Autism Spectrum Disorders
Medicine Central™ is a quick-consult mobile and web resource that includes diagnosis, treatment, medications, and follow-up information on over 700 diseases and disorders, providing fast answers—anytime, anywhere. Explore these free sample topics:
-- The first section of this topic is shown below --
- Group of neurodevelopmental disorders of early childhood: DSM-5: umbrella term autism spectrum disorders (ASDs) which combines autistic disorder, childhood disintegrative disorder, Asperger disorder, pervasive developmental disorder not otherwise specified (PDD-NOS), early infantile autism, childhood autism, Kanner autism, high-functioning autism, and atypical autism (1)[A]
- Two symptom-driven subtypes: impairment of effective social skills and absent or impaired communication skills
- Fixed interests/repetitive behaviors
- Repetitive and/or stereotyped behaviors and interests, especially in inanimate objects (2)[A]
- Severity levels
- Level 1: requiring support
- Level 2: requiring substantial support
- Level 3: requiring very substantial support
- Important to distinguish autism disorder from social (pragmatic) communication disorder. Separate DSM-5 criteria for individuals with social communication deficits but do not meet autism-spectrum criteria.
- Predominant age: onset in early childhood
- Predominant sex: male > female (4.5:1)
Symptom onset seen in children <3 years of age (except for childhood disintegrative disorder)
- According to the Centers for Disease Control and Prevention (CDC), an estimated prevalence of 1/68
- Among children aged 3 to 17 years within the United States, there was found to be a 2.2% (22.4 in 1,000) parent-reported prevalence.
Etiology and Pathophysiology
- No single cause has been identified.
- General consensus: A genetic abnormality leads to altered neurologic development.
- No scientific evidence relating vaccines, such as vaccines for measles, mumps, or rubella (MMR), or thimerosal causing ASDs
- Pathophysiology is not fully understood.
- High concordance in monozygotic twins
- Increased recurrence risk (2–18%) in subsequent siblings
- Having an affected sibling confers 5 times greater risk of developing autism.
- Advanced parental age
- Early screening for early intervention means a better prognosis.
- Some ASDs are caused by genetic disorders.
- Economic costs
- An additional $17,000 to $21,000 is an estimated cost for raising an ASD child.
- Due to caretaker burden, family earnings are found to be 28% less among families with ASD compared to children without health conditions.
Commonly Associated Conditions
- Mental retardation, ADHD, anxiety, depression, or obsessive behavior
- Phenylketonuria (PKU), tuberous sclerosis, fragile X syndrome, Angelman syndrome, and fetal alcohol syndrome (rare)
- Seizures (increased risk if severe mental retardation)
- Maternal use of selective serotonin reuptake inhibitors (SSRIs) during pregnancy
- Sleep issues: insomnia, circadian rhythm sleep-wake disorder, sleep-related movement disorder