Autism spectrum disorder

From MEpedia, a crowd-sourced encyclopedia of ME and CFS science and history

Autism spectrum disorder is a developmental disorder, meaning it affects how an individual develops mentally and physically. As of 2020, the CDC estimates 1 in 36 children have an autism diagnosis.[1]

Causes[edit | edit source]

A 2017 Swedish study suggests autism is 83% heritable.[2] In other words, most cases of autism are caused by genes inherited from one's parents. There are up to 1,000 genes that can potentially be involved in developing autism.[3]

Some prenatal environmental triggers are also linked with autism, including (but not limited to):

  • Prenatal infection with viruses such as measles and rubella. It's unclear whether a fetus' development changes due to direct interference from the virus or influence from the mother's activated immune system.[4]
  • Prenatal exposure to the the insecticide dichlorodiphenyltrichloroethane (DDT).[5]
  • Maternal exposure to traffic-related air pollution. More specifically, mothers living within 309 meters (~3.5 football fields) of a freeway during the third trimester are more likely to have autistic babies.[6]

It's important to note that environmental triggers generally do not cause autism by themselves.[7] Rather, they cause changes that are thought to overlap with a child's pre-existing genetic risk factors - tipping the scales, so to speak.

There is little to no evidence that individuals can develop autism after birth.[8] Research repeatedly demonstrates no connection between autism and childhood vaccination.[9]

Similarities to ME/CFS[edit | edit source]

People with autism can develop many of the same symptoms as ME/CFS, including:[10]

Autistic Burnout[edit | edit source]

Autistic Burnout Symptoms[edit | edit source]

Autistic burnout is a phenomenon characterized by:[12]

  • Severe exhaustion: Physical and mental fatigue can impact employment, relationships, and self-care. Similar to post-exertional malaise, the fatigue can worsen after straining oneself mentally or physically. However, physical triggers generally involve sensory sensitivities rather than exercise.
  • Reduced tolerance to stimulus: Individuals may be more sensitive to noise, light, and other sensory stimuli. They may also have more trouble regulating their emotions than they used to. Some may grow extremely dependent on routines in order to self-regulate.
  • Loss of skills: Individuals may have difficulty with executive functions like following plans and making decisions. They also may have trouble speaking or remembering common vocabulary. These skills can often return after the burnout episode, but not always to the level they were before.
Autistic Burnout Diagnosis[edit | edit source]

The term "autistic burnout" was coined around 2005 and reached mainstream awareness around 2018.[13] Some research may also call it "autistic regression."[14] However, neither of these names are an official diagnosis.

There is no official test for autistic burnout. However, a 2024 study found the AASPIRE Autistic Burnout Measure (ABM) is a valid measure of autistic burnout.[15] (Validity means the test accurately captures the concept it claims to measure.)

While some symptoms of autistic burnout do overlap with depression criteria, the two conditions are distinct. Autistic people experiencing burnout can still experience the full range of emotions and find joy in special interests. While low mood is common, it's not the defining feature of burnout.[16]

This distinction is important because it affects treatment. Currently rest is the primary method of recovery from autistic burnout. However, some depression therapies, such as Behavioral Activation Therapy (BAT), urge people to push through tiredness to combat feelings of apathy. BAT is not recommended for people experiencing autistic burnout.[16]

Autistic Burnout Triggers[edit | edit source]

Autistic burnout typically occurs when the stressors of a person's life overwhelm their coping mechanisms. Research suggest a large contributing factor is masking - when a person suppresses their autistic traits to avoid discrimination. This may look like memorizing scripts for conversations, consciously maintaining eye contact, or leaving their ear defenders at home to avoid looking 'different'. The chronic stress of masking may contribute to mitochondrial dysfunction and ultimately end in a burnout episode.[17][18]

Transitional periods like puberty or graduation can also be a risk factor. These periods often involve an increase in demands on a person's energy and time, while also removing access to the routines and support networks that helped a person cope in the past.[18]

Notable studies[edit | edit source]

  • 2024 - A genome-wide association study suggests autism has a "shared genetic architecture" with fatigue, multi-site pain, and IBS. However, it's too early to say whether there is a causal relationship.[19]
  • 2024 - Children with autistic traits are 78% more likely to have chronic disabling fatigue by the time they reach 18. The link between autism and fatigue held true even when researchers controlled for depressive symptoms. The study authors said this link was likely mediated by higher levels of the inflammatory cytokine IL-6.
  • 2022 - In a study of 973 autistic adults, 21% had a formal diagnosis of one or more central sensitivity syndromes (CSS). These included fibromyalgia, ME/CFS, IBS, restless leg syndrome, and temperomandibular joint disorder. In addition, 60% of participants met the clinical cut-off for a CSS on the Central Sensitization Inventory.
  • 2018 - Patients with chronic fatigue syndrome do not score higher on the Autism Spectrum Quotient (a test measuring autistic traits) than healthy controls.[10] (Abstract)

Learn more[edit | edit source]

References[edit | edit source]

  1. ↑ CDC (July 19, 2024). "Data and Statistics on Autism Spectrum Disorder". Autism Spectrum Disorder (ASD). Retrieved January 25, 2025.
  2. ↑ Sandin, Sven; Lichtenstein, Paul; Kuja-Halkola, Ralf; Hultman, Christina; Larsson, Henrik; Reichenberg, Abraham (September 26, 2017). "The Heritability of Autism Spectrum Disorder". JAMA. 318 (12): 1182–1184. doi:10.1001/jama.2017.12141. ISSN 0098-7484. PMC 5818813. PMID 28973605.
  3. ↑ Chen, Jason; Penagarikano, Olga; Belgard, T. Grant; Swarup, Vivek; Geschwind, Daniel (2015). "The Emerging Picture of Autism Spectrum Disorder: Genetics and Pathology". Annual Reviews. 10: 111–144.
  4. ↑ Shuid, Ahmad Naqib; Jayusman, Putri Ayu; Shuid, Nazrun; Ismail, Juriza; Kamal Nor, Norazlin; Mohamed, Isa Naina (March 10, 2021). "Association between Viral Infections and Risk of Autistic Disorder: An Overview". International Journal of Environmental Research and Public Health. 18 (6): 2817. doi:10.3390/ijerph18062817. ISSN 1661-7827. PMC 7999368. PMID 33802042.
  5. ↑ Brown, Alan S.; Cheslack-Postava, Keely; Rantakokko, Panu; Kiviranta, Hannu; Hinkka-Yli-Salomäki, Susanna; McKeague, Ian W.; Surcel, Heljä-Marja; Sourander, Andre (November 1, 2018). "Association of Maternal Insecticide Levels With Autism in Offspring From a National Birth Cohort". The American Journal of Psychiatry. 175 (11): 1094–1101. doi:10.1176/appi.ajp.2018.17101129. ISSN 1535-7228. PMC 6377859. PMID 30111184.
  6. ↑ Volk, Heather E.; Hertz-Picciotto, Irva; Delwiche, Lora; Lurmann, Fred; McConnell, Rob (2011-06). "Residential proximity to freeways and autism in the CHARGE study". Environmental Health Perspectives. 119 (6): 873–877. doi:10.1289/ehp.1002835. ISSN 1552-9924. PMC 3114825. PMID 21156395. Check date values in: |date= (help)
  7. ↑ "Autism". National Institute of Environmental Health Sciences. Retrieved January 25, 2025.
  8. ↑ "Is Autism Genetic?". UCLA Medical School. April 10, 2024. Retrieved January 26, 2025.
  9. ↑ Gabis, Lydia; Attia, Odelia; Goldman, Mia; Barak, Noy; Tefera, Paula; Shefer, Shahar (January 2022). "The myth of vaccination and autism spectrum". European Journal of Paediatric Neurology. 36: 151–158.
  10. ↑ 10.0 10.1 Bileviciute Ljungar, Indre; Maroti, Daniel; Bejerot, Susanne (2018), "Patients with chronic fatigue syndrome do not score higher on the Autism-apectrum quotient than healthy controls: comparison with autism spectrum disorder", Scandinavian Journal of Psychology
  11. ↑ Madra, Moneek; Ringel, Roey; Margolis, Kara G. (2020-7). "Gastrointestinal issues and Autism Spectrum Disorder". Child and adolescent psychiatric clinics of North America. 29 (3): 501–513. doi:10.1016/j.chc.2020.02.005. ISSN 1056-4993. PMC 8608248. PMID 32471598. Check date values in: |date= (help)
  12. ↑ Raymaker, Dora M.; Teo, Alan R.; Steckler, Nicole A.; Lentz, Brandy; Scharer, Mirah; Delos Santos, Austin; Kapp, Steven K.; Hunter, Morrigan; Joyce, Andee; Nicolaidis, Christina (June 1, 2020). ""Having All of Your Internal Resources Exhausted Beyond Measure and Being Left with No Clean-Up Crew": Defining Autistic Burnout". Autism in Adulthood. 2 (2): 132–143. doi:10.1089/aut.2019.0079. ISSN 2573-9581. PMC 7313636. PMID 32851204.
  13. ↑ Mantzalas, Jane; Richdale, Amanda L.; Adikari, Achini; Lowe, Jennifer; Dissanayake, Cheryl (March 1, 2022). "What Is Autistic Burnout? A Thematic Analysis of Posts on Two Online Platforms". Autism in Adulthood: Challenges and Management. 4 (1): 52–65. doi:10.1089/aut.2021.0021. ISSN 2573-9581. PMC 8992925. PMID 36605565.
  14. ↑ Tan, Christine; Frewer, Veronica; Cox, Georgina; Williams, Katrina; Ure, Alexandra (2021-03). "Prevalence and Age of Onset of Regression in Children with Autism Spectrum Disorder: A Systematic Review and Meta-analytical Update". Autism Research: Official Journal of the International Society for Autism Research. 14 (3): 582–598. doi:10.1002/aur.2463. ISSN 1939-3806. PMID 33491292. Check date values in: |date= (help)
  15. ↑ Mantzalas, Jane; Richdale, Amanda; Li, Xia; Dissanayake, Cheryl (Apr, 25, 2024). "Measuring and validating autistic burnout". Autism Research. 17 (7): 1417–1449. Check date values in: |date= (help)
  16. ↑ 16.0 16.1 Higgins, Julianne; Arnold, Samuel; Weise, Janelle; Pellicano, Elizabeth; Trollor, Jullian (June 4, 2021). "Defining autistic burnout through experts by lived experience: Grounded Delphi method investigating #AutisticBurnout". Autism. 25 (8).
  17. ↑ Mahony, Caitlyn; O'Ryan, Colleen (November 25, 2022). "A molecular framework for autistic experiences: Mitochondrial allostatic load as a mediator between autism and psychopathology". Frontiers in Psychiatry. 13: 985713. doi:10.3389/fpsyt.2022.985713. ISSN 1664-0640. PMC 9732262. PMID 36506457.
  18. ↑ 18.0 18.1 Mantzalas, Jane; Richdale, Amanda; Dissanayake, Cheryl (April 13, 2022). "A conceptual model of risk and protective factors for autistic burnout". Autism Research. 15 (6): 976–987.
  19. ↑ Li, Yiran; Xie, Tian; Vos, Melissa; Snieder, Harold; Hartman, Catharina A. (November 23, 2024). "Shared genetic architecture and causality between autism spectrum disorder and irritable bowel syndrome, multisite pain, and fatigue". Translational Psychiatry. 14 (1): 1–9. doi:10.1038/s41398-024-03184-4. ISSN 2158-3188. PMC 11585586. PMID 39580447.

Centers for Disease Control and Prevention (CDC) - The Centers for Disease Control and Prevention is a U.S. government agency dedicated to epidemiology and public health. It operates under the auspices of the Department of Health and Human Services.

See Centers for Disease Control and Prevention.

an organism's complete set of DNA, including all of its genes[1]

genome an organism's complete set of DNA, including all of its genes

cytokine any class of immunoregulatory proteins secreted by cells, especially immune cells. Cytokines are small proteins important in cell signaling that modulate the immune system. (Learn more: me-pedia.org)

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