On April 2, World Autism Awareness Day, awareness-raising activities are carried out in our country as well as all over the world, and studies are carried out to raise awareness on autism.
Autism Spectrum Disorder (ASD), seen as a communication problem, can be congenital or present during the first years of life. Although the etiology of the disease is unknown, studies are carried out on the effects of genetic and environmental factors.
In genetic and cytogenetic studies, chromosomal number or structure disorder was not revealed, and autism was not proven to be a single gene-related disease. Embryological neurodevelopmental studies also emphasize the difference in brain and nervous system development and nerve branching in the first trimester of pregnancy.
When we look at environmental factors, common infections in the prenatal period, environmental pollution, advanced age of parents, immune system disorders, malnutrition, diseases and neurochemical disorders play a role in the emergence of ASD.
Autism manifests itself from infancy through dysfunctional behaviors such as making eye contact, indifference to signs and the environment.If the child is not interested in the game that his/her peers play, shows an excessive interest in spinning objects, shows obsessive behavior, has a retarded speech, does not react when he/she is called and overreacts to changes in the order in his daily life, he/she may be showing signs of Autism Spectrum Disorder. The effects of ASD continue for life and its severity is variable.
Some symptoms specific to autism start between the ages of two and earlier. However, it takes an average of three years for the situation to be noticed by the family and to apply to a health institution. The physical development and external appearance of babies with ASD are not different from their typically developing peers. However, most of them suffer from sleep and nutrition problems.
It is known that approximately 50 percent of children with autism who receive an early diagnosis and intensive education with an an accurate method for Autism Spectrum Disorder can control their symptoms and make progress.
In ASD, diagnosis is made based on behavioral characteristics observed in children rather than a laboratory method or a special test. Undiagnosed conditions such as hearing loss, communication disorders, mental retardation, anxiety disorder, seizures and even post-traumatic stress disorder should be evaluated with a multidisciplinary team.
One of the most important criteria for the diagnosis, a psychiatric examination is carried out by an expert. During the evaluation, it is important to take a detailed developmental history, make observations in the natural environment, video images and advanced medical evaluations, and thus early diagnosis of ASD.
Autism can be diagnosed in our country by pediatric psychiatrists and pediatric neurologists, taking into account the Diagnostic and Statistical Manual of Mental Disorders (DSM) 5 diagnostic criteria.
Cases in which hearing loss and Autism Spectrum Disorder are diagnosed together are not rare.It is stated that hearing-impaired individuals are also lagging behind in their language development and social skills, similar to those in ASD, and that repetitive behaviors are observed in these individuals. However, individuals with hearing impairments can be distinguished in terms of their ability to maintain communication and regulate appropriate emotional responses, in accordance with their level of development.
Parents of children with ASD often suspect hearing loss because their children cannot use speech as a language of communication and show indifference to speech sounds. In the hearing assessment of children with ASD, behavioral audiometry tests often cannot be answered and their hearing should be evaluated with objective methods. For this, Auditory Evoked Brainstem Responses (ABR) and Transient Evoked Otoacoustic Emission (TEOAE) tests can be used. Autism can be diagnosed later in children with hearing loss than in children with normal hearing.
In special education, no definite information could be obtained on the etiology of autism, anda definite conclusion could not be reached regarding its treatment. Since each individual has different characteristics, methods including different perspectives can be used together in treatment. In the treatment, first of all, the strengths and weaknesses of the individuals should be determined and individualized training plans should be applied.
Res. Asst. Çağla TÜRK
Res. Asst. Azize KÖSEOĞLU
Department of Audiology
