Autism spectrum disorder (ASD) is a disorder that is often hard to explain or qualify. Those who suffer from autism fall on a spectrum, with degrees of severity at either end. Autism and its related disorders are qualified with several diagnostic criteria, including a difficulty in communicating, following abstract concepts, and difficulty using language, among others. No two cases of autism are alike, and you will often here people say, “if you’ve met one person with autism, you’ve met one person with autism.” Essentially, this means that everyone on the spectrum is a bit different from each other. For example, many children and adults who are autistic are non-verbal throughout their life, but those with Asperger’s syndrome (a different part of the autism spectrum), may talk nonstop.
Autism and its related disorders are often comorbid with many other problems. This means that the person with autism may be suffering from more than one mental or medical condition. Just as stroke and hypertension go together, and anxiety and depression often go together, those with autism may have other problems in addition to their autism. This can make care especially complicated, depending on what the comorbid disorder is. We are going to take a look at some of the most comorbid conditions.
Those who do not understand autism or who are not familiar with it may mistake ASD for an intellectual disability. This is far from true–in fact, many on the autism spectrum have extremely high IQs (which is also subjective upon how IQ is measured). It is common in autism that one may be exceedingly proficient in one area, and extremely deficit in another. A good example of this is the movie Rain Man. While they call Raymond an “idiot savant,” he is actually autistic, with exceedingly special talents (like counting cards).
Intellectual disability is something quite different; however, it can be comorbid with autism and is one of the most common comorbidities. In fact, roughly 40 percent of children with autism also have an intellectual disability.
Like autism, this can mean several different things, but it is usually qualified with a child or person who has an IQ under 70. This is taking into account the fact that autistic people may have very uneven skills.
Intellectual disability (ID), like autism, has no cure, but it can be managed effectively with the right provider. If you suspect your child may be suffering from both, a professional psychological IQ test is a good next step. In children under 6 years of age, ID is often referred to as a developmental delay. However, so is autism in many cases, so it’s very important to be clear with clinicians and test administrators.
Seizures and Epilepsy
Another problem that is extremely comorbid with autism is epilepsy. Epilepsy is a neurological condition that causes seizures. It is estimated that 20 to 30 percent of those with autism also have epilepsy. It is important to note that seizures can begin at any time in those who are autistic. It is less common for them to onset after puberty, however. The most common time that seizures may begin is between the ages of 5 and 17. No one knows why seizures are so common in the autistic population; however, in most cases, epilepsy can be managed quite well with pharmacological treatment.
There are many types of GI problems within the autistic population. With everything from GERD to persistent heartburn, those who have autism also have comorbid GI issues. These types of issues are more common in more severe ASD cases; however, they can occur across the entire spectrum. Just as with epilepsy, scientists are not sure why GI issues and autism are linked. However, many problems, such as GERD, are easily managed under a doctor’s care.
Having both Down syndrome and autism is a lot more common that people realize. Down syndrome is a chromosomal disorder, and those with Down syndrome have an extra 21st chromosome. These children have noticeable facial features, as well as intellectual disability, motor coordination problems, and hearing and vision problems. Those with Down also are more likely to have congenital heart defects. It is important that, if a child has both Down syndrome and autism, that both their mental and medical needs are being met. Treatment may also be very focused on the improvement of muscle and motor coordination.
Now that Asperger’s has been taken out of the Diagnostic and Statistical Manual for Mental Disorders, hyperactive children are much more likely to receive a diagnosis of ADHD or ADHD and autism. Attention deficit hyperactivity disorder manifests as hyperactivity, inattention, inability to pay attention to others, and other significant problems that can delay learning. Medication therapy is one of the most common lines of treatment when it comes to ADHD. There are many similarities when it comes to ADHD and Asperger’s, and many clinicians still believe Asperger’s should be placed back in the DSM, as it is too different from ADHD. However, for those on the autism spectrum with ADHD symptoms, treatment lines will be very similar.
Anxiety and Depression
Anxiety and depression are prevalent in every population, including those with autism. It is more common for the onset to occur as a child ages, however, it is not impossible for a younger child with autism to experience anxiety and depression, particularly if they have also been witness to trauma. As with adults or older teenagers, treatment includes therapy and medication. However, a good clinician will use medications that also treat some autistic symptoms as well. For example, benzodiazepine therapy is not unheard of for autistic patients, and it is also often a first-line treatment for serious anxiety. Risperidone is another medication that is commonly prescribed for autism. While it is an antipsychotic, it can also help with behavior modification in conjunction with Applied Behavioral Analysis (ABA) therapy.
Other common comorbidities include cerebral palsy, motor coordination difficulties, bipolar disorder, Fragile X syndrome, Tourette syndrome, insomnia, and obsessive-compulsive disorder.
If you child has autism and you believe he or she is also suffering from a comorbid disorder, it’s best to seek help as soon as possible. If it’s more of a medical issue, finding a pediatrician with experience in autistic patients is always a plus.
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