approximately 80% of risk is expected to be inherited.
Epigenetic Factors

• Epigenetic inheritance alters the transcription of genes without changing the DNA
sequence.
Immune System Factors
• Maternal autoantibodies targeting fetal brain proteins • Pregnancy-related infections
Nutritional factors
• Issues with folic acid metabolism.
• Vitamin D deficiencies.
Environmental Factors
• Electromagnetic radiation (EMR) •
Prenatal exposure to air pollution
Parental age is a risk factor.
• Older males (>40 years) had a 6x higher risk of having a kid with autism compared to
 fathers under 30. • Teenage and older mothers (in their 40s) have a higher autism risk. •
Large parental age gaps (e.g., older men with much younger women) can raise
neurodevelopmental risks.
 Maternal problems include: o Obesity, o Diabetes, o Immune system abnormalities, o
Extreme prematurely born or extremely low birth weight, and o Birth difficulties,
including brain oxygen deprivation.

 Symptoms:

 Autism Spectrum Disorder (ASD) Diagnostic Criteria, DSM-5

A. Persistent deficiencies in social interaction and communication in various contexts:
• Social-emotional reciprocity deficiencies:
Unusual social behavior
o Inability to engage in back-and-forth dialogue
o Less sharing of passions, feelings, or affect
o Inability to start or participate in social interactions
• Nonverbal communication deficiencies include:
o Inadequate fusion of verbal and nonverbal communication
o abnormalities in body language and eye contact
o Difficulty interpreting and utilizing gestures
o Absence of facial expressions and other nonverbal clues
• Relationship problems:
o Inability to modify conduct to suit various social situations
o Difficulty forming friendships or sharing imaginative play
o Lack of interest in peers
 B. Restricted, repeated patterns of behavior, hobbies, or activities (at least two):
• Repetitive or stereotypical behaviors, such as:
Repetitive motor motions, such as hand flapping and rocking.
- Repetitive use of objects (e.g., arranging toys)
Repetitive speech, including echolalia and idiosyncratic words.
• Insisting on consistency, such as rigid routines or extreme anxiety with minor changes.
o Ritualized behaviors, such as taking the same route every day.
• Intense emphasis on strange interests, such as spinning wheels or remembering data.
• Sensory abnormalities may include hyper- or hyporeactivity to sensory input, as well as
unusual interest in sensory features such as lighting, textures, or sounds.
💡 Obsessive and restricting interests are frequently intense on uncommon topics.
 C. Early developmental onset: • Symptoms must appear in the early developmental
phase.
• Symptoms may not appear until social demands exceed coping capacity or are obscured
by learnt methods.
D. Functional Impairment: • Symptoms must cause severe impairment in social,
occupational, or other relevant areas of functioning.


Daily life challenges:

  Using camouflage to conceal signs of autism (Masking)
In order to fit in with societal norms, masking is hiding or repressing autistic
characteristics.
Here are some instances of masking:
Making eye contact when speaking
Tolerating sensory discomfort in circumstances that are noisy or overstimulating
More prevalent among women and girls
linked to detrimental effects on mental health, such as fatigue and stress
 Communication and Social Difficulties (If Left Untreated)
Relationship formation and maintenance difficulties Issues with: Recognizing social cues
Recognizing unwritten societal norms
Having a reciprocal conversation
If nothing is done, these problems may:
deteriorate with time
cause loneliness and social exclusion
 Burnout in Autism
A condition of extreme exhaustion with:
Social disengagement
Cognitive impairment
an escalating of symptoms of autism
Different from conventional burnout and depression
Initiated by:
Poor match between the individual and the surroundings
Overloading the mind
Long-term application of compensating techniques
Associated with:
Discrimination
Shame
Insufficient assistance and changes in the environment
has a detrimental effect on life quality (QoL).

Prognosis
The Importance of Prognosis
• Assists caregivers and families in setting reasonable goals and making plans.
• Helps educators and healthcare professionals customize supports and interventions.
• Informs public policy and resource allocation.
General Features
It is a lifelong condition:
• Autism has no known cure; symptoms can change or get better with time.
• Rather than curing autism, interventions seek to enhance functioning and quality of life.
Early Diagnosis and Treatment
• Making homes, schools, and communities autism-friendly requires early diagnosis.
While enhancing support and adaptation, core symptoms may not necessarily change.
• Early Intensive Behavioral Intervention (EIBI):

o May enhance traits including adaptive behavior and cognitive abilities.

Effectiveness differs greatly from person to person.

Cognitive Function as a Predictive Factor:

IQ is a significant indicator of long-term results.
A better prognosis is associated with higher early childhood IQ.
By the age of five or six, children who have a normal-range IQ and some language skills will be
more independent as adults.
Effects of Genetic and Medical Comorbidities
• Coexisting conditions such as genetic disorders and epilepsy
o Intellectual disabilities typically result in worse results, such as decreased living independence
and adaptive functioning.
The severity and variability of the outcomes
• The intensity of symptoms affects the prognosis and can vary over time.
• Some people:
o Become relatively independent o
Others need care for the rest of their lives
• Pre-intervention historical data: o
Poor results (no independent living, limited social participation, or employment) were
experienced by 60–78%.

Treatment:

 Parent Training: In autism intervention programs, parental and family participation is

crucial.
• Predicated on the idea that family interactions influence children's conduct.
•One thing that parents can learn is how to: o Adjust for emergencies at home.
Encourage and strengthen appropriate behavior.
• Parent education has been shown to be successful in enhancing young children's social
abilities.
Analysis of Applied Behavior (ABA)
ABA is the study of behavior modification based on operant learning concepts.
• Emphasizes learning new skills and enhancing socially appropriate behaviors.
•Standard ABA methods consist of:
 o Positive reinforcement, which uses toys, food, and praise to promote desirable
behaviors.
o Shaping (rewarding a behavior's successive approximations)
o Fading (progressively lowering cues to encourage self-reliance)
o Extinction (removing rewards for undesirable actions)
o Punishment (reducing behaviors using adverse stimuli)
 o Differential reinforcement, which rewards different actions or the absence of
problematic ones.
 Physical therapy focuses on enhancing motor abilities, including gross motor skills (like
body coordination) and fine motor skills (like finger movement).

 There is growing evidence that cognitive-behavioral therapy, or CBT, is beneficial for

school-age children and adolescents with ASD.
• Indicate improvements in: o Symptoms of anxiety
o Self-help and daily life abilities
Pharmaceutical Interventions for Specific Symptoms
• The main symptoms of ASD cannot be treated by medicine.
•The goal of pharmacotherapy is to control related symptoms, such as impulsivity,
hyperactivity, and inattention.
Aggression, tantrums, and irritability
Obsessive habits, depression, and anxiety
· Issues with sleep and seizures
 • Drugs can assist manage: o Self-harming behaviors (such as biting or head banging); o
Excessive energy or difficulty concentrating
• 41% of children with ASD have two or more psychiatric comorbidities, whereas up to
70% have at least one.
Speech and Language Therapy: Enhances:
o Language comprehension and usage o Communicating both expressively and
receptively
Occupational therapy helps people learn how to live independently by teaching them how
to dress, eat, take showers and interact with others.
• Could also include:
o Sensory Integration Therapy: to enhance responses to excessive sensory information