Autism

Abstract

Autism spectrum disorders are characterised by severe deficits in socialisation, communication, and repetitive or unusual behaviours. Increases over time in the frequency of these disorders (to present rates of about 60 cases per 10 000 children) might be attributable to factors such as new administrative classifications, policy and practice changes, and increased awareness. Surveillance and screening strategies for early identification could enable early treatment and improved outcomes. Autism spectrum disorders are highly genetic and multifactorial, with many risk factors acting together. Genes that affect synaptic maturation are implicated, resulting in neurobiological theories focusing on connectivity and neural effects of gene expression. Several treatments might address core and comorbid symptoms. However, not all treatments have been adequately studied. Improved strategies for early identification with phenotypic characteristics and biological markers (eg, electrophysiological changes) might hopefully improve effectiveness of treatment. Further knowledge about early identification, neurobiology of autism, effective treatments, and the effect of this disorder on families is needed.

Communicating Concern about Early Signs of Autism to Parents

“…ABA-based methods (such as discrete trial training, pivotal response training, and teaching functional routines) may be effective in improving adaptive behavior, language, and socialization in some children with autism [23,24]. Nevertheless, given the state of the evidence about their effectiveness, claims of "cure" and "recovery" from autism produced by ABA are misleading [25,26].…”

Can Parents of a Child with Autism Refuse Treatment for Him?

“…Justification for overriding parental refusal of therapy is strongest when the therapy is known to be highly effective and low-risk and other options are inadequate. A recent review article by Susan Levy notes that the weight of the available evidence suggests that early intervention improves outcomes, but that data for long-term prognosis are scarce, and concludes that more knowledge about neurobiology and effective treatments is needed [2].…”

Functional SPECT neuroimaging using machine learning algorithms distinguishes autism spectrum disorder from healthy subjects

“…The high heterogeneity and complexity of ASD has previously limited the capacity of neuroimaging to produce reliable and consistent biomarkers that can be applied in a standard clinical evaluation. Currently, the diagnosis of ASD includes a clinical history, physical examination, and structured screening tools including the Autism Diagnostic Interview-Revised [3] or Autism Diagnostic Observation Schedule [4,5]. As autism often involves impairments across multiple domains that affect both social and intellectual function, the time from initial clinical visit to diagnosis lasts up to 13 months [6].…”