Overview

What is Autistic Spectrum Disorder (ASD)?

Autism is a disorder which affects language skills, communication, social skills and behaviour. It is diagnosed when there is a significant delay in development in each of these areas, with onset in early childhood (prior to three years of age).

Language

Children with autism have difficulties in their use of language. This may mean that they do not develop any functional language, do not use gestures or non-verbal language, or do not understand language used to communicate to them. Some children with autism do develop these skills, but not to the same extent as their peers. Others have particular problems with some skills, for example they may understand a lot of what is said, but have difficulty using language themselves.

Social skills and communication

Children with autism have difficulty in the area of social skills, and are often described as being “in their own world”. Some examples of these difficulties can include not forming relationships with peers, not sharing enjoyment or interests (for example looking at something, but not looking at mum to see if she saw it too), a lack of eye-contact or treating other people as “tools” (for example taking a person’s hand and pushing it towards the door handle when they want the door opened).

Behaviour

Individuals with autism tend to engage in ritualistic or stereotyped behaviours. This can range from rocking, hand flapping or toe walking to having a “specialist subject” – one area of interest that they concentrate on to the exclusion of others. Children with autism often do not know how to play and instead spend a lot of time preoccupied with parts of objects (for example they may turn over a toy car and spin the wheels rather than run it along the ground). Children with autism will all have difficulties in each of these areas, but the level of difficulties they have will vary from child to child and therefore one of the most striking things about a group of individuals with autism is their differences.

How and when does autism occur?

Autism is a biological/neurological disorder, but exactly what neurological differences there are is not known. The etiology (cause) of the disorder is not known, but there are many theories currently being researched and many more emerging. What we do know is that it is a biological (not psychiatric) disorder, and that there is a genetic component to autism, though this does not fully account for the development of the disorder. It is much more common in boys than girls (ratios ranging from 4:1 to 8:1 appear in the literature). Although diagnosis usually occurs at about three or four years of age, parents often report that their concerns start at about eighteen months of age, around the time that social, language and complex play skills typically develop.

Autism across a spectrum

Autism is described as a spectrum disorder. The spectrum is often represented as going from Classic Kanner’s Autism to Asperger’s Syndrome. A child with Classic Kanner’s Syndrome would have very few social skills, would prefer to be alone, and spend most of their time engaged in stereotyped or “self-stimulatory” behaviour such as rocking or twirling a piece of string in front of their eyes. They would have little understanding or production of language, and would probably score within the moderate to severely intellectually disabled range on standardised IQ tests.

A child with Asperger’s Syndrome would not have a significant delay in language skills, and would score within the normal or above normal range on standardised IQ tests. They would however have difficulty with social skills, for example understanding tone of voice or other people’s emotions. They would engage in some stereotyped behaviour, usually a “special interest” in a specific area, for example they may only want to talk about trains and engine models. As with any spectrum, there are an infinite number of points between these two extremes.

Treatment of autism

Autism is treated through education. There are a large number of educational approaches used to teach children with autism, the most common being traditional special education settings, TEACCH (Treatment and Education of Autistic and related Communication handicapped Children) and ABA (Applied Behaviour Analysis). In addition some therapies are used to augment or sometimes as alternatives to education, the most common being Speech and Language Therapy and Occupational Therapy. Physiotherapy, Music and Art Therapy as well as many others can also be used to treat autism.