The first two features are used to diagnose ASD according to the Diagnostic (more.) The three core features of ASD are deficits in social communication, restricted and fixated interests together with speech deficits, and language delays. Figure 1 illustrates the diversity of these symptoms and comorbidities.Ĭlinical features of ASD. A diversity of symptoms along with many psychological and physiological comorbidities may be present. A major feature of ASD is the heterogeneity of its clinical features. Secondary symptoms of ASD include aggression, hyperactivity, impulsivity, and the occurrence of co-morbidity such as anxiety and depression. For example, intense interest in a certain topic, sensory fixations on a particular object, or adherence to a specific routine or method of doing a task ( 6). Individuals with ASD also tend to have specific or restricted interests. These can be stereotyped actions such as hand flapping and rocking of the body, and verbal behaviors such as repetitive words and phrases. The third core feature of ASD is the presence of repetitive or restricted behaviors. Individuals tend to have difficulty adapting to new environments, persons, and materials, likely due to highly specific stimuli. Another area often impacted in ASD is the capacity to generalize skills across different settings. Thus, difficulty with performing independent behaviors and initiating tasks are notable features of ASD. They also often suffer from difficulties with processing stimuli and planning out the steps of an activity and may display ritualized or rigid behavior patterns. They commonly tend not to initiate interactions with their environment, particularly social interactions. Executive function and organizational skills are notably impacted in individuals with ASD. Delay in speech development, learning impairment, and difficulties with social interaction are common in ASD. The clinical diagnosis of ASD is based on the presence of some key features, such as impaired social development, and repetitive behaviors and interests (see chapter 2). While some features of ASD remain relatively stable, the quality of life of an individual with ASD can be improved by creating a strong social support system or other accommodations and interventions ( 5). Intellectual functioning and IQ tend not to change over time. Symptoms, particularly communication skills, can improve over time as the individual reaches adolescence and adulthood. Most symptoms of ASD persist into adulthood, especially with regards to social functioning and cognitive ability. Early indicators of ASD in childhood (before age 3) include lack of response to one’s name and discomfort with maintaining eye contact ( 4). However, ASD are also associated with many co-morbidities, which can be psychological and physiological.ĪSD typically start to manifest in childhood and is diagnosed by age 3 in most cases. The clinical features historically associated with ASD are the triad of impairments in speech, social interaction, and the presence of repetitive or restricted behaviors. Thus, spectrum disorder classification is reflective of the heterogeneous nature of ASD. With the establishment of the DSM-V (diagnostic and statistical manual of mental disorders, fifth edition), these formerly separate diagnoses were brought under one unifying umbrella as ASD ( 3) (see chapter 2). The term incorporates several conditions such as idiopathic forms, including autism, Asperger syndrome and Pervasive Developmental Disorder - Not Otherwise Specified, and Childhood Disintegrative Disorder and certain genetic disorders like Rett syndrome, which can exhibit autistic traits ( 3). Nowadays, the umbrella term “autism spectrum disorders” (ASD) is used to describe a clinically heterogeneous group of neurodevelopmental disorders that share common behavioral core features affecting social communication and include restrictive and repetitive stereotypic behavioral patterns and interests. Hans Asperger adopted the term autism in the 1940s to introduce a syndrome in children with behavioral differences in social interaction and communication, and restrictive and repetitive interests ( 1, 2). While “autism” as a term was initially introduced to describe a behavioral symptom of self-withdrawal in schizophrenic patients, psychiatrists Dr.
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