top
+
Home Tag: "ASD"

Tag: ASD

23Feb

Autism is a condition that has been with humanity since the start of the species, but unlike some other illnesses, such as tuberculosis, or pneumonia, it was not easily recognized. For centuries, autism wasn’t even regarded as a distinct condition but was often misdiagnosed as other forms of illness. It wasn’t unheard of, for example, for certain types of autism to be diagnosed as schizophrenia, and for patients with such a diagnosis to be treated with antipsychotic medication because some of their symptoms would respond to that treatment.

Today, however, it is a very different situation. Medical science has grown both more advanced and more nuanced, and autism, or Autism Spectrum Disorder (ASD) as it is currently known, is better understood, and given its own distinct medical category. That doesn’t mean that ASD is completely understood, or that there is a cure for it, but the more focused awareness of the condition and its related symptoms means that better research and treatment is now being done.

One of the unique things about ASD is how varied its symptoms are. It’s because of this that when ASD was first given its own category in medical texts, it was initially broken up into four categories. Today, this is no longer the case, but because the change in medical interpretation was recent, having only taken place in 2013, many people are still more familiar with the “classic” categories. There are the autism types people used to be classified under.

The Changing DSM

The classification and diagnosis of ASD are, at least in American medicine, largely defined by on important medical publication, and that is the Diagnostic & Statistical Manual of Mental Disorders, more commonly known as “DSM,” published by the American Psychiatric Association. The DSM was first published in 1952 and is now known as DSM-I. Every time there is a major revision, a new version of the DSM appears.

It was in DSM-II, in 1974, that ASD was first given an entry in the manual, although it was a very different interpretation of the disorder at the time, defined as a psychiatric condition arising from being raised by a cold or distant mother. In DSM-III in the 1980s, ASD was finally recognized as a neurological/developmental condition, and the four classic categories were established.

Asperger’s Syndrome

Considered the “high functioning” version of the disorder, people with Asperger’s experienced the “mildest” symptoms, to the point where some weren’t even diagnosed and were merely considered “eccentric” or “quirky” people. Those with Asperger’s were generally considered able to cope with daily life requirements, though there might be some difficulty in socializing.

Pervasive Developmental Disorder, Not Otherwise Specified

Usually referred to as PDD-NOS, this was a miscellaneous category for people with more severe ASD symptoms. Here the socialization issues are more pronounced, and there may also be additional behavioral symptoms that interfere with other aspects of life, such as work. PDD-NOS was a problematic category because so many people fell into this classification.

Autistic Disorder

This is the “classic” form of ASD, made most famous by the movie Rain Man. Symptoms are much more intense, often leading to an inability to live a normal life. This requires more extensive attention and treatment, and has more visible symptoms such as strongly repetitive motions, very specific means of communication, inability to maintain eye contact, aversion to touching and others.

Childhood Disintegration Disorder

CDD, as it is called, was often considered the most severe form, not only because of how intense the symptoms were but because of the regressive nature of the disorder. Unlike the others, that may have shown evidence early people with CDD may appear to develop normally for a few years, and then display regression, losing language skills, socialization etiquette and even reflexes.

ASD Today

In 2013, with DSM-V, the decades of research finally concluded that four categories of high and low functioning ASD were too simple to convey the condition of ASD accurately. So the four categories were done away with, replaced instead with Autism Spectrum Disorder, with the emphasis being on individual symptoms diagnosed individually, on a spectrum.

This does away with the big problem the previous classification system had, where so many people fell under “miscellaneous” that PDD-NOS diagnoses were out of proportion with other classes, since many people with ASD did not fit “neatly” into the other three categories, thus calling the accuracy and effectiveness of those categories into question.

There is still some lingering stigma from the previous categories, with some biases towards “high functioning” and “low functioning” ASD as a simple way to distinguish a mild case from a severe one. However, the more accurate diagnoses look at what each person’s symptoms are, and how severe or not those individual characteristics are, to come up with an individual approach for the treatment and symptom management, rather than trying to apply only one of four possible treatment possibilities based on categorization.

19Feb

Medical science is a constantly evolving branch of knowledge. There is always more to learn, more to understand, and, in terms of technologies and techniques, always more to try. It’s because of the continuing advances in medicine that things like insulin allow people with diabetes to live full lives, and that some forms of cancer are now treatable, while dangerous viruses like AIDS/HIV continue to be researched with a hope for an eventual cure.

However, treatment and advancement do not come without understanding. Diagnosis is a critical part of medical treatment, and in the case of Autism Spectrum Disorder, or ASD, it has often been one of the most challenging aspects. For decades, ASD was not even diagnosed as a distinct medical condition but was misdiagnosed as a type of schizophrenia. Even when medical experts began to suspect it was a unique condition, it was incorrectly thought to be an entirely behavioral issue, arising from poor parenting, specifically from mothers.

Today, ASD is understood to be a complex condition with many symptoms. But how is it diagnosed?

The Old Versus New

ASD diagnosis is still experiencing something of a transition as both people with ASD, and established medical experts continue to grapple with a new form of classification and diagnosis. In the 1980s, when ASD was first entered into official medical texts, like Diagnostic & Statistical Manual of Mental Disorders (DSM), it was broken down into four categories that tried, roughly, to divide ASD patients by severity, with people having Asperger’s Syndrome considered “high functioning” while those that were diagnosed with Childhood Disintegrative Disorder were considered “low functioning” and had the most severe symptoms.

In 2013, with DSM-V, the four categories were eliminated due to the difficulty in accurately categorizing and treating patients with ASD. Instead, as the name implies, Autism is now diagnosed across a spectrum of different, individual symptoms. People are no longer described as high or low functioning and classed according to a ranking of their ability. Now the specific symptoms are evaluated for individual severity, and treatments are more personalized to each individual depending on the spectrum and intensities of those symptoms.

Evaluating ASD

ASD can be noticed in children at a very early age. Even just several months after birth, before a baby is even a toddler, it is sometimes possible to see behavior that can lead to early suspicions of ASD. For any parent that is wondering whether a child’s behavior is an indication of ASD, don’t sit on that suspicion, bring the child in for an evaluation and get an experienced specialist to conduct a diagnosis.

Early intervention is one of the best ways to give ASD children a better start in life. The parents need to get an accurate assessment of a child’s behavior, and the details of the condition so that they have a better understanding of how to raise and interact with the child, without creating unnecessary barriers or limitations that could impact the quality of life.

The Criteria

Under the current DSM-V diagnoses, parents should be on the lookout for behaviors that fall into three general categories:

Social-Emotional Reciprocity

A child shows a deficit in providing normal emotional or social responses to interactions. Children that display little or no emotional reaction are one example. Or failing to respond to questions, or interact in conversation is another. An unwillingness to initiate or even engage in social interaction is another example.

Nonverbal Communication Skills

Besides speech, there are many nonverbal actions and “cues” that are considered a normal but subtle part of communication. Eye contact, for example, is something that is not usually explained to children, but is learned over the course of interaction. A child that is unwilling to look people in the eye when communicating shows a deficit in nonverbal communication that might require evaluation.

Social Interaction & Maintenance

A more general deficit is the ability to interact or maintain social connections with others successfully. Due to the difficulties in social-emotional reciprocity, and/or nonverbal communication, a child may either prefer to be alone or be unable to successfully interact with others despite a wish to do so, resulting in alienation from other children.

There are also specific behavioral elements that parents should keep an eye out for. If two of the following are present in a child’s behavior, that also merits a closer look by a medical professional:

Repetitive Movements: A child performs the same action, or says the same words repeatedly.

Adherence To Ritual: A child insists on a specific routine or order, and is extremely upset when disruption occurs.

Hyper Focus: An ability, or insistence on focusing on an activity or other preoccupation with abnormal intensity.

There may be other associated factors to consider as well, like intellectual impairment, or other mental disorders, such as schizophrenia. This is why it is critical to try not to self-diagnose, but use the guidelines above as signs to bring a child in for a proper, detailed evaluation.

10Feb

Autism, which is more properly referred to as Autism Spectrum Disorder (ASD), is a far-ranging medical condition that can be so mild a person is unaware of having the condition, or so severe it may require intensive treatment and therapy very early on life. But as with other medical conditions, having ASD is not the final arbiter of whether someone will succeed in life or not. Some aspects of ASD, such as the ability to focus on details and quickly process vast amounts of information, can even directly result in success in life.

That’s why while there may be cause for concern if a child is diagnosed with ASD, it should never be regarded as a fixed, non-negotiable limitation to a prosperous life. Some very talented people have succeeded despite—or even because of—ASD, and here are a few of the many examples in history and modern culture.

Benjamin Banneker

Benjamin Banneker is a unique figure in late 18th-early 19th-century history. He was a brilliant African-American scholar who lived as a free man in a time when slavery was still legal in the United States. While people were not diagnosed for ASD during his time, many suspect from historical records that he properly had an ASD condition, as he was known to fixate on minute details, such as the watch of a friend, which would then inspire him to create his own extremely detailed, intricate experiments.

During his life, he was a farmer, inventor, astronomer, naturalist, surveyor, and author, all during a period when the color of his skin should have been a huge limitation. Instead, he transcended all those limitations.

Alonzo Clemons

Alonzo Clemons is an African-American who is also widely regarded as one of the greatest technical sculptors on the planet. A brain injury during his youth left him with an IQ deficit of only 40-50 points, well below the average. However, Clemons has the incredible ability to look at an image of an animal, even if only for a few moments, and construct an accurate sculpture in less than an hour.

No one instructed Clemons how to do this; he is entirely self-taught in sculpting. However, it is his brain, which is somehow able to retain and process complex visual information, even from a two-dimensional photograph, and interpolate that into three full dimensions, perfectly translated from his mind to his fingers.

Kim Peek

Kim Peek was the inspiration for the film Rain Man, in which Dustin Hoffman’s ground breaking performance introduced the entire world to the more severe effects of ASD. Kim was one of the more unusual examples of ASD in that while he has difficulty with simple tasks, such as tying his shoes, his memory is perfect, and he has complete recall of any text he reads.

Peeks currently remembered over 12,000 books that he read,  as well as performing extremely complex calculations based on the calendar. He died in 2009 at the age of 58, but was a crucial example of bringing more understanding of ASD, and the savant state, to the world.

Glenn Gould

A celebrated Canadian pianist, Glenn Gould was renowned throughout the world for his astonishing piano technique, which was widely unconventional by traditional music standards. Gould was a child prodigy of the piano, but where many musical geniuses improved their skill through practice, Gould improved himself through study. He claimed that it was easier to get better by reading music than it was to play it on the piano.

While he had never been diagnosed, since he died in 1982, Gould is now strongly suspected of having ASD. His characteristic rocking motions while playing, as well as his insistence on routine, and violent reactions to any disruption to routine are typical of some ASD symptoms. His focus on detail and his unusual ability to process musical information without even playing or hearing it, just reading notation, are other strong indicators.

Sir Anthony Hopkins

Hopkins is one of the most renowned elder actors of our time, but he was also diagnosed later in life with ASD. He is another of the people who appear to be on the “higher functioning” end of the spectrum, although in his case, he would likely argue that it was not that high.

Hopkins, like many people with ASD, experienced difficulty socializing and did not get on well with traditional schooling. As a result, he fell behind in some respects, but his inability to socialize didn’t deter him from having an innate ability to study human behavior and incorporate it into a performance. So despite not getting along very well with others in a normal social setting, Hopkin’s keen eye for observation has allowed him to integrate what he sees into some of the greatest performances in cinematic history, such as his stunning portrayal of the psychopathic Hannibal Lector in The Silence of the Lambs.

23Jan

To most of the general public, autism, more accurately referred to in clinical circles as Autism Spectrum Disorder, or ASD is viewed as a mysterious, even frightening disorder. Popular culture has portrayed the disorder as either a crippling condition that leaves people unable to function in everyday settings, or results in eccentric genius, with an inability to bond meaningfully with others.

The truth, as with most public misconceptions and media portrayals, lies somewhere in the middle. People with ASD are not either doomed to the margins or blessed with genius. As the word “spectrum” implies, those with ASD have a huge range of different symptoms at different intensities. Some with milder forms of ASD may not even know they have the condition, and live their lives simply thinking of themselves as “introverted with a few quirks.” Others may, if the symptoms are severe, require extensive treatment to cope with the world.

But a few people have achieved enormous amounts of success and fame sometimes despite, and sometimes because of, their ASD. Here are a few famous people that have been diagnosed with ASD.

Satoshi Tajiri

While the name itself may not be commonly known in households, the product of this Japanese game developer is globally recognized by the young and young at heart everywhere. Tajiri is most well known for creating Pokemon, the Japanese phenomenon that went worldwide. Pokemon started as a portable videogame for children on the Nintendo Gameboy in 1996 and went on to become a huge hit all over the planet.

Over 20 years later, Pokemon continues to be a massive phenomenon, both for a new generation of children and for adults that still enthusiastically embrace the idea of collecting cute creatures for fights and duels. Tajiri has publicly admitted his autism diagnosis but prefers not to talk about it in depth, preferring to let his work do the talking.

Temple Grandin

In some circles, Temple Grandin is widely regarded as both a respected female scholar and writer. She is a professor at Colorado State University for Animal Science but has also authored many books on topics such as handling livestock and dealing with ASD. She is a very prominent advocate for ASD, having been diagnosed early in her life with the condition.

She did not speak until she was four years old, and her ASD was severe enough that, at the time, in the 1950s, her parents were advised she should be institutionalized. Her family did not follow that advice and allowed her to grow and develop without the obstacles of 20th century, pre-ASD treatment methods. Today she has made great strides both professionally and helping to educate the public about ASD.

Susan Boyle

She was once just another average Scottish woman until her stunning debut at the Britain’s Got Talent reality TV show. Susan Boyle’s average appearance belied an incredibly powerful singing voice that, until 2012, had gone completely undiscovered. After that debut, she went on to a professional career and, in less than ten years, has already sold over 14 million albums worldwide.

Susan Boyle, however, was also officially diagnosed during her life with Asperger’s Syndrome, one of the four old classes of autism until modern medical diagnoses did away with dividing ASD into different categories. As with many people with ASD, Boyle finds it occasionally difficult to cope with people and is happiest pursuing her interests, which in this case, include singing.

Sir Anthony Hopkins

One of the most revered “elder statesmen” of acting today, Anthony Hopkins is such a talented actor that he eventually received a knighthood in 1993 for his service to the arts. Hopkins is probably best known for his role as the cannibalistic psychiatrist Hannibal Lecter in a widely-acclaimed performance in the movie Silence of the Lambs.

Hopkins, however, is also another celebrity diagnosed with, at the time, what would have been classified as Asperger’s Syndrome. He was not diagnosed until much later in life and, as a result, had a difficult childhood. He was treated poorly by peers, had trouble keeping grades up, and his inability to understand social interactions led to frustration and even substance addiction to cope.

Greta Thunberg

Perhaps the most famous person with ASD in the world right now is also one of the youngest. Greta Thunberg, a teenager from Sweden, is only 17 years old but has already become a Time “Person of the Year,” traveled the world advocating for fighting climate change, and has given fiery, angry speeches to no less than the entire United Nations. She is one of the few 17-year-old girls that rich, powerful men fear and want to stop, because of her powerful messaging.

She was also diagnosed early in life with ASD, but she refers to it as her “superpower,” and claims that it is because of her ASD, and her inability to comply with conventional social expectations, telling people what they want to hear, that she can move ahead and tell people what they need to hear.

15Jan

Umbilical Cord Stem Cells

Autism, clinically referred to today as Autism Spectrum Disorder, or ASD, has had a long and difficult road to understanding and, more important, treatment. For many centuries, ASD wasn’t even properly recognized as a distinct condition with its own needs and treatment methods. While there was often a clear behavioral component, there was little understanding of the neurophysiological nature of the condition. Today, while there is much more knowledge about the condition available, the medical comprehension regarding the condition is still far from complete.

Research into the condition continues, and so far, much progress has been made in both gathering data and finding different ways to manage ASD. One thing that eludes medical science, however, is a cure. ASD, at least with modern treatments, still currently has no cure, the symptoms can only be managed through various methods. Those methods range from behavioral therapy techniques to medications like anti-psychotics. There is one new avenue that is being explored, and that is using umbilical cord stem cells. But what are umbilical cord stem cells, and why is this development so promising?

There Is Power In Potential

Umbilical stem cells are simultaneously one of the most basic cells in human anatomy and the most difficult to use for medical purposes. It wasn’t until just a few decades ago that medical science got to the point where experts understood the potential of stem cells put them to use. A stem cell is the basic building block of life. DNA is the blueprint that provides a complete “map” for building a human being, but it is stem cells that do the work.

Other cells in the human body are singular in their reproductive ability. Skin cells can only reproduce more skin cells, and hair can only grow more hair. Nerves don’t grow out of eye cells, and stomach cells can’t create additional brain cells. Stem cells, however, are the exception to this rule. These cells start “blank,” in that they don’t have a previously assigned “function.” Because of that, they are capable of “reprogramming” themselves to become any cell in the body, whether it is more skin cells that easily reproduce or rare heart cells that don’t reproduce at all.

This is how human beings are born. When an egg is fertilized by sperm, and a new genetic blueprint is formed from the fusion of DNA, the first order of business is to divide and create more and more stem cells. These stem cells, once they are sufficient in number, eventually specialize into the organs like brain, kidneys, and heart.

A Limited Window

Unfortunately, while stem cells are unlimited their ability to become any cell, they are limited in their presence. The stem cells created during pregnancy are known as “pleuripotent” because of their cellular versatility. The catch is that pluripotent cells are only generated during pregnancy by the considerable resources provided by a pregnant mother. Human beings, after birth, do create more pluripotent stem cells of their own.

Humans do, however, continue to create other, more limited stem cells. Bone marrow is a source of stem cells after birth. In the bone marrow, stem cells are created that can become different types of blood cells, wether that is red, white, or other cells.

It was the discovery of these stem cells in the bone marrow that eventually led to an effective treatment for leukemia that is now officially approved by American medical organizations, and larger Federal bodies like the FDA. Leukemia is a form of blood cancer that causes mutations in blood cells, so they reproduce incorrectly, with more and more flaws. Stem cells harvested from bone marrow, however, can restore the balance of cells that reproduce healthily.

Limited Applications

Pluripotent stem cells have been extensively used in research, and are now seen as a potential treatment for a variety of formerly incurable conditions, such as Alzheimer’s, and ASD. Curiously, in the United States, only stem cell treatments for blood-related illnesses such as leukemia are currently endorsed by the FDA. Other countries, such as Germany, China, and Georgia, are years ahead in branching out to other treatments. Even the celebrated American athlete Payton Manning famously traveled to Germany for stem cell treatments to his neck to recover from an otherwise career-ending vertebral injury that had no available treatments in America.

Pluripotent cells can only be ethically harvested in significant numbers from the umbilical cord, which is why they are sometimes referred to as umbilical cord cells. To use umbilical cord cells, a mother, after childbirth, must request—or agree to a request—to collect the cells and store them for future use. Stem cells are only compatible with close genetic relations, so ideally, a child, for example, being treated for ASD would use stem cells stored from birth. Failing that, the stem cells of a close genetic relative, such as a younger sibling, would suffice if those stem cells were stored, but the patient’s stem cells were not.

14Jan

Autism, which today is clinically known as Autism Spectrum Disorder (ASD), is one of the more complex and largely still unknown conditions in medical science today. It is a disorder with so many symptoms, in a broad range of intensities, that for centuries, it was not even properly recognized as a distinct condition. In past years, some forms of ASD were misdiagnosed as schizophrenia, because of some behavioral similarities and the fact that some ASD patients did respond positively to some schizophrenic treatments like prescribing antipsychotic medication.

Today, ASD understanding has improved, but the knowledge we have of the disorder is far from complete. Over the decades, many iterations of our understanding of ASD have come and gone. This has left some people confused as to the exact state of an ASD diagnosis since many are now outdated and no longer medically classified in such a way. All ASD patients today, for example, are diagnosed on “the spectrum.” There is no longer any distinct classification such as one ASD patient having Asperger’s Syndrome, while another has Childhood Disintegration Disorder.

One of these classifications that are no longer used is Atypical Autism, and there are many good reasons for that.

The Early Classifications

There is one medical document that is often considered a central source for global medical references, and that is the Diagnostic & Statistical Manual of Mental Disorders. The DSM, as it is more conveniently referred to, has been a touchstone of American mental health knowledge and reference since 1952. It is a “living document” in the sense that it is periodically updated to reflect discoveries, treatments and developments in the mental health medical space. So, the first edition of the text used is now referred to as “DSM-I.”

It was only in the 1980s, with the introduction of DSM-III, that ASD was given a distinct classification. However, unlike the current system, which defines ASD as one condition with a spectrum of different symptoms at different intensities, the DSM-III text created four different classifications for ASD and then tried to fit ASD patients into each of these categories. Atypical Autism was one of these four categories.

What Was Atypical Autism?

Atypical Autism, under DSM-III was not clinically referred to with this term. The technical term for it was Pervasive Developmental Disorder-Not Otherwise Specified, or PDD-NOS. As the name indicates, PDD-NOS was a “miscellaneous” category where those diagnosed with autism who didn’t fall into the other three categories would go. Asperger’s Syndrome was the first category and considered the “mildest and high functioning.”

The other categories, “Classic Autism” and “Childhood Disintegration Disorder,” were considered more severe. This meant people with ASD symptoms more severe than Asperger’s, but milder than Classic or CDD went into the PDD-NOS category, which quickly showed how inadequate a four-class category system was as more and more people failed to fit into the other three categories neatly.

The symptoms of people formerly classed as having PDD-NOS included:

Anomalous/Unusual Social Interactions

This was difficult to categorize since so many potential symptoms could be included, but in general, if a child experienced difficulty smoothly socializing with other children, and it was due to specific behaviors, such as unprovoked hostility, or unwillingness to speak, these fell into the category.

Linguistic/Communication Issues

Those with PDD-NOS in the past were also characterized by having communication deficits that made it difficult for them to be understood by others. This may have manifested as delayed communication development, or other anomalies, such as speaking without inflection and sounding like a robot.

Repeating Actions

Like other former categories of autism, PDD-NOS also included symptoms of repetitive motions or behaviors. Repeating certain gestures, actions, or words would often be a soothing activity in times of stress. However, there was little discretion about when these repeating behaviors would occur, which could be interpreted as inappropriate given the timing and circumstance.

Atypical Sensory Experience

This can be difficult to diagnose properly since an objective measurement is difficult. Atypical sensory experience means people formerly diagnosed with PDD-NOS may have apprehended their senses in ways that differ from those without the condition. Colors, for example, may look different, smells may be stronger or weaker, the sensation of touch may feel different.

The New Classification

By the 21st century, it was apparent that trying to fit the huge variance of autism symptoms into four categories wasn’t working as accurately as envisioned. In 2013, with DSM-IV, the four categories of autism were discarded. We now operate on a single system of Autism Spectrum Disorder, where individuals are diagnosed as being “on the spectrum.” From there, a more in-depth diagnosis is made to catalog and diagnose the specific symptoms and then treat each person in a customized, personalized manner that suits their needs, rather than classing them as Category 1 or Category 4 and using only treatments specific to that category. ASD is far more complex than that and requires a nuanced treatment strategy.




up-arrow-1