Discuss autism in children and adults, including presenting
symptoms, diagnostic criteria, differential diagnosis, prognosis, potential
complications, pharmacologic and non-pharmacologic treatment options, referrals
needed, and patient education.

Autism is classified under Autism spectrum disorder (ASD). It
is a lifelong neurodevelopmental ailment that is characterized by communication,
social interaction, repetitive behaviors, activities and interests. About 1 in
68 children is diagnosed with Autism and it mostly affects boys than girls (American
Psychiatric Association, 2013). This paper will discuss autism in adults and
children, deferential diagnosis, diagnostic criteria, prognosis, complications,
treatments and patient educations.

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Autism in adults and children may present differently.
Autism is mainly diagnosed at a young age. With early childhood intervention,
an autistic child may live a normal life as an adult. Some adults with autism
may lead a normal independent life. As individuals with autism grow their
patterns of behavior change, many they start to gain a lot of skills and
understanding, however they tend to develop anxiety, epilepsy and depression.

 

Presenting symptoms of autism are poorly integrated verbal
communication, nonverbal communication, poor eye contact, abnormal body
language, poor understanding of gestures, social emotional reciprocity,
difficult adjusting to change or new environment, reparative movements, speech
or use of objects, ritualized patterns of behavior, change in response to
sensory aspects of the environment, and preoccupation with certain objects or
interests.  Severity of Autism is based
on levels; level 1 the child will be requiring little support; level 2,
requiring substantial support, and level 3 requiring very substantial support

 

Diagnostic criteria are based on the DSM-5 criteria, and
these include restricted interest in activities, repetitive patterns of
behavior; persistent deficits in social interaction and communication; the
symptoms should impair function; and the symptoms ought to be existing in the
early developing period of the child (American Psychiatric Association, 2013).  There are several tools that are used to
diagnose ASD and these are Autism Behavior Checklist which is a list of 57
questions divided in to relating, sensory, object and body use, language,
social and self-help question that are completed by the teacher or parent, and
can be uses on children as young as 3 years. Gilliam Autism Rating Scale has 56
questions and is used for children and young people up to 22 years, the
questions include restrictive/repetitive behaviors, social communication,
social interaction, cognitive style, emotional responses, and maladaptive
speech. Autism Diagnostic Interview is a 2-3 hour meeting that probes for
autism indicators. Childhood Autism Rating Scale is a fifteen-item direct observation
tool intended to simplify the diagnosis of autism in children older than two
years, and each of the items is scored. Autism Diagnostic Observation Schedule
is available for ages from 12 months through adulthood.  It is a semi structured assessment that
includes social interaction, communication, play, and imaginative use of
materials. The assessment is scored and it takes 40 to 60 minutes to
administer. Autism Diagnostic Observation Schedule-Toddler Module, is used in
children aged 12 to 30 months. The assessment targets communication, emerging
object use, reciprocal social interaction and play skills (Augustyn, 2016).

Differential diagnoses of autism are Global developmental
delay, pragmatic disorder, intellectual disability, language based learning
disability, developmental language disorder, Landau-Kleffner syndrome, hearing
impairment, reactive attachment disorder, Rett disorder, anxiety disorder and
obsessive-compulsive disorder.  To
distinguish these disorders from Autism, a complete history is the best tool,
and at times additional tests may be essential (Augustyn, 2016)

Prognosis is good if the functional language is available by
5 years of age. The life expectance of individuals with autism is normal. While
come people with autism may require lifelong assistance, others with
appropriate treatment and early interventions they can attain independency, (American
Psychiatric Association, 2013).

 

Potential complications for children with autism are
depression, they may be depressed if they realize that they are different from
others. Children with autism may develop behavioral problems such as Obsessive
Compulsive Disorder, and this can intrude into their daily routine.  Attention deficit hyperactivity disorder
(ADHD), is another complication for children with autism. They may be hyper
active and easily distracted. Autistic children may develop anxiety due to
having difficulty to cope with different situations. One third of children with
autism develop seizures. Children with autism may develop problems associated
with sensitivity. They may develop sensitivity to environmental changes and
stimuli. Some children with autism have some mental retardation.

 

 

Pharmacologic and non-pharmacologic treatment options are
aimed at improving symptoms of ASD. There is no cure for Autism neither do
children outgrow it.  Treatment may
include the applied behavior analysis (ABA), it includes rigorous teaching
educational sessions and skill building sessions. Parent support and training,
speech therapy, occupational therapy and skills training are part or the
treatment. Those children with behavioral issues or depressed may be put on
medications. special nutritional supplements, diets, a consistent and
predictable day can also help children with autism function better (Benson,
2016).

 

referrals needed are Early Intervention services; Developmental
pediatrics, neurology, genetics; Center for Autism Spectrum Disorders; Audiology
evaluation; Interdisciplinary assessment or formal diagnostic evaluation; Communication
evaluation; Labs; Genetics consultation; Imaging; ABA/Behavior Therapy; Speech
and Language Therapy; Occupational therapy; Social Skills groups;

 

patient education.

 

 

References

American Psychiatric Association. (2013). Diagnostic and
statistical manual of mental disorders (5th ed.). Arlington, VA: American
Psychiatric Publishing.

Augustyn, M., (2016). Autism spectrum disorder: Diagnosis.
Retrieved from https://www.uptodate.com/contents/autism-spectrum-disorder-diagnosis

Benson, S., (2016). What Is Autism Spectrum Disorder?
American Psychiatric Associations. Retrieved from https://www.psychiatry.org/patients-families/autism/what-is-autism-spectrum-disorder