Autism Spectrum Disorder (299.0

Some children with this disorder have heightened sensitivity to sound, while others will ignore

loud noises. They have increased senses of smell and taste that can lead them to dislike of

many foods. Other children will have decreased awareness of hunger and won’t eat unless

prompted. Certain surfaces are unpleasant to these children and the sensation of pain is often

decreased unless they see blood, and then the pain awareness ramps up beyond normal. The

disease may or may not be genetic but many of these children will have a parent or sibling who

is affected.

No one knows the incidence or prevalence of SCD as it is a new diagnosis. Many children who

have previously been diagnosed with other disorders, such as autism spectrum disorder or

other language disorder, will be recategorized as having this disorder. Because Asperger

syndrome has been removed from the DSM-V, more children will be placed in the SCD

category.

AUTISM SPECTRUM DISORDER (299.0)

Autism spectrum disorder or ASD is now a single diagnosis, according to the DSM-V. This is a

broadly-defined developmental disorder in which the child exhibits impairment in verbal

communication, interaction with those around him, and difficulties with behavior. There is a

wide range of different symptoms and deficits with this disorder and varying levels of

impairment. The incidence appears to be increasing; however, there is an increased awareness

that is probably a contributing factor. The incidence is believed to be about 1 in 68 children

with 4-5 times as many boys having the diagnosis when compared to girls.

The two main areas where symptoms are noticeable are in communication (in social situations)

and behavior (with repetitive behaviors commonly seen). Impairments in both of these areas

are necessary to make the diagnosis of ASD. They often have difficulty with discourse and fail

to share their interests with others, failing to start or continue interactions with other people.

Eye contact is often limited and there are peculiarities in nonverbal communication and the

understanding of others’ facial expressions and other nonverbal communication. They cannot

engage well in imaginative play and often lack interest in their peers.

The behavioral abnormalities often present as stereotypical motor movements and echoing the

speech of others, unable to understand word meaning. They are most comfortable with rigid

routines and will display aggression and frustration if the routines are changed. They are often

preoccupied with objects and will underreact or overreact to various sensory inputs.

According to the DSM-V. there are three levels of severity. In Level 1, the patient is said to

“require support.” The biggest limitation is with language and communication deficits, with at

least one life area affected by behavior. Level 2 involves “substantial support.” There are

impairments in language that are present despite support. Behavioral difficulties are also

prevalent in many areas of the individual’s life. Level 3 patients require “very substantial

support” with limitations in all areas of the person’s life (both behavioral and communication-

related).

The onset of the disorder may not be gradual; however, the awareness that the child is not

developing at the same rate as his or her peers begins by the age of three years. It is critical

that the diagnosis and support begin as early in the child’s life as possible. Signs that a child

might have the disorder include having a focus on objects, having little eye contact, and not

engaging in play with parents or peers. These things can be seen in infancy and definitely by

three years of age. Some children will acquire language skills but will lose them by the age of

three years.

There is a checklist called CHAT, which stands for Checklist for Autism in Toddlers, which is a

screening tool for preschoolers done by pediatricians. There is cultural bias in the tool so it isn’t

appropriate to children from other cultures. Things that must be ruled out when making the

diagnosis in kids include hearing loss, developmental language disorder, Rett syndrome,

intellectual delay, schizophrenia, reactive attachment disorder, selective mutism, and complex

motor tics.

Besides intensive therapy and family intervention, these children need basic healthcare. They

seem to be more prone to infections and are susceptible to seizure disorders. They have

behaviors and vulnerability to eating difficulties that affect their appetite and nutritional status.