Autism is the most common condition in a group of developmental disorders known as the Autism Spectrum Disorders (ASDs). Autistic disorder, sometimes called Autism or classical ASD, is the most severe form of ASD, while other conditions along the spectrum include a milder form known as Asperger syndrome, and childhood disintegrative disorder and pervasive developmental disorder not otherwise specified (usually referred to as PDD-NOS).
Although ASD varies significantly in character and severity, it occurs in all ethnic and socioeconomic groups and affects every age group. Males are four times more likely to have an ASD than females.
Autism is characterised by:
• Impaired social interaction
• Problems with verbal and nonverbal communication
• Unusual, repetitive, or severely limited activities and interests
• Most recently, sensory disturbances have also been added as marked symptoms
Autism is a neurobiological disorder. Studies of people with ASD have found irregularities in several regions of the brain. Other studies suggest that people with ASD have abnormal levels of serotonin or other neurotransmitters in the brain.
These abnormalities suggest that ASD could result from the disruption of normal brain development early in fetal development caused by defects in genes that control brain growth and that regulate how brain cells communicate with each other, possibly due to the influence of environmental factors on gene function.
While these findings are intriguing, they are preliminary and require further study. The theory that parental practices are responsible for ASD has long been disproved.
Some of the early markers of autism may be:
• Absence or delay of speech and language (a child should have at least 6 recognisable words at 18 months)
• Repetition of words (echolalia) in place of a normal verbal communication.
• Hand leading to communicate in place of verbal requests.
• Absence of verbal communication.
• Meltdowns & tantrums
• The need for sameness in routine.
Difficulties relating to other children and adults:
• Absence of eye contact. (When directly in front of the child, they may look in every direction, except at the individual in from of them)
• Apparent aloofness
• Lack of interest in other children and what the other children are doing.
• Lack of response to verbal requests.
• No response when their name is called.
• Avoidance of physical contact (even with parents and siblings).
• Indifference to others in distress or pain.
Behaviours:• Self-stimulation, spinning, rocking, hand flapping, etc
• Inappropriate laughter or tantrums for no apparent reason
• Inappropriate attachment to objects
• Obsessive compulsive behaviours i.e. lining up objects
• Repetitive odd play for extended periods of time. Example: stacking blocks for a half hour at a time
• Insistence on routine and sameness
• Difficulty dealing with interruption of routine schedule and change
• Possible self injurious behaviour or aggressive behaviour toward others
Sensory Challenges:• Hyper (over) or Hypo (under) sensitivity of the five senses
• Abnormal responses to the senses
• A lack of response to pain or an overreaction to something seemingly minor such as a door closing
How Is Autism Diagnosed ?
Autism varies widely in its severity and symptoms, and may go unrecognised, especially in mildly affected children and can sometimes be masked by more debilitating handicaps. Doctors rely on a core group of behaviours to alert them to the possibility of a diagnosis of autism.
These Symptoms & Behaviours may be:
• Impaired ability to make friends with peers
• impaired ability to initiate or sustain a conversation with others
• Absence or impairment of imaginative and social play
• Stereotyped, repetitive, or unusual use of language
• Restricted patterns of interest that are abnormal in intensity or focus
• Preoccupation with certain objects or subjects
• Inflexible adherence to specific routines or rituals
Diagnostic teams will often use a questionnaire or other screening instrument to gather information about a child’s development and behaviour. Some screening instruments rely solely on parent observations; others rely on a combination of parent and the diagnostic teams observations. If screening instruments indicate the possibility of autism, a more comprehensive evaluation will be necessary. (DSM 4 or DSM 5)
Autism is a complex disorder. A comprehensive evaluation requires a multidisciplinary team and may include a psychologist, speech therapist, occupational therapist and other professionals who diagnose children with autism. The team members will conduct a thorough neurological assessment and in-depth cognitive and language testing. As hearing difficulties can cause behaviours that could be mistaken for autism, children with delayed speech development should also have their hearing tested.
After a thorough evaluation, the team usually meets with parents to explain the results of the evaluation and present the diagnosis. Children with autistic behaviours but well-developed language skills are often diagnosed with Asperger syndrome, although this is due to be phased out, due to the umbrella term of Autistic Spectrum Disorder coming into use as set out in the DSM 5. (Diagnostic and Statistical Manual of Mental Disorders (DSM) is the standard classification of psychological disorders used by mental health professionals in the United States and worldwide, and contains a listing of diagnostic criteria for every psychiatric disorder recognized by the U.S. healthcare system)
It is important to note that the HSE will only accept multi disciplinary diagnosis, but the Department of Education will accept single Psychologist assessments to access supports within the school system, as long as the psychologist is registered with NEPS (National Educational Psychological Service)
There is no cure for autism but early intervention is vital in the development of the child. Each child or adult with autism is unique and, so, each autism intervention plan should be tailored to address specific needs.
Therapies and behavioural interventions are designed to remedy specific symptoms and can bring about substantial improvement. The ideal treatment plan coordinates therapies and interventions that target the core symptoms of autism: impaired social interaction, problems with verbal and nonverbal communication, and obsessive or repetitive routines and interests.
Typically, different interventions and supports become appropriate as a child develops and acquires social and learning skills. As children with autism enter school, for example, they may benefit from targeted social skills training and specialized approaches to teaching. Adolescents with autism can benefit from transition services that promote a successful maturation into independence and employment opportunities of adulthood.
Developmental Milestones in Children with Autism
While children with autism can reach some developmental milestones at about the same time as other children, they can have delays in other areas. The development of language and social skills presents special problems to children with autism spectrum disorders. Yale School of Medicine points out that the American Academy of Paediatrics recommends screening all children for ASDs at 18 and 24 months, whether or not they’ve reached basic developmental milestones within the timeline typical for children their age.
Although most babies will respond to their names by turning their heads by age 1, children who have an autism spectrum disorder usually don’t. According to the Centres for Disease Control and Prevention, failing to respond to his name could be a red flag that your child has an ASD. Most kids grow keenly curious about the world as they develop, but children with ASDs don’t always seem interested in other people or aware of what is going on around them. They lack social skills and need help learning how to socially interact with others. Children on the autism spectrum may avoid making eye contact, typically prefer to play alone, won’t take turns or share with other children and may have problems understanding how other people feel.
The School of Health Professions at the University of Missouri — Columbia points out that generally children begin saying their first words between 12 and 15 months old. A child who isn’t developing language by this time could have a problem. Once a doctor has ruled out hearing loss or other developmental problems, screening for an autism spectrum disorder is usually the next step in finding the cause for a child’s language delay. Other signs that a child may have a problem communicating include not using nonverbal cues such as gestures and not understanding what words mean.
At a time when other children are learning self-control, a child with an autism spectrum disorder may continue to act without thinking, have temper tantrums or become aggressive. Abnormal emotional responses are another sign. Although some of a child’s behaviours and emotional responses might seem unusual, Helpguide.org points out that an early sign of autism is the lack of normal behaviours. Talk to your baby’s paediatrician if she seems detached or if she resists being held. There may be a problem if your baby fails to respond to the sound of your voice, doesn’t follow people or objects with her eyes or doesn’t look at you or smile back when you smile at her.
Children with autism spectrum disorders often have unusual behaviours and don’t act appropriately for their age. The CDC says that although most children begin to pretend play by the time they are 18 to 24 months old, many autistic kids lack imaginative play skills. Often, children with ASDs display repetitive behaviours, become preoccupied with parts of toys, will only watch certain television programs and videos, or practice obsessive-compulsive, non-functional rituals or routines. Some autistic children imitate sounds, words or phrases they hear other people say, repeating them over and over again. Others engage in self-stimulatory behaviour with repetitive motor movements like spinning in circles, flapping their hands or rocking their bodies back and forth. These can all be signs that a child has autism and should be evaluated by a health professional.
Autism Fact Sheet
What is Autism?
• Autism is a bio-neurological developmental disability that generally appears before the age of 3.
• Autism impacts the normal development of the brain in the areas of social interaction, communication skills, and cognitive function. Individuals with autism typically have difficulties in verbal and non-verbal communication, social interactions, and leisure or play activities.
• Individuals with autism often suffer from numerous co-morbid medical conditions which may include: allergies, asthma, epilepsy, digestive disorders, persistent viral infections, feeding disorders, sensory integration dysfunction, sleeping disorders, and more.
• Autism is diagnosed four times more often in boys than girls. Its prevalence is not affected by race, region, or socio-economic status. Since autism was first diagnosed in the U.S. the incidence has climbed to an alarming one in 68 children in the U.S.
• Autism itself does not affect life expectancy, however research has shown that the mortality risk among individuals with autism is twice as high as the general population, in large part due to drowning and other accidents.
• Currently there is no cure for autism, though with early intervention and treatment, the diverse symptoms related to autism can be greatly improved and in some cases completely overcome.
Autism Facts & Stats
• Autism now affects 1 in 68 children.
• Boys are four times more likely to have autism than girls.
• About 40% of children with autism do not speak. About 25%–30% of children with autism have some words at 12 to 18 months of age and then lose them. Others might speak, but not until later in childhood.
• Autism greatly varies from person to person (no two people with autism are alike).
• The rate of autism has steadily grown over the last twenty years.
• Comorbid conditions often associated with autism include Fragile X, allergies, asthma, epilepsy, bowel disease, gastrointestinal/digestive disorders, persistent viral infections, PANDAS, feeding disorders, anxiety disorder, bipolar disorder, ADHD, Tourette Syndrome, OCD, sensory integration dysfunction, sleeping disorders, immune disorders, autoimmune disorders, and neuroinflammation.
• Autism is the fastest growing developmental disorder in the world.
• For children with autism to progress – early intervention is key.