Reading time is 3 mins
.
.
AUTISM SPECTRUM DISORDERS
Autism spectrum disorder is a neuro-developmental disorder that occurs in the first years of life, is characterized by delay in social interaction and verbal and nonverbal communication, apathy towards the external environment; limited, repetitive unusual movements are more common in boys.
The incidence of autism spectrum disorder is increasing today. The incidence of ASD is considered to be 1 in 68 births. The reasons for the increase in incidence are the increase in awareness of ASD, the change in diagnostic criteria and the easing of diagnosis, the increase in the frequency of ASD, the advanced maternal and paternal age.
When looking at its etiology, many studies have been conducted and continue to be conducted to explain the cause of ASD. Although there is no definite etiological model, it is accepted that it occurs due to genetic and environmental causes. In some studies, genetic causes are higher, while in others, environmental causes are higher. In the recent meta-analysis, it was emphasized that the inheritance rate varies between 64% and 91%, and environmental factors are also important.
.
PRENATAL FACTORS
- Medications (Thalidomide,Valproate, Misoprostol, Terbutalin),
- Heavy metals (Chlorinated solvents, Cadmium, Lead)
- Pesticides, industrial chemicals and by-products of industrial processes
- Gestational diabetes
- Low sun exposure and vitamin D deficiency
- Infections (rubella, measles, mumps, HSV)
- Cigarette
- Advanced paternal age
- Air pollution
- Assisted reproductive techniques *
- Fish oil *
.
NATAL / POSTNATAL FACTORS
- C/S
- Hypoxia
- Prematurity
- Hyperbilirubinemia
- Neurophysiological fators
- Studies are inconsistent *
It has been shown that no association with autism has been found in studies conducted on vaccines.
.
CLINICAL APPEARANCE
ASD symptoms are observed in the areas of social interaction and verbal and nonverbal communication and behavior. The most common symptoms are observed between 12 and 24 months.
From the month on, not looking into the speaker’s eyes, lack of mutual smile or rarity, not looking when the name is mentioned, short-term eye contact during interaction with the caregiver, poor expectation of being held and playing with other people, being passive, reaching for the toys he wants with the help of the caregiver, weakness of emotional expression are the symptoms that can be observed. These symptoms become apparent between the ages of 1-2, the most common reason for applying to the outpatient clinic is not looking at the name, difficulty making eye contact, unresponsiveness to communication and delayed speech, delayed imitation skills, delay in understanding commands and deceptive practice symptoms are observed.
If the symptoms given below are observed in children who have completed 12 months, they should be evaluated by a Child Psychiatric Specialist.
The child does not respond to smiling
When you talk to each other, he does not look at your face or rarely looks, he does not make short eye contact
Not attempting to attract common attention by pointing to a toy or object, not sharing his interest with someone else by pointing to an event or object that he is interested in
The child does not look at the object you are pointing at; when he does not look when you call his name
When it is difficult to interact with the child, observing situations in which only short-term interaction can be established
In cases where the child does not imitate the parent’s behavior and actions
.
DIAGNOSIS
The diagnosis of OSB is made after the evaluations of child psychiatry specialist Turkish doctors.
The diagnostic criteria are shown below.
Social communication problems (3/3):
Nonverbal communication
Social and emotional reciprocity
Ability to start/maintain relationships
Limited interest (2/4)
The Stereotype
Unusual sensory responses
Insistence on sameness, ceremonial behavior
Limited, fixed interest
.
TREATMENT
The aim of ASD treatment in Turkey is to increase the individual’s behaviors aimed at establishing social relationships, improve verbal and nonverbal communication behaviors, and reduce dysfunctional behaviors. In order to achieve these goals, special educational and behavioral treatment techniques that have been proven to be effective are applied. In addition, drug treatments are given for aggression, impulsivity, stereotypical movements, other psychiatric symptoms seen in patients accompanied by hyperactivity.
Information about Different Current Treatment Approaches for OIZ1
B12 and folic acid treatment have not been shown to be effective.
Oxytocin reliability studies are low A study found a difference in emotion identification compared to placebo
Reliability of hyperbaric oxygen therapy low efficacy has not been shown.
B6 e Mg treatment carries a toxic risk.
There are reliability and efficacy problems in the study with Carnosine and Gaba agents.
Efficacy has not been demonstrated in studies conducted with lamotrigine.
Studies with D cycloserin, amantadine and memantine, dextromethorphan are insufficient.
In the study conducted with gallantamine and donezepil, no effect was shown.
Neurofeedback and sensory integration therapies have no place in the treatment of ASD.
Psychotherapist
ISU Istinye University MedicalPark Hospital Istanbul
.
.
Turkey's world-renowned organ transplant specialist. Dr. Demirbaş has 104 international publications and 102 national publications.
Physician's Resume:
Born on August 7, 1963 in Çorum, Prof. Dr. Alper Demirbaş has been continuing his work as the President of MedicalPark Antalya Hospital Organ Transplantation Center since 2008.
Prof. who performed the first tissue incompatible kidney transplant in Turkey, the first blood type incompatible kidney transplant, the first kidney-pancreas transplant program and the first cadaveric donor and live donor liver transplant in Antalya. Dr. As of August 2016, Alper Demirbaş has performed 4900 kidney transplants, 500 liver transplants and 95 pancreas transplants.
In addition to being the chairman of 6 national congresses, he has also been an invited speaker at 12 international and 65 national scientific congresses. Dr. Alper Demirbaş was married and the father of 1 girl and 1 boy.
Awards:
Eczacibasi Medical Award of 2002, Akdeniz University Service Award of 2005, Izder Medical Man of the Year Award of 2006, BÖHAK Medical Man of the Year Award of 2007, Sabah Mediterranean Newspaper Scientist of the Year Award of 2007, ANTIKAD Scientist of the Year Award of 2009, Social Ethics Association Award of 2010, Işık University Medical Man of the Year Award of 2015, VTV Antalya's Brand Value Award of 2015.
Certificates:
Doctor of Medicine Degree Hacettepe University Faculty of Medicine Ankara, General Surgeon Ministry of Health Turkey EKFMG (0-477-343-8), University of Miami School of Medicine Member of Multiple Organ Transplant, ASTS Multiorgan Transplant Scholarship. Lecturer at Kyoto University. Lecturer at University of Essen, Research assistant at the University of Cambridge .
Professional Members:
American Society of Transplant Surgeons, American Transplantation Society Nominated, Middle East and Southern Africa Council Transplantation Society 2007, International Liver Transplantation Association, Turkish Transplantation Association, Turkish Society of Surgery, Turkish Hepatobiliary Surgery Association.
Disclaimer:
Our website contents consist of articles approved by our Web and Medical Editorial Board with the contributions of our physicians. Our contents are prepared only for informational purposes for public benefit. Be sure to consult your doctor for diagnosis and treatment.