How Does A Child Get Autism

Understanding Autism Spectrum

Autism spectrum disorder (ASD) is a complex developmental condition that involves persistent challenges in social interaction, speech, and nonverbal communication. It is associated with restricted and repetitive behaviors, interests, or activities. In the context of 'how does a child get autism', it is crucial to understand the signs in children and the process of diagnosis and screening.

Signs in Children

Autism can sometimes manifest differently in girls and boys. Autistic girls may exhibit different signs compared to autistic boys, making it potentially harder to identify autism in girls [1]. Children on the autism spectrum may display delays in spoken language or differences in how they interact with peers. However, they usually meet physical milestones such as sitting, crawling, and walking on time. Subtler differences in the development of gestures, pretend play, and social language often go unnoticed by families and doctors.

Some common signs of autism in children include:

• Difficulty with eye contact
• Lack of interest in peers
• Limited use of gestures for communication
• Repetitive behaviors or speech
• Unusual response to sensory input

Diagnosis and Screening

It's important to note that getting a diagnosis can help a child with autism receive any extra support they might need. ASD can be diagnosed reliably by the age of 2 by an experienced professional. The American Academy of Pediatrics (AAP) recommends that all children be screened for autism at ages 18 months and 24 months. Additionally, developmental and behavioral screenings should be conducted during regular well-child visits at 9 months, 18 months, and 30 months [3].

A study by the Autism Specialty Group revealed that less than 2% of children presumed to have autism after 12 months of age were later found not to have the disorder. On the other hand, 24% of children considered neurotypical in early evaluations did go on to receive an ASD diagnosis.

Diagnosis of autism involves two steps:

1. Developmental Screening: A short test to tell if a child is learning basic skills at a normal pace or if they have delays.
2. Comprehensive Diagnostic Evaluation: A thorough review that may include looking at the child’s behavior and development and interviewing the parents, a hearing and vision screening, genetic testing, neurological testing, and other medical testing.

Early diagnosis and intervention can significantly improve a child's development and quality of life. Therefore, understanding the signs and getting an early diagnosis are critical steps in managing autism.

Factors Contributing to Autism

In the quest to understand the origins of Autism Spectrum Disorder (ASD), researchers have identified several key factors that may contribute to its development. These factors range from genetic influences to environmental exposures and maternal health conditions.

Genetic Factors

Research has shown that genetics play a significant role in the development of autism. Some individuals inherit certain gene variants from their parents that may increase the likelihood of a child having autism. A 2019 study estimated ASD's heritability to be approximately 80%, indicating a strong genetic influence [4]. However, it is also important to note that not all children with these gene variants develop ASD, suggesting that other factors may also be at play.

Environmental Factors

Environmental factors are another key aspect of autism development. These factors include, but are not limited to, exposure to certain infections or medications during pregnancy, very low birth weight, maternal obesity, and older parental age at the time of conception. There is also concern about the impact of prenatal and early childhood exposure to heavy metals, like mercury, lead, or arsenic, and altered levels of essential metals like zinc or manganese.

Despite these findings, more research is necessary to fully understand the role that environmental factors might play in the development of autism. To this end, NIEHS-funded scientists are conducting large-scale studies such as the Childhood Autism Risk from Genetics and the Environment (CHARGE) study, the Markers of Autism Risk in Babies - Learning Early Signs (MARBLES) study, and The Early Autism Risk Longitudinal Investigation (EARLI) study.

Maternal Diabetes Risk

Maternal health conditions also appear to play a role in the development of autism. Problems with a mother’s immune system, certain metabolic conditions, or inflammation during pregnancy may be linked with higher autism risk for her children.

Furthermore, research suggests that taking vitamins and supplements might provide protective effects for those exposed to certain environmental contaminants during pregnancy. For instance, NIEHS-funded studies have found that taking prenatal vitamins may help lower autism risk.

Overall, the development of autism is likely influenced by a complex interplay of genetic and environmental factors, as well as maternal health conditions. By better understanding these influences, researchers hope to provide more targeted strategies for autism prevention and early intervention.

Prenatal Influences on Autism

In the quest to understand how a child gets autism, one area of research focuses on prenatal influences. These include exposure to certain medications and heavy metals during pregnancy, and the role of prenatal vitamins.

Medication Exposure

Exposure to medication during pregnancy, particularly in the first trimester, is a recognized risk factor for Autism Spectrum Disorder (ASD). Of particular concern is the drug valproate, often used in the treatment of epilepsy and other neurological disorders. According to research, children exposed to valproate in utero have an eight-fold increased risk of developing ASD.

Other medications that have been associated with an increased risk of autism in children include antidepressants and paracetamol. Such prenatal medication use can lead to developmental delays, motor activity deficiencies, and social behavior issues in children [7].

Heavy Metal Exposure

Another prenatal influence linked to autism risk is exposure to heavy metals. Prenatal and early childhood exposure to metals like mercury, lead, or arsenic, altered levels of essential metals like zinc or manganese, pesticides, and other contaminants have been associated with an increased risk of autism [5].

These substances can interfere with normal neurological development, leading to the characteristics associated with ASD. It's crucial for expectant mothers to avoid exposure to these substances as much as possible to minimize the potential risk to their unborn child.

Importance of Prenatal Vitamins

On a positive note, taking prenatal vitamins may help lower the risk of autism. Research funded by the National Institute of Environmental Health Sciences (NIEHS) has found that these supplements might provide protective effects for those exposed to certain environmental contaminants during pregnancy.

Prenatal vitamins typically contain higher amounts of certain nutrients, such as folic acid and iron, that are important for the baby's development. These nutrients can help ensure healthy brain development and may offset some of the risks associated with prenatal exposure to harmful substances.

While the exact causes of autism remain elusive, understanding the impact of these prenatal influences can provide valuable insights into how to potentially prevent or reduce the risk of ASD.

Early Detection of Autism

Understanding the early signs of autism can play a crucial role in addressing the condition and providing the necessary interventions. This can greatly improve a child's development and quality of life. Early detection of autism primarily involves observing a child's developmental milestones and their joint attention skills.

Developmental Milestones

Children on the autism spectrum often hit physical milestones like sitting, crawling, and walking on time. However, they may show delays in spoken language or differences in how they interact with peers. Subtler differences in the development of gestures, pretend play, and social language often go unnoticed by families and doctors.

Almost all children on the autism spectrum show delays in nonverbal communication and spoken language. For example, they may have words they use to label things but not to ask for things. They may also repeat what they hear for a longer period, a behavior known as parroting or echoing [2].

Additionally, about 25% of children later diagnosed with autism spectrum disorder may develop some language that they suddenly or gradually stop using, typically between the ages of 15 and 24 months. This change, accompanied by becoming more socially withdrawn, is called a regression in skills [2].

Joint Attention Skills

One of the most important developmental differences between children on the autism spectrum and children without ASD is a delay in or lack of joint attention, which is a building block for later social and communication skills. Delays in joint attention skills are found in most children with ASD [2].

Joint attention skills involve the ability to share a common focus on something (people, objects, a concept, an event, etc.) with someone else. It involves the ability to gain, maintain, and shift attention. Joint attention serves as a foundation for children's learning of language, and influences their social development and ability to participate in social relationships.

Acting early upon concerns about how a child plays, learns, speaks, acts, or moves can make a big difference in their development. It is essential to talk with a pediatrician if there are any concerns, as early intervention is crucial [2].

Developmental Differences in Autism

Understanding the developmental differences in autism can provide insights into the question, "how does a child get autism?" Two key differences include language and communication delays and regression in skills.

Language and Communication Delays

Almost all children on the autism spectrum show delays in nonverbal communication and spoken language. For example, children may have words they use to label things but not to ask for things. They may also repeat what they hear for a longer period, a behavior known as parroting or echoing.

Regression in Skills

About 25% of children later diagnosed with autism spectrum disorder may develop some language that they suddenly or gradually stop using, typically between the ages of 15 and 24 months. This change, accompanied by becoming more socially withdrawn, is called a regression in skills. Regression could also involve loss of social skills, motor skills, or other developmental achievements [2].

These developmental differences in autism can be early indicators of the condition. Early detection and intervention can significantly improve outcomes for children on the autism spectrum. Thus, understanding these differences is crucial not only for answering "how does a child get autism?" but also for providing the right support and resources for children with autism and their families.

Risk Factors and Associated Conditions

In the quest to understand how a child gets autism, it's crucial to consider the various risk factors and associated conditions that can accompany this complex disorder. Factors such as recurrence risk, irritability and aggression, and the presence of conditions like Attention Deficit Hyperactivity Disorder (ADHD) and anxiety disorders can all play a role.

Recurrence Risk

Autism, being a pervasive developmental disorder, shows a pattern of recurrence among siblings. According to a study, the recurrence risk in siblings of children with autism is estimated to be between 2% and 8%. However, this risk rises to 12% to 20% if siblings show some impairment in one or two of the three domains affected in autism. Twin studies further suggest that this aggregation within families is better explained by shared genes rather than shared environment [6].

Irritability and Aggression

Individuals with autism often exhibit behaviors such as irritability, aggression, and self-injurious actions. Self-injurious behaviors can include actions like hitting, pinching, scratching, biting, head banging, and hair pulling. Risk factors for more serious and persistent self-injurious behaviors include intellectual disability, limited communication skills, lower adaptive functioning, and sensory processing deficits.

ADHD and Anxiety Disorders

Attention Deficit Hyperactivity Disorder (ADHD) is commonly associated with autism. Limitations of executive functioning are common in both Autism Spectrum Disorder (ASD) and ADHD, suggesting that both may be conceptualized through an "executive functioning deficit model." Social skills deficits are typically underdeveloped or impaired in both ASD and ADHD.

Anxiety disorders, with specific phobias and generalized anxiety disorder being the most common, are frequently found in individuals with ASD. Diagnosing specific anxiety disorders in the context of ASD can be challenging due to shared features associated with both autism and anxiety disorders [8].

Additionally, individuals with ASD are at double the risk of developing a substance use disorder (SUD). Autistic individuals share common risk factors for developing SUDs with the general population, including genetic predisposition, environmental effects, stressful family events, and psychological distress [8].

Understanding these associated conditions and risk factors is a key part of navigating the complexities of autism. By being aware of these factors, caregivers and medical professionals can better manage and support individuals with autism.

References

[1]: https://www.nhs.uk/conditions/autism/signs/children/‍

[2]: https://www.healthychildren.org/English/health-issues/conditions/Autism/Pages/Early-Signs-of-Autism-Spectrum-Disorders.aspx

‍[3]: https://www.autismspeaks.org/signs-autism

‍[4]: https://www.medicalnewstoday.com/articles/what-causes-autism

‍[5]: https://www.niehs.nih.gov/health/topics/conditions/autism

‍[6]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3513682/

‍[7]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5377970/

‍[8]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10048473/