Autism history and symptoms: Difference between revisions
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=== '''Social interaction difficulties''' === | === '''Social interaction difficulties''' === | ||
Impaired social communication is one of the most common presentations of autism.<ref name="pmid14550703">{{cite journal |vauthors=Volkmar FR, Pauls D |title=Autism |journal=Lancet |volume=362 |issue=9390 |pages=1133–41 |date=October 2003 |pmid=14550703 |doi=10.1016/S0140-6736(03)14471-6 |url=}}</ref><ref name="pmid9826299">{{cite journal |vauthors=De Giacomo A, Fombonne E |title=Parental recognition of developmental abnormalities in autism |journal=Eur Child Adolesc Psychiatry |volume=7 |issue=3 |pages=131–6 |date=September 1998 |pmid=9826299 |doi= |url=}}</ref> | |||
* Absent, preferential or inconsistent social smile. | * Absent, preferential or inconsistent social smile. | ||
* Reduced ability to do non-verbal communication (problems with eye-contact, body language and facial expressions). | * Reduced ability to do non-verbal communication (problems with eye-contact, body language and facial expressions). | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Autism is distinguished by a pattern of symptoms rather than one single symptom. The main characteristics are impairments in social interaction, impairments in communication, restricted interests and repetitive behavior. Other aspects, such as atypical eating, are also common but are not essential for diagnosis. Individual symptoms of autism occur in the general population and appear not to associate highly, without a sharp line separating pathological severity from common traits.
History
Family history
Past medical history
Social history
Socioeconomic status
Symptoms
- The characteristic behaviors of autism spectrum disorder may be apparent in infancy (18 to 24 months), but they usually become clearer during early childhood (24 months to 6 years)
- Symptoms of autism consist of three core symptom interaction:
Social interaction difficulties
Impaired social communication is one of the most common presentations of autism.[1][2]
- Absent, preferential or inconsistent social smile.
- Reduced ability to do non-verbal communication (problems with eye-contact, body language and facial expressions).
- Inappropriate response to social overtures: aloofness, excessive shyness or fussiness if interaction is forced. Reduced attention span.
- Inability to initiate a social encounter properly, resulting in social awkwardness and behaviors mistaken to be ranging from extreme friendliness to aggressive beaviors for example, inappropriate touching, stroking, pushing or hitting others
- Reduced ability to develop friendships.
- Indifference or excessive clinginess
- Excessive familiarity, absence of social inhibitions and stranger anxiety.
Communicative challenges
Meaningful speech does not develop in 30–50% cases. If it does, language is delayed or deviant.
Verbal communication
- Children may only exhibit abnormal sounds. These are considered persistent if seen beyond 3 y.ears:
- Meaningless speech
- Echolalia (repetitive speech)
- Neologisms (word substitution by sounds)
- Reduced ability to hold conversations
- Inability or difficulty in understanding sarcasm, jokes or indirect speech.
- Excessive inqusitiveness or talking only about restricted topics.
Non-verbal communication
- Reduced ability to understand gestures
- Absence of or decreased pointing (either for expressing desire or sharing interest). They may keep crying without pointing or go to great extents to obtain something in order to avoid asking for assistance
- Forcefully ask someone to help indicate something (even trying to drag them)
Repetitive behaviors
It is not uncommon for children with ASD being brought for concerns related to co-morbid conditions. These include:
Neurological symptoms
(a) Cognitive Impairment [Global developmental delay (GDD) or Intellectual disability (ID)]:
- This has been reported in 50–70% individuals. The wide variability is due to difference in evaluation methods. Assessment should be done by tools that rely predominantly on non-verbal based skills.
(b) Epilepsy:
- All types of seizures are seen in 25–30% with bimodal presentation (infancy and adolescence).
(c) Psychiatric Illnesses:
- Attention Deficit Hyperactivity disorder
- Depression
- Anxiety
- Obsessive-Compulsive disorders.
(d) Feeding Disturbances:
- Decreased chewing
- Poor food acceptance
- Picky eater
- Food aversion
- Meal time misbehavior
Gastrointestinal symptoms
- Frequent vomiting
- Gastro-esophageal reflux
- Recurrent diarrhea
- Chronic constipation
- Recurrent abdominal pain
Sleep Disturbances:
Difficulty in falling asleep, repeated nocturnal awakenings, unusual bedtime routines lead to increased daytime behavioral issues and parental stress.
Dysmorphism:
This is observed in 18–20% individuals (syndromic or non-specific dysmorphic features).