Autism can be described as a developmental/behavioral condition clinically characterized by qualitative differences in addition to delays in social interaction and communication along with limited interests and repetitive behaviors. Over time, concepts of the causes of autism have advanced from the theory of “refrigerator mothers,” a questioned notion asserting that youngsters developed autism because of the incapability of bonding with unfriendly, cruel mothers, to that of a more academically and developmentally grounded condition. Traditional analytical surveys have centered principally on intrinsic or genetic brain origins of autism. Nevertheless, fresher models, are centering on the possible role of numerous systemic and biochemical aspects which can be extrinsic to the brain, however, having secondary impacts on the brain. This approach takes into consideration the likelihood of a model shifting from seeing autism as an unchangeable, static, permanent condition to one which is extra dynamic and possibly agreeable to treatment. The current paper is an analysis of the pathophysiology, recent research and possible treatment of autism spectrum disorders.
Pathophysiology
As a general rule, neuroanatomical investigations support the theory that autism can entail a mixture of brain reduction in certain parts and enlargement in others. These explorations infer that autism can be triggered by anomalous neuronal development in addition to pruning throughout the early phases of postnatal and prenatal brain growth, leaving certain regions of the brain with very few neurons and other parts with excessively numerous neurons. A certain study has stated a general brain expansion in autism, whereas others claim anomalies in some parts of the brain, counting the corpus callosum, the limbic system, the mirror neuron system, the frontal lobe, and the temporal lobe (Volden, 2017). In practical neuroimaging analyses, when executing the facial emotion response in addition to the theory of mind assignments, an average individual on the autism continuum shows less initiation in both the brain’ secondary and primary somatosensory cortices than the average participant of the suitably sampled control population. The study result concurs with reports showing anomalous patterns of grey matter volume and cortical thickness in those areas of the brains of autistic individuals.
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The temporal lobe functions are associated with a lot of the deficits witnessed in persons having autism spectrum disorders, for instance, joint attention, social cognition, receptive language, empathy action and observation. Moreover, the temporal lobe comprises the fusiform face area and the superior temporal sulcus, which can facilitate facial processing. Dysfunction in the superior temporal sulcus causes the social insufficiencies which characterize autism. Paralleled to normally developing persons, research established that persons with high-functioning autism had lessened action in the fusiform face area when observing images of faces (Lo et al., 2018).
The mirror neuron system contains a system of brain parts which have been linked to responsiveness procedures in human beings. In human beings, the mirror neuron system has been ascertained in the inferior parietal lobule and inferior frontal gyrus and is believed to be triggered in the course of imitation or observation of conducts (American Psychiatric Association, 2013). Nonetheless, the association between mirror neuron dysfunction and autism is uncertain, and it remains to be understood exactly how mirror neurons possibly will be associated with several key features of autism.
Experts postulated that augmented action of serotonin in the evolving brain can ease the inception of autism spectrum condition, with a relationship established between the usage of selective serotonin reuptake inhibitors by the expecting mom and the development of autism spectrum disorder by the kid exposed to selective serotonin reuptake inhibitor in the antenatal setting (Lombardo et al., 2018).
Persons with Autism spectrum disorder may have several biomedical causes which may affect the functioning of the brain. To begin with, nutritional deficiencies (mainly in antioxidant nutrients, magnesium, zinc, B vitamins, vitamin A, vitamin D, and omega-3 fatty acids) may affect the brain functioning, in turn resulting to autism. Furthermore, a substantial subsection of persons with autism is intolerant or sensitive to foods. Even though some might as well have typical allergies (immunoglobulin E [IgE]–facilitated), several have immunoglogulin G (IgG)–facilitated sensitivities which may cause physical in addition to behavioral or neurological symptoms (Yenkoyan et al., 2017). The IgG allergies are different from normal food sensitivities as they may happen in a more postponed timeline (up to three days following consumption of an upsetting foodstuff).
Another factor is intestinal dysbiosis. A constantly-growing body of research is acknowledging the significance of a fit intestinal microbiome and the narrow interconnection of intestinal and brain fitness and working. Intestinal dysbiosis, which refers to a disproportion in the useful bacteria in the gastrointestinal tract or an excessive-growth of pathogenic bacteria, may be observed in several persons who have autism. Also, methylation and transsulfuration anomalies affect the brain functioning thus causing autism. The sulfation, methylation, and folate cycles are interrelated cycles which aid crucial functions in gene expression, neurotransmitter metabolism, purine as well as pyrimidine synthesis, detoxification and antioxidant support (Lo et al., 2018). These pathways normally operate badly in persons having autism and are reliant on vitamin B6, vitamin B12, and folic acid, all of which are usually insufficient or deficient in people with autism. Other factors that affect the brain functioning include poor detoxification, oxidative stress, inflammation (of brain and intestine) and excessive pro-inflammatory cytokines, insufficient oxytocin, immune imbalances and mitochondrial/metabolic dysfunction.
Recent Research and Treatment
Generally, autism has no recognized cure, though individuals with Asperger syndrome and persons who have autism and necessitate small-to-no support have a higher likelihood of experiencing a decrease of symptoms as time passes. The central aims of treatment are to reduce related deficits and family grief, as well as to upsurge functional independence in addition to the quality of life. By and large, greater IQs are linked to better responsiveness to treatment as well as better treatment results. Even though evidence-centered interventions for autistic kids differ in their approaches, several implement a psychoeducational method for improving communication, social skills, and cognitive while lessening problem activities. Experts claim that no particular treatment is ideal and treatment is normally customized to the youngster's needs (Rodgers et al., 2017).
Comprehensive, continuous special education interventions in addition to behavior rehabilitation early in life may aid youngsters to obtain self-care, job and social skills. Obtainable methods take in social skills therapy, structured teaching, developmental models, applied behavior analysis, job-related therapy and language and speech therapy. Amongst these methods programs, either emphasis treatment on a particular part of deficit or treat autistic aspects broadly. Typically, when teaching individuals with autism, particular approaches might be applied to efficiently convey info to these persons (Spain et al., 2017). Using social interaction and applying semantic groupings that entail allocating words to usual theoretical groups may be valuable in nurturing learning.
There has been growing interest in the development of evidence-centered interventions for young children with autism spectrum disorders. Two hypothetical frameworks delineated for early babyhood intervention consist of the developmental social-pragmatic mockup and applied behavioral analysis. Even though applied behavioral analysis treatment has a sturdy evidence basis, principally concerning early thorough home-grounded treatment, its efficiency can be restricted by the IQ and diagnostic severity of the individual affected by autism spectrum disorder (Rodgers et al., 2017). The parent training model is a different evidence-established intervention which has confirmed effectiveness, which informs parents exactly how to apply different developmental social-pragmatic and applied behavioral analysis methods themselves. Numerous developmental social-pragmatic programs have been established to unambiguously provide intervention systems via home-based parent application. According to Volden (2017), in the year 2015, the American Academy of Pediatrics recommended novel evidence-based suggestions for timely interventions in autism spectrum disorder for kids below 3 years of age. These suggestions underline prompt involvement with both behavioral and developmental approaches, support for and by caregivers and parents, as well as an attention on both the central and related symptoms of autism spectrum disorder.
Conclusion
A particular person suffering from autism spectrum disorder might have any mixture of the factors affecting the functioning of the brain, and the therapist's problem is to ascertain which factors are pertinent to that particular person. When identified by laboratory or clinical assessment, manifold possible therapeutic alternatives become obtainable. I believe that treatments need to incorporate removal of problematic foodstuffs, adjustment of nutritional deficiencies, refurbishment of optimum intestinal flora equilibrium, encouraging detoxification and methylation pathways, lessening of inflammation and oxidative stress, upgrading of mitochondrial utility, and oxytocin provision. Offering the brain and body what they require and eradicating that which could be interrupting, will provide the possibility of considerably improving general brain working and consequently the quality of life for persons who have autism spectrum disorder.
I strongly suggested further research on the role of the aforementioned anomalies in the pathophysiology of autism spectrum disorder. The major upsurge in the incidence of autism spectrum disorder (over seventy-eight percent from the year 2002 to 2008) in America stated by the Center for Disease Control and Prevention during the year 2012 is a solid signal for reconsidering analytically each potential factor and pursue likely indications so as to decelerate or stop this steady upsurge in the incidence of autism spectrum disorder in children and establish more curative prospects to treat autism spectrum disorder more competently .
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®) . American Psychiatric Pub.
Lo, B. H., Klopper, F., Barnes, E., & Williams, K. (2018). Autism spectrum disorder. Journal of paediatrics and child health , 54 (2), 212-213.
Lombardo, M. V., Moon, H. M., Su, J., Palmer, T. D., Courchesne, E., & Pramparo, T. (2018). Maternal immune activation dysregulation of the fetal brain transcriptome and relevance to the pathophysiology of autism spectrum disorder. Molecular psychiatry , 23 (4), 1001.
Rodgers, J., Hodgson, A., Shields, K., Wright, C., Honey, E., & Freeston, M. (2017). Towards a treatment for intolerance of uncertainty in young people with autism spectrum disorder: development of the coping with uncertainty in everyday situations (CUES©) programme. Journal of autism and developmental disorders , 47 (12), 3959-3966.
Spain, D., Sin, J., Harwood, L., Mendez, M. A., & Happé, F. (2017). Cognitive behaviour therapy for social anxiety in autism spectrum disorder: a systematic review. Advances in Autism , 3 (1), 34-46.
Volden, J. (2017). Autism spectrum disorder. In Research in Clinical Pragmatics (pp. 59-83). Springer, Cham.
Yenkoyan, K., Grigoryan, A., Fereshetyan, K., & Yepremyan, D. (2017). Advances in understanding the pathophysiology of autism spectrum disorders. Behavioural brain research , 331 , 92-101.
