Understanding Childhood Autism
Autism Spectrum Disorder (ASD)
As the name suggests is a spectrum of disorders which includes multiple symptoms. The severity and type of symptoms along the spectrum are used to determine the type of disorder. The different diagnoses include:
- Asperger syndrome
- Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS).
In order to understand the key signs and symptoms of ASD it is helpful to divide them into three core groups of symptoms, these are known as the triad of ASD. The ‘Triad’ is composed of:
- Social communication
- Social skills
These symptoms are in essence, a way of the child’s functioning in all situations and depending upon how a child reacts or behaves in any particular situation they will fall in the spectrum of ASD. Contrary to popular belief, there are no physical characteristics that differentiate those with ASD from those that don’t. The difference lies in how they may communicate, interact, behave, and learn in ways that differ from most other children.
Diagnosis of Autism
For a diagnosis of Autism a child must have a specified number of symptoms in all three areas (detailed below). In Asperger Syndrome there is no general delay in language or in cognitive development. Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) will have symptoms in more than one area but do not fulfil the diagnostic criteria for Autism or Asperger Syndrome. It is important to keep in mind that some of these symptoms could be present in all populations but for people with ASD, these become severe enough both in intensity and frequency to make activities of daily living difficult and challenging. In a very small proportion these may lead to self-injury and/or aggression.
Core groups of symptoms are:
1. Social Communication
- Children with an ASD have communication difficulties. This includes spoken language as well as using and understanding gestures, body language, or tone of voice. They find it hard to develop ways to communicate with other children of the same age group. They might use language in unusual ways. They have trouble putting words into real sentences. Some say only one word at a time or repeat the same words or phrases over and over. Some may repeat what others say (echolalia). Their voices might sound flat, high-pitched, and/or robot-like. They may not respond to you when you speak to them or make eye contact. They will have a very literal sense of language and won’t be able to understand jokes or sarcasm. In Asperger Syndrome language and cognitive ability develops in accordance with similar age groups.
2. Social Skills
Difficulties with social skills are common symptom in all types of ASD. These are significantly much more than just shyness. Severity of these symptoms again depends upon where they are at on the spectrum. Some may not have any interest in interaction; others desire contact but struggle to reciprocate social interaction or may make inept or awkward attempts to reciprocate. Children with ASD often find it hard to recognise or understand what other people are feeling and may have trouble expressing their own feelings. They may be very sensitive to being touched and might not want to be held or cuddled. They prefer to spend time on their own and are often referred as ‘loners’. They find it difficult to accept simple social cues or rules and can be mistaken as ‘uninterested’ and behaving strangely because they may not able to respond in socially acceptable way. They find it difficult to empathise with other children.
3. Behaviour and Interests
Children with an ASD have unusual interests and behaviours. One of the things linked to these is that they lack imaginative or pretend play. They may find it difficult to see the world from other children’s point of view and to some extent predicting what someone might do. This in turn leads to developing strict routines to be sure of their own activities. They may become distressed if these routines aren’t followed or impose those routines on other people. They are resistant to change in any form and change has to be done gradually. Their interests are limited and restricted in focus or activity and derive pleasure from limited resource. They are more interested in repetitive behaviour and self-stimulatory behaviours (e.g., flapping arms over and over).
4. Other Symptoms
Apart from the core group of symptoms of autism some children with ASD are sensitive to other sensory stimuli’s like certain sounds, sights, tastes and textures. Depending upon the sensitivity they may show different symptoms.