Autistic Spectrum Disorder
What is an Autism Spectrum Disorder?
Autism spectrum disorder is characterised by difficulties in social interaction, impaired communication, and restricted or repetitive interests and behaviors. Sensory sensitivities are also extremely common. The word ‘spectrum’ is used because ASDs affect individuals in different ways and there is a range of symptoms and severity of difficulties that the person may experience. Studies suggest that 1 in 110 children have an ASD and it is four times more prevalent in boys than girls.
What difficulties characterise Autism Spectrum Disorders?
There are three main areas of difficulty that characterise ASDs.
- Impairment in social interaction.Children with autism spectrum disorders often display a lack of interest in seeking to share enjoyment, interest and activities with other people. Typically they are not interesting in chatting or playing with other children and may not respond when people speak or gesture to them, even if their names are called. As a result children with ASD often have difficulty
forming and sustaining friendships.
- Impairment in communication
Impairments in communication in children with ASDs may span both verbal and non-verbal means of communication. They often have limited use and understanding of non-verbal communication such as eye gaze, facial expression, tone of voice and gesture and will rarely use non-verbal gestures such as nodding. Often children with ASD will make little eye contact with others when speaking to them or being spoken to. Sometimes these children will have delayed language development and may have stereotyped and repetitive use of language such as repeating phrases from television shows. Children with ASD who are verbal may talk primarily about their own restricted interests and may focus on categorising everything around them.
- Restricted and repetitive interests, activities and behaviours.
Children with ASDs may have unusually intense or focused interests and may not be willing to explore other topic areas. They may also display stereotyped and repetitive body movements such as hand flapping or play with objects in an inappropriate and non-functional manner (e.g. lining up toys and collecting objects such as twigs, strings or balls). These children may also insist on adhering to a routine, even if it is non-functional, and are easily upset by changes in the routine.
Other: Sensory sensitivities
Children with ASDs may also show sensory sensitivities and unusual sensory interests such as sniffing objects. This may lead to avoidance of everyday sounds and textures such as hair dryers and vacuum cleaners. They may also have unusual eating and sleeping habits and may be described as irritable or detached. There may also be a range of behavioural symptoms such as hyperactivity, short attention span, impulsivity, aggressiveness, self- injurious behaviour and temper tantrums.
What are the different types of ASD?
There are three primary types of autism spectrum disorders:
- Autistic disorder
Autistic disorder is also sometimes known as classic autism. This is a diagnosis given to individuals with impairments in social interaction and communication, as well as restricted and repetitive interests, activities and behaviours. Children with autistic disorder may reach developmental milestones later than their typically developing peers. The disorder is generally evident before three years of age.
- Asperger’s syndrome
Individuals with Asperger’s syndrome primarily have difficulties with social interaction and social communication as well as restricted and repetitive or restricted interests, activities and behaviours. Individuals with Asperger’s syndrome do not have significant delays in language development, cognitive abilities or self-help skills. However, they may exhibit unusual language use patterns such as speaking in a very formal way with a monotone voice.
Typically these individuals have difficulty forming and sustaining social friendships.
- Pervasive Developmental Disorder Not Otherwise Specified
The diagnosis of PDD-NOS, otherwise known as atypical autism, can be made when an individual exhibits marked social impairment but fails to meet the full criteria for either autistic disorder or Asperger’s syndrome. These individuals may also display communication impairments and/or restricted and repetitive interests, activities and behaviours.
What causes ASD?
It is not yet known what causes ASD, but studies have identified a strong genetic basis. However, it is unlikely to be a single gene that is involved; rather it is probably a result of several genes that interact. It is important to note that autism is not a result of what parents have or have not done. Furthermore, there is no solid evidence to suggest that ASD is a result of environmental factors such as diet, vaccinations, allergens etc.
Is there a cure?
There is currently no known cure for ASD but most individuals make marked improvements with social skills training, individualised education and structured support. Early intervention is the key for prolonged improvement in children with ASDs. There are a range of different therapies and providers available. Many children benefit from seeing professionals such as speech therapists (for speech skills), occupational therapists (for motor skills) and psychologists (for social and behavioural skills). Please feel free to call our centre to discuss what programs we have on offer.
Tips for parents
If your child has difficulty initiating interactions with other children, it may be beneficial to rehearse things they might say to other children (e.g. Hi, my name is ____. What’s your name?). It is also important to rehearse alternative endings to a social scenario (e.g. what to do when a child says that they don’t want to play).
Provide as many opportunities for your child to meet and interact with other children as possible. For example, joining sporting clubs, group music lessons, scouts etc gives your child a chance to mix with other children who may share their interests.
It may also be helpful to draw your child’s attention to, and specifically teach, the social rules that govern their interactions with others. For example, when conversing with your child you may want to illustrate and highlight principles such as turn taking in conversation and maintaining appropriate distances.
Children with autism may also have trouble recognising the emotions that are associated with various facial expressions. It may be helpful to teach these explicitly. There are also a number of online games that may assist with developing emotional awareness such as www.dotolearn.com/games/facialexpressions
It is also important for children to understand the ways that body language may provide information about other’s emotions and what body language is appropriate for different situations. Drama games such as charades are a good way of teaching this concept.
Children with ASDs often have difficulty generalising their skills to other situations. For example, they may learn that turn taking is important when talking to mum but may have difficulty seeing that this relates to other people as well. Therefore, it is important to have your child practice their social skills in as many different environments and with as many different people as possible.
Children may also benefit from specific social skills training from a psychologist.
As children with ASD may have difficulty understanding simple instructions, it may also help to use consistent phrases to indicate the order of activities or instructions (e.g. ‘first this then this”).
Illustrate daily routines and order of instructions with pictures in order to cement your child’s understanding of them. If your child has difficulty communicating verbally, it may be beneficial to consider using picture based communication systems such as PECS.
Ensure that your house has a structured routine so that your child knows what to expect and when. If there will be deviations from the set routine advise your child in advance.
It is important to not inadvertently reinforce unwanted behaviours. For example, many children with ASD may throw tantrums in order to gain attention, which the parents inadvertently reinforce by attending to their naughty behaviour. Thus, when it is safe and appropriate to do so inappropriate behaviours should be ignored rather than reprimanded.
Conversely, wanted behaviours should be followed by lots of praise and encouragement. Children may also be motivated through token and reward systems such as star charts. For example, your child may earn a star each time they initiate contact with a peer or when they complete each step of an activity. Ensure that there is a motivating reward at the end (e.g. when the child reaches 4 stars, they are allowed an extra 15 mins of tv time).