A Case Study in Autism Spectrum Disorder

Introduction

Autism spectrum disorder (ASD) is a common but serious neurodevelopmental disorder of communication and social deficits, and unusual repetitive sensory-motor behaviours. Previously known as autism, pervasive developmental disorder, the terminology of autism spectrum disorder has evolved. Autism spectrum disorder is an umbrella term used now to represent spectrum of heterogenous disorders with severity spectrum ranging from mild to severe and affecting several aspects of life of the individuals with this disorder (American Psychiatric Association, 2013). Subtypes previously classified as pervasive developmental disorder not specified otherwise and Asperger syndrome are now included in this new terminology of autism spectrum disorder.

First description of infantile autism in English literature is attributed to Leo Kanner (Kanner, 1943), who in 1943 described 11 children with impaired social interaction, atypical language development and abnormal repetitive behaviors such as hand flapping, or body rocking. Asperger syndrome, now considered a part of autism spectrum disorder (DSM-V) was described in 1944 by Hans Asperger (Asperger, 1944). These children had good verbal skills but were otherwise quite similar to children with autism in social and other behaviors. It was not until 1980s that autism as a clinical entity started gaining adequate attention of the scientific community.

Onset of symptoms suggesting deficits in social and communication skills during early childhood, often during infancy. It is not infrequent for parents to report normal development in their child during first 12-15 months followed by loss of language and social skills, which may appear to be heralded (or at least that is what many parents think), by a common intercurrent childhood illness. Later in the course, children may remain stable, show worsening or may show some improvement.

Clinicians, researchers, parents and lay public have become increasingly concerned about the rise in prevalence of autism spectrum disorder over a period of time. Global prevalence of autism spectrum disorder has been estimated at about 1%, and 1.5% in developed countries (Lord, Elasabbagh, Baird &Veenstra-Vanderweele, 2018; Lyall et al. 2017). Prevalence of autism spectrum disorder determined in the 2010 Autism and Developmental Disabilities (ADDM) cohort was 1 in 68, being a little more common in the white than the other racial groups (Hviid, Hansen, Frisch, & Melbye, 2019). Even in developing countries, the prevalence of autism spectrum disorder has risen in recent years, attributed at least partially to enhanced awareness among general public, teachers, and health care providers (Dalwai et al., 2017).

Despite its common occurrence, the diagnosis is often missed or delayed. The therapeutic interventions have largely remained empirical. Genetic factors are increasingly being implicated in causation, but role of environmental factors has not been entirely discounted (Lord et al., 2018; Howes, Rogdaki, Findon, Wichers, & Charman 2018). Although, autism spectrum disorder has onset during early life, the affected individuals continue to experience its consequences in social, academic and occupation settings throughout the life span. Various aspects of autism spectrum disorder will be highlighted through a case study followed by review of its relevant clinical, diagnostic and therapeutic aspects.