Autism Spectrum Disorder

Introduction

Child development is a crucial period, due to certain reasons there occur many developmental delays in children. Sometimes this delay can take the form of Autism Spectrum Disorder. Being parent knowing that your child has autism or s/he is on spectrum can be an overwhelming experience. This booklet is aimed at providing helpful guidelines that will helps you in working with autism either you are a parent of a child with autism or a professional.

These guidelines will help you

  • understand what autism is
  • impact of autism
  • discover ways to support your child

Autism Spectrum Disorder

Autism is a neurobiological developmental disorder that affect brain processing and affects individuals social skills, communication, interest and behavior. Children with ASD have difficulties in 4 main areas

  1. impairment in social skills, /socialization
  2. language and communication skills,
  3. play,
  4. Restricted, repetitive, and stereotypical behaviors.

Level of difficulty in these areas can be of mild to severe degree. Autism is usually referred to as spectrum due to broad diversity in its symptoms. Moreover two children diagnosed with the same condition may express different nature of symptoms, skills and ability, intellectual functioning and behavior. Being considered as spectrum individuals with autism can be low functioning requiring high level of support and high functioning requiring less support.  ASD usually appears early in life, often before the age of three.

Core Symptoms

Core symptoms of autism are divided in to two broad categories according to DSM-V which include unhealthy social communication, problems in social interaction and expression of repetitive and stereotypical patterns of behavior. These symptoms must be present across multiple contexts. Further detail of symptoms is as follows,

Impairment in Socialization

Children with autism will face difficulty in giving and maintaining eye contact. They may use gestures or facial expression instead of verbal communication. Children with autism have difficulty understanding the emotions and feelings of others and inability to relate with others. They have limited social interest and usually prefers to be alone and had difficulty in playing with peers hence unable to make friends. They may show less sharing of interests with others. Small transitions can be very difficult for children with autism, and they prefer same routines on daily basis. Difficulty in understanding social ‘rules’ ‘cues’, behavior and relationships in social setting is quite common among autism. Children on spectrum are more object oriented than people. They are more adult orientated than peer orientated. They don’t want to be comforted in distress.

Impairment in Social Communication

Most of the kids on spectrum are non-verbal, there speech and language milestones are delayed. In some children they will develop language on appropriate time but they may become mute or regress in there speech usually between the age of 2 to 2½ years. Some children are may be verbal but there use of verbal language will be limited.  They may not be eager to communicate and have difficulty making conversations. Sometimes children have unusual speech patterns like repeating words, sentences, may use unfamiliar words. Imitation skills and pretend play lacks in autism. They often use words out of context and without trying to communicate. Forth and back communication is usually missing in children with autism.

Repetitive Behavior/ Restricted Interests

Repetitive behaviors are very common among asd children like they may have body rocking, spinning of objects or may spin themselves, hand flapping, flicks fingers, jumping etc. Their interest are uncommon, strong and limited like they want to talk about same topic or activity even for longer time. Asd kids usually focus on some part of toy rather than playing the toy as a whole e.g. they might spin wheels of a car.

Sensory Difficulties

Sensory difficulties are much common in autism. Most of the behaviours shown by children with autism are usually result of their sensory processing problems. Sensitivity could be more or less to sights, sounds, touch, smells and tastes than others. Visual sensory difficulties includes staring at lights, blinking, gazing at fingers, lining up objects, moving objects in front of the eyes, looking at minute particles, picking up smallest pieces of dust, fascination with reflections and brightly coloured objects. Auditory problems includes tapping fingers, snapping fingers, grunting, humming, covers ears, makes loud rhythmic noises. Olfactory (Smell) difficulties include smelling objects, sniffing people etc. Gustatory difficulties are licking objects and placing objects in mouth, holding water or food in mouth. Tactile problems are scratching, clapping, feeling objects, nail biting, hair twisting, toe-walking, resists touch Likes pressure, tight clothes

Vestibular issues include rocking, spinning, jumping, pacing and Proprioceptive issues include teeth grinding, pacing and jumping

Emotional Difficulties

Children might face anxiety, depression, anger, mood swings and stress due to environmental stimuli. Frustration due to increased amount of verbal instruction, excessive noise, or a change in routine also affects these children. Children may become withdrawn and resisting any interaction with others thus having distress. These children often exhibit anxious and irritable mood in social situations as they experience difficulty in understanding their social surroundings and societal norms and rules which they are supposed to follow, meeting unknown people, having problem explaining needs and emotions in words, problem in choosing out of too many options etc which often lead to emotional breakdown and they show temper tantrums out of their severe frustration.

Motor Problems

Motor issues include milestone delays. These children may experience difficulty in gross and fine motor skills leading to difficulties in holding things such as spoon, pencil etc., getting dressed independently, brushing teeth, tying shoes laces, running and riding.

 

Early Indicators of Autism

There are certain signs that are indicators of early onset of autism in children. Parents should keenly observe their children and if they notice any sign they should get professional guidance. Early signs include absence of social smile and sharing of emotional experience of joy till the age of 6 months, no response on sounds, name and lack of facial expressions by the age of 9 months, delayed speech and language milestones, absence or lack of eye contact, less or inappropriate use of non-verbal gestures like pointing, waving etc.  Repetitive movements of body (like hand flapping, body rocking etc.) and with objects (lining up objects, spinning the wheels etc.), at the age of 2-3 years. Loss of acquired skills like of language and socialization

What cause autism

Till to date no single cause of autism is known. There is a great agreement of researchers that autism is caused by both genetic and environmental factors.

 

Management Strategies for Autism

There is a wide variety of intervention techniques available for autism. There is no single intervention that can be applied to each every child. Every intervention technique has its own pros and cones. Best management practice is to use eclectic or multi method approach as this approach provides flexibility in management and it can be tailored to meet child’s individual needs. A team of professional should work with ASD child which includes, special educationist, psychologist, speech therapist, occupational/sensory therapist, music therapist, self-care trainer etc.

  • Functional behavior assessment may helps in understanding purpose of any behavior that it may be serving. This will help in understanding behavior and then developing strategies for behavior management.
  • Use discrete trail training while working with your child. It involves a direction, behavior, and consequence. Direction will be instruction on part of parent or any care giver, behavior is the desired response on part of child and consequences meant reinforcement provided that will strengthen behavior.
  • Occupational therapy will help in teaching activities of daily living.
  • Sensory therapy will regulate sensory integration.
  • While changing the routine of children or introducing new activity/person to the child, keep the mood and anxiety of the child under consideration
  • It is always helpful to keep a record or baseline of your child’s behavior including trigger, behavioral response and the consequences to identify the problematic situations for the child and deal with them accordingly.
  • You should have an established and consistent routine for your child.
  • Avoid changing the routine unless necessary. In case of change, discuss it with your child beforehand.
  • Give one instruction at a time so the child may have time to understand each instruction accordingly and process information easily.
  • Prefer soft toys for your child as they may help in reducing stress.
  • Identify a distraction free place which the child is familiar with to provide a safe area where he can always go to and spend time whenever he feels nervous or irritable.
  • It is important to teach children the importance or social rules. Visual prompts are the best to teach children with autism about practicing the societal rules and norms.
  • Patience and tolerance are the biggest virtue of parents while dealing with children experiencing autism
  • Reinforcing children for desirable behavior is very important.
  • Observe and record y=the sensory issue that your child might have. The more understanding regarding sensory issues you have, the better you will be able to deal with the child. Try to avoid those sensory triggers.
  • The sensory overload is problematic for the child. The child may have difficulty using more than one sense at the same time. He may not listen to you or look at you at the same time. Minimize the distractions that directly affect senses such as loud noises, rush areas etc.
  • While talking to them, you need to be focused on the child to get the child’s focus too. Say their name before beginning your sentence. Attend to your child as he follows through your instructions.
  • Your instructions should be clear and in short sentences. Be calm while talking to the child.
  • Use concrete language and avoid metaphors unless you are sure that your child understands the meaning of the metaphors you are using.
  • Always ask your child what he understood after you have given your instructions. He may not have comprehended all of your commands and may have lost his attention in between. Always clarify before starting to practically follow the instructions.

 

Who should be consulted?

If you see any red flag in your toddler/child do consult child pediatrician, get him or her screened for autism via expert team of professionals including psychologist, speech therapist, sensory and occupational therapist.

 

 

Hope for Parents

Getting a diagnosis of autism doesn’t mean that your child lakes skills instead children with autism can have certain skills as their strength in comparison with other children like children with autism have singular and detail focus and can concentrate for longer time on a single activity. Children with autism have limitless potentials which are hidden. It depends upon us how we tackle them and provide them opportunities for utilizing their potentials.

Donate