Introduction:
Autism spectrum disorder (ASD) is a neurological developmental disorder caused by differences in the brain. People with autism spectrum disorder have problems with interaction, communication, restricted behaviors, learning, attention, and movement issues. The symptoms generally appear in the first two years of life. It is also known as a spectrum disorder because it has a wide variation in severity and the types of symptoms that people experience. The symptoms can range from mild to severe. It occurs irrespective of all races, ethnicities, gender, and economic backgrounds. Treatment can improve the signs and daily functioning. Parents should be aware of autism spectrum screening tests and evaluations. ASD screening is the initial step in diagnosing the disorder.
What Are Comorbidities?
Co-morbidities are the occurrence of one or more conditions in addition to the primary disease. It is a second-order diagnosis that has symptoms distinct from the primary condition. For example, comorbid psychopathology means the occurrence of two or more forms of psychological disorders that accompanies the existing psychological disorder. It includes anxiety disorders, mood disorders, conduct, oppositional defiant disorders (argumentative behaviors), schizophrenia (a disorder that affects the ability to think and behave), attention deficit, or hyperactivity. Bipolar disorder and depression are mood disorders. Obsessive compulsive disorder, social anxiety disorders, panic disorders, and phobia are anxiety disorders. Children with autism have anxiety disorders. The anxiety in the children is assessed with anxiety rating scales, clinical interviews, direct observations, and physiological measures. Children and young adults with pressure have high rates of anxiety. Comorbid psychopathologies impact outcome variables such as adaptive behavior, challenging behavior, communication, language, and quality of life. Children and adolescents with autism have anxiety separation disorder, agoraphobia (situation of helplessness and panic), and depressive disorder. The factors such as overeating, undereating, depression, and repetitive behavior significantly differed between children with and without autism. Comorbidities are more common in people with autism spectrum disorders and others.
What Are the Signs and Symptoms of Autism Spectrum Disorder (ASD)?
The characteristics of ASD include:
- Repetitive or restricted behaviors include children repeating the exact words or phrases repeatedly (echolalia). They line up objects and get irritated if the order is changed. They have obsessive interests. Their behaviors and interests are unusual. They have unusual reactions to smell, taste, look, and feel.
- They have delayed language skills.
- Unusual emotional disturbances.
- Gastrointestinal issues such as constipation.
- More fear than usual or lack of fear.
- Abnormal sleeping and eating habits.
- Hyperactive behavior.
- Not making eye contact with others.
- The trouble with change in routine.
- Delay in learning and communication.
- Unusual or no response to gestures.
- Repeated body movements such as spinning, locking, and flapping hands.
- Obsession with specific objects.
What Are the Genetic Disorders Associated With ASD?
The genetic disorders associated with ASD are:
Some genetic disorders are common in ASD, such as Down’s syndrome, fragile X syndrome, neurofibromatosis type I, tuberous sclerosis complex, and Duchenne muscular dystrophy. In addition, children with autism are vulnerable to many neurological disorders such as macrocephaly (the head circumference is vast), epilepsy, hydrocephalus (fluid collection in deep cavities of the brain), cerebral palsy, migraine, headaches, congenital nervous system abnormalities. Sleep disorders are a primary problem in autism, occurring in about 85 percent of the affected individuals. ASD has interactions of several different genetic etiologies that lead to abnormal brain wiring (connections between the neurons).
Fragile X syndrome (FXS) is the leading cause of inherited intellectual disability. Fragile X syndrome is a single-gene disorder in all autism cases. It is absorbed that 3 percent of all the instances with ASD have FXS. Children with FXS have high rates of social anxiety, intellectual disability, hyperarousal, and repetitive behavior.
Some autistic children have Down’s syndrome. These children have a loss of language and social skills, developmental regression, and poor communication skills. They have self-injurious behaviors such as biting, head hitting, and skin pulling. Repetitive motor behaviors include hand flapping, rocking, and teeth grinding. ASD children with Down’s syndrome suffer from unusual vocalizations such as humming and grunting. With unique sensory responses like staring at lights and spinning.
Some ASDs are more prevalent in Duchenne muscular dystrophy. It is a disorder characterized by progressive muscle degeneration and weakness due to the alteration of a dystrophin protein that helps the cells of the muscle remain intact. It is not only a muscle disease. It also affects the brain.
What Are the Neurological Disorders in Autism?
The neurological disorders of autism are:
Autistic children have a variety of neurological disorders, such as migraine, hydrocephalus, cerebral palsy, and epilepsy. Epilepsy is a neurological disorder characterized by episodic unusual mental changes with recurrent convulsions. Eight percent of epileptic children have autism. Autism is comorbid with epilepsy and vice versa.
Epilepsy is characterized by zoning out, rapid eye blinking, disturbed consciousness, and epileptic encephalopathies. In addition, there is an increased prevalence of autism and epilepsy, and intellectual disability simultaneously.
Common pathological mechanisms are responsible for epilepsy in autism. There is an abnormal accumulation of clusters of alpha-synuclein protein in the neurons. The other pathologies for autism and epilepsy include synaptopathy, the dysfunction of synapses in the brain, peripheral nervous system, and spinal cord. Inflammation and abnormal glial cell connections. The risk of developing epilepsy in ASD is female gender and history of intellectual disability.
The high excitability in the brain because of epilepsy during early childhood causes impaired plasticity (the ability of the neural network of the brain to evolve through growth), which causes cognitive impairment and autism.
Seizures and autism develop during early brain development, which shows the connections between autism and epilepsy. Some of the behaviors of autistic children include aggressive behavior, odd behaviors, neurological deficits, low response, and self-injurious actions, irrespective of epilepsy.
Autistic children have an autonomic nervous system problem. The autonomic nervous system changes include heart rate, blood pressure, a typical autonomic response to anxiety, and sympathetic nervous system hyperactivity.
Toe-walking is one of the commonest unusual motor movements. The purpose of toe walking is to reduce the overstimulation in the feet caused by walking on the whole foot. Toe walking is also seen in Duchenne muscular syndrome.
Incontinence is common in autistic children. They have anxiety related to toileting. It is more common in verbally impaired individuals. They tend to urinate in places other than toilets. Children with this problem are vulnerable to punishment, public embarrassment, and low self-esteem. Those with lower adapting ability were associated with higher toileting problems.
Sleep disorders are more common in children with autism. They include nighttime reawakening, sleepwalking, and the inability to sleep in flat positions.
What Are the Diagnostic Methods for Detecting Psychopathologies of Autism?
The autistic child should be evaluated with EEG (electroencephalogram) for 24 hours or longer by a pediatric neurologist. A video EEG can be used for human intellectual disabilities. It is also recommended for autism associated with tuberous sclerosis and Down’s syndrome. Epilepsy can be fatal, so it is essential to treat the seizure disorder as early as possible if the child has multiple episodes.
Conclusion:
Comorbidities are very common in children with autism. They are more likely to have neurological disorders than the general population. Eighty percent of autistic individuals have sleep disorders. The pathophysiology of autism is mainly because of anti-brain antibodies. Children treated appropriately by ruling out their medical concerns first have better learning that applies to all children with autism.
