Autism, or autism spectrum disorder (ASD), is a complex neurobiological developmental disorder that, according to the DSM-5 (2013), affects social interaction, communication, behavior, and sensory perception. Since it is a spectrum, symptoms, and challenges can vary significantly from person to person, each individual having a unique combination of characteristics and abilities.

What is autism (ASD)?

Autism, also known as autism spectrum disorder (ASD), is a neurodevelopmental condition characterized by difficulties in social interaction and verbal and nonverbal communication, as well as the presence of repetitive behaviors and restricted interests. It is typically recognized in early childhood, with diagnosis based on behavioral observations and professional assessments. Since autism affects various developmental areas, its manifestation varies among individuals and can change throughout a lifetime (National Framework for ASD Screening and Diagnosis, 2015).

The modern approach to autism emphasizes that it should not be viewed solely through a clinical lens but as part of natural human diversity. Autism is a neurological difference that influences how a person thinks, communicates, interacts, and perceives the world. There is no cure for autism, as it is not a disease with physical symptoms but rather a specific way in which the brain functions.

In recent decades, the prevalence of autism has significantly increased, partly due to improved diagnostic methods and greater awareness of the condition. According to the World Health Organization (WHO, 2021).

Diagnosis and Early Signs of Autism

Autism is typically diagnosed between the ages of two and four, although some symptoms can be recognized even earlier. Early signs of autism include:

Lack of interest in social interaction
Delayed speech development or absence of speech
Avoidance of eye contact
Repetitive behaviors
Unusual play patterns (e.g., lining up toys instead of engaging in symbolic play)

Causes and Risk Factors

The exact cause of autism is still not fully understood, but research indicates a complex combination of genetic and environmental factors that influence early brain development. Rather than a single specific cause, autism develops under the influence of multiple interconnected factors.

· Genetic Factors – Studies have identified a link between specific genes and autism, suggesting that genetic predisposition plays a key role in its development (Sandin et al., 2017).

· Prenatal and Perinatal Factors – Certain environmental influences, such as infections during pregnancy, premature birth, and low birth weight, may increase the risk of developing autism (Gardener et al., 2011).

· Neurobiological Factors – Research has shown differences in brain structure and function in individuals with autism, indicating specific neurological characteristics associated with this condition (Courchesne et al., 2019).

Key Characteristics of Autism

Autism spectrum disorder (ASD) is characterized by difficulties in three main areas: social interaction, communication, and repetitive behaviors with restricted interests.

Difficulties in social interaction manifest as challenges in understanding and using nonverbal communication, such as eye contact, facial expressions, and gestures. Individuals with autism may have a limited understanding of social rules, making it difficult for them to establish and maintain relationships, recognize and interpret the emotions of others, and participate in group activities (American Psychiatric Association, 2013).

Difficulties in communication range from a complete absence of speech to a well-developed vocabulary but with challenges in understanding language pragmatics. Some individuals with autism may experience delayed speech development, repeat words or phrases without understanding (echolalia), and speak in a monotone or unusual manner. They often interpret language literally, making it challenging to understand metaphors, jokes, and figurative expressions (Lord et al., 2020).

Repetitive behaviors and restricted interests include stereotypical actions such as rocking, tapping, or hand-flapping, as well as a firm adherence to routines and resistance to change. Individuals with autism may develop intense interests in specific topics, such as trains, astronomy, or numbers, to which they devote significant attention (Hyman et al., 2020).

These characteristics vary in intensity and expression, making each person with autism unique in how they perceive and interpret the world around them.

Depending on the child's age, the visible characteristics of autism may change. Below is a table outlining the key characteristics of autism based on age:

Sensory Processing and Autism

Individuals with autism spectrum disorder (ASD) often experience difficulties with sensory integration, meaning their brain processes and responds to sensory stimuli from the environment differently. These sensory challenges typically manifest in three primary forms:

Hyposensitivity – Reduced sensitivity to certain stimuli, which may lead to seeking intense sensory experiences such as spinning, rocking, or touching various textures. Some individuals with autism may have a reduced sense of pain or temperature.

Hypersensitivity – Increased sensitivity to light, sound, touch, smells, or tastes can cause discomfort, stress, or sensory overload in everyday situations. For example, bright lights or loud noises may be highly distressing and trigger anxiety.

Difficulties with sensory integration—Problems with processing multiple sensory inputs simultaneously can make activities such as dressing, eating certain foods, or participating in group environments challenging (Dunn, 2007; Baranek et al., 2013).

Sensory difficulties can significantly impact daily functioning and quality of life for individuals with autism. In this context, sensory integration therapy can help regulate sensory challenges and facilitate environmental adaptation (Schaaf & Benevides, 2018).

Given the common sensory integration challenges in individuals with autism spectrum disorder, it is crucial to ensure that different environments provide opportunities to meet their sensory needs in a socially acceptable manner. This is where SENcastle plays a vital role. SENcastle is a compact sensory room designed to function as a small-scale sensory space that can be integrated into educational and healthcare institutions and everyday living spaces, creating a sensory oasis where individuals can fulfill their sensory needs.

By using various sensory cards in combination with six different sensory cushions, individuals can customize sensory input according to their unique needs, whether they require more or less stimulation. Once their sensory needs are met, they can return to their planned daily activities with improved focus and engagement.

Therapies and Interventions

While there is no universal cure for autism, various therapies and approaches can significantly improve the quality of life for individuals with autism. Interventions focus on supporting the development of communication, social, and adaptive skills and adapting the environment to facilitate daily functioning.

The most commonly used interventions include:

Behavioral Therapies – Applied Behavior Analysis (ABA) therapy has been proven effective in developing communication and social skills while reducing unwanted behavioral patterns.

Speech and Occupational Therapy – Speech therapy helps develop verbal and nonverbal communication, while occupational therapy supports sensory integration and essential daily skills needed for independence.

Educational Support – Tailored educational programs and individualized approaches are crucial for the successful learning and socialization of autistic children.

Pharmacological Interventions – Although they do not treat autism, certain medications can help manage symptoms such as anxiety, aggression, and hyperactivity, thereby improving overall quality of life.

Since autism encompasses a wide range of needs and abilities, the most effective approach involves individualized support tailored to each person's specific needs.

World Autism Awareness Day

World Autism Awareness Day is observed on April 2nd. Its goal is to raise awareness and provide support for individuals with autism and their families (United Nations, 2007). On this day, people wear blue as a symbol of support for individuals with autism.

Blue has been recognized as the color of autism because it symbolizes calmness, trust, and awareness. The organization Autism Speaks prominently uses blue in the global "Light It Up Blue" campaign.

References:

· American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5). American Psychiatric Publishing.

· Baranek, G. T., Woynaroski, T., Nowell, S. W., Turner-Brown, L., DuBay, M., Crais, E. R., & Watson, L. R. (2013). "Sensory features as diagnostic criteria in autism: Challenges and opportunities." Journal of Autism and Developmental Disorders, 43(5), 1177-1191.

· Courchesne, E., Pramparo, T., Gazestani, V. H., Lombardo, M. V., Pierce, K., & Lewis, N. E. (2019). "The ASD cortical signature: Distinctive neuroanatomical features of autism spectrum disorder." Annual Review of Neuroscience, 42, 285-307.

· Dunn, W. (2007). Supporting children with autism spectrum disorder through sensory-based interventions. OT Practice, 12(17), 1-7.

· Gardener, H., Spiegelman, D., & Buka, S. L. (2011): Perinatal and Neonatal Risk Factors for Autism: A Comprehensive Meta-analysis. Pediatrics, 128(2), 344-355.

· Hyman, S. L., Levy, S. E., & Myers, S. M. (2020). "Identification, evaluation, and management of children with autism spectrum disorder." Pediatrics, 145(1), e20193447.

· Lord, C., Elsabbagh, M., Baird, G., & Veenstra-VanderWeele, J. (2020). "Autism spectrum disorder." The Lancet, 392(10146), 508-520.

· Ministarstvo zdravlja Republike Hrvatske. (2015): Nacionalni okvir za probir i dijagnostiku poremećaja iz spektra autizma.

· Sandin, S., Lichtenstein, P., Kuja-Halkola, R., Hultman, C., Larsson, H., & Reichenberg, A. (2017): The Heritability of Autism Spectrum Disorder. JAMA, 318(12), 1182-1184.

· Schaaf, R. C., & Benevides, T. W. (2018). Autism and the sensory integration approach. American Occupational Therapy Association.

· United Nations. (2007). "World Autism Awareness Day." UN General Assembly Resolution 62/139.

· World Health Organization. (2021). Autism spectrum disorders fact sheet.

Autism & Sensory World: Understanding the Spectrum