Autism Spectrum

Jul 26, 2023

Table of contents

30 Second Summary

  • Autism is a developmental disorder that occurs in early childhood and is characterized by social interaction, verbal and non-verbal communication, obsessive behaviors and limited interests.
  • The exact cause is unknown, but a combination of genetic and environmental factors are thought to play a role.
  • Complete recovery is not possible, but early intervention and education can alleviate symptoms and improve the child's quality of life.
  • Symptoms can be recognized in early childhood, but in some children symptoms may appear later.

What is autism spectrum?

Autism spectrum disorder, commonly known as autism, is a serious developmental disorder seen in early childhood. Children with autism usually do not have any retardation in motor skills such as walking or sitting. Although there is no retardation in height and weight gain, the appearance of children with autism is not different from their peers. However, some children may have larger head circumferences.

The main point affected by autism is social communication. Limited interests and repetitive behaviors seen in children with autism lead to restricted social interaction. In some children, symptoms appear after the age of 1 year, while in others they develop normally and begin to say their first syllables.

Autism, which has nothing to do with the socio-economic level of the family and child-rearing methods, is thought to be caused by nervous system problems that cause the brain structure and nerves to be affected.

Autism, which cannot be diagnosed in the womb, is 4 times more common in boys than in girls. The reason for this distribution is not fully known, but the term autism is the term used for pervasive developmental disorder. For this reason, there are many subspecies.

Autism diagnosis methods

Autism is diagnosed by child psychiatrists. There is no test or imaging method that can diagnose autism. For this reason, the diagnosis is based on questions answered by the family and observation of the children.

In addition, differential tests can be performed to rule out certain diseases or to identify concomitant diseases. These include the following:

  • Blood tests
  • Neurological tests
  • Ear, nose and throat examination
  • Differential testing for metabolic diseases

In addition, child psychiatrists may recommend some developmental tests to check whether developmental, cognitive and social skills are developing. These tests include the following:

  • Babies up to 6th month react to a happy facial expression with a happy expression
  • Babies up to 9 months can copy sounds or facial expressions
  • Babies up to 12 months babbling or mumbling
  • Babies up to 14 months start pointing or waving
  • Babies up to 16 months start saying one word
  • Up to the 18th month, babies develop the ability to imitate or pretend to believe
  • Babies up to 24 months can form two-word sentences

In the absence of the above-mentioned developments or in the event of a sudden pause, the presence of autism can be mentioned.

Symptoms of autism

Since autism is diagnosed in the first 3 years of life, the diagnosis is not always easy. Because it cannot always be determined whether young children do not communicate because they do not care or because of autism. In addition, it is normal for parents to be confused because it is possible for speech delay to occur in many healthy children.

This is the main reason why autism is called a general developmental disorder. Autism causes a range of symptoms from mild to severe. For this reason, they range from healthy children with slow development to children with severe neurological developmental disorders.

In order to talk about autism, at least 6 of the following symptoms must be seen in the child:

  • Limited or no eye contact
  • The child does not react when called by name
  • Excessive mobility
  • Excessive inactivity
  • Lack of interest in their environment
  • dislike gestures that require physical contact, such as hugging or kissing
  • Delay in speech development
  • Failure to establish a dialog with their peers
  • Not participating in games
  • Isolate themselves
  • Speech learners repeating the same word over and over again
  • Speaking with inappropriate sentence patterns
  • Uniformity of speech patterns and tone of voice,
  • Obsession with any part of an object
  • Giggling or laughing even at irrelevant things
  • Obsession with order
  • They become irritable if their routine is disrupted
  • Developing excessive addiction to certain objects
  • Repetitive movements
  • Playing the same game over and over again
  • Stubbornness
  • Irritability
  • Excessive fear and reactivity in social situations
  • Eating disorder
  • Insensitivity to danger
  • Self-harm
  • Damage to their environment
  • Insensitivity to pain
  • Not understanding the joke or innuendo
  • Insensitive to normal learning methods
  • Pretending not to hear people talking to him/her
  • Prefers to play alone
  • Lack of a specific facial expression
  • Failure to initiate or maintain spontaneous dialog
  • Using dialogue only to ask for something
  • Speaking with a singing rhythm
  • Repeating words or phrases verbatim but not understanding how to use them
  • Failure to understand simple instructions
  • Failure to recognize the feelings of others
  • Inability to express their emotions
  • Coordination problems
  • Walking on toes
  • Using awkward, exaggerated and harsh body language
  • Hypersensitivity to light or sound
  • Inability to imitate
  • Eating certain foods or rejecting certain food groups altogether

Symptoms of autism in infants

Small clues are evaluated to diagnose autism in infants. In this critical period for autism and the development of babies, families can evaluate some clues to understand whether expert help is needed.

In babies under 6 months of age, limited or no eye contact as well as limited or no smiling can be considered a sign of autism. At this age, it is important to watch out for a lack of joy in babies.

Babies over 9 months of age are expected to respond to sounds, laughter or other facial expressions. If these reactions are absent or very rare, a specialist should be consulted.

In babies up to 12 months, the expected development includes movements such as humming, pointing, waving or reaching for an object. If these developmental features are not seen or seen very little, it is recommended to consult a specialist.

Babies up to 16 months need to start speaking with words. If this development is not seen, a specialist should be consulted again. Finally, if babies up to 24 months of age do not use many or any meaningful two-word phrases, a specialist should be consulted.

In addition, babies of any age should consult a specialist in case of the following symptoms:

  • Loss of social and speech abilities, even though they were previously acquired
  • Avoid eye contact
  • Symptoms of attention deficit
  • Prefer to be alone
  • Difficulty understanding other people's feelings
  • Hypersensitivity to sound, smell or light
  • Repeated behaviors
  • Limited interests
  • Showing big reactions even to small changes in the environment
  • Delayed language development
  • Constant repetition of words and sounds

Types of autism

Autism is one of the umbrella terms covering a wide spectrum. For this reason, there are many types of symptoms, varying in severity.

Asperger's syndrome

The characteristic symptom of Asperger's syndrome, which does not cause any retardation in language and mental development, is difficulty in communicating. Although individuals experience weaknesses in visual and perceptual areas, it does not cause any weakness in vocabulary and grammar.

Atypical autism

Symptoms caused by atypical autism appear at an early age. However, in some cases it is not possible to make a complete diagnosis. Individuals with atypical autism have symptoms of speech difficulties, developmental disorders and problems in social life. Problems are eliminated with a correct treatment plan. In addition, it is the type of autism that responds most successfully to treatment.

Rett syndrome

Rett syndrome, a form of autism that occurs in girls, is based on genetic causes. This syndrome, which is characterized by slow growth of the head circumference in the first 5 months of life, is also characterized by obsessive hand movements. Over time, personal skills decline. In addition, it responds positively to the treatment planned with medications and necessary therapies to be used for attention deficit.

Childhood disinteragrative disorder

In this form of autism, children develop normally until the first two years of life. Then, with the occurrence of symptoms, the acquired abilities are quickly lost. Mental retardation is also seen in this type of autism, which also causes mental skills to be affected.

Causes of autism

Although the number of children diagnosed with autism is increasing today, the causes of autism are not fully known. Both genetic and environmental factors are thought to cause autism. In addition, the link between vaccines and autism has not been fully established as in other causes.

Genetic factors

Some different genes are known to be involved in some types of autism. These include Rett syndrome and fragile X syndrome. Other gene mutations are thought to increase the risk of autism.

On the other hand, genetics is also a factor affecting the brain development of individuals, the signals within the brain and the communication between brain cells. For this reason, genetics also have an impact on the severity of autism symptoms seen in individuals.

Environmental factors

The influence of environmental factors on autism has not been fully proven. However, medications used during pregnancy, viral infections and air pollution are thought to have an effect on autism.

Autism treatment methods

The aim of autism treatment is to increase the person's socialization and develop their individual abilities. For this reason, the treatment to be applied must be suitable for both the individual with autism and his/her family and living conditions. To achieve this, many treatment methods are used. For this reason, individuals with autism need to be treated in a wide range of ways.

Behavioral and communication therapies

In behavioral and communication therapies used in the treatment of autism, many methods are used to improve the social, language and communication skills experienced by individuals. Some of these programs help to reduce repetitive behaviors, while others help to learn new skills. In addition, teaching individuals with autism how to behave in social environments is also included in these programs.

Educational therapies

Individuals with autism are not expected to respond to the regular education program. However, great success can be achieved with the implementation of programs prepared intensively and for individuals with autism. These education programs include a variety of activities to improve social skills, behavior and communication.

Family therapies

Family therapies enable families to fully understand their child's condition and to be informed about how to help him or her and his or her treatment. Through these therapies, families are taught what they can do to improve the skills and social interactions of the child with autism.

Medicines

Medicines do not cure autism. However, it can help to control some of the symptoms of autism. For this reason, medicines are used in some cases.

Sensory integration therapy

Sensory problems experienced by children with autism cause a decrease in their harmony with their environment. These problems also prevent children from behaving appropriately. Other problems that can be caused by sensory problems include the following.

  • Reduces the individual's adaptation to life
  • Makes it difficult to demonstrate daily living skills
  • Makes academic education more difficult
  • Causes self-care problems

Sensory integration therapies apply an integrative approach. In this way, it contributes to the improvement of individuals' behavior as well as minimizing symptoms.

Auditory integration therapy

With this therapy, it is determined which frequency of sounds the individual with autism is hypersensitive to. Afterwards, music without these frequencies is played with the help of headphones. This therapy helps to desensitize individuals who are particularly sensitive to sound.

Music therapy

We work with therapists specialized in music therapy. In these therapies, individuals with autism are encouraged to sing, dance or play musical instruments. In this way, an emotional bond is established between the therapy and the individual, while at the same time providing the child with a sense of achievement.

Art therapy

In art therapy, which enables individuals with autism to express themselves, art branches such as painting, sculpture, ceramics or plastic arts are used. It allows individuals to express the emotions that they have difficulty in expressing, while at the same time helping them to be happy.

Drama therapy

Drama therapy is used to help the emotional development of individuals with autism. Activities such as role-playing and storytelling in performing arts also help individuals to express themselves. Different play objects are also used as tools in drama therapy, which is based on reaching the creative mind of the individual.

Animal therapy

Establishing communication between the child with autism and the therapy animal allows the child to develop emotionally. Animal therapies are practiced in many different ways. Basically, it reduces the stress and anxiety level of the individual with autism.

Medical health problems

In addition to autism, individuals with autism may also have health problems such as epilepsy, stomach diseases and sleep disorders. Proper management of these health problems is effective in controlling the general condition.

Puberty problems

It can be challenging for children with autism to adapt to the changes in their bodies during puberty. They may also have problems making sense of these changes. Since adolescence also causes social relations to become more complex, the symptoms of individuals with autism in this period may be exacerbated. In order to control this, treatments specific to this period are used.

Other mental problems

Other mental problems such as anxiety or depression are much more common in people with autism. In order to manage these health problems properly, additional treatment plans need to be implemented.

What is the most prominent characteristic of individuals with autism?

Since autism is an umbrella concept, there are many subtypes. Each subtype has its own unique and distinctive features. However, the common characteristics of individuals with autism are generally the following.

  • Difficulty with social interaction
  • Communication skill deficiencies
  • Repetitive behaviors
  • Sensitivity to smell, sound, light and physical contact
  • Obsessive eating and drinking behaviors
  • Avoid eye contact

Toilet training in children with autism

Enabling individuals with autism to lead an independent life is the basis of rehabilitation processes. One of the most important steps in achieving this goal is toilet training. Although toilet training for children with autism is usually given around the age of 3, the child's readiness is accepted as the main criterion for starting toilet training. Finally, while the toilet training process gives results in a shorter period of time for some individuals with autism, it is possible for some individuals to complete it in a longer period of time. There are two different toilet training methods that are used for children with autism. One of these methods is the traditional method and the other is the fast method.

Traditional method

Before the traditional method is applied, families should keep a diary for 10 days in order to determine the duration of dryness in children. If the dryness period in these diaries is found to be less than 1 hour, it is understood that the child is not ready for toilet training. For children who can stay dry for 1 hour or longer, toilet training is started.

In the traditional method, the child is not diapered during the day. The child is taken to the toilet 10 minutes before the time specified in the diary and waited for 1 to 2 minutes. If the child defecates, he/she is rewarded with reinforcers. If it does not, it will be removed.

Children who do not go to the toilet are distracted for a short time with another activity and then taken to the toilet again. Rewarded for using the toilet. Children who do not use the toilet are not punished in any way.

Both the child's urine and stools are added to the chart and the intervals between visits to the toilet are extended over time so that the child stays dry for longer.

Fast method

In the fast method, the amount of fluid consumed by the child is increased and the frequency of going to the toilet is changed. For this, the child is given favorite drinks and water while sitting on a chair in the bathroom. When the amount of fluid given reaches the maximum level, the child is placed on the toilet. The child who does the toilet is rewarded. Children who do not do so are kept in the toilet for 20 minutes. If he/she fails to do so within this period, he/she is removed from the toilet and placed back on the chair. After a while, the child's underwear is checked. Underwear is reinforced with dry. If it is not dry, it is not reinforced and the process is renewed after 30 minutes.

What should be the family approach in autism?

Since the way children with autism perceive the world is different, their needs, interests and expectations also differ. Because of these characteristics, they face some difficulties in their daily lives. Family members are of great importance in overcoming these situations. For this, the child's daily life must first be organized. In addition, it should be ensured that tasks that can be assigned to the child are planned and that children fulfill these tasks. Among the points that families should pay attention to in the development of children with autism are the following.

  • Families must first accept the child's condition
  • The child's daily schedule should be determined and should always be adhered to. Another important point is the detailed preparation of the program. Within this program, fine details and tasks such as the time when the child should wash his/her face should be determined.
  • Changes in the home and its rooms should be avoided as much as possible.
  • Since repetitive movements are very common in children with autism, it is necessary to teach simpler movements that can be done instead of these movements.
  • The child needs to be spoken to often. But they should not be forced to do so. It is preferable that the topics of the speech are chosen within daily life.
  • Since children with autism have problems expressing themselves, families need to help their children at this point.
  • They may not always understand what is being said. This should be taken for granted.
  • Since they have difficulties in learning some subjects, this situation should be seen as an opportunity and the necessary groundwork should be prepared for their further learning.
  • Children with autism may be disturbed by certain things in the environment. Therefore, the environment needs to be adapted to them.
  • They are eager and enthusiastic about learning certain subjects and it is important that they are supported in this.
  • Since they do not like noise, it is important to make sure that the house is noise-free.
  • They should be taken for regular health check-ups to keep their health under control.
  • Since they have difficulty understanding figurative meanings, everything needs to be explained in a simple way.
  • Authoritarian behavior should be avoided. This behavior will increase their anxiety.
  • Instead of punishment, they should always be warm and caring.
  • It should be approached with love.
  • What children with autism need most is understanding. Therefore, they need to be understood and families need to make them feel this.
Question: My niece is 5 years old. She has been diagnosed with autism. She hardly eats, and she only likes to drink apple juice. Her parents are worried because she complains that her stomach is hurting, but she refuses to eat. What should we do?

T** T** | 14 Jan 2024

Dr. David Adam Fedoronko answered | 146 days ago
Introducing new foods to a child using their favorite flavors can facilitate the process. For instance, you might try foods similar to their preferred apple juice, like apple puree. Additionally, creating attractive presentations, using colorful plates, or arranging food in fun shapes can capture the child's interest. Eating meals together as a family can also help the child learn eating habits and manners.
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