Makindo Medical Notes

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by challenges in social interaction, communication, and repetitive or restrictive behaviors. ASD is a spectrum condition, meaning that it varies widely in its presentation and severity.

Key Features

• Social Communication Deficits: Impaired ability to engage in reciprocal social interaction. This may include difficulty in maintaining eye contact, understanding non-verbal cues, or initiating and maintaining conversations.
• Repetitive Behaviors: Engaging in repetitive movements, speech (echolalia), or having specific, intense interests.
• Restrictive Interests: Highly focused interests in specific subjects, often to the exclusion of other activities.
• Sensory Sensitivities: Over or under sensitivity to stimuli such as light, sound, or texture.

Important Note for Doctors

• ASD is highly heterogeneous, and no single treatment works for all individuals.
• Diagnosis should be made by a multidisciplinary team, and management often involves tailored interventions
• These include behavioral therapy, speech therapy
• Sometimes medications for associated symptoms like anxiety or ADHD.

Diagnosis

• Developmental Screening: Routine screening during pediatric well-child visits is essential. Early identification improves long-term outcomes.
• Comprehensive Diagnostic Evaluation: A formal diagnostic evaluation may include a clinical interview, parent/caregiver reports, direct observation, and standardized assessment tools like the Autism Diagnostic Observation Schedule (ADOS).

DSM-5 Criteria for ASD: For a diagnosis the following must be present

• Persistent deficits in social communication and social interaction across multiple contexts.
• Restricted, repetitive patterns of behavior, interests, or activities.
• Symptoms present in early developmental period.
• Symptoms cause clinically significant impairment in social, occupational, or other important areas of functioning.

Management

• Behavioral Interventions: Applied Behavioral Analysis (ABA) and other behavioral therapies can help modify social and communication skills.
• Educational Support: Individualized education programs (IEPs) tailored to the child’s specific needs.
• Speech and Language Therapy: To enhance verbal and non-verbal communication.
• Occupational Therapy: Focus on improving daily living skills and sensory integration.
• Medications: There are no medications to treat ASD itself, but associated symptoms such as irritability, anxiety, or hyperactivity may be managed with medications.

Comorbidities: Common comorbid conditions include

• ADHD (Attention-Deficit/Hyperactivity Disorder)
• Anxiety Disorders
• Intellectual Disability
• Epilepsy
• Sleep Disorders
• Gastrointestinal Issues

Prognosis

The prognosis for individuals with ASD varies widely. Early intervention, appropriate therapies, and support can significantly improve quality of life. Some individuals may live independently, while others may require lifelong support.