Autism

Autism is not a disease. Autism spectrum disorder (ASD) is a neurodevelopmental disorder that can cause significant social, communication, and behavioral challenges.

In the past, autism spectrum disorders were divided into several different diagnoses such as:

• Asperger's syndrome

• Autistic disorder

• Kanner's Syndrome

• Childhood autism

• among others

Today, ASD is so-called because it is not divided into several names of different disorders, but is divided into a wide range of variations in type and severity.

Classification of the different levels of the ASD

Anyone who meets the criteria for having autism spectrum disorder (ASD) will later be diagnosed as having ASD level 1, 2, and 3 according to the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders.

These levels are based on a person's strengths and limitations in terms of their ability to communicate, adapt to new situations, expand beyond restricted interests, and manage everyday life. They specifically indicate how much support an autistic person needs, with level 1 meaning relatively little support is needed and level 3 indicating the need for a lot of support.

How is ASD explained biologically?

It is only known that autism affects information processing in the brain and the way nerve cells and their synapses connect and organize, however, how this occurs is not well understood.

Epidemiology

An average of 1 in 160 people worldwide have an ASD. Nevertheless, it is important to bear in mind that this number does not reflect a total reality since in less developed countries the diagnosis of ASD is not made.

A big myth about ASD is the fact that many people consider it to be something that only affects men, and that's a lie. Most studies show that the male: female ratio is 4:1, and there are even articles that go further and say it is 3:1. What happens is that ASD manifests itself differently in women and so often the diagnosis of ASD is not made. This happens because most of the studies done on autism are about males, nonetheless, it is necessary to understand that the functioning of the female body is different from the male body.

Causes

Although there are many studies on ASD, the truth is that this disorder is so complex that it is not possible to know for sure what the real causes are. It is only known that there are factors that make children more likely to develop an ASD, in particular genetic and environmental factors.

Genetic factors

• Heredity

• mother having an autoimmune disease

• Structural variations (deletion, duplication, or inversion)

• Genomic imprinting (a genetic phenomenon in which certain genes are expressed by only one allele, while the other is methylated (inactivated))

• X linkage (X-linked mutation)

Environmental factors

• Pollution

• Exposure to heavy metals

• Infectious diseases

• Phenols (used in plastics)

• Pesticides

• Alcohol

• Smoke

• Illicit drugs

Some myths about autism

Myth: Some vaccines like measles and rubella can cause ASD

FALSE - Studies show that nothing is linking ASD with vaccines used to immunize children.

Myth: Autistic people live in their own world and cannot socialize with other people

FALSE - Although some grades of ASD compromise socialization more, it is perfectly possible for people with autism to live with social interaction. At more advanced levels treatment may be needed.

Myth: People with ASD do not become intellectually stagnant, unable to learn.

FALSE - Autistic children may have more difficulties in learning according to regular education, however, everyone can learn and develop within their proper context. The autistic child/youth must be monitored by trained professionals who are able to understand the best way to teach them.

Myth: People with ASD are geniuses

FALSE - Some autistic people indeed have some exceptional ability, but they are not the majority.

About 10% of autistic people have what is called Savant Syndrome, also known as a genius syndrome. These people usually have a below-average IQ but some very strong ability in a specific area such as memory, calculation, languages, painting, or music, for example.

Myth: There is no cure or treatment for ASD

FALSE - The reality is that there is no cure for ASD as it is not a disease.

Medications are only prescribed when there are more severe symptoms that can harm the person's integrity or for other underlying disorders or illnesses besides autism (eg epilepsy, depression, anxiety, attention deficit disorder, hyperactivity, etc.).

But there are therapies for the person with autism to improve their social interaction, for example. These therapies usually involve the intervention of psychologists, doctors, occupational therapists.

Bibliography

• Ecker, C., Spooren, W., & Murphy, D. G. M. (2013). Translational approaches to the biology of Autism: False dawn or a new era. Molecular Psychiatry, 18(4), 435–442. https://doi.org/10.1038/mp.2012.102

• Iles, A. (2021). Autism Spectrum Disorders. Primary Care: Clinics in Office Practice, 48(3), 461–473. https://doi.org/https://doi.org/10.1016/j.pop.2021.04.003

• Loomes, R., Hull, L., & Mandy, W. P. L. (2017). What Is the Male-to-Female Ratio in Autism Spectrum Disorder? A Systematic Review and Meta-Analysis. Journal of the American Academy of Child and Adolescent Psychiatry, 56(6), 466–474. https://doi.org/10.1016/j.jaac.2017.03.013

• Prelock, P. A. (2021). Autism Spectrum Disorders. In The Handbook of Language and Speech Disorders (pp. 129–151). John Wiley & Sons, Ltd. https://doi.org/https://doi.org/10.1002/9781119606987.ch7

• Sanders, S. J., He, X., Willsey, A. J., Ercan-Sencicek, A. G., Samocha, K. E., Cicek, A. E., Murtha, M. T., Bal, V. H., Bishop, S. L., Dong, S., Goldberg, A. P., Jinlu, C., Keaney, J. F., Klei, L., Mandell, J. D., Moreno-De-Luca, D., Poultney, C. S., Robinson, E. B., Smith, L., … State, M. W. (2015). Insights into Autism Spectrum Disorder Genomic Architecture and Biology from 71 Risk Loci. Neuron, 87(6), 1215–1233. https://doi.org/https://doi.org/10.1016/j.neuron.2015.09.016

• Silverman, C. (2011). Understanding Autism: Parents, Doctors, and the History of a Disorder. Princeton University Press. https://doi.org/doi:10.1515/9781400840397

• State, M. W., & Šestan, N. (2012). The emerging biology of autism spectrum disorders. Science, 337(6100), 1301–1303.

• https://www.onecentralhealth.com.au/autism/10-myths-about-autism/ [16/09/2021]

• https://www.autismspeaks.org/what-autism [16/09/2021]

• https://www.who.int/news-room/fact-sheets/detail/autism-spectrum-disorders [16/09/2021]

• https://www.seeherthrive.com/blog/2020/11/5/autism-in-women-why-its-different-and-what-to-look-out-for [16/09/2021]