Medical aspects of autism spectrum disorders
Introduction: Medical understanding of autism spectrum disorders (ASD) has changed since it was first described by Leo Kanner. The current medical literature suggest there are many medical underpinnings of autism, and that it cannot solely be a mental, psychiatric or developmental disorder. There is now an understanding that ASD is a neuro-developmental medical condition associated with unique abnormalities in brain development, rather than a mental health or behavioral disorder. The aim of this article is to present medical issues of children with autism spectrum disorders which may be identified and treated by general practitioners as a review of current medical papers in the context of author’s professional experience.
Findings: Some of the medical abnormalities found to date in ASD include: anxiety disorders, bipolar disorder, gastrointestinal disorders, depression and other psychopathological disorders, ADHD, Fragile X syndrome, intellectual disability, neuroinflammation and immune disorders, nonverbal learning disorder,motor clumsiness, obsessive-compulsive disorder, Tourette syndrome, epilepsy, sensory problems, tuberous sclerosis, oxidative stress, acquired mitochondrial dysfunction and metabolic abnormalities, etc. Our previous study showed that the most prevalent medical condition were acute infectious disease: varicella in 34.5% and measles in 6.5% of the persons with autism. Angina was seen in 33%, 16 patients had allergies. Convulsions as a symptom were represented in 14% of subjects, and 11% had gastrointestinal disorders.
Conclusions: Many of these medical conditions are treatable, often resulting in improved quality of life for the patient. Each case of an autistic child improving after a medical intervention is important for the society. Improving the ability of these patients to lead relatively independent living has a great economic impact.
Keywords: autism spectrum disorders – medical aspects – medical symptoms – diagnosis – autism treatment – medical issues
Prof. Dr. med. Vladimir Trajkovski is full professor in Autism Spectrum Disorders, Human Genetics, Physiology and Functional Anatomy, and Medical Aspects of Disability at the University of St. Cyril and Methodius, where he works within the Institute of Special Education and Rehabilitation. He is the president of Macedonian Scientific Society for Autism. He is on the list of DAN doctors. He teaches on undergraduate and postgraduate courses within the University and supervises PhD and MA students in the Republic of Macedonia. He has published widely on autism spectrum disorders and he is editor-in-chief of Journal of Special Education and Rehabilitation since November 2008. He participated in more than eighty seminars, congresses, symposia and conferences at home and abroad. He actively participates in the preparation and execution of fifteen professional and scientific national and international projects. He is author of over 90 papers in domestic and foreign periodicals of which ten are in journals with impact factor. His most important works is worth mentioning: “Manual of Human Genetics” (2003), monograph “Autism” (2004), textbooks “Human genetics” (2005), “Medical Basis of Disability (2008)” Physiology and Functional Anatomy (2009) and “Autism and Pervasive Developmental Disorders (2011).”
LECTURE about REATTACH FOR AUTISM
Weerkamp Bartholomeus P, Trajkovski V. Multimodalna intervencija za decu i odrasle sa autističnim spektrom poremećaja: „Reattach“. Zbornik rezimea ‡ IV stručno-naučni skup sa međunarodnim učešćem „Aktuelnosti u edukaciji i rehabilitaciji osoba sa smetnjama u razvoju“. Beograd, 24-25 oktobar, 2015; 19.
Trajkovski V, Ajdinski Lj, Spiroski M. Plasma concentration of immunoglobulin classes and subclasses in children with autism in the Republic of Macedonia. Congress Abstracts from 12th World Congress IASSID, June 14-19, 2004, Montpellier, France. Journal of Intellectual Disability Research vol. 48, p.288.
Trajkovski V. Biomedical teatments of autism. Knjiga sažetaka – Međunarodni znanstveni i stručni skup: “Rehabilitacija – stanje i perspektive djece s teškoćama u razvoju i osoba s invaliditetom. Rijeka, 12-13 listopada, 2006; 13.
Spiroski M, Trajkovski V, Trajkov D, Petlichkovski A, Strezova A, Efinska-Mladenovska O, Srbinovska O, Hristomanova S, Djuleic E, Petrov J. Concomitant autoimmunity, allergy and immune tolerance are possible immunological disorder in autism. 5th Balkan Congress of Immunology, June 01-03, 2008, Ohrid. Maced J Med Sci; 1 (Suppl. 1): S21-S22.
Trajkovski V. Genetic evaluation and Genetic counseling of Autism Spectrum Disorders. Book of abstracts – International conference: “Rain Man is among us. Contemporary forms of Support for Autistic Persons. A systems Approach. Krakow, November 27-29, 2008; 158-159.
Trajkovski V. Health care system for people with intellectual disabilities in Macedonia. Book of abstracts – International Congress of Best Practice in Intellectual Disability Medicine. Bristol, UK, 13-14 May, 2010; 14.
Davkovska R, Trajkovski V. Family status of parents of children with autism. Book of abstracts – First International Conference of Students of Special Education and Rehabilitation: “Special Education and Rehabilitation”. Belgrade, April 15-18, 2011; 237-238.
Trajkovski V. Epigenetics of autism spectrum disorders. Book of abstracts – 32nd Balkan Medical Week. Nish, 21-23 September, 2012; O56.
Trajkovski V. Co-morbid medical conditions in autism spectrum disorders. In: Chichevska Jovanova N, Dimitrova Radojichikj D, Jachova Z, editors. Proceedings of Fourth International Conference: Modern Aspects of Special Education and Rehabilitation of Persons with Disabilities, 2013 October 17-19; Ohrid: Faculty of Philosophy; c2014. 56-69.
Troshanska J, Trajkovski V. Stages of communication in children with autism. In: Chichevska Jovanova N, Dimitrova Radojichikj D, Jachova Z, editors. Proceedings of Fourth International Conference: Modern Aspects of Special Education and Rehabilitation of Persons with Disabilities, 2013 October 17-19; Ohrid: Faculty of Philosophy; c2014. 70-80.
Trajkovski V, Cickovska T. Inclusion of children with autism spectrum disorders in mainstream schools in southwestern Macedonia. Book of abstracts ‡ 8th International Scintific Conference – „Special education and rehabilitation today“. Belgrade, November 7-9, 2014; 103.
Mitevska K, Trajkovski V. The grade of dependence in daily functioning of children with autism compared to children with mild intellectual disability. Book of abstracts ‡ 8th International Scintific Conference – „Special Education and Rehabilitation Today“. Belgrade, November 7-9, 2014; 136.
Trajkovski V. Implementation of assistive technology in children with autism spectrum disorders. Book of abstracts – „Assistive technology to support human development“. Cracow, September 23, 2015; 20.
Trajkovski V. Complementary and alternative medicine (CAM) treatments in children with autism spectrum disorders (ASD). Book of abstracts ‡ 5th Congress of Croatian speech and language therapists with international participation – „Multidisciplinary approach in speech and language sciences and practice“. Osijek, September 24-26, 2015; 94.
Mateska N, Trajkovski V. Stress that parents of autistic children and parents of children with cerebral palsy face. Book of abstracts ‡ 9th International Scintific Conference – „Special Education and Rehabilitation Today“. Belgrade, September 25-27, 2015; 31.
Preece D, Trajkovski V, Symeou L, Stosic J, Mavrou K, Theodorou E, Troshanska J, Blazevic S, Ruzic A, Baranger A, Fortuna R, Capper A, Charalambous-Darden N, Winstanley A, Hardcastle J, Bramble P, Kokkinos A, Fernandez C, Frey Skrinjar J. Developing ecologically valid parent education for families living with autism in a part of Europe. XI Autism Europe Congress “Happy, healthy and empowered”. Edinburgh, September 16-18, 2016.http://programme.exordo.com/autismeurope2016/delegates/presentation/274/
Nolcheva M, Trajkovski V. Parenting stress in parents of children with autism spectrum disorders in relation to coping mechanisms and family support. XI Autism Europe Congress “Happy, healthy and empowered”. Edinburgh, September 16-18, 2016.http://programme.exordo.com/autismeurope2016/delegates/presentation/288/
Trajkovski V. Evidence-based practice in autism spectrum disorders. First international congress for persons with disabilities “Why not to be so different”. Skopje, October 14-16, 2016; 43-44.
Trajkovski V, Preece D, Troshanska J, Mavrou K, Teodorou E, Stošić J, Fray Škrinjar J, Bramble P. Pomoć roditeljima u razumevanju i podršci njihovoj deci sa autizmom u Jugoistočnoj Evropi. Zbornik rezimea „Dani defektologa Srbije”. Novi Sad, 09-12 Februar, 2017; 23.
Preece D, Stosic J, Frey Škrinjar J, Troshanska J, Symeou L, Mavrou K, Theodorou E, Trajkovski V. Education for families of children with ASD. Book of Abstracts „9th International Conference of the Faculty of Education and Rehabilitation Sciences University of Zagreb”, Zagreb , 17 – 19 May 2017; 32.
Preece D, Aguila Munoz S, Capper A, Charalambous Darden N, Fortuna R, Frey Škrinjar J, Gerolemou C, Mavrou K, Ruzic A, Stosic J, Symeou L, Theodorou E, Trajkovski V. „Positive Approaches to autism“ – education for parents. Book of Abstracts „9th International Conference of the Faculty of Education and Rehabilitation Sciences University of Zagreb”, Zagreb , 17 – 19 May 2017; 108.
Troshanska J, Trajkovski V. Auditivno i vizuelno procesiranje učenika sa autizmom u poređenju sa učenicima sa lakom mentalnom retardacijom i učenicima neurotipične populacije. Zbornik rezimea „Aktuelnosti u edukaciji i rehabilitaciji osoba sa smetnjama u razvoju“. Valjevo, 19-21 Maj, 2017; 44.
Preece D, Symeou L, Stošić J, Theodorou E, Mavrou K, Troshanska J, Frey Škrinjar J, Trajkovski V. Listening to (empower) parents: family education for children on the autism spectrum in south-east Europe. European Reserach Network about Parents in Education (ERNAPE), 11th Biennial Conference: „Intensification, constraint and opportunity: changing roles for parents, schools and communities. Adressing equity and diversity issues“. London, 5-7 July 2017.
Trajkovski V, Ajdinski Lj, Spiroski M. Plasma Concentration of Immunoglobulin Classes and Subclasses in Children with Autism in the Republic of Macedonia: Retrospective Study. Croatian Medical Journal 2004; 45 (6): 746-749.
Trajkovski V, Petlichkovski A, Efinska-Mladenovska O, Trajkov D, Arsov T, Strezova A, Ajdinski Lj, Spiroski M. Higher Plasma Cocentration of Food-Specific Antibodies in Persons with Autistic Disorder in Comparison to Their Siblings. Focus on Autism and Other Developmental Disabilities 2008; 23 (3): 176-185.
Spiroski M, Trajkovski V, Trajkov D, Petlichkovski A, Efinska-Mladenovska O, Hristomanova S, Djulejic E, Paneva M, Bozhikov J. Family analysis of immunoglobulin classes and subclasses in children with autistic disorder. Bosnian Journal of Basic Medical Sciences 2009; 9 (4): 283-289.
Mladenovska B, Trajkovski V. Opinions and attitudes of parents and students for sexual development, sexual behavior and gender identity of persons with autism in the Republic of Macedonia. Journal of Special Education and Rehabilitation 2010; 11 (1-2): 7–24.
Stankova T, Trajkovski V. Attitudes and opinions of employers, employees and parents about the employment of people with autism in the Republic of Macedonia. Journal of Special Education and Rehabilitation 2010; 11 (3-4): 16–29.
Trajkovski V, Spiroski M. DNA typing of HLA-A, -C, -B, AND -DRB1 in the children with autism in the Republic of Macedonia. Bratisl Lek Listy 2015; 116 (1): 14-19. DOI: 10.4149/BLL_2015_003.
Nolcheva M, Trajkovski V. Exploratory study: stress, coping and support among parents of children with autism spectrum disorders. Journal of Special Education and Rehabilitation 2015; 16(3-4): 84-100.
Trajkovski V. Immunogenetic aspects of autism spectrum disorders. Paediatria Croatica 2016; 60 (Supl 1): 84-89.
Hansen DB, Orton LE, Adams C, Knecht L, Rindlisbaker S, Jurtoski F, Trajkovski V. A Pilot Study of a Behavioral Parent Training in the Republic of Macedonia. J Autism Dev Disord 47(6): 1878-1889. DOI 10.1007/s10803-017-3112-6.
Preece D, Trajkovski V. Parent education in autism spectrum disorder – a review of the literature. Hrvatska revija za rehabilitacijska istraživanja 2017; 53(1): 118-128.