Understanding Autism

Autism, or autism spectrum disorder (ASD), represents a broad range of indispositions characterized by challenges with social skills, repetitive behaviours, speech and nonverbal communication. This lifelong developmental condition affects how sufferers perceive the world and interact with others.

There is no single type of autism but many subtypes that are mainly influenced by a combination of genetic and environmental factors. According to autismspeaks.org, each person with autism has a specific set of strengths and challenges. People with autism see, hear and feel the world differently to other people. Therefore, their learning, thought and problem-solving can vary from highly skilled to severely challenged. Some may need significant support daily, while others may need less or live entirely independently.

Research studies have found that there are several factors linked to the development of autism. These are as follows:

  • sensory sensitivities
  • medical issues such as gastrointestinal disorders
  • seizures or sleep disorders
  • mental health challenges such as anxiety, depression and attention issues

How common is autism?

Autism is much more common than we think. In the United Kingdom, there are around 700,000 people suffering from Autism. That is more than 1 in every 100 people. They come from all nationalities, cultural, religious and social backgrounds. However, it appears to affect more men than women. In the United States, the Autism Society recognises that the prevalence of autism has risen from 1 in 125 children in 2010 to 1 in 59 in 2020. This increasing trend is also the same for Thailand. It is estimated that there were 180,000 children with Autism nationwide which is 3 per 200 children under the age of 15. However, this may underestimate the true scale.

Diagnosis

Just like any other illness or disease, it is always very good to get diagnosed early. This is usually done by a multi-disciplinary diagnostic team, often including a speech and language therapist, paediatrician, psychiatrist and/or psychologist. Over the years, different diagnostic labels have been used, such as autism, autism spectrum disorder (ASD), autism spectrum condition (ASC), classic autism, Kanner autism, pervasive developmental disorder (PDD), high-functioning autism (HFA), Asperger syndrome and Pathological Demand Avoidance (PDA). The characteristics of autism vary and the different categories reflect the various diagnostic manuals and tools used, and the different autism profiles presented by individuals. In order to diagnose, a person will usually be assessed on the following characteristics:

  • as having had persistent difficulties with social communication and social interaction
  • restricted and repetitive patterns of behaviour, 
  • Unusual activities or interests since early childhood,
  • to what extent the above setbacks limit and impair daily functions.

The benefits of a diagnosis

Getting a thorough assessment and diagnosis early can be very useful because:

  • it helps the families, partners, employers, colleagues, teachers and friends to understand why they may experience certain difficulties and what they can do about them
  • it allows health professionals to access the type of support needed.

Signs of autism according to autismspeaks.org

The autism diagnosis age and intensity of autism’s early signs vary widely. Some infants show hints in their first months. In others, behaviours become obvious as late as age two or three.

Not all children with autism show all the signs. Many children who don’t have autism show a few. That’s why professional evaluation is crucial.

The following may indicate a child is at risk for an autism spectrum disorder. If the child exhibits any of the following, a paediatrician or family doctor should be asked for an evaluation right away:

By 6 months

  • Few or no big smiles or other warm, joyful and engaging expressions
  • Limited or no eye contact

By 9 months

  • Little or no back-and-forth sharing of sounds, smiles or other facial expressions

By 12 months

  • Little or no babbling
  • Little or no back-and-forth gestures such as pointing, showing, reaching or waving
  • Little or no response to name

By 16 months

  • Very few or no words

By 24 months

  • Very few or no meaningful, two-word phrases (not including imitating or repeating)

At any age

  • Loss of previously acquired speech, babbling or social skills
  • Avoidance of eye contact
  • Persistent preference for solitude
  • Difficulty understanding other people’s feelings
  • Delayed language development
  • Persistent repetition of words or phrases (echolalia)
  • Resistance to minor changes in routine or surroundings
  • Restricted interests
  • Repetitive behaviours (flapping, rocking, spinning, etc.)
  • Unusual and intense reactions to sounds, smells, tastes, textures, lights and/or colours

Treatment and management

There is no cure for autism. However, there is a range of strategies and interventions and methods of enabling learning and development which have been found to be helpful. These strategies and interventions may reduce symptoms, improve cognitive ability and daily activity skills, and maximise the ability of the child to function and participate in the community.

The differences in how ASD affects each person means that people with ASD have unique strengths and challenges in social communication, behaviour and cognitive ability. Therefore, treatment plans are usually multidisciplinary, may involve parent-mediated interventions and target the child’s individual needs.

Behavioural intervention strategies have focused on social communication skill development, in particular targeting those at young ages. This is because the child would naturally be able to gain these skills and reduce his or her restricted interests, repetitive tendencies and challenging behaviours. For some children, occupational and speech therapy may be helpful, as could social skills training and medication in older children. The best treatment or intervention can vary depending on an individual’s age, strengths, challenges, and differences.


Functional Medicine Approach

According to extensive research initiatives, managing autism as a systemic functional brain disorder opens up several treatment pathways. These pathways start by identifying the metabolic imbalances such as biochemical individuality, toxin exposures, nutritional deficiencies, gut health, inflammation and oxidation stress. Knowing and understanding the causes reduces the treatment to three easy steps as follows:

  1. Replenish the necessary nutrients such as vitamins, minerals, probiotics and others that can help the genes of the individual work better.
  2. Remove any food allergens, inflammation, oxidative stress, infections and any possible toxicity from the body.
  3. Rebalance the body system by adjusting digestion and absorption, detoxification, neurotransmitter function to boost an equilibrium ecosystem in the body.

Dramatic improvements have been noted in children treated using the integrative functional medicine approach. Therefore, it is important to identify their specific pathways to healing and treating any problem at the source.

Conclusion

All autistic people may share certain difficulties, but being autistic will affect them in different ways. This means that people living with autism will need different levels of support. All people on the autism spectrum are able to learn and develop. With early diagnosis and the right form of management and support, those living with autism will be able to live a more fulfilling life of their own choosing.


Author: Ezree Ebrahim, Head Business Development (Healthcare), Absolute Health Group. For Further information, please contact: ezree.ebrahim@akesisoncology.com

Series Editor: Christopher F. Bruton, Executive Director, Dataconsult Ltd, chris@dataconsult.co.th. Dataconsult’s Thailand Regional Forum provides seminars and extensive documentation to update business on future trends in Thailand and in the Mekong Region.