Autism spectrum disorder

Autism spectrum disorder

What is Autism spectrum disorder?

People with autism spectrum disorder find it hard to relate to others socially and have problems with communication and behaviour. A lifelong disorder, it is often diagnosed in childhood.

Some people with autism spectrum disorder, or ASD, are unable to speak or function in society, and may need life-long care. However others are articulate, able to function well and can lead normal lives and live independently. People with autism can often find improvements in their lives with a range of therapies, especially if therapy starts early in life.

Symptoms

Everybody with ASD is different. But everybody with ASD has elements of three things in common. They:

  • have difficulties relating to people – for example, they don’t like making eye contact, or find it hard to understand body language, or don’t easily understand other people’s emotions, or avoid physical contact
  • have areas of intense interest – such as a certain colour, or aeroplanes, or numbers
  • have repetitive behaviours – such as rocking, or twitching, or repeating certain words or phrases.

Some people with ASD have poor verbal skills or delayed speech. Some have difficulty playing imaginary or creative games. Some are upset by things such as crowds, loud noises and bright lights. Some seem to be indifferent to pain. Some sniff, taste or touch toys or objects excessively. Some stick inflexibly to routines or ritualised behaviour.

Many people with ASD have some intellectual disability, while many others don’t.

Most parents of a child with ASD notice the symptoms when their child is between one and three. Sometimes, parents pick problems up earlier.

Types & Severity

ASD describes a cluster of symptoms. There is no fixed ‘syndrome’, and no two people with ASD are identical. It is very important to treat people with ASD as individuals, and to examine and explore what they can do, and what they are capable of learning.

Some people with ASD find it difficult to speak at all, have few social interactions, and become very distressed at change. They find independent life too difficult and need lifelong care.

On the other hand, many people with ASD are only mildly affected, and can lead independent lives and function well in society.

Until recently, ASD was seen as three separate (or near separate) conditions:

  • Asperger’s syndrome, where the person affected has normal intelligence but finds difficulty with social interaction. They may have restricted but intense interests, and show little empathy for others.
  • Autistic disorder, where the person affected has serious difficulties with speaking, thinking, emotions and repetitive behaviour.
  • Pervasive developmental disorder not otherwise specified (PDD-NOS), where the person affected has some symptoms of autism but not all the signs and symptoms of autistic disorder.

Some people who were previously diagnosed with these conditions might prefer to stick to these names. But all these ‘conditions’ now fall under the umbrella term ASD.

Some people with ASD also have other medical or psychiatric conditions, such as anxiety, depression, epilepsy, depression, ADHD, immune disorders or Fragile X syndrome. This increases the importance of the person with ASD having a team caring for them that they and their families and carers can talk to.

Causes

There is no single known cause of autism. It is likely that something goes wrong with the way the baby’s brain develops. But why?

Genetics probably plays a part. ASD tends to run in families, so there might be a combination of genes that causes problems. Also, older parents are more likely than others to have children with ASD, which might be because older parents are more likely than others to have damaged genes.

The environment also probably plays a part. Some people with ASD were exposed to toxic chemicals such as pesticides before birth or in early childhood. And if a woman develops an infection while pregnant, that might affect the development of her baby’s brain.

But it is never possible to say: ‘this person’s ASD was caused by that’. And it is clear that autism is not caused by vaccinations, and it is not caused by how parents raise their child.

Diagnosis

Most people caring for someone with ASD say it takes a long time to get a diagnosis. That is partly because there is no specific test for ASD, and partly because no doctor wants to wrongly label someone with ASD, so they tend to take their time before committing. Some parents and carers also found that their concerns weren’t taken seriously.

If it is thought that someone you care might have ASD, they should be referred to a specialist like a paediatrician, a neurologist or a child or adult psychiatrist for assessment and diagnosis. Note that in some other states, it needs more than one specialist to confirm a diagnosis. The doctor/s will talk to you and the person you care for, examine them, and look at their behaviour and development. They might also arrange other tests such as:

  • hearing tests
  • vision tests
  • neurological tests.

 

Treatment and therapy

While there is no cure for autism, therapies and treatments can lead to great improvement. For children, therapy should start as soon as possible, while your child’s brain is developing rapidly.

 

Early childhood intervention programs

Early childhood intervention programs can help children with ASD reach their full potential. The interventions teach them new skills, help them to improve behaviour and function better in the family, community and later at school.

Your child should have an individual plan developed to fit their needs. The plan is usually developed by health professionals involved in their treatment, by you, and preferably by their school or preschool. Your child should be cared for by a multidisciplinary team that might include a:

  • speech pathologist to help your child to speak and understand facial expressions
  • occupational therapist
  • early special educator
  • conductive educator to help your child with daily living skills
  • psychologist.

Exactly what’s in the early intervention programs will depend on the needs of your child, where you live and what services are available. Individual sessions might take place in your home or at a clinic or hospital. You will also be supported and coached to do a lot of things to help your child at home.

 

Therapies for adults with ASD

There are many many therapies capable of helping adults with ASD. They include therapies to help with:

  • behaviour and development
  • education
  • finding and keeping work
  • dietary supplements.

Some people will benefit from a wide range of technologies to help with communication, mobility and many of the tasks of daily life.

 

Medication

Some people with ASD benefit from prescribed medication for particular problems such as hyperactivity, anxiety, or obsessive or aggressive behaviour. Some might also need medication for other conditions, such as epilepsy.

You should find out the benefits, risks and side effects of taking particular medications before starting.

Living with Autism spectrum disorder

If the person you care for has just been diagnosed with ASD, you might be feeling shock, denial, anger, guilt, sadness and more. It might also be a relief to finally get a diagnosis, so you have something firm to hold on to.  

It can helpful to find out as much as possible about ASD from your doctor, from reliable websites such as Raising Children Network and from organisations such as Autism Awareness Australia. Because there are lots of myths about autism, you should be wary of claims of miracle cures and diets. Keep in touch with your doctors, and talk to them before making any radical changes.

It can also help to get support. You might be able to get the support you need from your partner, your family and your friends, but you can also look for support from a professional such as a psychologist, counsellor or social worker.

Children with ASD face extra hurdles with learning, with more than half needing special tuition or help from a disability support person or counsellor at school. They might find higher education too difficult, and can find it hard to get a job. There are new computer-aided technologies that might aid learning. Organisations such as Cerebral Palsy Australia can provide vocational and career services that can help.

Courses such as the Program for Education and Enrichment of Social Skills (PEERS) can help teenagers and young adults with ASD learn social skills and learn how to make and keep friends.

People with ASD might qualify for a package of services through the National Disability Insurance Scheme. For children, this package can include subsidies for early childhood intervention services and programs such as PEERS.

In places where the NDIS has not yet been rolled out, you might be able to get assistance through the Australian Government’s Helping Children with Autism and Better Start for Children with a Disability programs.

 

Sources

Raising Children Network (Autism spectrum disorder, how Autism spectrum disorder is diagnosed, conditions that can occur with Autism spectrum disorder) Healthdirect (Autism) Brain Foundation (disorders, Autism) The Royal Children’s Hospital Melbourne (Autism Spectrum Disorder).

Last updated November 2017

The National Disability Insurance Agency (NDIA) is taking steps towards refining certain aspects of the National Disability Insurance Scheme (NDIS) following a report on NDIS costs.


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