Question

Discuss current changes to the criteria previously used to diagnose and treat autism. How was autism diagnosed and treated previously? How will it be diagnosed and treated now? What factors influence ASD? Explain.

note citations and refrences please

Answer 1

Autism is neuro-developmental disorder marked by communication disorders, short attention span, and inability to treat others as people (social interaction).

The criteria for diagnosis of autistic disorder changed to improve consistency across all practitioners and clinicians. These changes in diagnostic criteria is updated in Diagnostics and Statistics Manual - 5 (DSM-5) by American Psychiatric Association (APA). Following are changes made to diagnosing criteria and treatment for autistic disorder:

1. There were 4 separate disorders in previous diagnostic criteria, namely autistic disorder, Asperger’s disorder, childhood disintegrative disorder and pervasive developmental disorder-not otherwise specified (PDD-NOS). This caused difference in diagnosing disorders and treatment methods. Now, DSM-5 provides one diagnosis for all these separate disease conditions as autism spectrum disorder.

2. Domains of impairment in new criteria are (i) social interaction and social communication and (ii) restricted interests and repetitive behaviors. It should be observed that there are only 2 domains of impairment in new criteria, whereas previous criteria had 3 domains of impairment.

3. If an individual displays 5 out of 7 possible impairments, then diagnosis of autism spectrum disorder can be given according to new criteria, whereas it was 6 out of 12 according to previous criteria for diagnosis.

4. All 3 impairments coming under social interaction and communication domain should be present and at least 2 out 4 impairment from another domain (restricted interests and repetitive behaviors) present to qualify for the diagnosis of autism spectrum disorder according to new criteria.

5. Severity ratings can be observed in new criteria of DSM-5. These severity ratings include level 3-requiring very substantial support; level 2-requiring substantial support; level 1-requiring support.

6. It should be observed new category called social communication disorder is present in new criteria. This shows disorder in social communication domain only and no impairment observed in restricted interests and repetitive behaviors.

Following are the factors influencing autism spectrum disorders:

(a) Genetic factors: Studies have shown prevalence of autism in siblings of autistic children is approximately 15-30 times greater than general population, this means genetic factor plays a role in this disorder, yet it is not found that single common gene is responsible for this disorder.

(b) Prenatal and peri-natal factors: Condition like gestational diabetes, usage of drugs, maternal/paternal age exceeds 30 years influenced the occurrence rate of this disorder. Vitamin D level at early development phase of children has influence on acquiring this disorder.

(c) If some damage to brain caused by vaccinations or medicines, then it might result in getting autistic spectrum disorder.

(d) If there is exposure to pollution and allergy causing materials during pregnancy, then this might influence the children getting autistic spectrum disorder.