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Autism, which is often referred to autism spectrum disorder (ASD), is a condition that encompasses a wide variation in functional impact and symptom severity (Anagnostou et al., 2014). The main features of autism include restricted interests or repetitive behaviors, language distortion, and difficulties in social interactions. This condition has become one of the most common neurodevelopmental diagnoses among children in the United States. Kong (2015) explains that it occurs in approximately 1 in every 68 children.

Autism, which is often referred to autism spectrum disorder (ASD), is a condition that encompasses a wide variation in functional impact and symptom severity (Anagnostou et al., 2014). The main features of autism include restricted interests or repetitive behaviors, language distortion, and difficulties in social interactions. This condition has become one of the most common neurodevelopmental diagnoses among children in the United States. Kong (2015) explains that it occurs in approximately 1 in every 68 children.

Autism 

Autism, which is often referred to autism spectrum disorder (ASD), is a condition that encompasses a wide variation in functional impact and symptom severity (Anagnostou et al., 2014). The main features of autism include restricted interests or repetitive behaviors, language distortion, and difficulties in social interactions. This condition has become one of the most common neurodevelopmental diagnoses among children in the United States. Kong (2015) explains that it occurs in approximately 1 in every 68 children. The significant increase in the prevalence rates of autism has created a huge demand for accurate and timely diagnosis (Anagnostou et al., 2014). This essay explores the history of diagnosis of the disease, its etiological explanations, methods of treatment, and factors that influence the treatment.

History of Diagnosis of Autism

For many medical conditions, one can draw a straight line from their initial descriptions to their diagnostic criteria. However, this is not the case with autism whose history has taken a number of detours. The diagnosis of autism has changed significantly since its inception with assessment, screening, and monitoring techniques continuing to evolve (Constatino & Charman, 2016). Originally, autism was described as a type of childhood schizophrenia that resulted from cold parenting, then as a set of developmental disorders, and lastly as a spectrum condition with wide-ranging degrees of impairment.  Along with these changes in views of the disease so has its diagnostic criteria shifted as well. Kanner discovered autism in the 1940s and diagnosed it using symptoms such as difficulty with forming relationships and social interactions, communication deficits, and repetitive and restricted interests and behavior (Anagnostou et al., 2014).

In the 1950s and 1960s, the diagnostic criteria still followed Kanner’s original observations with additions of other symptoms such as nervousness and obsessiveness, family characteristics, and language distortion (Adams & Matson, 2016). In the late 1960s, the diagnosis criteria involved comparing the development of a child with established milestones in what was referred to as a checklist of symptoms of Early Infantile Autism (Evans, 2013). Coding behavior of children with developmental conditions has been the main criteria for diagnosing autism since then. In the recent past, children who had autism were often identified and diagnosed at the age when they started attending school. However, this practice is changing fast because of various reasons including widespread screening requirements for autism, increased awareness about the disease, and increased acknowledgment of the significance of early intervention. Presently, reliable identification and diagnosis of autism are possible as early as the infancy stage.

Etiological Explanations

            Autism is a pervasive developmental disorder that still has no definitive etiology. What is known for sure is that the disease is caused by developmental problems in the brain that affect the phenotypic aspects of communication and social interaction. Considerable research has been conducted on the etiology of autism and the findings are that the disease is caused by different sets of causal factors that include neurobiological, environmental, and genetic that manifest in characteristic behavior signs.

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  • Neurobiological factors: Because of abnormalities in the genetic code of a child, it may lead to abnormal mechanisms for brain development which would, in turn, cause functional and structural brain abnormalities, neurobiological and cognitive abnormalities, and symptomatic behaviors (Williams, 2012). Neurobiological differences that are related to autism include issues with development of genetic code that involves multiple regions in the brain; functional and structural abnormalities of the brain such as increased gray matter in temporal and frontal lobes, functional and anatomical differences in the limbic system and the cerebellum; and differences in the response of the brain to the environment including disruptions in normative patterns that leads to reduced attention to social stimuli and diminished neural sensitivity to dynamic gaze shifts in infancy.
  • Environmental factors: Researchers are investigating how post- and prenatal environmental factors such as exposure to environmental intoxicants and drugs or dietary factors interrelate to genetic susceptibility to autism. There are various social disorders that have already been identified for further studies including insecticides, hydrocarbons, lead, flame retardants, and automotive exhaust (Landrigan et al., 2012). However, there are no specific environmental triggers that have been identified as yet.
  • Genetic risk factors: Many scientists in the medical field agree that autism is caused by genetic differences or mutations even though not all children can be identified as possessing a genetic mutation or linkage to members of their family. Research findings that support the idea that autism is linked to genesis include one that shows the disease is more common in boys as compared to girls because of genetic differences related to the X chromosome and twin studies that show identical twins have a high chance of having the disease in comparison to fraternal twins (Iossifov et al., 2014).

Best Practices for Treatment of Autism

There are many interventions for autism spectrum disorder yet only a few are seen as effective. The interventions that studies have proved to be effective are referred to as evidence-based practices (Wong et al., 2015). Below are examples of best practices in the treatment of autism:

  • Antecedent Package: These approaches involve making changes to the environment of the patient before the start of the problem behavior.
  • Joint Attention Intervention: These approaches are taught through other renowned treatments. The joint attention interventions are meant to increase the ability of patients of autism to focus on an activity or object. They are crucial to the development of communication and social skill. 
  • Behavioral Package: These interventions involve analyzing the behavioral data gathered before and after problem behavior and then designing a plan that involves changing the outcomes provided for appropriate and inappropriate behavior.
  • Modeling: This involves a strategy for instruction whereby individuals with autism are showed behavior and skill that they are supposed to have.
  • Comprehensive Behavioral Treatment for Young Children: This is also referred to as Early Intensive Behavioral Intervention (EIBI) or Applied Behavior Analysis (ABA). The interventions involve intensive early behavioral interventions that assist the affected persons to develop communication academic, and social skills.
  • Naturalistic Teaching Strategies: These interventions are used to teach a broad variety of skills in a real-world and contextualized format that is child-oriented and has high chances of leading to general success with the skill.

Other evidence-based practices used in treating autism include Peer Training Package, Schedules, Pivotal Response Training, Self-management, and Story-Based Intervention Package.

Current Understanding of what Influences Treatment of Autism

Autism is a complicated condition and until recently its pathophysiology has been poorly understood. The pace of research on autism has increased radically in recent years (Damiano et al., 2014). Neurological and immunological research in autistic patients has immensely enhanced the understanding of this condition. It is important that the findings of this research get to clinical practice so as to ensure appropriate therapies are used to treat the disease. According to Damiano et al. (2014), autism requires a multidisciplinary approach which would enable maximization of potential benefits for patients. Natural therapy also plays a crucial role in supporting the outcomes of other therapies including speech therapy, occupational therapy, and psychology. Recent discoveries of underlying genomic factors have shown that autism is very complex and has several networks of causal factors. According to Anagnostou et al. (2014), new experimental therapeutics focus on treatment of key symptoms and this can alter the developmental trajectories of the disease. The study also determines that treatment in animal models with single gene mutations for autism are very promising and most are in the clinical trial phase.

Conclusion

            Autism is a neurodevelopmental disorder that affects many children and whose prevalence is on the rise. This is a severe condition that significantly impacts the development of the affected individuals. Evidence-based practice is crucial in treating autism. The long-term outcomes of individuals affected by autism are significantly impacted by the kinds of interventions that they are provided with. This shows the importance of using appropriate treatment methods for children suffering from this condition. Because of the severity and prevalence of this disease, there is extensive research about what influences its treatment, its assessment, and diagnosis, as well as its etiology. The findings thus far are promising and, in the future,, there will be better ways of combating autism.

References

Adams, H. L., & Matson, J. L. (2016). History and Purpose of Assessment and Diagnosis of Autism. In Handbook of Assessment and Diagnosis of Autism Spectrum Disorder (pp. 1-9). Springer, Cham.

Anagnostou, E., Zwaigenbaum, L., Szatmari, P., Fombonne, E., Fernandez, B. A., Woodbury-Smith, M., … & Buchanan, J. A. (2014). Autism spectrum disorder: advances in evidence-based practice. Canadian Medical Association Journal, 186(7), 509-519.

Constantino, J. N., & Charman, T. (2016). Diagnosis of autism spectrum disorder: reconciling the syndrome, its diverse origins, and variation in expression. The Lancet Neurology, 15(3), 279-291.

Damiano, C. R., Mazefsky, C. A., White, S. W., & Dichter, G. S. (2014). Future directions for research in autism spectrum disorders. Journal of Clinical Child & Adolescent Psychology, 43(5), 828-843.

Evans, B. (2013). How autism became autism: The radical transformation of a central concept of child development in Britain. History of the Human Sciences, 26(3), 3-31.

Iossifov, I., O’roak, B. J., Sanders, S. J., Ronemus, M., Krumm, N., Levy, D., … & Smith, J. D. (2014). The contribution of de novo coding mutations to autism spectrum disorder. Nature, 515(7526), 216.

Kong, M. Y. (2015). Diagnosis and history taking in children with autism spectrum disorder: dealing with the challenges. Frontiers in Pediatrics, 3, 55.

Landrigan, P. J., Lambertini, L., & Birnbaum, L. S. (2012). A research strategy to discover the environmental causes of autism and neurodevelopmental disabilities. Environmental Health Perspectives, 120(7), a258–a260.

Williams, D. (2012, March). Neurological basis for autism: Implications for speech-language pathologists. Miniseminar presented at the Ohio Speech-Language-Hearing Association, Columbus, OH.

Wong, C., Odom, S. L., Hume, K. A., Cox, A. W., Fettig, A., Kucharczyk, S., … & Schultz, T. R. (2015). Evidence-based practices for children, youth, and young adults with autism spectrum disorder: A comprehensive review. Journal of autism and developmental disorders, 45(7), 1951-1966.

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