Autism Spectrum Disorder

Another neurodevelopmental disorder is broad-spectrum autism that includes cases of different degrees associated with genetic and environmental factors, whose manifestation is variable, is identified in early stages -18 months and is consolidated at 36 months of age- will be present throughout the life course, specifically affecting communication and social interaction, such as behavior, with the presence of repetitive and restricted behaviors and interests, the evaluation must be multidisciplinary, it is important to detect it early in the child in order to improve social communication. This shows great heterogeneity ranging from mild personality modifications to severe disability. (Lara, 2012) the author makes reference that this term appears for the first time in the monograph Dementia Praecox oder Gruppe der Schizophrenien written by Eugene Bleuler (1857 – 1939) for the Treatise on Psychiatry directed by Gustav Aschaffenburg (1866-1944) and published in Vienna in 1911. Leo Kanner, psychiatrist in 1943 published in Nervous Child the classic article Autistic disturbances of affective contact, adopting the term autism. (Roberto Chaskel & Maria Fernanda Bonilla) refer that autism derives from the Greek autt (o), which means that it acts on oneself and the suffix -ism, which means pathological process. So far there is no curative treatment for autism. (A. Hervás Zuñiga, 2017) The prevalence of ASD is higher in boys at 23.6 per 1,000 than in girls at 5.3 per 1,000 in the 8-year-old US population. The diagnosis of ASD is eminently clinical, the cause of the disorder is not known. According to (Claudia Talero-Gutiérrez, 2016) the subjects who suffer from this disorder tend to isolate themselves, this due to the difficulty of relating in a social environment and present clinical manifestations such as alterations in the development and organization of language, repetitive actions and change of mental judgment or cognitive flexibility.

(Psychiatry, Diagnostic and Statistical Manual of Mental Disorders, 2014) the latest version of the DSM-5 manual placed all the subtypes of autism in a single category: Autism spectrum disorders replaces the term Pervasive developmental disorders.

  1. Persistent deficiencies in social communication and social interaction in various contexts, manifested by the following, currently, or by background (examples are illustrative, but not exhaustive)
  2. Deficiencies in socio-emotional reciprocity range, for example, from abnormal social rapprochement and failure of normal two-way conversation to decreased interests, emotions, or shared affections to failure and initiation or response to social interactions.
  3. The deficiencies in nonverbal communicative behaviors used in social interaction vary, for example, from poorly integrated verbal and nonverbal communication, through abnormalities in eye contact and body language, or deficiencies in understanding and use of gestures, to total lack of facial expression and non-verbal communication.
  4. Deficits in the development, maintenance and understanding of relationships vary, for example, from difficulties adjusting behavior in various social contexts to difficulties sharing imaginative games or making friends, to a lack of interest in other people.

Specify the current severity:

The severity is based on impaired social communication and restricted and repetitive behavior patterns.

  • Restrictive and repetitive patterns of behavior, interests or activities, manifested in two or more of the following points, currently or by background (the examples are illustrative, but not exhaustive).
  • Stereotyped or repetitive movements, use of objects, or speech (eg, simple motor stereotypies, alignment of toys or moving objects, echolalia, idiosyncratic phrases).
  • Insistence on monotony, excessive inflexibility of routines or ritualized patterns of verbal or non-verbal behavior (eg, great distress in the face of small changes, difficulties with transitions, rigid thought patterns, greeting rituals, need to take the same walk or eat the same foods every day).
  • Very restricted and fixed interests that are abnormal in their intensity or focus of interest (eg, strong attachment or preoccupation with unusual objects, overly circumscribed or persistent interests).
  • Hyper or hyporesponsiveness to sensory stimuli or unusual interest in sensory aspects of the environment (eg, apparent indifference to pain / temperature, adverse response to specific sounds or textures, excessive sniffing or palpation of objects, visual fascination with lights or movement).

Specify the current severity:

The severity is based on impaired social communication and restricted and repetitive behavior patterns.

  • Symptoms must be present early in the developmental period (but may not fully manifest until social demand exceeds limited capacities, or may be masked by strategies learned later in life).
  • Symptoms cause clinically significant impairment in social, occupational, or other important areas of normal functioning.
  • These alterations are not better explained by intellectual disability (intellectual development disorder) or global developmental delay. Intellectual disability and autism spectrum disorder often coincide; to make diagnoses of comorbidities of autism spectrum disorder and intellectual disability, social communication must be below that expected for the general level of development.
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Bibliography
A. Hervás Zuñiga, N. B. (2017). Autism spectrum disorders (ASD). Comprehensive Pediatrics.

Claudia Talero-Gutiérrez, C. M.-V.-M. (2016). Autism spectrum disorder and executive function. Acta Neurológica Colombiana, (pp. 246 -252). Bogota D.C.

Lara, J. G. (2012). Autism History and Classifications. Mexico.

Psychiatry, A. A. (2014). Diagnostic and Statistical Manual of Mental Disorders. Madrid: Editorial Médica Panamericana.

Psychiatry, A. A. (2014). Diagnostic and Statistical Manual of Mental Disorders (DSM-5a). Madrid: Editorial Médica Panamericana.

Roberto Chaskel, M., & Maria Fernanda Bonilla, M. (s.f.). Autism spectrum disorder. CCAP, Volume 15 number 1 pages 19-29.

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