ASD is a diagnosis that describes a developmental disorder, characterized by a difficulty in communication and social interactions, behaviour, interests and repetitive activities. These impairments vary between individuals.

When does it start and what does it look like?

The first signs of ASD begin to show around 2 years of age and include a withdrawal or lack of progress in social skills in the early stages of achieving these skills such as language, non verbal communication, eye contact etc.

How to the impairments expressed?

- Lack of interest in the surroundings, interactions are only made to answer needs, lack of consideration in other people’s interests or level of understanding, and a lack of understanding other’s emotional responses.

- Doesn’t copy you (for example, doesn’t clap after you clap)

• Indifference or aversion from touch and social physical affection

• Lack of use and understanding of non verbal communication such as eye contact, gestures, facial expressions, intonation and body position

• Language developmental delay : Lack of use of language as a communication tool, limited vocabulary ( 1-2 words) , in some cases communicates through body movements

• Difficulty starting or having a conversation, and difficulty understanding what is being said

• Difficulty drawing conclusions, expressing opinions

• Monotonicity and resistance to change: preference to the same food , same words, same path to reach a certain goal

• Limited areas of interest: trains, cars, animals etc.

• Inappropriate sensual behaviour such as : looking a t objects through the angle of the eye, dealing with edges, rotating objects, or bright surfaces, lights or smells, sniffs and licks inedible objects, indifference to pain, over sensitivity to frequencies or specific noises with a lack of response to close noises or voices of other children.

• ADHD, depression, sleep disturbances, anxiety and learning difficulties

• Motor disturbances : difficulty walking such as tiptoeing, off balance, delay achieving age appropriate motor milestones.

What causes ASD?

Although most of the time there is no clear cause for ASD, there are known causes in some cases such as:

• Genetic diseases

• Brain abnormalities

• Parental age - there is a connection between parents of older age and the birth of a child with ASD

• Environmental factors such as exposure to substances, infections around the birth etc.

• Use of maternal drugs during pregnancy

Treatment

Treatment takes a comprehensive and multidisciplinary approach which uses and strengthens the child’s strengths in order to deal with the child’s difficulties. Interventions are decided based on each child’s age and needs.

• Behavioural and educational interventions aimed at the core effects of ASD meaning - communication/ social interaction difficulties and behavioural patterns, limited fields of interest, repetitive behaviours and activities.

• Medical - to treat medical or psychiatric complications or to provide control of symptoms

Treatment Goals

• Improve social skills

• Improve communication skills (spontanious and functional)

• Improve adapting skills

• Reduce negative and unwanted behaviours

• Promote academic performance

When should treatment start?

Of course, each treatment is adapted according to each child’s strengths, weaknesses and specific needs of the child and family. The early diagnosis and treatment has the potential to affect the outcome, especially behavioural, functional performance and verbal and non verbal communication.

Although there is no cure, the symptoms can be reduced with time and in a small number of cases be reduced until they no longer cause any functional disability.

Who is involved in the treatment?

A multidisciplinary team who follow the progress, provide guidance for behavioural programs and go over the child’s medical condition.

This team may include:

• Pediatrician, developmental doctor, paediatric neurologist

• Psychologist, neuropsychologist

• Occupational therapist, physiotherapy, behavioural analyst, speech theorist among others.

Ms. Hadeel Jumah, Ms. Tamar Sudry, Dr. Yair Sadaka

Child Neurology and Child Development

Last update:

27.03.20

Sources:

·  https://www.uptodate.com/contents/autism-spectrum-disorder-terminology-epidemiology-and-pathogenesis?search=autism%20causes&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

·  https://www.uptodate.com/contents/autism-spectrum-disorder-in-children-and-adolescents-overview-of-management?search=autism&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2