Advanced Health Tune Up

AUTISM/ASPERGERS SYNDROME

The autistic spectrum disorders are a neurobiologically diverse group of conditions whose precise relationship to each other is unclear, yet they present with a consistent, diffuse pattern of abnormality across several areas of behaviour. Individuals with these disorders do not present merely with slow or limited development, but rather with development that is atypical in the pervasive but diffuse areas of functions affected. Three main clusters of behaviours define autism, as follows: (1) social abnormalities, especially a lack of social reciprocity; (2) language abnormalities, with deviant communication features and limited development of language; and (3) rigid, stereotyped, repetitive patterns of unusual behaviour. Individuals with Asperger syndrome (aka Asperger’s disorder) are often seen as having a milder version of autism. Similar to autism, patients with Asperger’s disorder have restricted and stereotyped behaviour patterns and interests, plus significant social impairments. However, unlike autism, patients with Asperger syndrome have much less impairment in cognitive development and have no significant general delay in language development.

Aetiology / Risk Factors

Despite extensive investigation, no consistent pattern regarding the cause of autism has emerged. In fact, more than 60 different disease entities have been shown to be likely causes of autism, including genetic, infectious, endocrine, toxic, and space-occupying aetiologies. This suggests that autism is a final common clinical presentation of a variety of underlying neurobiological and genetic processes. Some possibilities include:

Abnormal levels of serotonin in the brain and blood, with 1/3

rd having elevated levels

Immune overactivity, allergy and auto immunity.

Impaired detoxification ability and metallothionine disorders resulting in a build up of toxins and heavy metals.

Side effects of vaccination – many patients develop autism following immunisation, although this is quite controversial

Qualitative impairment in social interaction, as manifested by at least 2 of the following:

Marked impairment in the use of multiple nonverbal behaviours such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction

Failure to develop peer relationships appropriate to developmental level

A lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interests)

Lack of social or emotional reciprocity

Delay in, or total lack of, development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gestures or mime)

In individuals with adequate speech, marked impairment in the ability to initiate or sustain conversation with others

Stereotyped and repetitive use of language or idiosyncratic language

Lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level

Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or in focus

Apparently inflexible adherence to specific, nonfunctional routines or rituals

Stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole body movements)

Persistent preoccupation with parts of objects

Characteristic deviant communication features in autism include a lack of social chat, pragmatic deficits, pronoun reversal, delayed echolalia, neologisms, lack of emotion in speech, phrase repetitions, and idiosyncratic use of language. Behavioural manifestations frequently involve repetitive, self-stimulatory behaviour, especially in more severely affected individuals. This behaviour can be self-injurious in some, as with arm biting, head slapping, and skin picking.