Overview of Autism Spectrum Disorders

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What is ASD aka Pervasive Developmental disorders (PPDs)?

Autism Spectrum Disorders are a complex group of heterogeneous disorders of brain development with a spectrum of similar neuro-behavioral manifestations and disabilities. The Center for Diseases Control and Prevention (CDC) defines Autism Spectrum Disorders as a group of developmental disabilities that can cause significant social, communication and behavioral challenges. There has been an exponential rise in prevelance of autism in recent times.

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A recent 2008 Center for Diseases Control report revealed that while ASD prevalence estimates in the overall population increased 23% for the 2-year period 2006–2008, and 78% during the 6-year period 2002–2008, the largest increases over time were noted among Hispanic children and non-Hispanic black children. disability.

Frequently the terms autism and autism spectrum disorders (ASD) are used synonymously.
There is significant increase in gastrointestinal problems in autism. Studies also indicate that the severity of behavioral problem correlates with the seevrity of gastrointestinal disturbances.

Disorders included in Autism Spectrum Disorders

Classic autism or early infantile/childhood autism or Kanner’s autism with symptoms manifesting before the age of 3 years)
Asperger disorder/syndrome
Pervasive Developmental disorders (PPD)-not otherwise specified including atypical autism

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A broader classification of Autism Spectrum Disorders also includes

Rett disorder/syndrome
Childhood dis-integrative disorder

Clinical Features of Autism Spectrum Disorders

Symptoms and severity varies from mild to severe
Abnormal social interaction (sharing emotions, understanding how others think and feel, and holding a conversation)
Communication problems (both verbal as well as nonverbal like eye contact)
Behavioral dysfunction especially stereotyped behaviors, interests and activities, along with abnormal thinking, feeling
Frequently associated with other bodily dysfunction and delays different skills sets that develop from infancy to adulthood.

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Differentiating features of autism spectrum syndromes

Autistic Disorder aka “classic” autism

Significant language delays
Social and communication challenges
Unusual behaviors and interests.
Intellectual impairments

Asperger Syndrome

Usually have milder symptoms
Social impairments
Unusual behaviors and interests
No significant with language or intellectual issues
Notably, the cognitive function and social interactive skills are superior to other ASD.
Also has been characterized as high-functioning autism

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Pervasive Developmental Disorder – Not Otherwise Specified (PDD-NOS; also called “atypical autism”)

A “catch-all” but a controversial category
Includes all ASD patients who meet some but not all of the criteria for autism spectrum disorders
Later age of diagnosis
Atypical or fewer and milder symptoms than those with autistic disorder
May only involve social and communication problems

Rett syndrome

Main distinguishing feature: Head growth slows and patients have smaller than normal head size
Usually seen in females only
MECP2 gene mutation involved in many cases
Characterized by developmental reversal
Kids initially grow as normal kids. Symptoms amy start manifesting as early as 6 months, but marked changes start occurring at 6-12 months of age and regression after 18 months of age
Repetitive motor activities
Dementia
Expressive language and movement and coordination function is mostly affected.
Difficulty with communication and crawling/walking
Develop unique hand patterns like wringing or rubbing
May develop sudden loss of speech
Gradual development of nonverbal communication skills over time
Co-morbid conditions include arrhythmias, scoliosis, constipation

Childhood disintegrative disorder

Distinguishing feature: Normal age-appropriate growth and development until2-3 years of age followed by regression
Loss of acquired skills after the age of 2 years in at least two of the features (language, social skills and adaptation, bowel or bladder control, play or motor skills)
Similar to other ASD except normal early development/growth
May be associated with seizure disorders
Repetitive behaviors or stereotyped behaviors such as repeating words, plays or actions, obsessively following routines or schedules
Some kids who have been developing normally regress in their learned skills/behavior and manifest later.

How to differentiate between Asperger syndrome from high functioning autism?

Language function is not delayed although social communication may be affected
Cognitive development is not delayed
Learning and adaptive skills are age-appropriate

Increased prevalence of autism

Male sex
Mental retardation
Fragile X syndrome
Tuberous sclerosis

Link between autism and vaccination

According to the National Institute of Child Health and Adult Development wing of the NIH, "there is no conclusive scientific evidence that any part of a vaccine or combination of vaccines causes autism". This conclusion has been challenged by some including a recent article in Journal of Immunotoxicology as well as by celebrities like Jenny McCarthy.

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