Autism Spectrum Disorders

Autism spectrum disorders are neurodevelopmental disorders. It is characterized by impaired social interaction and communication, repetitive and stereotyped patterns of behavior and uneven intellectual development, often associated with mental retardation. The symptoms begin in early childhood. The cause is unknown in most children, a genetic involvement is suspected. In some patients, the disorder can be caused by medications. Diagnosis is based on the previous development and observation. Treatment includes behavioral training and sometimes drug therapy.

Autism spectrum disorders show a number of differences in the development of the nervous system, which are regarded as neurodevelopmental disorders. Neurodevelopmental disorders are neurologically based conditions that occur early in childhood, usually affecting before starting school and the development of personal, social, academic and / or professional functioning. They usually include difficulty acquiring, in maintaining or application of specific skills or of rows of information. Disturbances in the development of the nervous system can result in dysfunction of attention, memory, perception, language, problem solving and social interaction. Other common neurodevelopmental disorders include attention deficit hyperactivity disorder, learning disorders (e.g., dyslexia) and limited intellect.

Autism spectrum disorders are neurodevelopmental disorders. It is characterized by impaired social interaction and communication, repetitive and stereotyped patterns of behavior and uneven intellectual development, often associated with mental retardation. The symptoms begin in early childhood. The cause is unknown in most children, a genetic involvement is suspected. In some patients, the disorder can be caused by medications. Diagnosis is based on the previous development and observation. Treatment includes behavioral training and sometimes drug therapy. Autism spectrum disorders show a number of differences in the development of the nervous system, which are regarded as neurodevelopmental disorders. Neurodevelopmental disorders are neurologically based conditions that occur early in childhood, usually affecting before starting school and the development of personal, social, academic and / or professional functioning. They usually include difficulty acquiring, in maintaining or application of specific skills or of rows of information. Disturbances in the development of the nervous system can result in dysfunction of attention, memory, perception, language, problem solving and social interaction. Other common neurodevelopmental disorders include attention deficit hyperactivity disorder, learning disorders (e.g., dyslexia) and limited intellect. Current estimates of the prevalence of autism spectrum disorders range from 1/68 in the US, with similar areas in other countries. Autism occurs approximately 4 times more common in boys. In recent years there has been a rapid increase in diagnoses of autism spectrum disorders, partly caused by changes in the diagnostic criteria. Etiology The exact cause of most cases of autism spectrum disorders remains unknown. Nevertheless, some cases of congenital rubella syndrome, cytomegalovirus, phenylketonuria and fragile X syndrome have occurred. Genetics may play a major role. For parents of a child with a disorder on the autistic spectrum, the risk of having another child with a disorder on the autistic spectrum to have 50 to 100 times larger. The concordance rate in monozygotic twins is high. Family studies have shown several genetic hotspots as that of neurotransmitter receptors (serotonin serotonin and ?-aminobutyric acid, GABA) or the control of the cerebral structure (HOX genes). Environmental conditions were suspected as the cause, but this has not been proven. There are strong evidence that vaccines do not cause autism and the primary study, which has raised this relationship, was withdrawn because its author has falsified data (see also MMR vaccine and autism). Differences in brain structure and brain function seem to underlie the etiology of autism spectrum disorders. Some children with autism spectrum disorder images of have enlarged ventricles, some hypoplasia of the cerebellar vermis, and others have altered brainstem nuclei. Symptoms and complaints autism spectrum disorders can manifest themselves during the first year of life, but the diagnosis unclear be Two main features characterize autism spectrum disorders can-depending on the severity of the Symptome- up to school age: Persistent deficits in social communication and interaction Limited , repetitive patterns of behavior, interests and / or activities Both patterns have at a young age exist (although they can not be detected at this time) and must be pronounced enough to clear the child’s ability at home, at school or in other situations to work to affect. Manifestations must be clearly present in a higher degree than can be expected for the child’s age and otherwise the standards be adapted in different cultures. Among the examples of deficits in social communication and interaction include deficits in social and / or emotional reciprocity (z. B. to start failure social interactions or conversations or respond to this, no exchange of emotions) deficits in nonverbal social communication (eg difficulties interpreting body language, gestures and expressions of others;. diminished facial expressions and gestures and / or eye contact) (friends, for example, adapt behavior to different situations.) deficits in developing and maintaining relationships, the first of the parents noticed manifestations, delayed language development and the lack of interest from the parents or typical games can be. Among the examples of limited, repetitive patterns of behavior, interests and / or activities include Patterns of template or repetitive movements or language (eg. As repeated hand flapping or finger snapping, repeating idiosyncratic phrases or echolalia, lining up toys) Inflexible adherence to routines and / (to be followed to have extreme stress with small changes in eating or clothing, for example, or stereotypical greeting rituals.) or rituals Severe, unusually intense fixed interest (eg employment with vacuum cleaners;. elderly patients who schedules work out) extreme About – or under-reaction to sensory stimuli (. eg extreme aversion to certain smells, tastes or textures; apparent indifference to pain or temperature) Some affected children hurt themselves. About 25% of affected children experience a loss of already acquired skills. All children with an autism spectrum disorder have at least some difficulty with interaction, behavior and communication; However, the severity of the problems is very different. Current theories assume that the underlying problem of interference images of the autistic spectrum is a “spiritual blindness”, which manifests itself in the inability to empathize with another person and their thoughts. This difficulty will lead to abnormal interpersonal interactions and thus disorders of language development according to this theory. One of the first signs of autism is the inability of annuals to point to an object in the distance. The theory is that the child can not imagine that another person understands what it wants to show. Instead, the child things that it seeks only by touch displays or by dealing with the other hand on the object. Comorbidities are common, particularly limited intellect and learning disorders. The results of a neurological examination bring no focal findings down to a poorly coordinated response and stereotyped movements. Seizures occur in 20-40% of children before, especially in children with an IQ <50 Diagnosis Clinical Evaluation The diagnosis is clinical, based on the criteria of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and requires evidence of a lack of social interaction and communication, one-sided, repetitive stereotyped behaviors or interests. Although the manifestations of autism spectrum disorders may vary significantly in scope and severity, previous categorizations such as Asperger syndrome, childhood disintegrative disorder, and pervasive developmental disorders from autism spectrum disorders are grouped together and not distinguished. Screening tests include questionnaires to a social communication and the Checklist for Autism in Toddlers (M-CHAT-R and other tests). M-CHAT is available online. See also: Practice parameter: Screening and Diagnosis of Autism American Academy of Neurology and the Identification and Evaluation of Children with Autism Spectrum Disorders of the American Academy of Pediatric. Formal standard diagnostic tests such as the Autism Diagnostic Observation Schedule-2 (ADOS-2), based on criteria of the DSM-5 are carried out usually by psychologists or pediatricians who specialize in developmental problems in children. Children with clinical pictures of the autistic spectrum are difficult to test; for standard IQ tests cut in the practical part often better than in the verbal part and show few age-appropriate services despite their retardation in most areas. Nevertheless, the reliable diagnosis of autism spectrum disorders in recent years is increasingly possible. The process performed by an experienced examiner IQ test provides a useful guidance for further development. Treatment behavioral therapy speech therapy and speech therapy Sometimes physiotherapy and occupational therapy Drug Therapy Treatment usually takes place multidisciplinary. Recent studies have shown that children measurable benefit from intensive behavioral training that promotes interpersonal communication. Psychologists and educators focus on behavioral analysis, judging the behavior therapy according to individual problems at home and in the school. See also Management of Children with Autism Spectrum Disorders of the American Academy of Pediatrics speech therapy should start early and use a variety of media, including sign language, pictures exchange and supportive communication aids such. B. devices, the words sounded leave when a child presses a corresponding button or other handheld devices, as well as the language. Physical and occupational therapists design long-term plans for the learning of movements to compensate for specific deficits in motor skills and sensory development. Treatment with medications can help relieve symptoms. There is evidence that atypical antipsychotics (eg. As risperidone, aripiprazole) alleviate behavioral problems such. B. ritualized, self-injurious and aggressive behaviors. Other drugs are sometimes used for the control of individual symptoms such. As selective serotonin reuptake inhibitors (SSRIs) in ritual behavior, mood stabilizers (eg. As valproate) for self-harm and tantrums, as well as stimulants and other medications for attention deficit / hyperactivity disorder (ADHD) in inattention, Impulisivität and hyperactivity. Dietary measures, including some vitamins and a gluten-free and casein-free diet is not helpful enough to be recommended to; while some families may choose to use it, which makes an observation regarding malnutrition and nutritional excess necessary. Further additional and experimental therapeutic approaches have not proven to be effective (eg. As certain speech therapy, chelation therapy, auditory integration training, and hyperbaric oxygen therapy). Summary Affected children have a combination of symptoms such as impaired social interaction and communication, repetitive stereotyped patterns of behavior and uneven intellectual development, often associated with mental retardation. The cause is usually unknown, but it appears to be a genetic component to be there; Vaccines ruled out as a cause. Screening tests include standardized questionnaires for social communication and the Checklist for Autism in Toddlers (M-CHAT-R). Standardized diagnostic tests are usually done by psychologists or paediatricians specializing in developmental disorders. Treatment usually takes place multidisciplinary, using an intensive behavioral training that promotes interpersonal communication. Medications (eg. As atypical antipsychotics) can help (self-injury, aggression z. B.) with severe behavioral problems. Bibliography Modified Checklist for Autism in Toddlers (M-CHAT-R) American Academy of Neurology: Practice parameter: Screening and Diagnosis of Autism American Academy of Pediatrics: Identification and Evaluation of Children With Autism Spectrum Disorders American Academy of Pediatrics: Management of Children With Autism Spectrum Disorders National Institute for Children's Health Quality

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