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Autism Spectrum Disorder

Autism Spectrum Disorder (ASD) is a complex developmental condition involving persistent challenges with social communication, restricted interests, and repetitive behavior. While autism is considered a lifelong disorder, the degree of impairment in functioning because of these challenges varies between individuals with autism.

Early signs of this disorder can be noticed by parents/caregivers or pediatricians before a child reaches one year of age. However, symptoms typically become more consistently visible by the time a child is 2 or 3 years old. In some cases, the functional impairment related to autism may be mild and not apparent until the child starts school, after which their deficits may be pronounced when amongst their peers.

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Expert Q&A: Autism Spectrum Disorder

Some of the signs of autism spectrum disorder (ASD) may be noticed before the age of 1, although a reliable diagnosis by an autism specialist can be made in children as young as 18 months of age. Unfortunately many children end up waiting until after their 4th birthday to be diagnosed with ASD. Delays in seeking an initial assessment and limited access to specialists are just a couple of factors that help to explain this delay. Children who have less severe ASD, or are from minority backgrounds, tend to be diagnosed later than those with severe symptoms. Researchers are developing ways of being able to diagnose autism at even younger ages, such as using eye tracking technologies. The diagnosis of autism is typically based on a clinical examination, which is often supported with other information and tests. There is no single scan or blood test that can independently diagnose autism.

My advice to parents is to trust their gut instinct when they are worried about their child and to seek the advice of their primary care pediatrician. This general assessment may then lead to a referral to a specialist who will perform a more comprehensive evaluation. Parents should also feel empowered to ask for a specialist opinion if they do not feel adequately reassured by a primary care evaluation.

A small minority of children show considerable improvement in their ASD symptoms following diagnosis. While ASD has historically been considered a life-long condition, recent research has shown that the outcomes associated with an ASD diagnosis can vary considerably. Some people who were diagnosed with ASD in their youth may improve dramatically, and show little difference to people who have never had the diagnosis.

Whether these individuals “grew out” of autism, or simply responded exceptionally well to the therapeutic interventions, remains up for debate. One should also question if the initial diagnosis of ASD was accurate in these cases. At the moment it is difficult to identify which children will “grow out” of autism, although those who have less severe symptoms and those who obtain early access to the appropriate therapies appear to have better outcomes.

Parents naturally want the best for their child, and many will try different treatments, diets and therapies to help their loved one. It is difficult to cover all of the numerous therapies but here are the key points:

  1. Medical and psychiatric conditions that co-exist with ASD should be identified and treated by a suitably trained physician. These can include immune problems, digestive problems and ADHD.
  2. Natural therapies or treatments are often advertised as being safe and effective. Unfortunately most of these treatments do not have high quality scientific evidence that supports either claim. Some parents have described improvements in their child by using specialized diets. The most important point here is to make sure the child receives enough calories and nutrients regardless of the dietary change.
  3. Parents should be very cautious of treatments that are advertised as being able to “cure” autism; these claims are often of a dubious nature.

There has been limited research into specific therapies for adults with ASD, and most treatment recommendations are based on research performed on children and teenagers. In my experience, many adults with autism also demonstrate symptoms of depression, anxiety or ADHD. Sometimes they will benefit from treatment with either psychotherapy, a medication or a combination of both.

While every adult with ASD also has their own individual challenges and needs, many of them encounter a common set of broader challenges. These include finding employment, housing, making friends and establishing close relationships.

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Arshya Vahabzadeh, M.D.

Arshya Vahabzadeh, M.D.

Vice President, Health Strategy and Communications Brain Power, LLC

Medical leadership for mind, brain and body.

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