Autism and the autism spectrum are associated with a number of different neurological disorders, which usually complicate the life of the sufferer. The spectrum of autism includes various factors affecting the ability to function, which can vary individually with large differences. Even perfectly healthy people are very different in many ways, and the same applies to autistic people. Everyone has their own individual traits and ways of experiencing the world.

Some of those diagnosed with autism spectrum disorder are able to live independently, while some need help to survive in everyday life throughout their lives. An autistic person’s need for help can vary, e.g. depending on life situation, age and support measures. (1)

The word spectrum refers to the variation and intensity of symptoms arising from disorders. Autism spectrum disorder is recognized much more often in men than in women. Out of the entire population in Finland, less than one percent (0.7%) of the population suffers from autism. It is not yet known exactly what causes the differences in prevalence, but it is thought to be related to biological differences between the sexes. (2)

Traits of autism

Autism affects a person’s way of experiencing and sensing the environment. Most of the time, the interaction and communication of an autistic person differs from “normal”, so to speak.

Common features for autistics are e.g. difficulties in controlling one’s own activities, difficulties in social situations (communication), a different way of interpreting and sensing situations, and sensitivity to nervous system overload and stress. However, the features vary from case to case. (1)

Autism features also include areas that can manifest as exceptional talent, such as the ability to pay attention to details and solve even difficult puzzles. In addition to them, autistic people can have excellent concentration and a clear understanding of right and wrong. (1)

Common features for autistic people are difficulties in controlling their own activities, communication difficulties, and sensitivity to nervous system overload and stress.

Autism spectrum disorders

Autism spectrum disorders (Autism Spectrum Disorders, i.e. ASD) and related brain development disorders become apparent at an early stage. The characteristics and challenges in functioning of autistic people can vary significantly.

List of autism spectrum disorders:

• Autism
• Asperger syndrome
• Pervasive developmental disorder (atypical autism)
• Pervasive Developmental Disorder Not Specified (PDD-NOS)
• Rett syndrome
• Disintegrative developmental disorder (Heller’s disease)

There is not only one clear cause behind the disorders, but several biological factors influence it. Although the exact causes have not yet been identified, in any case, hereditary factors influence the prevalence of the disorder. According to current data, 65-90 percent of autism spectrum disorders are inherited. (2)

In the entire population, the autism spectrum is observed in about 1 percent of people. In developed countries, the number is higher (1.5%) and has almost doubled in 10 years. (3)

Asperger syndrome

Autism-related diagnoses have become more specific. Once thought of as a rare childhood disorder, Asperger’s syndrome is now classified as a lifelong illness. The syndrome in question was named after the Austrian pediatrician Hans Asperger and was introduced in Finland in the 1990s.

Asperger’s syndrome and autism are now classified as part of the autism spectrum disorder and those terms have been removed from the classification (ICD-11 and DSM-5). The autism spectrum is defined on a case-by-case basis from mild to severe. (3)

Symptoms of Autism

Autism-related symptoms usually appear already during early childhood, within the first three years of age. Sometimes the symptoms are only noticed in preschool or later. An autistic child usually has difficulty understanding verbal and non-verbal communication. Often, maintaining eye contact has also proven to be challenging. (2)

The symptoms related to autism are therefore especially manifested in social situations and interactions with others. The disorder may include certain repetitive behaviors and special interests that an autistic person easily becomes immersed in. Each person suffering from autism spectrum disorders has their own characteristics, and some may live very independently, while others may have a great need for help with everyday tasks. (2)

The most common symptoms related to autism spectrum disorder

• Difficulty understanding the feelings and thinking of others
• The challenges of starting and maintaining a conversation
• The difficulty of working in a group
• Difficulty accepting new situations and changes
• Avoiding eye contact
• Little use of sign language and facial expressions
• Difficulty forming lasting friendships. (4)

It is also possible that the symptoms are not noticed until later in life, when the pressures of working life or postgraduate studies increase. Potential disorders should also be diagnosed by adults, so that work, study and the necessary measures related to rehabilitation can be planned in the necessary way and the risk of being marginalized can be prevented. (3)

Getting a diagnosis of autism spectrum disorder is a multi-step process that is done together with the help of an expert doctor. Various tests, examinations and interviews are needed for diagnosis.

Autism test

Although the symptoms of autism spectrum disorder usually become apparent at an early stage, no specific age limit has been set for its definition. It is possible to make the diagnosis even for an adult, and for that there are tests that support the definition of autism. (5)

If you suspect an autism spectrum disorder in yourself or someone close to you, the general recommendation is to seek a doctor’s consultation and prepare for the appointment by thinking about and writing down all the observed features classified as autism spectrum that occur in everyday life. The doctor has the option of separately requesting an appointment with a neuropsychologist, where the matter can be examined in more detail with the help of various examinations. (5)

Getting an official diagnosis is a multi-step process and is usually done with the help of a doctor familiar with the subject through various examinations and interviews. In addition, the diagnosis often also requires interviewing close people, seeing a psychologist and therapist. In the studies, special attention is paid to functional ability, communication, interaction skills and interests throughout life. School certificates, birth records and other documents related to growth and development should be included to make the process easier, as comprehensive examinations to make a diagnosis often require a lot of time. (5)

Screening

There are various tests and screening tools to support the diagnosis of autism spectrum disorder. Filling out the form can make the doctor’s work easier and speed up the diagnosis.

In the links below, you can find screening forms to support the definition of autism in children and adults.

Digital CHAT evaluation form (in Finnish)

Digital M-CHAT-R extended evaluation form , (in Finnish)

The AQ-10 screening form intended for adults may be helpful at the doctor’s office when assessing the need for additional tests to make a possible diagnosis in an adult who does not have major learning difficulties.

AQ-10 evaluation form for identifying the autism spectrum in adults

The ASSQ screening form, designed for parents of children, can clarify and be helpful in the diagnosis of autism spectrum disorders.

ASSQ assessment form for parents

The GQ-ASC screening form below is designed to identify autism-related behaviors and abilities in cis and trans women.

GQ-ASC assessment form (cis and trans women)

An autistic child easily drifts into playing only his own games. In the behavior of an autistic child, deficiencies are also often observed in relation to language development and making eye contact.

An autistic child

Some autistic children manage well independently, while others may need daily support. At worst, an autistic child can also significantly challenge the lives of the child’s loved ones. (1)

In addition to genetics, there are also physiological factors involved in the manifestation of autism. Upbringing has not been found to have a connection with the prevalence of autism. (1)

Autism may appear in a child very early, before the age of 1 year. In general, deficiencies are noticed in the behavior of autistic children, e.g. in eye contact, language development and the way they play with other children. The child may also have a different way of answering questions and expressing emotions. An autistic child may get irritated easily and drift off to play only his own games. The importance of familiar and repeated routines is emphasized in an autistic child. (6)

Autism treatment

Autism spectrum disorders are congenital, and no curative treatment has yet been invented.

In the revised disease classification, autism is not currently separated into separate diagnoses and e.g. Asperger’s syndrome, a mild form of autism, is now considered part of the autism spectrum disorder.

Although there is no known cure for autism spectrum disorders, its symptoms can be alleviated and individual development can be supported with, for example, occupational therapy and speech therapy. In addition, it is important for an autistic child and his parents to accept the prevailing situation and learn to live with the personality traits that are associated with it. (7)

If the symptoms significantly challenge everyday life, it is worth discussing the matter together with an expert neuropsychologist, with whom the treatment of the situation and the need for different forms of support can be planned in an appropriate way. Usually, support and rehabilitation takes place in cooperation with kindergarten, healthcare or school. (7)

The control of one’s own actions and the development of the brain continue until at least the age of 25. The symptoms related to the autism spectrum may decrease after reaching adulthood, if the child receives the necessary support along the way and participates in a rehabilitation program. In some cases, with the help of successful rehabilitation and support, the symptoms can decrease so much that the previous diagnosis no longer matches the picture of the symptoms. (7)

Autism spectrum treatment with CBD

Symptoms of the autism spectrum are currently also treated with CBD products such as CBD oil and CBD capsules. This alternative and natural form of treatment has spread worldwide in popularity, when several doctors and parents of autistic children have publicly shared their positive experiences and results related to autism treatment.

Some studies have shown that cannabinoid products reduced the number and/or intensity of symptoms associated with the autism spectrum, including hyperactivity, self-harm, sleep disturbances , feelings of anger, anxiety , irritability, restlessness , psychomotor agitation, aggression, and depression .. In addition, they observed improvement in cognition, sensory sensitivity, attention, social interaction and language. The most common side effects were sleep disturbances, restlessness, nervousness and changes in appetite. (8)

Especially for minors, the safety of using CBD should always be evaluated on a case-by-case basis together with an expert doctor.

CBD is hardly a panacea that cures the disorder completely, but for many it seems to be a significant help in everyday functioning and in alleviating the symptoms. Read more in the next paragraph about how the endocannabinoid system and autism are connected.

The role of the endocannabinoid system in autism

The vital functions of almost every animal are controlled and balanced by an internal cannabinoid system. It is absent only in insects and protozoa. Complicated endocannabinoid system consists of a network of receptors covering the entire body, which are affected by neurotransmitters. It is known to influence and regulate e.g. brain, kidney, liver and immune system function. (9)

Based on new evidence, people with autism spectrum disorder have anandamide the amount found to be lower than in a healthy control group. Anandamide is an endocannabinoid, also known as the happiness molecule, or internal cannabinoid, and based on this research result, the internal cannabinoid system and the imbalance of cannabinoids can have an effect on the manifestation of the disorder. (10)

Autism-related disorder has also been linked to the amount of oxytocin in the body. Oxytocin, also known as the love hormone, is a neuropeptide consisting of amino acids that is expressed in mammals and acts as a messenger and hormone. Oxytocin is produced in the brain’s hypothalamus, from where it passes through the pituitary gland into the bloodstream. Today it is known that oxytocin plays a significant role in e.g. in the formation and maintenance of the attachment relationship between the child and its parents. In addition to that, oxytocin is also associated with social, emotional, cognitive functions. Since the production of oxytin is also regulated by the internal cannabinoid system, you can from CBD and some others of cannabinoids be useful in connection with its normal production. (11)

Researchers think that the interaction between anandamide and oxytocin and the correction of their deficiency states related to autism could provide relief in treating the symptoms (11).

The internal cannabinoid system also seems to play an important role in relation to social interaction skills and emotions, which CBD and certain cannabinoids can activate. By affecting the receptors of this body system, it may also have an effect on alleviating the symptoms of autism.

THC and autism

Although research is still ongoing, there are indications that THC-cannabinoid may reduce internal anandamide concentrations in the body. The concentrations of anandamide are already low in people with autism, so it should be avoided the continuous use of THC. Anxiety is also a common symptom associated with autism, and THC and THCV may make it worse for some. However, the experiments were done on rats and with strong THC-containing cannabis products, so how it affects humans is not yet fully understood.

Generally, in CBD oils, the traces of THC are minimal enough to be detrimental to anandamide levels. Understanding the issue is also complicated by the fact that, according to studies, full-spectrum CBD products are prone to side effects (see entourage effect) are therefore more effective for many diseases and imbalances in the body than isolated cannabinoids (isolates). Full spectrum means that the final product also contains THC, although often only in very small amounts.

If you are considering CBD products for the treatment of an autism spectrum disorder and want products containing as little THC as possible, you should consider CBD products activated by heating, because their THC concentrations are usually significantly lower. See more about how heating works decarboxylation affects the final product.

Sources

1. Autism Association. 2022. Basic information about autism. https://autismiliitto.fi/autismi/perustietoa-autismista/. Referred on 12/09/2022
2. Health house. Autism and autism spectrum disorders. https://www.terveystalo.com/fi/tietopaketit/autimi-ja-autismikirjon-hairiot/#Mit %c3% a4 %20on% 20autismin%20kirjo . Referred on 12/09/2022
3. Hanna Raaska & Raija Vanhala. 2020. Medical journal. Why and how do the diagnostic criteria for autism change? https://www.laakarilehti.fi/tieteessa/katsausartikkeli/miksi-ja-miten-autismin-diagnostiset-kritierit-muuutuvatt/?public=7fcf41d96a001eee7da91094299e5b86 . Referred on 08/12/2022
4. Mielenterveystalo.fi. Autism spectrum disorders (ASD). https://www.mielenterveystalo.fi/lapset/ammattilaisille/hairiot/autismikirjon_hairiot/Pages/autisimikirjon_hairiot_ASD.aspx. Referred on 13/09/2022
5. Autism Association. 2022. Diagnosing the autism spectrum. https://autismiliitto.fi/autismi/diagnosointi/. Referred on 13/09/2022
6. Autism Association. 2022. Autism in different stages of life. https://autismiliitto.fi/autismi/autismikirjo-eri-elamanvaiheissa/. Referred on 09/04/2022.
7. Pekka Räisänen & Ulla Boshkov. Autism in a child. https://www.mehilainen.fi/lasten-mehilainen/autismi-ja-autismikirjo. Referred on 13/09/2022
8. Estácio Amaro da Silva Jr. and others 2022. Trends Psychiatry Psychother. Cannabis and cannabinoid use in Autism Spectrum disorder: a systematic review. https://pubmed.ncbi.nlm.nih.gov/34043900/. Referred on 15/09/2022
9. Ethan Russo. 2015. Phytecs. Introduction to the Endocannabinoid System . https://www.phytecs.com/wp-content/uploads/2015/02/Russo-Introduction-to-the-Endocannabinoid-System-corr-January-2015.pdf . Referred on 14.09.2022
10. Debra S. Karhson et al. 2018. Molecular Autism. Plasma anandamide concentrations are lower in children with autism spectrum disorder.https://molecularautism.biomedcentral.com/articles/10.1186/s13229-018-0203-y. Referred on 15/09/2022
11. Don Wei et al. 2015. Pnas. Endocannabinoid signaling mediates oxytocin-driven social reward. https://www.pnas.org/doi/full/10.1073/pnas.1509795112 . Referred on 15/09/2022