Every April 2 is celebrated as World Autism Awareness Day. On this occasion, psychologist María Gallego explains what the disorder consists of and how it should be treated.
According to the Diagnostic and Statistical Manual of Mental Disorders, autism spectrum disorder (ASD) is diagnosed four times more frequently in males than in females. In clinical samples, girls are more likely to show accompanying intellectual disability, suggesting that in girls without intellectual impairment or language delay, the disorder may not be recognized, perhaps because the manifestation of social and communication difficulties is more subtle.
What is autism and are there different types?
Autism spectrum disorder is characterized by persistent deficits in social communication and social interaction in multiple contexts, including deficits in social reciprocity, nonverbal communicative behaviors used for social interaction, and skills in developing, maintaining, and understanding relationships.
In addition to deficits in social communication, the diagnosis of autism spectrum disorder requires the presence of restrictive or repetitive patterns of behavior, interests or activities.
Symptoms, which cause clinically significant impairment, must be present early in the developmental period, but may not fully manifest until social demands exceed limited abilities, or may be masked by strategies learned later in life.
In the diagnostic process we record the individual clinical characteristics of the patient through the use of specifiers, which gives us the possibility to individualize the diagnosis and to make a more detailed clinical description of the affected persons.
In this way we specify, for example, whether the patient has:
- With or without intellectual deficit.
- With or without language impairment.
- Associated with a medical or genetic condition or a known environmental factor.
- Associated with another neurodevelopmental disorder, or another mental or behavioral disorder.
At the same time, specifiers are used to describe autistic symptoms, establishing a classification, for example, according to the level of severity of the symptoms.
Can autism be prevented?
Some causes of autism are known to be related to genetic alterations and brain malformations. There are studies that point to advanced paternal age, the intake of certain drugs during pregnancy or prematurity as risk factors.
Research carried out to date has not been able to demonstrate a relationship with food or vaccines.
Current lines of research point to a genetic predisposition that could be influenced by environmental factors.
What difficulties do people with autism suffer in our society?
In some young children with ASD, deficiencies in social and communication skills, for example, can hinder learning, particularly that which occurs through social interaction or with peers. In the family home, adherence to routines and resistance to change, as well as sensory sensitivities, can interfere with day-to-day living (haircuts, dental work, etc.).
Difficulties in social relationships, rigidity and problems accepting change may persist into adulthood.
How is autism treated?
In order to improve the patient’s prognosis, it is advisable to make an early diagnosis in order to start treatment as soon as possible.
For this reason it is important to turn to the pediatrician, who will orient the family and refer to the neuropediatrician or child psychiatrist. These specialists may require complementary tests (medical, psychological…) and will advise the family about the professionals who should intervene, depending on the specific case (psychologists, speech therapists, pedagogues…), coordinating such intervention.
Treatment programs should be comprehensive, and should be oriented to the specific deficits presented by the patient. Likewise, it is advisable that the persons responsible for the child (family or teachers, generally) receive the appropriate advice and support.
How should we relate to children with autism? And with adults?
Taking into account the limitations they present, and understanding what their specific deficits consist of. Autism spectrum disorder encompasses people with very different clinical manifestations, so it is essential that we know the reality of the person himself.
Psychologists advise, mainly parents and teachers, on how to deal with the day-to-day life of the family or school.
Finally, it should be noted that although there are cultural differences with respect to normality in social interaction, nonverbal communication and relationships, people with autism spectrum disorder manifest a pattern markedly different from normality within their cultural context. Also, various cultural and socioeconomic factors may affect the age of recognition or diagnosis.