Category: Autism treatment knowledge

Autism is more technically referred to as autism spectrum order or ASD. It is a disorder that, depending on your point of view, is either growing in the number of people diagnosed with it or is now being accurately recognized as people that might have “slipped under the radar” in years past, are now being found and diagnosed with ASD.

It is a complex disorder, with many different symptoms, and, as a result, it wasn’t even until the 1980s that ASD was even given a distinct category in medical diagnosis. Before the recognition came, many people throughout the years were incorrectly diagnosed as being schizophrenic, an error that is now, thankfully, not being made today.

Unfortunately, while there is a greater understanding of what autism is, that doesn’t mean that a fast, convenient cure, like antibiotics, has been discovered that can “clear up” ASD with a single injection. With more understanding of what autism is—and isn’t—comes a greater appreciation for the complexity of the disorder and how to address it.

Stem cell therapy, a recent innovation in medical science, is one of the treatments that is showing promise, but what is it, and how can it help with autism?

ASD’s Uncertain Origins

One of the biggest hurdles to finding a definitive cure for autism is that there appears to be more than one way to contract the condition, and thus, no one way to prevent it from occurring. Autism can, in some instances, result from genetic inheritance, and there is medical evidence that shows autistic parents passing the trait onto their offspring.

However, ASD can also be pre-natal, meaning that during pregnancy, specific medical circumstances can occur, such as an infection resulting in inflammation, that can result in an autistic baby. On the other hand, autism can even be post-natal, as some medical data that suggests even a lack of oxygen during birth might lead an otherwise healthy baby to contract autism just as birth occurs.

The differences, even in just how ASD is contracted by a patient, have consequences for the ways to treat the condition. This is one of the reasons why no known cure for ASD currently exists in medicine. There are, however, different ways to manage the symptoms that arise from ASD. In some cases behavioral therapy with an emphasis on learning and training can make a difference. In others, stem cell therapy may be a solution.

The Promise Of Stem Cells

Stem cells are the powerful, versatile cells that the pregnancy process relies on to create a “complete” human being from a single, undifferentiated fertilized egg cell. Under ordinary medical circumstances, after birth, the only way to grow new replacement cells when cells from the same group reproduce. This is why, after a hair cut, hair only grows from existing hair, rather than hair growing out of your teeth, or your fingernails.

However, as a baby is developing in a mother’s womb, there are no lungs, kidneys, leg, or arm muscles in place, but they have to come from somewhere. Stem cells, also known by the nickname “master cells” can become any cell that is encoded in a person’s DNA, whether it is something as common as a skin cell, that is always growing new replacement cells, or a brain cell, which is far less prone to replacement.

Treating Autism

The challenge with autism is that there are different approaches to handling the symptoms. In some cases, the most productive approach is focused behavioral therapy, teaching an autistic child, for example, important skills to integrate and use for the rest of his or life that can also lay the groundwork for problem-solving skills that will always be a benefit. Stem cell therapy, however, takes a different approach.

While the symptoms of autism are largely behavioral, it’s not uncommon for there to be a physiological or neurological cause for that behavior. If the medical circumstances are such that damaged neural cells or atypical brain cell activity are involved, then the replacement of problem cells with “fresh,” undamaged cells may help to manage or mitigate certain symptoms.

Stem cell therapy works from this philosophy, by using either “cord blood,” or stem cells taken directly from the patient. Cord blood is the fluid in the umbilical cord that can, on request, be preserved after birth, since it is rich in stem cells. If the cord blood was not preserved, less versatile, but still effective stem cells from the patient’s bone marrow can be harvested and used in stem cell therapy.

The stem cells are then usually transfused intrathecally, which entails an injection in the spinal area, so that the stem cells may travel throughout the spinal cord and even into the brain. If stem cell therapy is a good fit for such a patient, results have been shown such as decreased hostility and even increased receptiveness to socialization and interaction with others.

However, it’s always important to get a proper medical consultation before committing to this decision. Stem cell therapy is not for every case of ASD.

Autism, today technically referred to as Autism Spectrum Disorder, or ASD is a condition that currently has no known cure. While it has some physical symptoms such as a higher occurrence of gastro-intestinal inflammation, ASD is most known for its wide range of different behavioral symptoms. It’s because of this range that, before the 1980s, people with ASD were often misdiagnosed as being schizophrenic, an error that is no longer made with today’s more nuanced understanding.

As the name implies, however, ASD’s different behavioral symptoms fall along a spectrum of different symptoms, with the symptoms themselves falling along a spectrum of intensity. Today’s diagnostic classification looks at the symptoms themselves, diagnosing whether the individual symptom is mild or severe.

In the past, however, the classification of mild to severe wasn’t applied to the individual symptoms but to the ASD patient. Different ASD intensities fell into different groupings, and one of them was known as “Atypical Autism.”

So what is it, and who would have been considered in this group?

According To The Book

An American medical document known as the Diagnostic & Statistical Manual of Mental Disorders is considered the “guide book” of American medical professionals when it comes to evaluating mental disorders according to an agreed-upon national standard. The DSM, as it is more commonly known, has occupied this position in American mental health science since its first publication in 1952. Since that initial publication, the DSM has occasionally been updated to reflect the current understanding of mental health conditions.

It wasn’t until the 1980s, with the third edition of the book, known as DSM-III, that Autism was even recognized as a unique condition. Before this, it was misdiagnosed as just a specific version of schizophrenia. After the inclusion of Autism in DSM-III medical professionals followed the protocols laid out in DSM-III and categorized people with Autism into four different categories. Atypical Autism, as it was informally known, was one of them.

What Is Atypical Autism?

The formal DSM-III designation for Atypical Autism was Pervasive Developmental Disorder-Not Other Specified, or PDD-NOS. It was one of four categories, the others being Asperger’s as the “mildest” Autism condition, PDD-NOS as more severe, Classic Autism, and Childhood Disintegration Disorder as the most severe.

PDD-NOS was one of the factors in showing the inadequacy of trying to categorize Autism patients by going over a list of symptoms that belonged only in specific categories, rather than focusing on the symptoms themselves. PDD-NOS became the “miscellaneous” category, where any symptoms that didn’t neatly fit into the other categories would go.

The only thing people could agree on was that PDD-NOS wasn’t as “mild” as Asperger’s, and included symptoms like:

Atypical/Unusual Social Behavior

This was a fairly broad area, so while there were no clear-cut definitions of what it was, it was easy to categorize what it wasn’t, and that was average/normal social interactions with others. If a person experienced difficulty socializing, or others commented that the behavior was abnormal, it would fall under this classification.

Language/Communication Deficit

People with Atypical Autism or PDD-NOS are also often characterized by noticeable communication issues. This could manifest itself early on as delayed communication development, where an infant is speaking the way other babies are. Alternatively, later in life, it shows itself in unusual modes of speech. Some with this condition will speak in a flat, emotionless monotone, like a robot, for example, having never learned to change pitch to communicate feeling or intent.

Repetitive Motions/Behaviors

As with many types of autism, Atypical Autism was also characterized by a focus on repetition. An AA patient would find repeating certain words, actions, or rituals soothing, and repeat them over and over again. This was an immediate, short-term way to deal with stress and attempt to calm down in an upsetting situation.

Atypical Sensory Experience

A very unique symptom of PDD-NOS is a sensory experience that differs from that of others. People with this symptom can process sensory input in very different ways. Smells can be stronger and more overpowering, sounds can be overwhelming; there may be a greater sensitivity to temperature, or tactile sensations. Even patterns or colors may be too bright. In some cases, the sensory experience is because of deprivation, with the PDD-NOS patient unable to smell or taste.

As the incidences of PDD-NOS patients ramped up, and it seemed like there might be more that fell in this category than the others, it was eventually decided by DSM-IV, in 2013, to collapse the previous categories that had been established. Rather than try to pigeonhole patients into specific symptoms in specific groups, the categorizations were removed entirely, the Autism Spectrum Disorder condition and diagnosis was used instead.

This is a much more accurate form of diagnosis for better results in treatment, as it focuses on on the individual symptoms, and the severity of each symptom, rather than drawing arbitrary lines where one ASD patient, “mild,” while another isn’t.

Autism Spectrum Disorder, or ASD, is a condition that affects behavior primarily. There are some physical symptoms associated with it, gastrointestinal inflammation being a very common occurrence among those diagnosed with ASD, but what the condition is most well-known for is the way it affects the behavior of the person. Because it is a condition, and not a disease or infection, such as pneumonia, there is no injection, antibiotics, or other treatment that can cure ASD. The symptoms can only be diagnosed, assessed, and then managed.

Because this is one of the key factors for getting good treatment for ASD is proper classification. If you don’t know what you’re dealing with, you won’t know how to treat it. This has been one of the biggest hurdles to those with ASD getting the help they needed. For example, it was only in the 1980s that ASD was even recognized as a disorder; before that, people with the conditioned were diagnosed as being schizophrenic.

This was problematic for many years because some people with ASD can, and do, respond positively to the prescription of antipsychotics, but it is not appropriate for everyone. This is one of the reasons why classifying and categorizing ASD has, in recent years, become more comprehensive and accurate.

Another example of this is ICD 10 and the diagnosis of severe autism. So what is ICD 10? Why and how is it being used?

An Administrative Standard

ICD stands for International Classification of Diseases, and it is created by the World Health Organization. The ICD-10 standard being discussed was delayed by several years, due to many objections from both American medical and insurance organizations. The objections were raised because of the growing complexity of the ICD system, as well as the ways it complicated an activity of particular importance to the USA, billing for insurance companies.

While the rest of the world uses the ICD system primarily for diagnosis, the USA also relies on it for classifying and approving the payment of medical services from medical insurance companies. Despite the USA being in the minority compared to the rest of the world for what the ICD system was primarily used for, it wasn’t until the medical and insurance organizations of America were satisfied that the ICD’s 10^th iteration, known as ICD-10, finally went into general release in 2013.

The Billing Issue

This means that by creating a standard, regarding diseases and other conditions, with a listing of what treatments are normally expected, insurance companies can more quickly determine whether all appropriate actions have been taken to pay—or not pay—on medical bills.

For example, if pneumonia were designated as T16, then this simple alphanumeric code is much easier to fill in forms, both paper and digital. It makes it easy to consult what the symptoms of T16 are, what the appropriate treatments are, and both doctors and insurance companies can check to see if all the “boxes” required for treating T16 have been met. If so, normal bureaucratic and financial actions, such as medical insurance covering payments, can now take place.

The ASD Designation

In the case of ASD, the general condition of autism is designated as F84. One important thing to note is that the ICD-10 designation is already out of date. In 2018, WHO released the ICD-11 classification system, so ICD-10 is already out of date, especially since it used the older forms of categorization that another American medical reference, the Diagnostic & Statistical Manual of Mental Disorders had already abandoned this form of categorization in with the publication of DSM-V in 2013. DSM-V diagnoses “collapse” different groupings of Autism into a single condition, ASD, while previous versions of DSM-III and DSM-IV categorized ASD patients into different groups. The ICD-10 system also used these same categorizations.

This is where severe autism under the old ICD-10 designation can come in. While children diagnosed under the current systems wouldn’t necessarily have these categorizations today, children diagnosed with F84 Autism had a subset of different, specific conditions that ran from F84.1 through to F84.9.

The most severe form of autism under the old ICD-10 standard was F84.4, named Overactive disorder associated with mental retardation and stereotyped movements. This was characterized by the following symptoms:

Severe mental retardation: Children diagnosed F84.4 was when evaluated for IQ, usually scored at 35, or less, where the average intelligence quotient is considered 100.

Hyperactivity: Children in this category show excessive levels of activity that is often paired with an inability to pay attention.

Stereotyped behaviors: In this case, stereotype refers to a repeated set of motions or behaviors that is triggered to a high degree. Rocking back and forth, complex hand movements, gazing, and other actions are repeated to excessive degrees, either unconsciously, or as a coping mechanism.

Severe autism can be extremely challenging for parents. This requires an extra level of care for a child, and likely means a very different, more attentive parental experience than what average families face. Patience and understanding are essential to the process.