WHAT IS AUTISM AND WHO IS TO BLAME?

“Sometimes I wonder where he got autism from, or could it be that I didn’t do something right? Nobody in our family has it…” a parent once said this in session.

We've heard these and many more from parents consecutively, and we don't blame them. It's only natural to question something that deeply affects your child’s life. Maybe, just maybe, they can find a solution or even a cure.

So the question is; What is Autism Spectrum Disorder (ASD)?

Autism spectrum disorder is a developmental condition that affects how a child communicates, interacts with others, and experiences the world. It's marked by challenges in social communication, repetitive behaviours, and restricted interests. The condition varies widely, both in its presentation and its impact on the daily functioning of the child, which is why it's referred to as a "spectrum.". Hence, no two individuals with autism are exactly the same. (American Psychiatric Association, 2013).

Common signs observed in children with autism include:

• Stereotyped or repetitive behaviours including simple motor stereotypies (e.g., hand flapping, finger flicking), repetitive use of objects (e.g., spinning coins, lining up toys), and repetitive speech (e.g., echolalia, the delayed or immediate parroting of heard words; use of "you" when referring to self; stereotyped use of words, phrases, or prosodic patterns).

• Excessive adherence to routines and restricted patterns of behaviour may be manifest in resistance to change (e.g., distress at apparently small changes, such as taking an alternative route to school or work; insistence on adherence to rules; rigidity of thinking) or ritualized patterns of verbal or nonverbal behaviour (e.g., repetitive questioning, pacing a perimeter).

  
  

  

  
  

• Highly restricted, fixated interests in autism spectrum disorder tend to be abnormal in intensity or focus (e.g., a toddler strongly attached to the tyre of a toy car or piece of string; a child preoccupied with fan spinning or an adult spending hours writing out timetables). Some fascinations and routines may relate to apparent hyper- or hypo-reactivity to sensory input, manifested through extreme responses to specific sounds or textures, excessive smelling or touching of objects, fascination with lights or spinning objects, and sometimes apparent indifference to pain, heat, or cold.

• Social communication deficits, although sometimes accompanied by intellectual developmental disorder (intellectual disability), are not in line with the individual's developmental level. This can be seen with his limited eye contact showing facial expressions (like happy etc.), or playing with peers. 

A child having autism doesn’t mean something is "wrong" with him/her. It simply means that the child thinks differently from other people and it is something he/she will have throughout a lifetime. Autism is unique to each child and can present in many different ways. Don't be scared! A child being diagnosed with autism doesn’t mean the end of the world, with the right support, your child can ultimately live a full and happy life.

Note: For proper diagnosis of autism in your child, it's important to talk to your child's doctor (paediatrics) or clinical psychologist. Don’t self-diagnose!

What causes autism spectrum disorder, and who is to blame?

It is important to state that autism spectrum disorder (ASD) has no single known cause. There are many causes due to the complexity of the disorder and the variability of symptoms and severity of the disorder. However, research shows that a combination of genetic and environmental factors likely plays a role.

1. Genetics: In the simplest terms, genes are hereditary units that determine what an organism is like, its’ appearance, how it survives, and how it behaves in the environment.

Several genes and genomic areas have been identified to be associated with ASD, including those involved in synaptic function, neuronal development, and chromatin remodelling. However, the genetic understanding of ASD is complex and likely to involve multiple genes, each contributing a small amount to the overall risk. 

ASD can be linked to mutations in those genes and associated with a genetic disorder, such as Rett syndrome or fragile X syndrome and may affect brain development, the way that brain cells communicate, or determine the severity of symptoms. Also, ASD is four times more common in males than females. It is important to state that some genetic mutations seem to be inherited, while others occur spontaneously.

Tick et al. (2016) meta-analysis of thirteen primary twin studies from numerous sources found that ASD has a heritability tendency of estimates ranging from 64% to 91%. Twin and family studies also show that the risk of ASD is significantly higher in first-degree relatives of individuals with ASD compared to the general population. In its simplicity, this means having a family health history of ASD makes you more likely to have a child with ASD, and having a child with ASD increases your tendency to have another child with ASD. 

2. Environmental factors. Since the contribution of environmental factors in ASD is unclear compared to that of genetic factors, research is still ongoing to explore whether factors such as viral infections, complications during pregnancy, air pollutants, parental age at conception (about 40 years), maternal infection during pregnancy, and complications during birth (such as low birth weight or hypoxia) significantly increase the risk of ASD.

   

   
   

   However, more research is needed to confirm these associations and understand the underlying mechanisms by which they may contribute to ASD risk.

   
   

Are you to be blamed?

As a parent, it's normal to carry the weight of your child's struggles, but autism is not something caused by poor parenting, a bad decision, or something you failed to do. You don’t control your genes. You don’t control most environmental factors.

So please, stop blaming yourself.

Autism is not a tragedy, ignorance is!

So enough of shifting blame! Instead, let's help your child.

While there is no cure for autism spectrum disorder, intensive early intervention can make a big difference in the lives of your child, and there has been evidence of improvement in children diagnosed with ASD. Don't wait it out! As soon as you notice a delay in communication and social interaction with your child, seek help immediately from professionals at Nuture Child Development Clinic and get a discounted consultation fee today.

References

Autism Spectrum Disorder. Centers for Disease Control and Prevention, https://www.cdc.gov/ncbddd/autism/facts.html.

Environmental Factors in Autism. National Institute of Environmental Health Sciences, U.S. Department of Health and Human Services, https://www.niehs.nih.gov/health/topics/conditions/autism/index.cfm.

Autism Spectrum Disorder (2023).” National Institute of Mental Health, U.S. Department of Health and Human Services, https://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd/index.shtml.

Autism Spectrum Disorder.” World Health Organization, https://www.who.int/news-room/fact-sheets/detail/autism-spectrum-disorders.

Hallmayer, Joachim, et al. “Genetic Heritability and Shared Environmental Factors Among Twin Pairs With Autism.” Archives of General Psychiatry, vol. 68, no. 11, 2011, pp. 1095–1102., doi:10.1001/archgenpsychiatry.2011.76.

Tick, B., Bolton, P., Happe, F., Rutter, M., & Rijsdijk, F. (2016). Heritability of autism spectrum disorders: a meta-analysis of twin studies. Journal of Child Psychology and Psychiatry, 57(5), 585-595.