What is Autism?
- A neurodevelopmental disorder – i.e. differences in the way the nervous system functions that results in developmental delays.
- A spectrum disorder – from high functioning (low support) to low functioning (high support). There is wide variation in challenges and in strengths.
Facts and Figures:
These figures are from the Centres for Disease Control and Prevention (2014):
- 1 in every 68 children is affected by Autism Spectrum Disorders.
- It occurs in all racial, ethnic and socioeconomic groups.
- It is 4.5 times more common in boys (1 in 42) than in girls (1 in 189).
- In 2000 the statistics were that it occurs in 1 in every 150 children, thus the incidences are increasing.
Autism Spectrum Disorders are characterised by:
The current criteria in the latest edition of the Diagnostic and Statistical Manual (DSM-V) are:
- Persistent deficits in social communication and social interaction.
- Restrictive or repetitive behaviours, interests or activities.
- Symptoms are present in the early developmental period.
- Symptoms cause clinically significant impairment in social, occupational or other important areas of current functioning.
Deficits in social communication and social interaction:
- Delayed language development (and some children remain non-verbal).
- Inappropriate use of language e.g. using language in the correct context, staying on topic and adjusting speech to fit in with different people or situations.
- A lack of communication reciprocity e.g. making eye-contact, smiling back at caregivers, initiation of interaction, turn-taking, engaging in back and forth conversation.
- Limited use of gestures e.g. waving or pointing.
- Limited understanding of non-verbal communication e.g. judging facial expressions, body language or tone of voice.
- Difficulty with developing, maintaining and understanding relationships e.g. showing an interest in peers, initiating interaction, making and keeping friends, engaging in imaginary play, understanding humour etc.
Restricted and Repetitive behaviours / interests:
- Repetitive motor movements or speech may be present e.g. lining up toys, arranging numbers in order, spinning wheels to watch them, echolalia in speech.
- Restricted and fixated interests that are present with increased intensity e.g. knowing all the facts about a particular field of interest such as dinosaurs.
- An inability to cope with changes and difficulty with transitioning between tasks and environments.
- Rigid thinking patterns.
- Rigid rituals e.g. with greetings/ hygiene rituals or things like taking the same route to school or eating off the same plate each night.
- Hyper- or hypo- sensitivity to sensory input e.g. a decreased awareness of temperature and pain; aversion to certain sounds or textures; an increased need for certain input e.g. spinning/ rocking/ jumping; and a fascination with certain input e.g. movement of wheels or fans.
How is Autism diagnosed?
- By paediatricians, paediatric neurologists, psychiatrists and psychologists.
- They use the criteria given by the DSM – V (as discussed above).
- They may use checklists and observations.
- There is also a screening tool used by some clinicians – the ADOS (The Autism Diagnostic Observation Schedule). This measures things like communication, social interaction and play.
Interventions for Autism:
- Early intervention is key!! Therefore, early diagnosis is so important.
- Being in the correct educational environment with adequate support for skill level.
- Speech and Language Therapy: to address language and communication difficulties.
- Occupational Therapy: to address self-regulation, sensory integration, motor planning and motor skill deficits.
- Floor time DIR (Developmental Individual-difference Relationship-based model): to improve intentional communication, interaction and learning through following the child’s lead and meeting them at their level.
- Applied Behaviour Analysis (ABA): the study of behaviour and use of principles of learning and behaviour (e.g. using reinforcers) to decrease or increase certain behaviours.
- Medication: often used for calming or for enhancing concentration.
- Equine therapy: a horse-riding based therapy to provide vestibular and proprioceptive input and help the child to engage with another living creature.
- Therapy dogs: the dogs act as social catalysts.
Written by Tamaryn Hunter – BSc (Occupational Therapy – Occupational Therapist)