Autism Spectrum Disorder
What is Autism?
Autism is a developmental disorder that’s caused by differences in the brain. Autism Spectrum Disorder affects how a person interacts with others and how they make sense of the world.
Understanding the signs of Autism: The Dyad:
Difficulties with Social Communication and Interaction
Children with Autism find it very difficult to understand read social cues, non-verbal communication and facial expressions. These difficulties can make the world a very difficult place to make sense of, which can result in children with Autism feeling overwhelmed. Children with Autism also find it difficult to understand and take on other people’s perspective. However, the ability to read facial expressions and social cues can be taught, as can coping skills via intervention.
Spotting the signs of social communication and social interaction difficulties which may be indicative of Autism:
The following may be indicative of social communication difficulties
- Difficulties making and retaining friends
- Displaying affection to others but only on own terms
- Reduced motivation to please others or a reduced response to praise
- Unusual social interactions with others for example; being forceful, overfriendly or reduced awareness of others availability to interact
- Reduced or no understanding of social norms or rules
- Being ‘too intense’ or passive in friendships
A reduced desire to communicate may be present…
- A reduced desire to interact with others or only interacting on their own terms
- Poor use of gesture and non-verbal communication e.g. no use of gestures or inappropriate / exaggerated gestures
- Flat or exaggerated facial expressions
- Good use of language but difficulties sustaining or engaging in a conversation that goes beyond their interest or a question-answer exchange
- Language is repetitive or formal
- Literal understanding of language
Difficulties with communication may present also as…
- Confusion of personal pronouns
- Inappropriately echoing phrases heard from others or on the TV
- Usual speech for example; rate, intonation and / or accent
- Unusual ways of describing things
- A tendency to talk about own interests at length
Rigidity of thinking / Repetitive Behaviours / Restricted Interests:
Reduced social imagination:
One of the first signs of social imagination is the ability to engage in pretend play. This can be an area of difficulty for children with Autism. They may develop the skill later than expected or not at all. Some children with Autism can engage in pretend play but struggle to involve others in such play or the range and variety can be limited.
Difficulties with social communication also make it difficult to predicts others behaviour and to imagine situations outside of daily routines. When you have challenges in these areas then the world can feel very unpredictable. This can lead to the emergence of strict routines to help reduce uncertainty. Changes in routine can cause lots of upset as a result.
- Reduced pretend play
- Reduced ability to take on other people ideas in play
- A focus on rules
- Difficulty recalling experiences
- Reduced ability to use past experiences to predict future events
- Reduced imitation
Repetitive behaviours and interests
Some children with Autism also engage in repetitive behaviours and these can be very obvious or subtle. Rather than playing with objects functionally or imaginatively the following can be features of play
- Lining up toys
- Gathering toys
- Setting up scenes but not developing a sequence
- Carrying toys
- Intense interests which preoccupy children
- Restricted range of interests
- Reduced ability to use figures as people in play
Body movements which are repetitive
- Hand flappy
- Licking wrists or fingers
Sensory aversions or interests
- Peering at items for a long time
- Rubbing services
- Smelling objects inappropriately
- A fear of hand dryers
- Resistance to brush teeth
- Chewing non-edible items
- High Pain Threshold
How is Autism Diagnosed?
The Diagnostic and Statistical Manual for Mental Disorders (DSM5) is used when making a diagnosis of Autism. Previously, in DSM4 there were a number of different subtypes of Autism which came under the umbrella “Autism Spectrum Disorder” including; Asperger Syndrome and Pervasive Developmental Disorder. However, within the DSM5 all are now diagnosed with the term ‘Autism Spectrum Disorder’.
An Autism assessment typically consists of; a parent interview, the administration or the Autism Diagnostic Interview – Revised (ADIR) and the Autism Diagnostic Observational Schedule (ADOS2). The psychologist will also link in with the preschool or school placement. Typically, the assessment takes approx. three weeks to complete and a fully comprehensive report is always provided. The report is accepted by the Department of Education and the HSE to access services.