Autism Spectrum Disorder
According to the Center for Disease and Control and Prevention, approximately 1% of children globally suffer from autism (McPartland, Law & Dawson, 2015 p.124). In the United States only, an estimated figure is given of 1 out of almost 70 births in the country. It is marked as the fastest growing developmental disease increasing at a rate of 119% from 2000 to the year 2014 (McPartland, Law & Dawson, 2015 p.124). Autism related services cost the United States up to approximately 260 billion US dollars annually, at the price of about 2 million US dollars per person (McPartland, Law & Dawson, 2015). The prevalence of autism and its inability to be curbed is attributed to the fact that autism is not preventable or curable. This paper explores several aspects of the disease including its management.
These are a group of psychological conditions that manifest people from childhood, causing impairment in selective parts of the body. The ICD-10 commonly refers to them as Specific Disorders of Psychological Development (Lord et.al, 2012 p.306). These disorders include language, learning, speech, motor, neurodevelopment, and autism. Others that can loosely be classified as developmental impairments include schizophrenia and antisocial behavior (Lord et.al, 2012 p.307). These conditions are present from childhood and depending on the stage of diagnosis, and they improve as the toddler develops. Most of them are diagnosed under the age of 9 when those surrounding a child notice defects or certain inabilities in comparison to children of the same age.
There is no specific cause of these disorders, apart from existing theories that are used to draw scientific hypotheses. The most significant characteristics in play involve genetic composition and environmental factors that disrupt the normal human development process and create abnormalities. According to research on of the theory states that stress or trauma during the early childhood period can cause developmental disorders.
What causes the autism spectrum disorders
The disease was first described in the mid-20th century by a psychiatrist known as Leo Kanner (McPartland & Dawson, 2015 p.127). He stated that autism was an inborn defect without a definite causative factor, and detected in children from as early as a few weeks after birth to three years of age. Recent research attributes the disease to biology, naming hereditary factors and the pre and peri-natal environments as the greatest influencing factors.
Autism spectrum refers to a variety of conditions that are classified as neurodevelopmental disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). These diseases include Asperger Syndrome, childhood disintegrative disorder, autism, and pervasive development disorder not otherwise specified, abbreviated as PDD-NOS (Lord et.al, 2012 p.308).
Classification of ASD
Previous diagnosis manuals classified Asperger’s Syndrome and Autism as different sub-categories of disorders. However, the latest DSM-V manual includes both as a range of a larger disease depending on its severity (Lauritsen, 2013 p.37). People with both syndromes are categorized under the Autism Spectrum Disorder (ASD). Secondly, the DSM-5 handbook does not emphasize on the aspect of language delay or the exact age when the disease manifests itself (Lauritsen, 2013 p.37). Instead, it is classified as a neurodevelopmental condition whose symptoms occur in the early childhood stage with possible diagnosis at a later date. The DSM- 5 also changed the impairment areas from three to two namely social communication and behavior (Lauritsen, 2013 p.37). Finally, the clinical presentation of the disease currently uses clinical specifiers to describe ASD (Lord et.al, 2012 p.309).
According to scientific study, there are three types of genetic associations of ASD. The first is the familial aggregation of autism common in the siblings of affected ones, and the second category is the genetic combination of other conditions present in the family members of the afflicted children (Lord et.al, 2013 p.4). The third kind of genetic association involves the connection with specific conditions of recognized genetic composition (Yuen et.al, 2015 p.187).
How is autism diagnosed
Doctors and physicians diagnose the disease by determining a child’s behavior and growth, and the symptoms are more noticeable from age two (Volkmar, 2014 p.7). For those whose diagnosis is missed by that age, the disease becomes noticeable when parents or educators detect anomalies based on how the children play, socialize, and communicate. Diagnosing adults with ASD is difficult because some of the symptoms usually overlap with those of mental disorders such as ADHD and schizophrenia (Volkmar, 2014 p.9).
Diagnosis in children occurs in two stages namely:
a) General developmental screening
This process occurs during the well-child check-ups stage in growth. Parents are encouraged to visit pediatricians or early childhood health care physicians for checkups. The CDC recommends parents to take their children when they turn 1 or 2 years and maintain regular visits (Schaefer &Mendelsohn, 2013 p.404). Children at high risk are those who portray ASD tendencies, were born premature, and belong to a family of someone affected with ASD (Schaefer &Mendelsohn, 2013 p.404). Guardians are also urged to take their children for screening at an earlier stage if any of the risk factors are mentioned. The toddlers who display growth problems at this stage are referred to the next screening phase.
b) Additional evaluation
In this step, doctors, developmental healthcare physicians, and other health specialties experienced in ADS take part in observing the children. They include a developmental pediatrician, child psychiatrist, psychologist, and a speech pathologist (Schaefer &Mendelsohn, 2013 p.407). The developmental pediatrician has extensive knowledge on child growth, while the psychologist and psychiatrist deal with the brain development aspect. A speech or language pathologist specializes in detecting communication difficulties. The evaluation includes determining the cognitive abilities, language proficiency, and age-appropriate skills for normal daily functioning. In other cases, additional blood and auditory tests will be conducted because ASD has the chance of occurring alongside other learning disorders.
In older children, the disease is diagnosed mostly after they start school. In this setting, the evaluation is conducted by specialists in special education, who refer the children to healthcare professionals. The most prevalent symptom at this stage is socializing and communication difficulties such as body language, facial expressions, and determining the tone of voice (Schaefer &Mendelsohn, 2013). They may also display a difficulty in understanding humor, sarcasm, and figures of speech, and have trouble forming friendships or bonding with their peers.
In the case of adults, most of them make a personal assessment and visit the appropriate physician for diagnosis or referral for an ADS test. They are evaluated on their social interactions, expression challenges, restricted interests, sensory issues, and repetitive tendencies (Schaefer &Mendelsohn, 2013 p.400). The specialists also assess their growth and development history for accurate diagnosis. In most cases, the physicians also interview close family members or associates.
After the National Survey of Children’s Health (NSCH), Center for Disease Control and Prevention (CDC), and the National Center for Health Statistics (NCHS) published data about the increase in ASD rate in the country; it was essential for the state to determine the reason for this increase (Blumberg et.al, 2013 p.1). A case study was conducted to determine the prevalence of ASD among school going children aged between 6 and 17 in the United States using data collected from the three bodies (Blumberg et.al, 2013 p.1). The results indicated that the primary reason for the increase in ASD cases was due to late diagnosis of children whose condition was previously not recognized (Blumberg et.al, p.1).