M05.09.03 Autism Spectrum Disorders

Autism Spectrum Disorders (ASD) are neurodevelopmental conditions characterized by challenges in social interaction, communication, and restrictive or repetitive behaviors. Understanding the clinical features, differential diagnoses, and treatment options is crucial for effective management.

Key Characteristics of Autism Spectrum Disorders

Diagnosis

• Age of Diagnosis: Typically diagnosed before age 3.
• Gender Differences: More prevalent in boys than girls.

Clinical Features

• The clinical presentation of ASD includes difficulties in communication, and social interaction, and the presence of restrictive and repetitive behaviors.

Communication and Social Interaction Problems

• Language Development: Abnormal or delayed language development.
• Verbal and Non-verbal Communication: Impairments observed in both forms.
• Separation Anxiety: Absence of separation anxiety; issues in forming relationships.
• Pronoun Reversal: Use of pronouns incorrectly.
• Posture and Touch: Failure to assume anticipatory posture; aversion to touch.
• Eye Contact: Poor eye contact.

Restrictive and Repetitive Behaviors (RRBs)

• Stereotypic Movements: Includes echolalia and lining up toys.
• Inflexibility: Resistance to change.
• Social Oblivion: Lack of awareness of the external environment.
• Preference for Inanimate Objects: Strong interest in non-living items.

Genetics and Associated Features

• Concordance Rates: Higher in monozygotic twins compared to dizygotic twins.
• IQ Correlation: The severity of symptoms often correlates with levels of intellectual disability.
• EEG Findings: Abnormalities may be present.
• Seizure Incidence: Approximately 25% of patients may experience seizures.

Differential Diagnosis

Treatment Options

• Management of ASD typically involves behavioral interventions and, in some cases, pharmacological treatments.

Behavioral Interventions

• Techniques: Behavioral techniques, such as shaping, are often employed.

Pharmacological Treatments

• Antipsychotics: Medications like risperidone are used specifically for managing aggression.

Points to Remember

• Autism is marked by significant challenges in social interaction and communication.
• Early diagnosis is crucial for better outcomes.
• There is a notable gender difference in prevalence.
• Behavioral and pharmacological treatments are available, with the former being the first line of intervention.

Bibliography Reference Links

• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
• Lord, C., et al. (2018). “Autism Spectrum Disorder.” Nature Reviews Disease Primers, 4, 18010. DOI: 10.1038/nrdp.2018.10
• Volkmar, F. R., et al. (2014). “Autism and Pervasive Developmental Disorders.” In Child and Adolescent Psychiatry.
• Simonoff, E., et al. (2008). “Psychiatric Disorders in Children with Autism Spectrum Disorders: Prevalence, Comorbidity, and Associated Factors.” Journal of the American Academy of Child & Adolescent Psychiatry, 47(8), 921-929. DOI: 10.1097/CHI.0b013e318179964f