What to know about autism

In the US, April is autism awareness month. According to the World Health Organization, autism affects 1 in every 100 children. More formally known as autism spectrum disorder (ASD), autism is an umbrella term used to describe a group of neurodevelopmental disorders. اضافة اعلان

Autism is mainly characterized by marked delay in language and social development. There is no estimate on the prevalence of autism in Jordan since no formal investigation has been done into the matter. Moreover, a proper estimate would be difficult due to the delay in diagnosis.

A 2013 review of 84 cases in Jordan investigated some of the causes of autism and parent knowledge of autism diagnosis. Only three of those participating in the study had been diagnosed with autism and an additional four were referred by the pediatrician who suspected autism. Furthermore, despite parents’ concerns about their child’s late development, a minority of patients received an early diagnosis or referral. The study attributed this to the lack of screening for ASD by pediatricians. In short, Jordan needs more campaigns to raise awareness about autism.

Autism typically becomes apparent in the early stages of childhood development, particularly between 12 and 24 months. A diagnostic tool for mental disorders, known as the DSM-5, divides ASD into two categories, and a child must display symptoms in both categories to be diagnosed with autism. One category is issues with communication and social interaction, which may vary widely, depending on the severity, but must present before the age of 5. Although infants do not generally begin to speak until they reach 12–18 months, there are other forms of communication that those with autism will not be able to use and that may serve as an early indication. These may include avoiding eye contact, not responding to their name, not displaying facial emotions, or rarely using hand gestures.

As they age, the signs of autism become more apparent as it is difficult to express feelings and understand others’ feelings, and to speak.

These traits continue to persist into adulthood.

The other category is restricted or repetitive patterns of behavior or activities. These can include repetitive movements or reciting words or phrases, an attachment to routines, and obsessive interests. Children with autism may also exhibit other signs such as hyperlexia, which is the ability to read well beyond their age, typically around 2 years old. Additionally, those with autism may become overstimulated by certain sensory inputs such as sound, smells, or tastes.

Types of autism

As the name implies, ASD refers to a broad range of developmental delays in social skills. As a result, the 2013 DSM-5 currently recognizes five different subtypes that serve as specifiers of the severity of ASD. The subtypes are:

1. With or without accompanying intellectual impairment.

2. With or without accompanying language impairment.

3. Associated with a known medical or genetic condition or environmental factor.

4. Associated with another neurodevelopmental, metal, or behavioral disorder.

5. With catatonia (a group of symptoms that usually involve a lack of movement and communication, and can also include agitation, confusion, and restlessness).

Under the new DSM-5, an individual can receive a diagnosis of one or more subtypes. Prior to 2013, it was common for people to receive diagnoses such as autistic disorder, Asperger’s syndrome, pervasive development disorder-not otherwise specified (PDD-NOS), or childhood disintegrative disorder. These conditions still fall under the term ASD, but no longer follow those names. A person previously diagnosed with one of the conditions should be reevaluated to receive a diagnosis that follows the DSM-5.

Causes

As is the case with many conditions and diseases, there is no exact cause for autism and is likely multifactorial. Environmental factors such as heavy metals, toxins, and some medications, such as valproic acid, have been linked to higher instances of autism. Some congenital conditions can also significantly increase the risk of autism, such as fragile X syndrome and tuberous sclerosis.

Genetic factors seem to be the biggest risk factors when it comes to autism. Some research seems to suggest that autism may be an X-linked disorder. This theory came about due to the fact that males are four times more likely to have autism than females.

Additionally, a family history of autism also plays a role. Those with an immediate relative who has autism is at higher risk. Due to the heavy involvement of genetics in autism, consanguinity (marriage within a common ancestry) may increase the risk of autism.

The aforementioned 2013 study found that of the 84 cases, 45 percent had a history of consanguinity. In Jordan, by 2018, consanguinity was still at 28 percent. Furthermore, a 2020 study investigating the relationship between consanguinity and autism found that it poses a significant risk of ASD and other complications. As a result, they suggest that high-risk groups in North Africa, Middle East, Pakistan, and south India undergo in-depth screening for autism.

Autism and vaccines

The concern that vaccines may cause autism goes back to 1998, to a doctor by the name of Andrew Wakefield. He and his colleagues published a case study that suggested a link between autism and the measles, mumps, and rubella (MMR) combined vaccine. Since then, the study has been debunked numerous times and it was retracted in 2010.

Shortly after the MMR controversy, people started being skeptical about an additive in vaccines known as thimerosal, which is a mercury-based preservative used to prevent contamination with bacteria and fungi in multidose vials. Critics began to assert that thimerosal could cause autism, even though it was not an additive in the MMR vaccine. Numerous studies have been published that established no link between thimerosal and ASD, nine of which were funded or conducted by the Centers for Disease Control and Prevention. Nevertheless, between 1999 and 2001, manufacturers began to remove or reduce the amounts of thimerosal in vaccines.

Helping those with autism

There is no cure for autism, which persists into adulthood. There are, however, many supportive therapies that can help alleviate certain symptoms, such as behavioral therapy, physical therapy, speech therapy, massages, weighted blankets, or meditation.

Every individual is different and there will be much trial and error before finding the most effective supportive therapy. There are many alternative remedies that claim to help those with autism, but research is mixed and some may even be dangerous. It important to research the information on alternative therapies from reliable sources.

Jordan is home to the Scientific Center for Autism and Developmental Disorders, one of the first to focus on developmental disorders and provide supportive services and comprehensive care to children with autism.


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