60 Mirror neuron system edit main article: Mirror neuron The mirror neuron system (MNS) consists of a network of brain areas that have been associated with empathy processes in humans. 61 In humans, the mns has been identified in the inferior frontal gyrus (IFG) and the inferior parietal lobule (IPL) and is thought to be activated during imitation or observation of behaviors. 62 The connection between mirror neuron dysfunction and autism is tentative, and it remains to be seen how mirror neurons may be related to many of the important characteristics of autism. 63 64 "Social brain" interconnectivity edit a number of discrete brain regions and networks among regions that are involved in dealing with other people have been discussed together under the rubric of the "social brain". As of 2012, there was a consensus that autism spectrum is likely related to problems with interconnectivity among these regions and networks, rather than problems with any specific region or network. 65 Temporal lobe edit functions of the temporal lobe are related to many of the deficits observed in individuals with asds, such as receptive language, social cognition, joint attention, action observation, and empathy. The temporal lobe also contains the superior temporal sulcus (STS) and the fusiform face area (ffa which may mediate facial processing. It has been argued that dysfunction in the sts underlies the social deficits that characterize autism.
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48 Low vitamin D levels in early development has been hypothesized as a risk factor for autism. 49 Vaccine controversy edit main article: mmr vaccine controversy perhaps the most controversial claim regarding autism etiology was the " vaccine controversy ". 50 This conjecture, arising from a case of scientific misconduct, 51 suggested that autism results from brain damage caused either by (1) the measles, mumps, rubella (MMR) vaccine itself, or by (2) thiomersal, a vaccine preservative. 52 no convincing scientific evidence supports these claims, and further evidence continues to refute them, including the observation that the rate of autism continues to climb despite elimination of thimerosal from routine childhood vaccines. 53 A 2014 meta-analysis examined ten major studies on autism and vaccines involving.25 million children worldwide; it concluded that neither the mmr vaccine, which has never contained thimerosal, 54 nor the vaccine components thimerosal or mercury, lead to the development of asds. 55 Pathophysiology edit main article: Autism Mechanism In general, neuroanatomical studies support the concept that autism may involve a combination of brain enlargement in some areas and reduction in others. 56 These studies suggest that autism may be caused by abnormal neuronal growth and pruning during the early stages of prenatal and postnatal brain development, leaving some areas of the brain with too many neurons and other areas with too few neurons. 57 Some research has reported an overall brain enlargement in autism, while others suggest abnormalities in several areas of the brain, including the frontal lobe, the mirror neuron system, the limbic system, the temporal lobe, and the corpus callosum. 58 59 In functional neuroimaging studies, when performing theory of mind home and facial emotion response tasks, the median person on the autism spectrum exhibits less activation in the primary and secondary somatosensory cortices of the brain than the median member of a properly sampled control. This finding coincides with reports demonstrating abnormal patterns of cortical thickness and grey matter volume in those regions of autistic persons' brains.
41 The shank gene family has been associated with symptoms of asd. In particular, the Shank3 gene has been linked to more severe deficits than other vietnamese genes within the family. 46 Genetics appears to interact with environmental factors. 41 Prenatal and perinatal risk factors edit several prenatal and perinatal complications have been reported as possible risk factors for autism. These risk factors include maternal gestational diabetes, maternal and paternal age over 30, bleeding after first trimester, use of prescription medication (e.g. Valproate ) during pregnancy, and meconium in the amniotic fluid. While research is not conclusive on the relation of these factors to autism, each of these factors has been identified more frequently in children with autism compared to their non-autistic siblings and other typically developing youth. 47 While it is unclear if any single factors during the prenatal phase affect the risk of autism, 48 complications during pregnancy may be a risk.
It is possible to identify general risk nurse factors, but much more difficult to pinpoint specific factors. In the current state of knowledge, prediction can only be of a global nature and therefore requires the use of general markers. 40 Genetic risk factors edit Of all of the conjectured causes of autism, genetics have proven to give the highest risk of being diagnosed with autism. If a family member is on the autism spectrum, there is a 50 percent chance that another member of the family will be diagnosed with the disorder as well, and being a twin gives a 69 to 90 percent chance of an asd diagnosis. 41 In addition, research suggests that there is a much higher concordance rate among monozygotic twins compared to dizygotic twins. 42 It appears that there is no single gene that accounts for autism. Instead, there seem to be multiple genes involved, each of which is a risk factor for components of the autism spectrum disorders. Genes for autism have been found on chromosome arms 2q, 7q, and 15q.
37 What looks like self-involvement or indifference toward others stems from a struggle to realize or remember that other people have their own personalities, perspectives, and interests. 38 Language expression by those on the autism spectrum is often characterized by repetitive and rigid language. Often children with asd repeat certain words, numbers, or phrases during an interaction, words unrelated to the topic of conversation. They can also exhibit a condition called echolalia in which they respond to a question by repeating the inquiry instead of answering. 37 However, this repetition can be a form of meaningful communication, a way that individuals with asd try to express a lack of understanding or knowledge regarding the answer to the question. 39 main article: causes of autism While specific causes of autism spectrum disorders have yet to be found, many risk factors identified in the research literature may contribute to their development. These risk factors include genetics, prenatal and perinatal factors, neuroanatomical abnormalities, and environmental factors.
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All of these issues stem from cognitive impairments. Difficulties in this thought process is called "theory of the mind" or mind blindness which translates that the mind has difficulty with thought process as well as being aware of what is going on around them. 35 Communication skills edit communication deficits are generally characterized by impairments regarding buying joint attention and social reciprocity, challenges with verbal language cues, and poor nonverbal communication skills 36 such as lack of eye contact and meaningful gestures and facial expressions. 37 Language behaviors typically seen in children with autism may include repetitive or rigid language, specific interests in conversation, and atypical language development. 37 Many children with asd develop language skills at an uneven pace where they easily acquire some aspects of communication, while never fully developing other aspects.
37 In some cases, children remain completely nonverbal throughout their lives, although the accompanying levels of literacy and nonverbal communication skills vary. They may not pick up on body language or may ignore cues such as eye contact and facial expressions if they provide more information than the person can process at that time. Similarly, they have trouble recognizing subtle expressions of emotion and identifying what various emotions mean for the conversation. They struggle with understanding the context and subtext of conversational or printed situations, and have trouble forming resulting conclusions about the content. This also results in a lack of social awareness and atypical language expression. 38 It is also common for individuals with asd to communicate strong interest in a specific topic, speaking in lesson-like monologues about their passion instead of enabling reciprocal communication with whomever they are speaking.
26 27 One course of development is more gradual in nature, in which parents report concerns in development over the first two years of life and diagnosis is made around 34 years of age. Some of the early signs of asds in this course include decreased looking at faces, failure to turn when name is called, failure to show interests by showing or pointing, and delayed pretend play. 28 A second course of development is characterized by normal or near-normal development followed by loss of skills or regression in the first 23 years. Regression may occur in a variety of domains, including communication, social, cognitive, and self-help skills; however, the most common regression is loss of language. 29 30 There continues to be a debate over the differential outcomes based on these two developmental courses.
Some studies suggest that regression is associated with poorer outcomes and others report no differences between those with early gradual onset and those who experience a regression period. 31 While there is conflicting evidence surrounding language outcomes in asd, some studies have shown that cognitive and language abilities at age 2 12 may help predict language proficiency and production after age. 32 overall, the literature stresses the importance of early intervention in achieving positive longitudinal outcomes. 33 Social skills edit social skills present the most challenges for individuals with asd. This leads to problems with friendships, romantic relationships, daily living, and vocational success. 34 Marriages are less common for those with asd. Many of these challenges are linked to their atypical patterns of behavior and communication.
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19 There is also a melisande unique form of autism called autistic savantism, where a child letter can display outstanding skills in music, art, and numbers with no practice. 20 Because of its relevance to different populations, self-injurious behaviors (SIB) are not considered a core characteristic of the asd population however approximately 50 of those with asd take part in some type of sib (head-banging, self-biting) and are more at risk than other groups. 21 Other characteristics of asd include restricted and repetitive behaviors (RRBs) which include a large range of specific gestures and acts, it can even include certain behavioral traits as defined in the diagnostic and Statistic Manual for Mental Disorders. 22 Asperger syndrome was distinguished from autism in the dsm-iv by the lack of delay or deviance in early language development. 23 Additionally, individuals diagnosed with Asperger syndrome did not have significant cognitive delays. 24 pdd-nos was considered "subthreshold autism" and "atypical autism" because it was often characterized by milder symptoms of autism or symptoms in only one domain (such as social difficulties). 25 The dsm-5 eliminated the four separate diagnoses: Asperger Syndrome, pervasive developmental Disorder Not Otherwise Specified (pdd-nos childhood Degenerative disorder, and Autistic Disorder and combined them under the diagnosis of Autism Spectrum Disorder. 19 developmental course edit autism spectrum disorders are thought to follow two possible developmental courses, although most parents report that symptom onset occurred within the first year of life.
Asperger syndrome is closest to autism in signs and likely causes; 13 unlike autism, people with Asperger syndrome usually have no significant delay in language development, according to the older dsm-4 criteria. 14 pdd-nos is diagnosed when the criteria are not met for a more specific disorder. Some sources also include rett syndrome and childhood disintegrative disorder, which share several signs with autism but may have unrelated causes; other sources differentiate them from asd, but group all of the above conditions into the pervasive developmental disorders. 13 15 Autism, Asperger syndrome, and pdd-nos are sometimes called the autistic disorders instead of asd, 16 whereas autism itself is often called autistic disorder, childhood autism, or infantile autism. 17 Although the older term pervasive developmental disorder and the newer term autism spectrum disorder largely or entirely overlap, 15 the earlier was intended to describe a specific set of diagnostic dog labels, whereas the latter refers to a postulated spectrum disorder linking various conditions. 18 asd is a subset of the broader autism phenotype (bap which describes individuals who may not have asd but do have autistic-like traits, such as avoiding eye contact. 17 Characteristics edit Under the dsm-5, autism is characterized by persistent deficits in social communication and interaction across multiple contexts, as well as restricted, repetitive patterns of behavior, interests, or activities. These deficits are present in early childhood, and lead to clinically significant functional impairment.
countries. For example, the icd-10 is the most commonly-used diagnostic manual in the uk and European Union. 11 Rather than categorizing these diagnoses, the dsm-5 has adopted a dimensional approach to diagnosing disorders that fall underneath the autism spectrum umbrella. Some have proposed that individuals on the autism spectrum may be better represented as a single diagnostic category. Within this category, the dsm-5 has proposed a framework of differentiating each individual by dimensions of severity, as well as associated features (i.e., known genetic disorders, and intellectual disability). Another change to the dsm includes collapsing social and communication deficits into one domain. Thus, an individual with an asd diagnosis will be described in terms of severity of social communication symptoms, severity of fixated or restricted behaviors or interests, and associated features. The restricting of onset age has also been loosened from 3 years of age to "early developmental period with a note that symptoms may manifest later when social demands exceed capabilities. 12 Autism forms the core of the autism spectrum disorders.
8, treatment efforts are generally individualized to the person's condition. 3, medications may be used to try to help improve certain associated problems. 3, evidence to support the use of medications, however, is not very strong. 5, autism spectrum is estimated to affect about 1 of people (62.2 million globally as of 2015). 1 6, males are diagnosed more often than females. Classification edit, further information: Autism Classification, in melisande the United States, a revision to autism spectrum disorder (ASD) was presented in the. Diagnostic and Statistical Manual of Mental Disorders version 5 ( dsm-5 released may 2013. 9 The new diagnosis encompasses previous diagnoses of autistic disorder, Asperger syndrome, childhood disintegrative disorder, and pdd-nos.
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Autism spectrum, also known as autism spectrum disorder asd buy is a range of conditions classified as neurodevelopmental disorders. Individuals diagnosed with autism spectrum disorder present with two types of symptoms: problems in social communication and social interaction, and restricted, repetitive patterns of behavior, interests or activities. Symptoms are typically recognized between one and two years of age. 1, long term issues may include difficulties in creating and keeping relationships, maintaining a job, and performing daily tasks. 7, the cause of autism spectrum is uncertain. 3, risk factors include having an older parent, a family history of the condition, and certain genetic conditions. 3, diagnosis is based on symptoms. Dsm-5 redefined the autism spectrum disorders to encompass the previous diagnoses of autism, asperger syndrome, pervasive developmental disorder not otherwise specified (pdd-nos and childhood disintegrative disorder.