In the US, April is
autism awareness month. According to the World Health Organization, autism
affects 1 in every 100 children. More formally known as
autism spectrum disorder (ASD), autism is an umbrella term used to describe a group of
neurodevelopmental disorders.
اضافة اعلان
Autism is mainly
characterized by marked delay in language and social development. There is no
estimate on the prevalence of autism in Jordan since no formal investigation has
been done into the matter. Moreover, a proper estimate would be difficult due
to the delay in diagnosis.
A 2013 review of 84 cases in Jordan investigated
some of the causes of autism and parent knowledge of autism diagnosis. Only
three of those participating in the study had been diagnosed with autism and an
additional four were referred by the pediatrician who suspected autism.
Furthermore, despite parents’ concerns about their child’s late development, a
minority of patients received an early diagnosis or referral. The study
attributed this to the lack of screening for ASD by pediatricians. In short,
Jordan needs more campaigns to raise awareness about autism.
Autism typically becomes apparent in the early
stages of childhood development, particularly between 12 and 24 months. A
diagnostic tool for mental disorders, known as the DSM-5, divides ASD into two
categories, and a child must display symptoms in both categories to be
diagnosed with autism. One category is issues with communication and social interaction,
which may vary widely, depending on the severity, but must present before the
age of 5. Although infants do not generally begin to speak until they reach
12–18 months, there are other forms of communication that those with autism
will not be able to use and that may serve as an early indication. These may
include avoiding eye contact, not responding to their name, not displaying
facial emotions, or rarely using hand gestures.
As they age, the signs of autism become more
apparent as it is difficult to express feelings and understand others’
feelings, and to speak.
These traits continue to persist into
adulthood.
The other category is restricted or repetitive
patterns of behavior or activities. These can include repetitive movements or
reciting words or phrases, an attachment to routines, and obsessive interests.
Children with autism may also exhibit other signs such as hyperlexia, which is
the ability to read well beyond their age, typically around 2 years old.
Additionally, those with autism may become overstimulated by certain sensory
inputs such as sound, smells, or tastes.
Types of autism
As the name implies, ASD
refers to a broad range of developmental delays in social skills. As a result,
the 2013 DSM-5 currently recognizes five different subtypes that serve as
specifiers of the severity of ASD. The subtypes are:
1.
With or without accompanying intellectual impairment.
2.
With or without accompanying language impairment.
3.
Associated with a known medical or genetic condition or environmental factor.
4.
Associated with another neurodevelopmental, metal, or behavioral disorder.
5.
With catatonia (a group of symptoms that usually involve a lack of movement and
communication, and can also include agitation, confusion, and restlessness).
Under the new DSM-5, an individual can receive a
diagnosis of one or more subtypes. Prior to 2013, it was common for people to
receive diagnoses such as autistic disorder, Asperger’s syndrome, pervasive
development disorder-not otherwise specified (PDD-NOS), or childhood
disintegrative disorder. These conditions still fall under the term ASD, but no
longer follow those names. A person previously diagnosed with one of the
conditions should be reevaluated to receive a diagnosis that follows the DSM-5.
Causes
As is the case with many
conditions and diseases, there is no exact cause for autism and is likely
multifactorial. Environmental factors such as heavy metals, toxins, and some
medications, such as valproic acid, have been linked to higher instances of
autism. Some congenital conditions can also significantly increase the risk of
autism, such as fragile X syndrome and tuberous sclerosis.
Genetic factors seem to be the biggest risk factors
when it comes to autism. Some research seems to suggest that autism may be an
X-linked disorder. This theory came about due to the fact that males are four
times more likely to have autism than females.
Additionally, a family history of autism also plays
a role. Those with an immediate relative who has autism is at higher risk. Due
to the heavy involvement of
genetics in autism, consanguinity (marriage within
a common ancestry) may increase the risk of autism.
The aforementioned 2013 study found that of the 84
cases, 45 percent had a history of consanguinity. In Jordan, by 2018,
consanguinity was still at 28 percent. Furthermore, a 2020 study investigating
the relationship between consanguinity and autism found that it poses a
significant risk of ASD and other complications. As a result, they suggest that
high-risk groups in North Africa, Middle East,
Pakistan, and south India
undergo in-depth screening for autism.
Autism and vaccines
The concern that vaccines
may cause autism goes back to 1998, to a doctor by the name of Andrew
Wakefield. He and his colleagues published a case study that suggested a link
between autism and the
measles, mumps, and rubella (MMR) combined vaccine.
Since then, the study has been debunked numerous times and it was retracted in
2010.
Shortly after the MMR controversy, people started
being skeptical about an additive in vaccines known as thimerosal, which is a
mercury-based preservative used to prevent contamination with bacteria and
fungi in multidose vials. Critics began to assert that thimerosal could cause
autism, even though it was not an additive in the MMR vaccine. Numerous studies
have been published that established no link between thimerosal and ASD, nine
of which were funded or conducted by the
Centers for Disease Control and Prevention. Nevertheless, between 1999 and 2001, manufacturers began to remove
or reduce the amounts of thimerosal in vaccines.
Helping those with autism
There is no cure for autism,
which persists into adulthood. There are, however, many supportive therapies
that can help alleviate certain symptoms, such as behavioral therapy, physical
therapy, speech therapy, massages, weighted blankets, or meditation.
Every individual is different and there will be much
trial and error before finding the most effective supportive therapy. There are
many alternative remedies that claim to help those with autism, but research is
mixed and some may even be dangerous. It important to research the information
on alternative therapies from reliable sources.
Jordan is home to the
Scientific Center for Autism and Developmental Disorders, one of the first to focus on developmental disorders
and provide supportive services and comprehensive care to children with autism.
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