Autism

The DSM-5 redefined the autism spectrum disorders to encompass the previous diagnoses of Autism, Asperger syndrome, pervasive developmental disorder not otherwise specified and childhood disintegrative disorder.

It is called a “spectrum” disorder because people with ASD can have a range of symptoms. People with ASD might have problems talking with you, or they might not look you in the eye when you talk to them. They may also have restricted interests and repetitive behaviors. They may spend a lot of time putting things in order, or they may say the same sentence again and again. They may often seem to be in their “own world.” It affects the way the brain works and should be diagnosed by a medical professional – preferably a developmental pediatrician. Autism is an evolving disorder and your child’s symptoms and needs may change as they pass through different stages of development.

Autism’s most-obvious signs tend to appear between 2 and 3 years of age. In some cases, it can be diagnosed as early as 18 months. Some developmental delays associated with autism can be identified and addressed even earlier.

Signs and Symptoms

Although every child with autism is different, children with autism usually have two main types of behaviors: “restricted / repetitive behaviors” and “social communication / interaction behaviors.”

Restrictive / repetitive behaviors may include:

• Repeating certain behaviors or having unusual behaviors
• Having overly focused interests, such as with moving objects or parts of objects
• Having a lasting, intense interest in certain topics, such as numbers, details, or facts.

Social communication / interaction behaviors may include:

• Getting upset by a slight change in a routine or being placed in a new or overly stimulating setting
• Making little or inconsistent eye contact
• Having a tendency to look at and listen to other people less often
• Rarely sharing enjoyment of objects or activities by pointing or showing things to others
• Responding in an unusual way when others show anger, distress, or affection
• Failing to, or being slow to, respond to someone calling their name or other verbal attempts to gain attention
• Having difficulties with the back and forth of conversations
• Often talking at length about a favorite subject without noticing that others are not interested or without giving others a chance to respond
• Repeating words or phrases that they hear, a behavior called echolalia
• Using words that seem odd, out of place, or have a special meaning known only to those familiar with that person’s way of communicating
• Having facial expressions, movements, and gestures that do not match what is being said
• Having an unusual tone of voice that may sound sing-song or flat and robot-like
• Having trouble understanding another person’s point of view or being unable to predict or understand other people’s actions.

People with ASD may have other difficulties, such as being very sensitive to light, noise, clothing, or temperature. They may also experience sleep problems, digestion problems, and irritability.

ASD is unique in that it is common for people with ASD to have many strengths and abilities in addition to challenges.

Strengths and abilities may include:

• Having above-average intelligence – the CDC reports 46% of ASD children have above average intelligence
• Being able to learn things in detail and remember information for long periods of time
• Being strong visual and auditory learners
• Exceling in math, science, music, or art.

What are the other conditions that may co-occur with Autism?

Autism may occur alone, or may be accompanied by other diagnoses. When autism co-occurs with another condition, it is important that all the interventions the individual receives are autism friendly.

Conditions that commonly co-occur with autism include:

1. Attention Deficit Hyperactivity Disorder (ADHD)
2. Intellectual Disability (previously known as Mental Retardation)
3. Anxiety Disorders
4. Depression
5. Sleeping Disorder
6. Seizures and Epilepsy
7. Learning Disorder (LD)
8. Cerebral Palsy (CP)
9. Fragile X Syndrome
10. Hearing Impairment
11. Visual Impairment

What Causes Autism?

No one knows for sure. Though genetics play a role in the development of the disorder, there are many other factors that affect the onset and severity of autism. As a parent, you need to understand that autism is NOT a result of something you did or did not do for your child.

An important point to keep in mind is that autism is not caused by an unhappy home environment, both parents working, mental stress during the pregnancy, poor handling by the mother, an emotional trauma, or other psychological factors. A parent or home environment cannot cause a person to have autism.

How Can I Help a Child with Autism?

Early intervention is very effective in Autism and improves a child’s ability to cope well with this life-long condition. The earlier the intervention is implemented, the better the outcome for the child. Research also shows that children whose families are strongly engaged and involved make better progress. Consistency and structure are very important. If you can work closely with your child’s therapist and teachers so that everyone is responding the same way, your child will benefit a lot.

The best strategies encourage therapists and parents to work with the child’s own interests or actions to slowly build engagement, interaction, and communication. Play often works better than more directive methods to help children learn. Recent research has shown these approaches to be very effective for children with autism.

The Applied Behavioural Analysis (ABA) approach focuses on the child’s interests and motivation to learn new, more adaptive behaviours. They are based on the principles of reward and reinforcement for appropriate behaviours.

Occupational therapy helps children develop appropriate social, play, and learning skills. The therapist aids the child in achieving normal daily tasks (e.g., getting dressed and playing with other children). Occupational therapists may use aspects of sensory integration therapy in order to help the child appropriately respond to and organize information coming through the senses.

Speech and language therapy is often beneficial for children with autism since about 30-50% of them do not use speech. Conventional methods of speech therapy are not always effective. Therapist should have a good understanding of autism and be able to emphasize non-verbal communication, like pictures and gestures if necessary. For children who speak, a speech & language therapist helps them by enabling them to use their language for social interaction and play. Play is often challenging for children who are verbal.

When choosing an intervention plan, educate yourself on the options which have been scientifically tested and shown to be effective for managing autism symptoms. Be aware that the internet is full of therapies that lack evidence supporting their use with autism. The best intervention plans are those which incorporate aspects of all of the aforementioned therapies as per the child’s needs and abilities.

Can a Child with Autism Do Well at School?

Children with autism are just like other kids in many ways. Some are very bright; some may be intellectually impaired. Their skills may be strong in some areas (memory, math, music) and weak in others (speech, self-care). Regardless of their abilities, it is important for children with autism to attend school because it provides a structured environment with clearly laid out expectations as well as opportunities for interacting with children of their age. Attending school is great therapy! Talk to your pediatrician or therapist to help you decide the best type of school for your child. Options include a regular school, an inclusive school (in which most children are typical, but some students have special needs), and special schools (meant specifically for children with disabilities).