Autism Awareness: A diagnosis which little of us understand

During the month of April, we celebrated autism awareness. However, autism is a diagnosis which little of us truly understand. It is disease which usually strikes fear and uncertainty into the hearts of parents and loved ones of the children who are diagnosed with it.

As an occupational therapist, I will answer some of the most frequently asked questions with regards to autism.

1. What is autism:

The National Institute of Mental Health describes it is as follows: “Autism spectrum disorder (ASD) is a developmental disorder that affects communication and behaviour. Autism is known as a “spectrum” disorder because there is wide variation in the type and severity of symptoms people experience. ASD occurs in all ethnic, racial, and economic groups. Although ASD can be a lifelong disorder, treatments and services can improve a person’s symptoms and ability to function.”

Alright, so let’s break this description down into more understandable terms.

Starting first with ‘spectrum disorder’. This refers to the fact that no two individuals diagnosed with ASD are the same. Some individuals may have a very mild form of autism, whilst others may present with more severe symptoms.

The next term we need to understand, is ‘developmental delay’. This term refers to the diagnosis is usually made during the first two years of their lifetime. We will discuss this more in the second point.

The last important term is ‘affects communication and behaviour’. This refers to the fact that individuals that have been diagnosed display behaviour not commonly seen in most children, like toe-walking or hand flapping.

2. When should I as a parent be concerned that my child displays signs of autism:

As previously stated, this diagnosis can be anytime during an individual’s lifetime, but the signs are usually present and diagnosis made within the first two years of a child’s lifetime.

Signs and symptoms include:

• The child almost always wants to arrange things in lines when playing with a few toys/objects.
• He/she have a lasting intense interest in certain topics, such as numbers, details, or facts.
• The child gets very upset by slight changes in a routine, and usually struggles to move from one activity to the next.
• They are usually more or less sensitive than other people to sensory input, such as light, noise, clothing, or temperature. They may not want to wear certain clothes due to the texture.
• They may also struggle to keep eye contact with other people.
• They may also present with behavioural signs, like preferring to walk on their toes instead of bearing their weight on all points of their feet, or flapping their hands when they become overstimulated.

3. What are the risk factors that can increase my child’s chances to be diagnosed?

Doctors and scientists are still not sure as to what exactly causes this disease. However, research suggests that it could be a combination of genes that act together with influences from the environment.

Some of the risk factors also include:

• Having a sibling with ASD.
• Having older parents.
• A very low birthweight.

4. Diagnosing:

Doctors usually diagnose ASD, looking at the development and behaviour of the child. There are two stages of diagnosing ASD in young children:

• Stage 1: General development screening should be done when your child needs to go for a check-up or an injection. The healthcare workers (including the speech therapist, occupational therapist and occupational therapy technician) at Parys Hospital does a screening to determine if the child is reaching all of their developmental milestones during the first two years. Children from families with one or some of the abovementioned risk factors, should be closely monitored. If the child is not developing as they should, they will enter the second stage.
• Stage 2: Additional testing with a team of healthcare workers, including a developmental paediatrician, a child psychiatrist and psychologist, a neuropsychologist, occupational therapist and speech and language therapist. The evaluation usually included a cognitive component, language ability and age-appropriate skills.

ASD in adolescents and adults presents differently as with young children, and are difficult to diagnose.

Please note: Due to the changes made in the latest DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) Asperger’s Disease, Autistic Disorder and Pervasive developmental disorder not otherwise specified (PDD-NOS) now all fall under the diagnosis of Autism Spectrum Disorder.

5. Okay, my child has been diagnosed with autism. Now what?

The first step when your child has been diagnosed with ASD, is to get in touch with the correct treatment. Treatment should start as early as possible after the diagnosis has been made.

“Early treatment for ASD is important as proper care can reduce individuals’ difficulties while helping them learn new skills and make the most of their strengths.”

Medication:

Doctors may prescribe medication to address certain issues the child presents with, such as irritability, hyperactivity, repetitive behaviour, attention problems or aggression.

Behavioural, Psychological and Educational Training:

These programs are typically highly structured and intensive and may involve parents, siblings, and other family members. Programs may help people with ASD:

• Learn life-skills necessary to live independently
• Reduce challenging behaviours
• Increase or build upon strengths
• Learn social, communication, and language skills

Other resources:

There are many social services programs and other resources that can help people with ASD. Here are some tips for finding these additional services:

• Find an autism support group. Sharing information and experiences can help individuals with ASD and/or their caregivers learn about treatment options and ASD-related programs.
• Record conversations and meetings with health care providers and teachers. This information helps when it’s time to make decisions about which programs might best meet an individual’s needs.
• Keep copies of doctors’ reports and evaluations. This information may help an individual qualify for special programs.
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