Amna Farooq: The ABCs of autism spectrum disorder

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      By Amna Farooq

      In Canada, less than five percent of children at every socioeconomic level are born with known limits to their development. By school age, more than 25 percent of children are behind where they should be in their physical, social, language, or cognitive development.

      In other words almost all children are born with a strong potential to grow, learn, and thrive but by school-age many, approximately one in five, have lost ground. These numbers are also a parent's worst nightmare because of the heavy prevalence of the autism spectrum disorder in children these days. When children start school and can’t hold a pencil, follow instructions, or get along with other children, they are said to be “vulnerable”.

      All children develop at different paces but most have the same general developmental milestones and they learn the same set of skills at the same time (more or less). These are skills such as socializing, language and communication, problem-solving, and physical development. If anyone of these skills is not developed at its scheduled time, this can be considered as some sort of a developmental disorder.

      In 2013, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) combined all kinds of "developmental delay disorders" such as the autism, Asperger syndrome, childhood disintegrated disorder and pervasive developmental disorders not otherwise specified and gathered them under an umbrella term called the Autism Spectrum Disorder (ASD). So the term ASD was coined and all other terms were removed.

      Autism is the condition in which a child is removed from social interactions and has difficulty with communication, resulting in isolation. In Asperger syndrome, children have difficulty in socializing but they do not have any problems with their language and communication. In childhood disintegrated disorder, children usually develop normally for their age but at some point between the ages of 2 and 10 they seem to lose their skills related to language, socializing, or problem-solving.

      The pervasive developmental disorders not otherwise specified is a catch-all category in which people meet some but not all features of autism, Asperger syndrome, or childhood disintegrated disorder.

      ASD is a complex neurobiological condition that impacts brain development and affects a person’s social relationships, communication, interests, and behaviour. The symptoms and characteristics present in a wide variety of combinations; and individuals can exhibit any combination of the behaviours in any degree of severity.

      Studies indicate that ASD affects one in every 68 children. ASD usually appears early in life, often before the age of three, and is four to five times more common in boys than in girls.

      Individuals with ASD tend to have difficulties communicating. Their communication challenges can range from being nonverbal to responding inappropriately in conversations to not understanding nonverbal cues, or having difficulty building friendships appropriate to their age. In addition, individuals with ASD may be overly dependent on routines, highly sensitive to changes in their environment, or intensely focused on inappropriate items. The symptoms and characteristics of ASD can present in a wide variety of combinations from mild to severe. Therefore, there is no standard type or typical person with ASD.

      Some red flags for the presence of ASD include little or no eye contact, difficulty in mixing with other children, insistence on sameness (resistance for changes in routine), inappropriate laughing and giggling, no real fear of dangers, sustained odd play, apparent insensitivity to pain, and echolalia (repeating words or phrases in place of normal language).

      Children with ASD prefer to be alone (aloof manner) and they may not want cuddling or act cuddly. They are also not responsive to verbal cues and can act as deaf. There may also be an inappropriate attachment to objects or toys and difficulty in expressing needs, noticeable physical overactivity or extreme underactivity, and displays of extreme distress for no apparent reason, including tantrums.

      These children may also be unresponsive to normal teaching methods and have uneven gross and/or fine motor skills. For instance, they may not want to kick a ball but can stack blocks.

      A child’s early environment has a vital impact on the way their brains and bodies develop. The quality of a child’s early environment and the availability of positive experiences at the right stages of development are crucial in determining the strength or weakness of the brain’s developing architecture and the resulting outcomes for healthy physical, thinking, and social and emotional development.

      A positive environment with adequate nutrition—filled with social interactions with caring, attentive caregivers—prepares the architecture of the developing brain to function optimally.

      It is well said that “it takes a village to raise a child”. I couldn’t agree more. It really does!

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