April is recognized as World Autism Awareness Month, and April 2nd is recognized as World Autism Awareness Day. The focus of this initiative, led by Autism Speaks, is to lower the age at time of diagnosis. During Autism Awareness Month, the organization hosts events and educational activities to increase public awareness regarding signs and symptoms of autism. These activities also seek to foster acceptance and overall awareness of autism.
Autism spectrum disorder (ASD) is a neurodevelopmental disorder in which children demonstrate abnormal abilities to communicate in a social environment and exhibit restricted, repetitive behaviors. These symptoms occur by the age of 3 years. Children can be diagnosed with autism as early as age 2. Most parents notice a developmental problem in their child before the age of 1. However, the CDC reports that most children are not diagnosed until after age 4. Data has shown that early interventions have positive impacts on long-term outcomes. This highlights the need for public education and awareness programs.
According to the CDC, about 1 in 59 children have ASD, and boys are affected 4 times more often than girls. If parents have a child with ASD, they have a 2-18% chance of having another child with ASD. Other risk factors include low birth weight, prematurity, and increased maternal age.
Symptoms of autism include difficulty with communication and restricted, repetitive behaviors. Communication difficulties are typically both verbal and nonverbal. Patients with ASD often have difficulty with spoken language, with approximately 1/3 of patients being nonverbal. Patients with ASD may not appropriately use or recognize nonverbal methods of communication, such as eye contact, facial expressions, gestures, tone of voice, and body language. They may also have difficulty expressing emotions or interpreting emotions. Patients with ASD demonstrate variable degrees of restrictive and repetitive behaviors. These may include repetitive body movements, ritualistic behaviors/routines, staring at objects, narrow or extreme interests, and extreme resistance to change.
ASD is diagnosed by signs and symptoms, and is graded according to severity. The DSM-5 diagnostic criteria provide the basis for diagnosis. The Modified Checklist for Autism in Toddlers (Modified Checklist for Autism in Toddlers, Revised, with Follow-Up™ (M-CHAT-R/F) is the preferred screening tool and is administered at 18- and 24-months of age.
There are no treatments to reverse ASD. However, early intervention can dramatically improve outcomes, thus heightening the need for early diagnosis. Early intervention focuses on treatment of symptoms. Children benefit from treatments such as physical therapy, occupational therapy, speech therapy, behavioral programs, and specialized school programs. Each child requires individualized evaluation and plans of care due to the variable course, progression, and presentation of ASD. Even siblings with ASD can have a very different presentation and course. Each child should be followed closely and reevaluated to determine how the plan of care should be changed to best meet their individual needs.
Read more about ASD:
Current Medical Diagnosis & Treatment 2019: Chapter 25: Psychiatric Disorders: AUTISM SPECTRUM DISORDERS
CURRENT Practice Guidelines in Primary Care 2019: MODIFIED CHECKLIST FOR AUTISM IN TODDLERS, REVISED WITH FOLLOW-UP (M-CHAT-R/F)