Strategic Management of Autism Spectrum Disorder

Autism spectrum disorder (ASD) is a complex, multi-factorial, neurodevelopmental disorder with a dynamic set of neuronal and behavioral abnormalities, which involves various systems of the body. A sharp rise in the incidence of ASD cases has been noted worldwide owing to the complex combination of increased awareness, broader diagnostic criteria, poor nutrition, various prenatal, perinatal and postnatal factors, genetic predisposition precipitated by adverse environmental conditions and gynecological interventions. ASD is not a single disorder but it encompasses a broad spectrum of disorders resulting from various genetic and non-genetic risk factors contributing independently as well as together. The co-occurrence of different disorders in ASD seems to be normal rather than the exception. Although no medicine has been recognized to treat ASD, several medicines have been proposed to ameliorate co-morbid conditions and are found to be the most efficacious in diminishing ASD-associated symptoms such as self-harm, aggressive episodes, irritability, unusual conduct, in-attention, anxiety, depression, hyperactivity and insomnia. Complementary therapies such as cognitive behavioral therapy, Speech therapy, music therapy, educational therapy, psychotherapy, occupational therapy and nutritional therapy have shown partial benefits when applied individually as per the specific needs of the child. Most importantly compassionate care coupled with assurance and reassurance by the parents and friends is crucial. No single therapy works completely for all kinds of patients. Different treatment approaches have been practiced to address different aspects of social behavior, communication deficits, physical disabilities, specific symptoms and co-morbidities. Therefore, designing appropriate routine and behavioral support by a psychotherapist tailored for each child as per its symptoms is essential for providing a comfortable life. Several substances targeting immune dysfunction, neuroinflammation, glutamate/GABA imbalance, NMDA receptors and neuropeptides are undergoing clinical trials with variable success. Stem cell therapy aimed at preventing neuro-degeneration, modulating the immune system and improving brain function is also being investigated. To help the unfortunate child and improve the quality of life of concerned families, an integrative approach combining drug therapy and non-drug therapy offers a great promise. However, along with the therapeutic management, the cooperation of family members backed by society is necessary for enhancing the quality of life of a child suffering from ASD..