Literature Review on Autism
Kiana GivpoorAutism and Autism Spectrum Disorder (ASD) are both general terms to describe a group of developmental brain disorders. Autism is an extremely complex disorder, and can be seen at varying degrees among different people. People with autism may have problems with social interaction, communication, and motor coordination. These irregularities in the brain correlate with the symptoms that occur with the disorder—issues with social behavior, communication, and difficulties in the motor coordination.
The complexity of autism has made it extremely difficult to understand the causes of the disorder and best treatment options for it. However, after increased research on autism, researchers have found that there is no single cause to the disorder. There is no specific type of autism; it is seen in differing degrees among a variety of people. In some cases it may just be slight inhibition on social interaction, and understanding while the most severe form of autism may completely impede speech. This broad spectrum of possible outcomes based on the severity of autism leads to the multiple causes of autism. While some of the causes have been discovered, researchers are continuing to look for more causes of autism to further understand the best options for treatment and allow for early indication of the disorder. This literature review explores probable causes of autism, and multiple treatment methods for people suffering from the disorder.
The causes of autism can be genetic, environmental or may even be a combination of the two. A recent study done by a team at the Bar Ilan University in Israel, found that through analysis of DNA methylation, the autistic brain reveals multiple irregularities in biological pathways. DNA methylation is a method used to regulate the expression of genes. The purpose of the study was to find a worldwide DNA methylation pattern for autistic brains. The team of researchers found that in specific regions in the brain there are specific changes in gene function without any alterations of DNA in the autistic brain. After further gene analysis it was seen that differentially methylated CpG sites (regions of DNA where a cytosine nucleotide is next to a guanine nucleotide) highlights the immune response as the most enhanced class which coincides with the speculation that a deregulated immune system is one of the factors contributing to ASD. The study also concluded that there is hypo-methylation, or under-regulation, of DNA with increased gene expression that also may cause the common symptoms of autism. However this study only describes one possible genetic irregularity, and further research of genes, and DNA is needed to thoroughly understand autism.
Besides the possible genetic causes of autism, there are also non-genetic or environmental causes such as problems or irregularities happening before or during birth. Katherine Bowers conducted a study that analyzed phenotypic differences in people with autism born preterm or at term gestation. Bowers concluded that people with autism born preterm versus at term gestation were not very phenotypically different, however ADHD (attention deficit hyperactivity disorder) has been found to be higher in children born preterm with ASD, and the further study of the correlation between the two may lead to chances of early intervention. The possible genetic overlap between ADHD and ASD could completely alter the treatment methods, and indication of each disorder. If a person is seen to have ASD, there could be a possibility that they also have ADHD—the identification of having both disorders would tell doctors that the person needs to be treated for both disorders rather than one, hopefully leading to better results.
Bowers’ research also indicated that females born preterm are more nonverbal than males born preterm, and more research on the correlation between nonverbal children and preterm gestation along with autism may also provide early indication of autism for parents. The identification of how these different causes may work together to increase the risk of autism, allows families to identify the symptoms of autism in their child earlier on, and gives them the opportunity to find the best treatment options available for their child’s type of autism.
There are so many causes of autism (known and unknown), and varying degrees of severity, that make it difficult to find the right treatment method for those with the disorder. The brain develops at different stages throughout the years; since autism is a developmental disorder, the disorder will develop at the different stages of the brain. This correlation between brain development, and the development of autism makes early indication and treatment very difficult because many children do not show symptoms of autism until they are two or three years old. Therefore, treatment methods vary from a wide range between, medication and therapeutic methods.
As stated earlier, ASD develops as the brain develops throughout the years; this relationship between ASD and brain development makes it extremely difficult to find medication that can continuously treat ASD because one medication may not work properly at the different stages of brain development. However, a recent hypothesis proposes the combination of two separate medications to cause sequential intervention in the brain. Many people with autism have mutations in the calcium activated chloride channels of a cell and Buteanide blocks the inward chloride transporters on a cell, therefore reducing symptoms of autism. A non-steroidal anti-inflammatory drug (NSAID) helps children that are at high risk for developing autism, but it is only most effective in the earlier stages of neurodevelopment Therefore NSAID can be combined with diuretic Bumetanide, a drug that reduces the levels of chloride in cells, to create a two-way interaction between behavioral and molecular situations (transitional psychiatry). The concept of combining two medications to treat different stages of the brain could potentially help decrease the symptoms of autism, however, this theory is completely hypothetically and has not been tested yet.
The treatment of autism is necessary and can ease the lives of those who suffer from the disorder, but using medication on a child’s developing brain could also lead to more developmental issues. Many of the medications used to treat autism are new and the long-term effects are very unclear, therefore it is questionable whether these medications are helping or further harming a child’s brain development.
With the lack of reliance on pharmaceutical methods as a means for treatment, many families turn to therapeutic programs to help their child ease into social interactions, and stimulate their brains in a way that medication may not be able to. The program PEERS (the Program for Education and Enrichment of Relationship Skills) is a social skills intervention for kids with ASD that includes a lot of family involvement during the treatment. Having a child with ASD directly affects the parents and family members, as it increases the disorganization, stress, and amount of time spent on the child, consequently the increased stress of the family can cause more behavioral problems for the child. A study was created to see if after a 14-week PEERS intervention parents would see a decreased stress level, decreased levels of chaos, and increased levels in parenting self-efficacy. The results displayed that after the PEERS sessions there was a decrease in chaos, and stress, but there was an increase in parenting self-efficiency where as in comparison to the control group the levels in chaos and stress increased and a decrease in parenting self-efficacy during the PEERS period.
In comparison to pharmaceutical treatments that could possibly be harmful to a child’s developing brain, therapeutic treatments have no negative impacts on the child. The therapeutic programs will either help the person with autism, or make no difference, but it will not cause any harm to their mental health.
While neither medication nor therapeutic methods alone can completely stop the symptoms of autism, it is possible that the use of both treatment methods may be the best option for those suffering from the disorder. Medication can minimize some of the symptoms such as behavioral problems, including self-harm or severe tantrums, while the therapy can help them better communicate, and better handle themselves in social interactions. The combination of both treatment methods could possibly be the most successful way to treat all of the different symptoms that come with ASD.
The complexity and minimal understanding of autism make it imperative for further research in the causes, treatment, and care for those who have the disorder. There is a multitude of causes for autism, and there are still many causes that are unknown. The causes of autism include genetic irregularities in the brain along with environmental causes. The brain is a very complicated organ, and researchers are still learning new things about the brain everyday, which makes it extremely challenging to analyze the brain for causes of autism. Due to this wide variety of causes and the varying degrees of severity, treatment is more complicated than with other disorders; there is no one medication that can completely stop the symptoms of autism. However, therapy is becoming a common method of treating the social behavior of people with autism. Unfortunately, many of the methods for treatment are hypothetical and the results are questionable. However, researchers should take into account different studies to gain a better understanding on the causes, symptoms, and treatments of autism. The more research continues and the more information about the disorder is provided, the better chance there is of medical detection or even a cure to serious developmental disability.
Works Cited
“Autism Treatments Proposed by Clinical Studies and Human Genetics are Complementary.” Transitional Psychiatry. N.p., 29 July 2014. Web. 7 Sept. 2014. <http://www.nature.com/tp/journal/v4/n7/full/tp201432a.html>.
Bowers, Katherine, et al. “Phenotypic Differences in Individuals with Autism Spectrum Disorder Born Preterm and at Term Gestation.” Sage Journals-Autism. N.p., 5 Sept. 2014. Web. <http://aut.sagepub.com/content/early/2014/09/04/1362361314547366.long>.
“DNA methylation analysis of the autistic brain reveals multiple dysregulated biological pathways.” Transitional Psychiatry. N.p., 2 Sept. 2014. Web. 7 Sept. 2014. http://www.nature.com/tp/journal/v4/n9/full/tp201470a.html
Karst, Jeffery S., et al. “Parent and Family Outcomes of PEERS: A Social Skills Intervention for Adolescents with Autism Spectrum Disorder.” SpringLink. N.p., 6 Sept. 2014. Web. 7 Sept. 2014. <http://link.springer.com/article/10.1007/s10803-014-2231-6/fulltext.html>.