Understanding Autism Spectrum Disorder: Symptoms, Diagnosis & Treatment

1. Autism Spectrum disorder Dr. VIVEK AGARWAL MD PROFESSOR DEPARTMENT OF PSYCHIATRY K.G. MEDICAL UNIVERSITY, LUCKNOW

2. Introduction • “Isolated in world of their own, people with ASD appear indifferent and remote and are unable to form emotional bonds with others.” • Prevalence of ASD is about 30-60 per 10,000. • Three to four times more common in boys than girls.

3. From the day she was born, Julie seemed different from other infants. At an age when most infants enjoy interacting with people and exploring their environment, Julie sat motionless in her crib and didn't respond to rattles or other toys. She didn't seem to develop in the normal sequence, either. She stood up before she crawled, and when she began to walk, it was on her toes. By 30 months old, she still wasn't talking. Instead, she grabbed things or screamed to get what she wanted. She also seemed to have immense powers of concentration, sitting for hours looking at a toy in her hand. When Julie was brought to a special clinic for evaluation, she sent an entire testing session pulling tufts of wool from the psychologist's sweater.

4. Clinical Features Of Autism “Autism is a disorder of brain characterized by deficits in social interaction, communication and restricted interest and behaviors.” Social symptoms • Aloof • Avoid eye contact • Inability to form attachment • Inability to understand other’s perspective • Aggression

5. Clinical Features contd... Problems of language • Deficits in both verbal and nonverbal language. • No speech 50%. • Delayed speech by 5-8 years. • Deviant speech- Echolalia, Confuses pronoun, stereotypic speech. • Inability to converse.

6. Clinical Features contd... Repetitive Behaviors • Hand, finger or whole body movements. • Unusual interests- staring at light, whirling fan, coins, wrappers etc. • Need for sameness. • Rituals

7. Clinical Features contd... Sensory symptoms • Highly sensitive to certain sounds, touch, smell or taste. • High pain threshold. Unusual abilities

8. Course of Autism • Onset • Regression • Adulthood • Lifelong disorder • Need continuous support

9. Screening • All MR children. • Lack of social responsiveness. • Aloof child. • Stopped speaking after developing some language. • Child not orienting to parent’s voice or his name. • Deficit in eye contact.

10. IQ test- MR in about 70%. • Visual and hearing acuity. • Syndromes like tuberous sclerosis, Fragile X. • Seizure disorder- 25-30% in adolescence. • EEG abnormalities are common but not an indication for treatment without symptoms. • Neuroimaging is generally not required.

11. Aetiology • Genetic- Fragile X, Tuberous sclerosis • Risk in sibling 4-5% • Abnormal development of Brain • Abnormal migration of neurons • Abnormal synaptic connections • Abnormality of mirror neurons

12. Treatment • Early identification and training • Families should get proper guidance and support. • Pharmacotherapy • Hyperactivity • Aggression • Self injurious behaviour • stereotype

13. Thank You