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Dr. Swati Mishra
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Dr. Rajeev Sharma
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Last updated on:
20 Nov 2024 | 03:06 PM (IST)

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Autism

Autism

Also known as Autistic Disorder, Asperger Disorder, Childhood disintegrative disorder, and Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS)

Overview

Autism, now known as autism spectrum disorder (ASD), refers to a broad range of conditions characterized by challenges with social skills, repetitive behaviors, speech and nonverbal communication. 


Autism is a developmental disability caused by differences in the brain due to genetic conditions. Other causes are not yet known, however there are multiple risk factors that can play a role in the development of autism. The most common risk factors are nutritional deficiencies during pregnancies, age of the parents, infections, exposure to toxic chemicals and certain drugs.


Individuals with autism have difficulty in communication and adapting to social situations. They find it hard to understand what others are thinking or feeling, they get very anxious about social situations and find it hard to make friends or prefer to be on their own.


The treatment and management depends on the severity of symptoms. Though, there might be no cure for autism the goal of treatment is to maximize an individual’s ability to function by training them on social, communication, functional and behavioral skills.

Key Facts

Usually seen in
  • Children between 12-18 months of age.
Gender affected
  • Both men and women, but more common in men.
Body part(s) involved
  • Brain
Prevalence
  • World: About 1 in 100 children has autism (2022)
  • India: About 1 in 84 children has autism (2021)
Mimicking Conditions
  • Heavy metal poisoning (mercury and lead)
  • Aminoacidurias
  • Hypothyroidism
  • Brain tumor
  • Organophosphate exposure
  • Seizure disorder (atypical)
  • HIV infection
  • Childhood schizophrenia
  • Other rare conditions (glycogen storage disorders)
  • Subacute sclerosing panencephalitis
  • Tuberous sclerosis
  • Creutz-Jacob disease/new variant CJD
Necessary health tests/imaging
  • Assessment for dysmorphic features
  • Wood’s lamp examination of the skin
  • Full neurologic examination with a head circumference
  • Genetic testing
Treatment
  • Therapies: Deep brain stimulation (DBS), Behavioral and psychological therapy, Occupational therapy and Communication therapy.
  • Medications: Antipsychotics and Antidepressants.
Specialists to consult
  • Pediatric neurologist
  • Developmental-behavioral pediatrician
  • Child psychiatrist
  • Child psychologist

Types Of Autism

 

In 2013, the American Psychiatric Association merged four distinct autism diagnoses into one umbrella diagnosis of autism spectrum disorder (ASD). They included:

 

Autistic disorder

It is also known as “classic” autism. Individuals with autistic disorder usually have significant language delays, social and communication challenges, and unusual behaviors and interests. Generally, people with autistic disorder may also have an intellectual disability.

 

Asperger syndrome

This syndrome is categorized by milder symptoms of autistic disorder and the individuals might have social challenges and unusual behaviors and interests. But, they typically do not have problems with language or intellectual disability.

 

Pervasive developmental disorder – Not otherwise specified (PDD-NOS)

This is sometimes called “atypical autism”, and individuals who meet some of the criteria for autistic disorder or Asperger syndrome, but not all, may be diagnosed under this. These people usually have fewer and milder symptoms than those with an autistic disorder which might cause only social and communication challenges.

 

Childhood disintegrative disorder

Also known as Heller's syndrome disintegrative psychosis is a rare condition characterized by developmental delays in language, social function, and motor skills after 3 years of age. 

There are a lot of myths regarding autism. Read about the top 7 myths about autism that are debunked here.

Symptoms Of Autism


Signs of autism usually appear by age 2 or 3. Some associated development delays can appear even earlier, and often, they can be diagnosed as early as 18 months. These include:

Symptoms in children

Usually, a child with autism will present with several indicators that include:

  1. Behavioral symptoms

  • Inexplicable tantrums
  • Unusual interests or attachments
  • Uncommon movements such as flapping hands or spinning
  • Extreme difficulty coping with any kind of change

  1. Sensory symptoms

  • Being scared of certain sounds
  • Does not look directly at an object or person
  • Fascinated with moving objects
  • High tolerance towards temperature and pain

  1. Communicational symptoms

  • Not responding to their name by 12 months
  • Not giving any reactions by 12 months

 

Know the 5 early symptoms of autism in children.
 

Symptoms in adults

People with autism have difficulty with social communication and interaction, restricted interests, and repetitive behaviors. The symptoms include:

 

  1. Behavioral or interactive symptoms

  • Avoiding eye contact
  • Infrequently sharing interest, emotion, or enjoyment of objects or activities 
  • Not responding or being slow to respond to one’s name or to other verbal bids for attention
  • Difficulty in keeping up with the conversations
  • Often talking at length about a favorite subject without noticing that others are not interested or without giving others a chance to respond
  • Displaying varied facial expressions, movements, and gestures 
  • Having an unusual tone of voice that may sound sing-song or flat and robot-like
  • Difficulty in understanding another person’s point of view
  • Unable to predict or understand other people’s actions
  • Difficulties adjusting behaviors to social situations
  • Difficulties sharing in imaginative play or in making friends

  1. Restrictive or repetitive symptoms

  • Repeating certain behaviors or having unusual behaviors
  • Having a lasting intense interest in specific topics, such as numbers, details, or facts
  • Overly focused interest in moving objects or parts of objects
  • Becoming upset by slight changes in a routine 
  • Being more sensitive towards light, sound, clothing, or temperature
  • Experiencing sleep problems and irritability

 

Note: People with autism also may have many strengths like being able to learn things in detail, having strong visual and auditory learners, and excelling in math, science, music, or arts.

Read about 7 things about autism that you may not know about.

Causes Of Autism

Autism is a complex disorder and there’s no exact cause for it, however, it can develop from a combination of genetic and nongenetic, or environmental influences. These influences appear to increase the risk that a child will develop autism.

Risk Factors For Autism


The fact that symptoms and severity vary from person to person and the complexity of this disorder, both genetics and environment may play a major role.

Genetic risk factors

  1. Genetic mutation: Most individuals with autism have rare gene mutations (changes) and these mutations occur in only a single gene.

  1. Heritability: The recurrence risk of pervasive developmental disorder in siblings of children with autism is 2% to 8%.

Environmental risk factors

  1. Paternal age: Studies suggest that advanced paternal age was associated with an increased risk of autism that in turn is associated with gene mutations. These mutations occur with advancing age.

  1. Environmental chemicals: Several environmental agents were identified as strong contributors to learning and developmental disabilities in humans. These include:

  • Arsenic
  • Lead
  • Manganese
  • Mercury
  • Pesticides
  • Polybrominated diphenyl ethers (PBDEs)
  • Polychlorinated biphenyls (PCBs)
  • Polycyclic aromatic hydrocarbons (PAHs)
  • Solvents

  1. Drugs: Exposure to pharmacological agents particularly during pregnancy represents a highly relevant environmental concern relative to the risk of autism. These include:

  1. Dietary factors: Diet-influenced factors are part of the potential environmental risk factors for autism that have been largely overlooked until recently. These include deficiencies of the following:

  • Vitamin D: Some studies have found that mothers of autistic children versus those with non-autistic children have reduced serum vitamin D levels.
  • Folic acid: Folate availability has also been suggested as a possible factor in the risk of autism because of its role in affecting neurodevelopment.

  1. Infections: The idea that maternal and/or early infant infections could influence neurodevelopment and contribute to adverse outcomes.

  1. Assisted reproductive technologies (ART): Children conceived using ART were more likely to be diagnosed with autism than those conceived naturally.

  1. Pregnancy-related factors: Studies demonstrate that certain prenatal factors that aid in the development of autism include:

  • Maternal asthma
  • Allergic conditions
  • Maternal toxemia or bleeding
  • Prenatal stressors
  • Beginning of prenatal care
  • Urbanization of birthplace
  • Pregnancy and birth complications like extreme prematurity, low birth weight, multiple pregnancies
  • Pregnancies spaced with less than a one-year gap


Understand week-by-week symptoms related to pregnancy.
Watch This

Diagnosis Of Autism

 

Evaluation of autism begins with a screening of the general pediatric population to identify children at-risk or demonstrating signs suggestive of autism, after which a thorough diagnostic evaluation needs to be done.
 

A parent interview, collection of any outside informant observations, and direct clinician observation of the child’s current cognitive, language, and adaptive functioning by a clinician experienced with autism should be components of this comprehensive assessment. Further, diagnostic evaluation include:

Complete physical examination

Individuals with autism often have a number of unusual physical characteristics, which can be evaluated by the following:

 

  1. Assessment for dysmorphic features: Dysmorphology is the study of the atypical development of physical features which include birth defects like presence or absence of ear pit. 

  1. Full neurologic examination with head circumference: Individuals with autism often show a high level of anxiety and are frequently affected by comorbidities that influence their quality of life. Also, studies demonstrate children with autism often exhibit an atypical trajectory of head circumference (HC) growth, which may be an indicator of vulnerability to autism.

  1. Wood’s lamp examination of the skin: This test is often used to make a diagnosis of specific skin and hair disorders. 

Genetic testing

Currently, no clear biomarkers or diagnostic measures exist for autism, and the diagnosis is made based on the fulfillment of descriptive criteria. Given a relatively high yield in patients with autism, clinical genetic testing is recommended. It can provide information regarding medical interventions or work that might be necessary and help with family planning.


Note: Children with autism should also be screened for other illnesses or learning disorders, the comprehensive evaluation may include blood tests and hearing tests. Get tests in the comfort of your home.

Celebs affected

Daryl Hannah
Daryl Hannah is an American actress & environmental activist who is known for her roles in films such as Splash, Blade Runner, and Steel Magnolias. She was diagnosed with autism as a child. Though she was extremely shy around other people and very fearful of the spotlight as an adult, her special interests in watching movies supported her career as an actress.

Prevention Of Autism


There's no way to prevent autism, however, certain measures taken during pregnancy along with early detection and screening can reduce the impact to a greater level. These include:

Get genetic testing done

Genes represent the baseline susceptibility, which results in physiological changes that overcome the individual’s resilience and adaptation. Manipulation of these factors can render some kind of prevention.

Find out more about genetic testing and whether the disease runs in your family.

Beware of congenital hypothyroidism

Maternal hypothyroidism during pregnancy also increases the risk of autism. Testing for congenital hypothyroidism during pregnancy can be a game changer.


Avoid smoking during pregnancy

Studies suggest that maternal smoking during pregnancy is correlated with risks for pregnancy and birth complications as well as long-term effects like asthma and behavioral problems or autism.

Want to quit smoking?

Try our exclusive smoking cessation range to get rid of this deadly habit.

Protect yourself from air pollution

Air and chemical pollution are also a matter of general public health that have an effect on the development of autism in children whose mothers are exposed to it. 


Avoid high thermal-intensity ultrasound

Studies suggest that the use of modern high thermal-intensity ultrasound in the first trimester of pregnancy increased the risk of autism. Since the toxic window covers the first trimester, avoidance or reasoned use of ultrasound during this period may decrease the overall risk for autism.


Eat healthy

Nutritional deficiencies are a known risk factor for the development of autism. Make sure to get enough Vitamin D and folic acid during pregnancy.


Add multivitamins to your regime

Multivitamin with folic acid during pregnancy is associated with a reduced risk of autism in children. Taking these supplements during pregnancy can be very beneficial to the mother and the child as well.

Explore our widest range of multivitamin supplements to meet all your needs.

Specialist To Visit

 

Diagnosing and managing autism requires a comprehensive approach that consists of the following:

  • Pediatric neurologist
  • Developmental-behavioral pediatrician
  • Child psychiatrist
  • Child psychologist

 

A pediatric neurologist diagnoses and treats children with diseases and conditions that affect the nervous system.

A developmental-behavioral pediatrician focuses on the strengths and weaknesses of the child.

A child psychiatrist is a doctor primarily concerned with the treatment of behavioral disorders and emotional problems that affect children.

A child psychologist is a mental health professional who uses psychological evaluations and various forms of therapy to help children.

Don’t hesitate to seek advice from our trusted team of doctors. 


Treatment Of Autism

 

The treatment of autism mainly consists of various educational and behavioral treatments. There are two kinds of interventions that have been used for treating autism, i.e. focused intervention practices and comprehensive treatments. These include:

Deep brain stimulation (DBS)

DBS has been used to send electrical impulses to specific parts of the brain [and provides a therapeutic benefit. Certain studies have demonstrated the efficacy of DBS for psychiatric disorders including refractory obsessive-compulsive disorder, depression, Tourette syndrome, and others in the past few years and have shown some good results in individuals with autism.


Medications

Antidepressants were the most commonly used agents followed by stimulants and antipsychotics. Antipsychotics were effective in treating repetitive behaviors in children with autism. Alternative options include opiate antagonists, immunotherapy, hormonal agents, megavitamins, and other dietary supplements.


Behavioral and psychological therapies

Individuals with autism may be referred to specialists who provide behavioral, psychological, educational, or skill-building interventions. These programs may help people with autism in managing their behavior as these are highly structured and intensive therapies that also involve caregivers, siblings, and other family members.


Other interventions

While there is no "cure" for autism, there are several effective interventions that can improve a child's functioning. Those include:

 

  1. Training for social skills: This training is done in groups and the children with autism are taught to navigate through social situations.

  1. Therapy to improve communication: These therapies are focused to improve the child's speech patterns and understanding of language.

  1. Training for parents: In this, the parents are shown effective ways of responding to problematic behavior and encouraging appropriate behavior in their child.

  1. Occupational therapy: This type of therapy addresses adaptive skills and helps individuals with activities of daily living, as well as problems with handwriting.

  1. Special education services: This includes special day classes for very young children to address language, social, and life skills.

 

Treating other conditions

Children with autism experience many other symptoms like insomnia, anxiety, depression, and intellectual disability that need to be addressed. The impact of these conditions can be reduced with the proper services, psychotherapy, and medical treatment.

 

Read about how cognitive therapy can benefit individuals with anxiety, which is a common trait of people with autism.

Home care For Autism

 

Managing individuals with autism can be tricky as every individual is different with an array of symptoms. The most important part is patience and care. Also, there are certain natural remedies consisting of dietary and sensory tips that have been known to yield good results in managing individuals with autism. These include:

Avoid gluten

Studies suggest a beneficial effect of the gluten-free diet (GFD) in managing behavioral and intellectual problems associated with autism. A gluten-free diet can also help in improving gut health, especially if the individuals have symptoms of digestive disorder.

Try deep-pressure techniques

It involves applying deep pressure, with the help of an inflatable ball, a cushion, or a pillow, which can help the individual calm down and go into a relaxed state as people with autism can have trouble keeping still or being calm.

Say hello to probiotics

Probiotics are healthy bacteria that can have a very positive impact on autism. In a preliminary study, probiotics have shown promising results in alleviating some of the symptoms of autism and mood disorders by directly restoring the gut microbiota. 

 

Buy pre and probiotic products online to keep your gut healthy and happy.

Add omega-3 fatty acids to the diet

Foods rich in omega-3 fatty acids help in the development of brain functions, and can have a positive effect on the development which is good for individuals with autism. These include

  • Fatty fish

  • Fish oil

  • Cod liver oil

  • Flax seeds (Alsi)

  • Chia seeds (Sabze ke beej)

 

Note: Add omega-3 supplements if you do not meet the dietary requirements. You can up your healthcare game by choosing omega-3 supplements from our extensive range.

 

Give importance to sleep

Autism can cause an imbalance of the sleep hormone called melatonin hormone leading to irritability and underdevelopment of the brain functions. Including melatonin in the diet can help in steadying the sleep pattern. Good food sources of melatonin include:

 

 

Use weighted blankets

It can improve the quality of sleep as weighted blankets provide a calming effect on the body. Individuals with autism can benefit the most from it because it increases the release of serotonin, a hormone responsible for mood, sleep, and digestion. 

Allow time with electronic tablets

Tablets help the overall education of the individual as it go at their speed and allow them to learn without pressure. Also, it can improve the motor skills of kids with autism.

Add supplements

Supplements like vitamin D, vitamin C, and magnesium, can be very helpful as the deficiencies of these can cause impairment in brain function, changes in behavioral patterns, and poor concentration.

Include turmeric in your food

Turmeric (Haldi) is the most versatile herb with antimicrobial, anti-inflammatory, and antioxidant effects on the body. It can significantly improve gut health which can improve or lessen certain symptoms of autism.

Apply essential oils

Children with autism can benefit from essential oils as it has various positive effects, including boosting the mood, promoting mental clarity and reducing stress. These oils include:

  • Sandalwood

  • Lavender

  • Cedarwood

  • Chamomile

  • Peppermint

Essential oils are not just good for relaxation. Read about the incredible benefits of essential oils that you are yet not aware of.

Complications Of Autism

A range of disorders generally accompany autism. These complications include:

 

  • Gastrointestinal (GI) problems: Children with autism tend to have more medical gastrointestinal (GI) symptoms such as abdominal pain, constipation and diarrhea when compared to others.

  • Epilepsy: It commonly develops with the risk of seizures that increases throughout childhood with the highest seizure number occurring during adolescence.

  • Malnutrition: Studies showed that limited food preferences were the most common atypical eating behavior in autism groups that can lead to decreased nutrition.

 

Is your child a picky eater? 

Learn how to provide complete nutrition with healthy eating habits.

Alternative Therapies For Autism

 

Complementary and alternative interventions for autism involve special diets and supplements. Along with this, there are certain therapies and treatments that can help manage the symptoms of individuals with autism. These include:

Homeopathy

Autism treatment in homeopathy can vary and there is no recipe book of homeopathic remedies to give to a child. However, homeopathic intervention in children with autism holds promise, and integration of homeopathy with conventional measures can enhance the outcome.

Ayurveda

Treatment of autism with Ayurveda generally focuses on maintaining balance and treating the “dosha” which includes a daily Ayurvedic massage. Many children have difficulties with a change in routine and a daily Ayurvedic massage can be soothing for the child.

Check out our Ayurveda page.

Traditional Chinese medicine (TCM)

Traditional Chinese Medicine, along with acupressure and acupuncture, is another approach to treating autism symptoms. Studies show that the use of interventional modalities in TCM has a positive impact on its efficacy.

Chelation therapy

This therapy is designed to flush heavy metals from the body and it involves the administration of a chelating substance that binds to heavy metals, such as lead and mercury, which then is excreted in the urine. There is no evidence that metals cause autism or proof that this option works.

Living With Autism


Autism is a complex disorder that needs utmost accessibility, inclusivity, and support and the care for people with autism needs to be accompanied by actions at community and societal levels. Living with individuals who have autism can be quite a task, here are a few tips for caregivers that can help in handling them:

Minimize any changes in the daily routine

Any changes in the daily routine can lead to erratic behavior as many people with autism get upset by minor changes. So, try to stick to a schedule and the way things are done. Also in case of illness, having a team of healthcare specialists come to your home, can minimize the disruption to the daily routine and make it easier to provide the necessary treatment.


Teach the patients relaxation techniques

Behavior problems are a common issue in people with autism and calming techniques, such as deep pressure massage or wearing weighted clothing, may soothe agitation. Relaxation teaching involves teaching how to tighten and relax their muscles, including those in the hands, arms, and legs in combination with deep breathing, and can help alleviate stress and agitation.

 

Learn 5 relaxation techniques to manage your stress and anxiety.

Manage social anxiety

For individuals with autism, social anxiety can act as a trigger. It can be hard to know if a person with autism is experiencing anxiety. Always stay alert to signs that your loved one with autism is not behaving in a way that is normal for him or her.


Maintain personal space and boundaries

If you’re caring for a child with autism, and your child is sick, bringing in a doctor who might not understand the personal boundaries can be a trigger and can also lead to the unintentional spread of germs. The best way to prevent this from happening is to rely on in-home treatment instead.


Supervise gastrointestinal disorders

Another common ailment in children with autism is a gastrointestinal disorder which can include chronic diarrhea and constipation. Make sure to give in-home careers so it can eliminate the risk of an accident or uncomfortable situation.


Be vigilant in case of emergency

Seizure disorders and epilepsy are frequently reported medical comorbidities in individuals with autism. In-home treatment is a top choice for someone experiencing a mild seizure, but if the symptoms include involuntary stiffening or jerking of muscles, confusion, loss of consciousness, call an ambulance or visit your doctor immediately.


Tips for Parents

Having a child with autism affects the whole family and it can be stressful, time-consuming and expensive. Paying attention to the physical and emotional health of the whole family is important. Here are some other tips that can help:

  • Learn everything about autism
  • Make a consistent schedule and routine
  • Connect with other parents of children who have autism
  • Seek professional help for specific concerns
  • Take time off for yourself and other members of the family
  • Understand your child's triggers and try to avoid them
  • Always use positive reinforcement to manage any tantrums.

Note: Children with autism often experience changing routines as a major challenge and one such major change in everyone’s life in the past couple of years was the COVID-19 pandemic. Get all your queries answered on COVID-19.

Frequently Asked Questions

References

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  10. Key Facts. Autism. World Health Organization.External Link
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