Autism Spectrum Disorder


AutismSpectrum Disorder

Autismspectrum disorder (ASD) is an intricate and diverseneuro-developmental condition (Deisher, Doan, Omaiye, Koyama &ampBwabye, 2014). It is diagnosed on the basis of the presence andharshness of central abnormalities in social communication as well asrepetitive conducts. This report will discuss ASD etiology,diagnostic features, co-morbidity, differential diagnosis, as well asintervention strategies in its treatment.


Theetiology of ASD has been broadly debated for a long time.Nevertheless, the accurate cause is still not known. Studies thathave been carried out by professionals indicate that ASD may becaused by either environmental or genetic factors or both (Shaw etal., 2014). Also, others have proposed that it may be a combinationof neurological development, environmental factors, and geneticfactors. Genetic factors have been perceived to play a critical role,but the extent of which they are considered as a cause for thedisorder has not been established. Although genetic factors have beenassociated with the cause of the disorder, empirical research has notbeen in a position to conclusively identify specific genes that arelinked with the disorder (Shaw Sheth, Li &amp Tomljenovic, 2014).Thus, more research is required in the area. Apart from thesefactors, some parents have pointed out that vaccines can cause ASD.However, there is no scientific evidence to indicate that vaccineshave a link to the disorder. A recent research conducted by Jain,Marshall, Buikema, Bancroft, Kelly &amp Newschaffer (2015) hasconfirmed that there is no association amid ASD and vaccines.Furthermore, despite environmental factors being claimed to cause thedisorder, studies have not established whether perinatal, postnatal,or prenatal factors cause the disorder. Therefore, it can be arguedthat the etiology of this disorder is a combination of environmentaland genetic factors although there is no research that has determinedthe accuracy of these factors as the contributors of the disorder.

DiagnosticFeatures of the Disorder

Thereare different diagnostic features that are associated with ASD. Oneof the characteristics includes constant deficits in socialcommunication as well as social interaction across differentcontexts. These may be exhibited by deficits in nonverbalcommunication behaviors for social interaction, a shortfall insocial-emotional reciprocity, and a decline in creating, maintainingand understanding relationships. Another feature entails havingrestricted, repetitive behavior patterns, activities, or intereststhat can be indicated by highly limited, fixated interests which areabnormal in focus stereotyped or recurring motor movements, speechor use of objects and insistence on sameness (American PsychiatricAssociation, 2013). In addition, another characteristic that can helpin the diagnoses of ASD is excessive adherence to schedules,ritualized patterns of verbal or nonverbal conduct, or extremeresistance to change.

DifferentialDiagnosis Associated with

Duringthe diagnostic evaluation process, it is critical for the leadclinician to collect and integrate data so as to determine whether anASD diagnosis is justified. This can be established throughcollecting adequate data and applying proper skills to distinguishASD from other disorders. Accurate diagnosis is important because ofthe effectiveness of early intervention in the disorder. Differentialdiagnosis associated with the disorder includes genetic conditions,mental health conditions, hearing impairment, selective mutism,speech disorder, and developmental delay (American PsychiatricAssociation, 2013).


Co-morbidityis to be expected in ASD either directly or indirectly (AutismTreatment Trust, 2014). There are different medical and psychiatricdisorders that may affect individuals having ASD they includeepilepsy, GI disorders, hypertension, hearing impairments, allergies,asthma, and dyslipidemia among others. These conditions can affectindividuals of different age groups. Adults who have developmentaldisabilities have a risk for osteoporosis (Autism Treatment Trust,2014).

FindingsAssociated With the Disorder As It Applies To a Forensic MentalHealth Population

Individualshaving ASD have been considered to exhibit some strange behaviors,especially when they are in a new environment. This disorientationhas made professionals in the forensic area find out a way that theycan help individuals suffering from ASD undergo trials. There areindications emerging from court decisions showing that mental healthexperts and judicial officers have not always been aware of thecounter-intuitive features of ASD so that they can be in a positionto make fair decisions in establishing the criminal culpability andresponsibility of individuals having ASD (Freckelton, 2013). As of2013, it can be indicated that the occurrence of cases where ASDbecomes summoned as related to criminal trials or sentencing appearsto be on the rise. This can be attributed to an increase in therecognition of those having ASD in the general population(Freckelton, 2013). Therefore, the legal community is playing acritical role in ensuring that those with ASD receive fair trials.

InterventionStrategies and Evidence-Based Practices in the Treatment of ASD

Thereare two broad categories of interventions that can be used in thetreatment of ASD, which include comprehensive treatment models (CTMs)and focused intervention practices. CTMs comprise of a set ofpractices that are designed to realize a broad learning ordevelopmental impact on the central deficits of ASD (Wong, Odom,Hume, Cox, Fettig, Kucharczyk &amp Schultz, 2014). Examples of CTMsinclude UCLA Young Autism Program, TEACCH program, and the LEAPmodel. Alternatively, the focused intervention practices are usuallydesigned so as to address a single skill or goal of a learner havingASD (Wong et al., 2014). These practices are operationally clear,address specific outcomes, and occur for a shorter period compared toCTMs. Examples of focused intervention practices include pivotalresponse training, promoting, and video modeling as well as discretetrial teaching. Focused intervention practices can be considered asthe building blocks of educational programs for youths having ASD.


ASDis a neuro-developmental condition. The etiology of the condition hasbeen broadly debated for a long time, but the precise cause is stillnot known. Genetic factors have been perceived to play a criticalrole, but the extent of which they are considered as a cause for thedisorder has not been established. Although genetic factors have beenassociated with the cause of the disorder, empirical research has notbeen in a position to conclusively identify specific genes that arelinked with the disorder. The etiology of this disorder is acombination of environmental and genetic factors. The diagnosticfeatures of the condition include constant deficits in socialcommunication as well as social interaction across differentcontexts restricted, repetitive behavior patterns, activities, orinterests and excessive adherence to schedules, ritualized patternsof verbal or nonverbal conduct, or extreme resistance to change.There are two broad categories of interventions that can be used inthe treatment of ASD, which include comprehensive treatment models(CTMs) and focused intervention practices. The focused interventionpractices are operationally clear, address specific outcomes, andoccur for a shorter period compared to CTMs.


AmericanPsychiatric Association (2013). AutismSpectrum Disorder.American Psychiatric Publishing.

AutismTreatment Trust (2013). MedicalComorbidities in s: A Primer for Health CareProfessionals and Policy Makers.Treating Autism Publications.

Deisher,A.T., Doan, V.N., Omaiye, A., Koyama, K. &amp Bwabye, S. (2014).Impact of Environmental Factors on the Prevalence of AutisticDisorder after 1979. Journalof Public Health and Epidemiology,Vol. 6(9) 271-284.

Freckelton,I. (2013). Forensic Issues in : Learning fromCourt Decisions. INTECHOpen Science Open Minds.

JainA, Marshall J, Buikema A, Bancroft T, Kelly JP. &amp Newschaffer CJ.(2015). Autism Occurrence by MMR Vaccine Status among US Childrenwith Older Siblings with and Without Autism. JAMA313(15):1534-1540. doi:10.1001/jama.2015.3077.

Shaw,CA., Sheth, S., Li, D. &amp Tomljenovic, L. (2014). Etiologyof autism spectrum disorders: Genes, environment, or both? OA Autism2(2):11. University of British Columbia, Vancouver.

Wong,C., Odom, S. L., Hume, K. Cox, A. W., Fettig, A., Kucharczyk, S. &ampSchultz, T. R. (2014). Evidence-based practices for children,youth, and young adults with . ChapelHill: The University of North Carolina, Frank Porter Graham ChildDevelopment Institute, Autism Evidence-Based Practice Review Group.

Autism Spectrum Disorder

AutismSpectrum Disorder


Profoundly,ASD refers to a malady that affects brain development it ischaracterized by the deficit in social interactions as well as socialcommunications. Additionally, repetitive behaviors, as well asrestrictions, can result in ASD (Laurtsen,2013).Therefore, ASD leads to constant difficulty with social interactionand communication, which impairs and limit daily functioning.

Etiologyand disorder

Theevaluation of autism spectrum disorder is mainly centered on thebehavioral symptoms that rarely have a reference to etiologicalcauses. Nevertheless, in the recent past there had been dedicatedscholars who investigated the etiological factors that led to autismspectrum disorder(Laurtsen, 2013).Even though there was not enough evidence or exact prove thatattributed fairly to be the cause of autism spectrum disorder, therehave emerged several factors that can be attributed as the main causeof ASD (Laurtsen,2013).For instance, genetics, environmental, and neurobiological factorsthat are manifested through behavioral symptoms.

GeneticRisk Factors

Themajority of researchers and epidemiologist agree that ASD can be as aresult of genetic differences, which are hereditable or consequentlyof genetic mutation within the body. However, genetic factor cannotbe said to be the cause of all disorders in children, but findingsthat support genetic linkage in individuals suffering from ASDdisplays that it is more common in boys than in girls, which is dueto genetic variance that is associated with the X chromosome(Laurtsen,2013).According to the study conducted by scholars, 20% of infants bornglobally have ASD disorder, especially if they have older siblingswith the same conditions. Besides, the risk is higher if the infantshave older siblings who are affected with AS condition.


Theprimary environmental factors that contribute to ASD disorderinclude diets, exposure to the toxicants in the environment and evendrugs(Laurtsen, 2013).These factors combine with the genetic susceptibility in anindividual and lead to the development of Autism spectrum disorder.Study and the investigation still continues, and variousenvironmental exposures such as lead, insecticides, vehicles exhaust,flame retardants, and hydrocarbons have been identified as causes ofautism spectrum disorder (Laurtsen,2013).Worth noting, epidemiologists have not found any specificenvironmental factor for ASD currently.


Geneticcode abnormalities bring about numerous anomalous mechanisms thataffect growth of the brain accordingly, it eventually leads tocognitive and neurobiological abnormalities, functional andstructural brain abnormalities as well as various symptomaticbehaviors (Laurtsen,2013).Similarly, various neurobiological factors are associated with autismspectrum behavior such as increased gray matter in the temporal andfrontal lobes of the brain, functional and anatomical variations inthe limbic and the cerebellum system, as well as decline in the whitematter compared to gray matter during adolescence period.

Descriptionof the diagnostic features of the ASD

Evidently,ASD diagnostic features description is well displayed in the Americanpsychiatric association DSM, the fifth edition(Lord, Leventhal &amp Amaral, 2013).The diagnosis consists of observation of the various attributes ofthe patient such as, social or emotional deficit e.g. failure tomaintain a conversation, lack of expressing emotions and inability toinitiate a social interaction(Lord, Leventhal &amp Amaral, 2013).Second, diagnostic feature involves observing the nonverbalcommunication behavior that is used in social interactions, forexample, poor coordination of verbal and non-verbal communication aswell as abnormalities in body language and eye contact beside failurein comprehension of gestures.

SevereASD comprises of restrictive patterns in behaviors, which aremanifested through stereotyped motor movements, excessive adherenceto various routines and having specific patterns in verbalcommunication(Lord, Leventhal &amp Amaral, 2013).The different symptoms usually limit the normal day to dayfunctioning, and it is important for the clinician to observeintellectual disability such as social communication that is alwaysbelow expected level at any development stage.

Descriptionof the differential diagnosis associated with the disorder as well ascomorbidity.

Someof these conditions may have similar symptoms with ASD(Lord, Leventhal &amp Amaral, 2013).Therefore, professional due diligence is critical when dealing withthe diagnosis and at the same time treatment of autism disorder.There are several disorders which can be misdiagnosed as autismspectrum disorder because they manifest themselves with symptomssimilar to the disorder(Lord, Leventhal &amp Amaral, 2013).These disorders include tuberous sclerosis, the Rett syndrome,Kluver-Bucy syndrome, Down syndrome among other disorders(Lord, Leventhal &amp Amaral, 2013).Although autism is recognized as a mental disorder, it is more of abody condition that is manifested by some symptoms.


Itrefers to the occurrence of two or more psychopathology disorders ina person at the same time(Lord, Leventhal &amp Amaral, 2013).Notably, these comorbid conditions in autism include mood disorders,anxiety, and epilepsy.


Anxietyis a common disorder in persons with ASD majority of them areaffected by factors such as the cognitive functioning level, socialimpairment degree as well as age (Sallows &amp Graupner, 2012). Itincludes fear of riding a bus, anxiety to interact with other peoplein social settings among others.


Itcan be divided into bipolar disorder or major depression. Depressionis the comorbid condition in ASD that has been diagnosed in majorityof children with Autism (Sallows &amp Graupner, 2012). It isessential to note that mood disorder predisposes patients to a riskof committing suicide, aggression and greater levels of withdrawal(Sallows &amp Graupner, 2012). If proper treatment is not applied,the condition can progress in severity and eventually affect thepatient negatively.


Epilepsyis also associated with ASD. It has been extensively established thatchildren with ASD condition one out of four, experience seizures,which begin during early childhood or at the adolescence stage(Sallows &amp Graupner, 2012). It is basically as a result ofunusual electrical brain activity, lack of enough sleep or evenhigher fever.

Discusslatest research findings associated with the disorder as it appliesto a forensic mental health population

Inthe recent past, many researchers have dedicated their interests onthe relationship between mental health and autism spectrum disorder(Qi,C.H. &amp Lin, Y.L., 2012).The opinion of many clinicians who handles mental health states that,children and young adults suffering from mental health illness as aresult of the ASD condition have been neglected.

Recently,doctors are trying to display that people with ASD have mental healthissues, but they are not dangerous, whereas they need care andaffection. For example, adults suffering from ASD have at least oneepisode of depression in their life. In a study conducted in the UKreveals that approximately 71% of the sample held that had autismalso had a psychiatric disorder (McDougle, 2016). The autism spectrumAustralia report also found out that more than 70% had clinicalmental condition (Qi,C.H. &amp Lin, Y.L., 2012).Therefore, it is significant to have a high level of co-morbidawareness while diagnosing the possibility of ASD condition in aperson. Givingthe person access to treatment and necessary support is essential tomental health.

Itis essential to ensure that individuals with autism have improvedrecognition and treatment of the disorder, providing increased mentalmedical surveillance in individuals with ASD disorder (Qi,C.H. &amp Lin, Y.L., 2012).Thus, they will be treated early and timely intervention among thosesuffering from the disease so as to prevent the ever increasingtreatment cost of mental health.

Interventionstrategies and evidence-based strategies

Evidence-basedpractice involves those that have been researched and practicedwidely and have been proven to be effective they include

Discretetrial training

Itinvolves the use of mass test instruction and the reinforcement thatassists the patient in acquiring new skills or behavior (Nightingale,2012).

Appliedbehavior analysis

Itis a procedure that is employed in changing a specific behavior aswell as evaluating the effectiveness of a particular intervention.The response relies mostly on the remediation and also in preventingproblematic behavior (Nightingale, 2012). It gives particularattention to the physical and social environment thus the method isused under supervision of trained psychologist or behavior analyst.


Lauritsen,M. B. (2013). Autism spectrum disorders.&nbspEuropeanchild &amp adolescent psychiatry,&nbsp22(1),37-42. Retrieved from:

Lord,C., Cook, E. H., Leventhal, B. L., &amp Amaral, D. G. (2013). Autismspectrum disorders.&nbspAutism:The Science of Mental Health,&nbsp28,217. Retrieved from:

Qi,C.H. and Lin, Y.L., (2012). Quantitative analysis of the effects ofvideo modeling on social and communication skills for children withautism spectrum disorders.&nbspProcedia-Socialand Behavioral Sciences,&nbsp46,pp.4518-4523. Retrieved from:

Nightingale,S. (2012). Autism spectrum disorders.&nbspNatureReviews Drug Discovery,&nbsp11(10),745-746. Retrieved from:

Sallows,G. O., &amp Graupner, T. D. (2012). s.Handbookof evidence-based practice in clinical psychology.Retrieved from: