Autism Spectrum Disorder

By: Catherine Joachin

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What is autism spectrum disorder? 

Autism spectrum disorder (ASD) is an umbrella term that encompasses various developmental  disabilities (American Psychiatric Association, 2013). This diagnosis covers different levels of  autism, including Asperger syndrome and pervasive developmental disorder, which were both  considered separate conditions under the previous iterations of the Diagnostic and Statistical  Manual of Mental Disorders (Cleveland Clinic, 2023). Characteristics of autism spectrum  disorder include social communication difficulties, poor social awareness, poor interaction  skills and a preoccupation for restricted or repetitive behaviors (Centers for Disease Control  and Prevention, 2022). These traits generally appear in early childhood, but autism can be  diagnosed at any age (National Institute of Mental Health, 2023). Symptoms can also vary with  respect to age, verbal and intellectual ability and disorder severity, but people with ASD tend to  struggle with:

* Establishing and maintaining eye contact

* Engaging in reciprocal social interaction 

* Adopting context appropriate social behavior.

* Coping with changes in routine

* Maintaining age-appropriate friendships

* Discerning and acting on gestures and non-verbal social cues

(World Health Organization, 2019)

Individuals with autism spectrum disorder also tend to show heightened interest in specific  areas and little to no interest in activities unrelated to said areas (American Psychiatric  Association, 2013). Lesser characteristics include delayed language, motor and cognitive skills,  hyperactive and/or inattentive behavior, epilepsy and seizure disorder as well as unusual fear,  emotional and mood responsiveness (Centers for Disease Control and Prevention, 2022).

Autism spectrum disorder can present itself with a comorbid intellectual development and/or  language impairment (World Health Organization, 2019). Being female also represents risk  factor for autism. Diagnosis for autism spectrum disorder generally includes medical exams,  assessments, as there is no regulated distinctive instrument that can be used to identify the  condition. 

There is no standard treatment for autism spectrum disorder; however, structured interventions  can improve target abilities in social interaction or behavioral deficits (National Library of  Medicine, n.d.). Certain treatment procedures having been flagged as ineffective or harmful  (e.g. secretin injections, ceasing vaccinations, chelation), but skill learning strategies tend to be  beneficial (Eunice Kennedy Shriver National Institute of Child Health and Human Development,  1998; National Health Service, 2022)


While statistics vary significantly, prevalence of epilepsy rates in individuals with ASD range  from 4 to 38%. In children, this co-occurrence is associated with intellectual disability and  lower socioeconomic status (Richard, Scheffer & Wilson, 2017; Durkin & Yeargin-Allsopp,  2018).

The etiology of autism spectrum disorder is unclear, but research suggests that a combination  of environmental and genetic factors could be at play. Supporting this link, recent identical  twins studies have report between 64 to 91% chance of both twins having ASD (Tanai et al.,  2008; Tick et al., 2016). No form of autism is caused by the administration of vaccines.

Autism spectrum disorder and epilepsy 

Approximately 30% of individuals with either ASD or epilepsy are affected by the other  disorder. However, in spite of evidence suggesting that prevalence rates in either population is  higher than in the general public, combined epilepsy and autism is frequently left undiagnosed.  In cases where autism-consistent difficulties succeeded epilepsy onset, delayed emergence of  developmental deficits might hinder the likeliness of receiving an ASD diagnosis (Holmes,  Sawer & Clark, 2021).

Studies have suggested that epilepsy and autism spectrum disorder rely on some of the same  neurobiological networks, independent of the presence of an intellectual disability (Bozzi,  Provenzano & Casarosa, 2017; Richard, Scheffer & Wilson, 2017; Specchio et al., 2022).  Emerging research in this area hopes to facilitate the development of diagnostic instruments  and therapeutic strategies that could improve the prognosis of individuals affected by this  comorbidity (Jeste & Tuchman, 2015; Su, Chi, Lin & Yang, 2016; Specchio et al., 2022). Animal  studies have already identified models to explore the neural mechanisms underlying combined  ASD and epilepsy symptomology by measuring observable behavior in rodents experiencing  epileptiform brain activity (Gilby, 2008; Lewis et al., 2018).

In terms of treatment outcomes, there is currently not enough evidence supporting the benefits  of drug treatment in people with both epilepsy and ASD (Tuchman, 2000; Hirota et al. 2013).  Contrastingly, behavioral interventions such as Acceptance and Commitment Therapy (ACT)  and Cognitive Behavioral Therapy (CBT) report higher well-being levels and quality of life and  yield positive results in terms of behavioral and mood outcomes in participants with epilepsy,  providing promising therapeutic recommendations for individuals affected by ASD symptoms  and epileptiform activity (Mannion & Leader, 2014).

In conclusion, autism spectrum disorder and epilepsy are highly co-occurring conditions who  together often go under diagnosed. Despite there being no cure for these disorders, further  research on their association can provide beneficial care and management strategies for  people affected by this comorbidity.


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