Autism Spectrum Disorder; is it a Neurodiversity that Needs Coping or A Disease that Needs Cure?!!!

Epidemiology of ASD

Autism spectrum disorder is prevalent in all socioeconomic classes, races, and ethnic groups with male to female ratio of 4-5:1 [2, 4].

According to estimates from Centres for Disease Control and Prevention (CDC’s Autism and Developmental Disabilities Monitoring (ADDM) Network), about 1 in 36 of 8 years aged children (period covered 2020) has been diagnosed as ASD (approximately 4% of boys and 1%of girls) [4].

Mohamed, et al. [5] revealed failure of M-CHAT (a screening tool for suspected ASD) in 1320 out of enrolled 5546 Egyptian toddlers (23.8%) recruited from those attending Primary Health Care Units in 6 Egyptian governorates with fair representation of urban, semi -urban, and rural Egyptian populations. Such results showed that ASD screening tools needs perfection of the delicate balance between their specificity and sensitivity in order to avoid missing early detection of autism or its over diagnosis.

Etiology of ASD

Etiology of ASD is still mysterious but its multifactorial origin is unquestionable with strong genetic predisposition interacting with exposure to many hazardous environmental factors. Such interaction is controlled by different epigenetic mechanisms as DNA methylation and histone modification [2, 6, 7, 8].

Sociocultural aspects of ASD

Approaches to support services and available therapeutic modalities for ASD and how it affects its individualized definition have become a public as well as a professional concern. Autistic community (autistics, their social support system, and interested professionals) is categorized into three camps; the Neurodiversity Movement, Autism Cure Movement, and Fringe Theory Supporters [9, 10, 11].

Neurodiversity theory supporters consider ASD as a different natural expression of human genome and accordingly no treatment is required but acceptance, support, and respect. Meanwhile, autism cure supporters recognize it as an organic disorder resulting from genetic defects and their biological consequences, hence should be addressed by targeting defective autism genes and their morbid outcome. Lastly, but by no means least, Fringe theory supporters recognize autism as a condition with multifactorial background that must be broadly addressed to empower its sufferers and improve their quality of life [9, 10, 11].

Autism and Maturation into Adulthood

Difficulty in starting social interaction, longing for sincere intimacy, and a profound sense of isolation are common concerns of autistic adults that usually necessitate struggling to develop social and or self awareness they do deserve. Statistically, a smaller proportion of autistics marry compared to general population and they prefer assortative mating and tend to pair with each other and raise autistic offspring to feel comfortable and alleviate stress of daily life demands and family needs. Autistics do well in highly systematized work places and connect successfully with their nitty gritty details [2].

Autism and Gender Impact

Autism is much more prevalent among males, consequently, females represent an ignored autistic sector even in research. Because females are usually more concerned with how they are viewed by others especially those who are not belonging to their families, their poor communication skills represents a major stressful handicap that could lead to severe anxiety and or clinical depression. During adolescence, they suffer a lot when they are obliged to join specialized educational programs where they are usually surrounded by males. Autistic females are less likely to marry , have families, go to college, have careers, and live independently with different interests if compared to their male counterparts [12].

Autistics and Animals

Autistics usually like animals as they have similar way of easy thinking dependent on visual input and output with minimal or no attention to what could be behind what they do see. Similar to autistics, animals do not have complex emotions and do not think in language or express their feelings verbally although they might have their own language [13].

Autistic Savants

An autistic savant is an autistic person with remarkable talent in one or more areas. Being savant is not unique for autism and not all autistic are savants. It is roughly estimated to be recorded in about 10% of autistics [14].

World Autism Awareness Day (WAAD)

World Autism Awareness Day has been assigned by United Nations (UN) Security Council, 2007 after being proposed by the UN Qatar representative and supported by all member states. It was agreed to be celebrated annually on the 2nd of April. It aims at enhancing collaboration between different autism organizations worldwide to help in its research, diagnosis, treatment, and acceptance with respect and inclusion of its sufferers. Each year WAAD celebration has its theme; 2024 theme is “moving from surviving to thriving: Autistic individuals share regional perspectives [15, 16, 17].

Light it Up Blue for Autism

Autism Speaks Organization started the Light it Up Blue for Autism Initiative aiming at seeing different prominent buildings across the world turn their lights blue on the 2nd of April (WAAD) annually to raise global awareness about autism and the needs of autistics. The blue color holds significant meaning in autism awareness as it refers to understanding, support, a sense of calmness and serenity [18].