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Expert: What Is Autism Spectrum Disorder?

Expert: What Is Autism Spectrum Disorder?

Autism is a lifelong neuro-developmental disability, that affects how the brain develops areas linked to social interaction, and communication.  People with Autism have difficulty communicating, and forming relationships with people; in developing language, and in using abstract concepts.  It also impacts on their ability to make sense of the world around them.

Autism is described as a ‘Spectrum Disorder’. This means that the symptoms and characteristics of Autism can present themselves in a huge variety of combinations, ranging from mild to severe. Two people with the same diagnosis can act very differently, and have varying skills.

How many people in Ireland have autism?

The official figure is that approximately 1 in 100 people in Ireland, have Autism. This figure is similar to the incidence in the United Kingdom, where the latest studies indicate that 1.1% of the population may have autism.

Although it is widely maintained that an increase in incidence can be attributed to better diagnostic procedures, it is apparent that the condition itself is reaching epidemic proportions worldwide. With an increasing number of young children coming into the system each year; the Autism community is swiftly growing; which is causing higher demand for support services in Ireland.

How early can a child be diagnosed?

Autism Spectrum Disorder is generally diagnosed from the age of 2 ½; because some of the emerging skills that the assessment team are looking for, won’t be apparent in a typically developing child before this.

Research shows that intervening before age 3 has a bigger impact than waiting until the child is over 5; so if you suspect your child might have autism, talk to your GP or the Child Development Team at your local health centre about getting a referral. If necessary, you may first be referred to a hearing specialist; to rule out other language and communication disorders, including deafness. If you’re concerned about a lack of emerging skills in your little one; there is a Checklist for Autism in Toddlers (CHAT) tool that you can use, to indicate if your child may have a social-communication disorder.

After assessment, you will receive a diagnostic report, listing recommendations for therapies, and for educational support. With this information you’ll be able to refer your child to the relevant services, and apply for Special Educational Needs (SEN) support, and any state benefits your family may qualify for. Be aware, unfortunately there are long waiting lists for some services for those on the autistic spectrum.

What Causes of Autism Spectrum Disorder?

What causes Autism is still largely a mystery. The disorder has such a wide range of features and behaviours, controlled by different areas of the brain; that finding out about the causes of Autism is an ongoing process. Genes have different effects on different parts of the brain in terms of behavior and thinking; so even when researchers discover the effect that Autism has on one brain region, there are still many more to be discovered. Research is also continuing to investigate when exactly autism strikes; as it is not yet known if children are born with it, or if it's a disability that develops later.

Autism is often referred to as a ‘hidden’ disability, because people on the autistic spectrum show no significant physical difference to their peers. Instead, it is their behaviour, and how they relate to others, that marks them out as different. 

The 3 main areas of difficulty for people with autism are referred to as the ‘triad of impairments’:

Social communication  

People with Autism may have difficulty with both verbal and non-verbal language. Many have a very literal understanding of language; and may experience difficulty with interpreting:

  • Facial expressions or tone of voice
  • Gestures
  • Jokes and sarcasm

Some people with autism may have limited speech, or be completely non-verbal. They could also prefer alternative communication techniques, such as sign language or visual symbols, instead. However, others will have good communication skills, but find it difficult to understand the social etiquette of conversation, such as turn-taking; and they may take time to process information. If this is the case, make sure you speak in clear, consistent manner; avoiding metaphors or sayings which could be taken literally.

Social interaction 

People with autism generally exhibit severe difficulties with socialisation. They are often unable to identify, express or understand emotions, which can make interaction and 'fitting in' difficult. Typical social behaviours of a person with autism may include:

  • Difficulty with understanding unwritten social rules; such as appropriate distance to stand at, and socially accepted topics of conversation.
  • Appearing insensitive, by being unable to detect how someone else is feeling.
  • Preferring to be alone, rather than seek out the company of other people.
  • Inability to seek comfort from others.
  • Displaying traits of low self-esteem.
  • Inability to express feelings, emotions or needs, which may result in inappropriate actions.
  • Being unintentionally aggressive in an attempt to be social.

Social imagination 

Social imagination allows us to understand and predict the behaviour of other people. It also helps us understand abstract ideas, or situations outside our immediate daily routine. People with autism often favour predictability; and prefer to follow a strict routine. Those who experience challenges with social imagination may find it difficult to:

  • Determine and interpret other people's thoughts, feelings and actions.
  • Identify hazards.
  • Engage in imaginative play and activities.  Children with autism may enjoy some imaginative play but have a strong preference to act out familiar scenes
  • Prepare for change and plan for the future.
  • Cope in unfamiliar situations, which may result in the person becoming stressed.
  • Appreciate other people may not be interested in their topic of interest which they talk obsessively about.

Difficulties with social imagination should not be mistaken for a lack of imagination. Many people with Autism are very creative, and go on to become accomplished artists, musicians or writers.

There is also a fourth area which has been identified as presenting people with autism with significant difficulties: Sensory processing. This involves either an over or under sensitivity to light, sound, smell, or touch; so areas like shopping centres which are filled with many different noises and lots of people, can be particularly overwhelming. Some shopping centres and supermarkets are now introducing 'quiet hours', and Shannon airport has created a Sensory Room. Hopefully many more will follow 

Options For Treatment

While there is no cure for Autism, there are many behavioural therapies that can significantly improve an autistic child’s symptoms, ability to learn, and overall quality of life.

Social and Communicative issues can be addressed with the following therapies:

  • Applied Behavioral Analysis (ABA) is a structured approach designed to teach appropriate behaviours, while helping autistic children to discontinue undesirable behaviours.

  • Speech-language interventions can be a huge help for those struggling with communication; helping children with autism to communicate more effectively, and learn to understand the subtle points of social interaction.

  • Occupational therapy helps autistic children to learn necessary tasks they do at home and at school; such as how to get dressed, use scissors, and write clearly.

  • Physical therapy works with children to develop strength, balance, posture, and coordination.

Autistic Children in the School System

Children with Autism face many challenges at school, but the goal of therapy inside and outside the classroom is to help them be as successful as they can be. Though those requiring more intense therapies may thrive best in a specialist school; integrating Autistic children with normally developing children is very helpful to their development, if teachers and peers are provided with some guidance as well. To that end, public schools are required to provide assistance to autistic children. To assist this, a team of professionals, including the parents, educators, and therapists; will develop an Individual Education Plan (IEP) which specifies what modifications and interventions are needed during the school day.

Medication for Children With Autism

Though there is no medication currently available to treat autism itself; medication may be used to treat specific symptoms, such as hyperactivity, sleep disruption, or gastrointestinal discomfort.

The decision on which medications (if any) are appropriate, is dependent on the autistic child’s symptoms. It may take some time to find the right combination of therapies and medications for each autistic child; but there is hope that with treatment, all children with autism can get the support needed to better navigate their world.

What can you do as a parent?

If your child is receiving behavioural and communication therapies, find out what you can do at home to help support these new skills. Children with autism have trouble with communication; but allowing them to communicate in a visual way may help; using traffic light symbols, number scales, and pictures; to help them articulate their feelings.

Be aware that an autistic child may need to be taught social skills that other children pick up on their own. If they have difficulty understanding emotion, it can be useful to describe things physically or visually: e.g Feeling a weight in the chest when sad, furrowed brows when angry, and smiling when happy.

Caring for a child with autism can be overwhelming, so as well as supporting your child, make sure you are getting the right support too; by finding a support group, talking to family and friends, and using the resources available from charities like Irish Autism Action, and the Irish Society for Autism.

If you feel that your child may have Autism Spectrum Disorder, or has recently been diagnosed; the Irish Society for Autism, and Irish Autism Action provide lots of useful information; and details of recommended therapies, and local support groups. 

This article is part of a series looking at different conditions which affect children and families; getting expert advice on how to spot the signs, and manage symptoms. There are plenty more available in our child health section; but for now check out Expert: Asperger Syndrome, And How To Recognise The Signs.

About the Author

eumom team 

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