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Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that affects behavior and the ability to communicate and interact socially and is characterized in part by patterns of repetitive behaviors. While symptoms of ASD can appear as early as 18 months, diagnosis by age two is considered reliable and standard. In the United States today, the overall prevalence of ASD is 1 in 59 children (CDC, 2017). ASD is diagnosed four times more among males than females (Jacquemont et al., 2014).
The word “autism,” which has been in use for about 100 years, comes from the Greek word “autos,” meaning “self” and describes conditions in which a person is removed from social interaction (www.dictionary.com). In the 1940s, researchers in the United States began to use the term “autism” to describe children with emotional or social problems. Leo Kanner, a doctor from Johns Hopkins University, used it to characterize the withdrawn behavior of several children he studied (Kanner, 1943). At about the same time, Hans Asperger, a scientist in Germany, identified a similar condition that is now called Asperger’s syndrome (McPartland, 2006).
While currently, the cornerstones of autism therapy are behavioral therapy and language therapy, with additional treatments added as needed (CDC, 2014). individualized biomedical nutrition is an important therapeutic option which aims to assess underlying biochemical/nutritional imbalances that may be contributing to autism symptoms.
Diagnostic criteria for ASD
The DSM-IV criteria previously diagnosed patients as having one of four separate disorders: autistic disorder, Asperger’s disorder (aka high functioning autism), childhood disintegrative disorder, or the catch-all diagnosis of pervasive developmental disorder not otherwise specified (PDD-NOS). However, the more recent DSM-5 criteria groups all of the above diagnoses under one umbrella disorder of ASD, which includes socio-communicative deficits and repetitive and restrictive behaviors and interests (RRBI) (American Psychiatric Association, 2013). Furthermore, the second diagnostic criterion now also includes difficulty integrating sensory information or strongly seeking or avoiding behavior of sensory stimuli.
According to DSM-5, ASD includes the following clinical features:
Individuals with high functioning ASD (HFASD) are differentiated from others on the autism spectrum by having a lower severity level in the diagnostic criteria (APA, 2013).
Etiology and comorbidities
The etiology of ASDs is unknown; while certain genetic syndromes, including Rett’s and Fragile X are associated with ASDs, only 6-15% of ASDs have genetic known origins (Schaefer, 2008). Cognitive and behavioral features of ASD are often thought to arise from dysfunction of the central nervous system (CNS), however many non-CNS, physiological abnormalities associated with ASD have been documented (Buie et al., 2010a; Ming, Brimacombe, Chaaban, Zimmerman-Bier, & Wagner, 2008). Recent research and clinical studies have implicated mechanisms such as immune dysregulation, inflammation, impaired detoxification, environmental toxicant exposures, redox regulation/oxidative stress and energy generation/mitochondrial systems, as well as nutritional disorders in the etiology of ASD (Ming et al., 2008; Theoharides, Asadi, & Patel, 2013).
While there is no cure, studies have shown that it can improve with early diagnosis and a range of treatments that address behavioral and learning skills. Treatments may include skill-building and teaching educational sessions, known as applied behavior analysis or ABA, and many more interactive, child-centered versions of behavior treatments. Treatment also include training and support for parents, speech and language therapy, occupational therapy, and/or social skills training (APA, 2013). The simultaneous implementation of biomedical and individualized nutritional therapies often help change the developmental trajectory of children with ASD.
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