What is Autism?
Autism is a developmental disorder that’s caused by differences in the brain. It affects how a person interacts with others and how they make sense of the world.
The Dyad: Understanding the signs of Autism:
1. Difficulties with Social Communication and Interaction:
Commonly, 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 may 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 with the help of intervention.
Spotting the signs of social communication and social interaction difficulties which may be indicative of Autism:
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
The following may be indicative of social communication difficulties
- 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
- 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
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
The Dyad; Understanding the signs of Autism Spectrum Disorder
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. Children with autism 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. The range and variety of pretend play can also be limited.
Difficulties with social communication 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.
- Difficulty recalling experiences
- Reduced ability to use past experiences to predict future events
- Reduced imitation
- Reduced pretend play
- Reduced ability to take on other people ideas in play
- A focus on rules
Repetitive behaviours and interests
Children with Autism Spectrum Disorder may also engage in repetitive behaviours and these can be very obvious or very 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 flapping
- Clicking wrists or fingers
- Sensory aversions or interests
- Peering at items for a long time
- Rubbing services
- Chewing non-edible items
- High Pain Threshold
- Smelling objects inappropriately
- A fear of hand dryers
- Resistance to brush teeth
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 these are all are now diagnosed with the term ‘Autism Spectrum Disorder’.
Autism Spectrum Disorder Assessment
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 comprehensive report is always provided. The report is accepted by the Department of Education and the HSE to access services.
Helpful Irish Autism Websites
- Irish Autism in Action http://autismireland.ie;
- Irish Progressive Association for Autism (IPAA) http://shineireland.com;
- Irish Society for Autism http://www.autism.ie;
Services for Autism Spectrum Disorder:
Multidisciplinary Diagnostic Assessments in which a report is provided that is accepted by services and schools
- Individualised psychological support
- Family support
- School behaviour support plans
- Occupational Therapy
- Speech and Language Therapy
- Worksop training for parents