Autism Spectrum Disorder

Autism spectrum disorder (ASD) is an umbrella term that refers to a range of conditions that share some common symptoms, including Autistic disorder and Asperger’s disorder. The causes of ASD are unclear, but its symptoms include difficulties with communicating, problem-solving and social skills.

ASD: difficulties and abilities
Children with ASD have a wide range of difficulties and abilities. In fact, some have very impressive skills and strengths. One child with ASD might know lots of words and have a very good memory. Other children might respond mostly to things they can see, making them good at completing puzzles and sorting objects by shape and colour.

By about the age of three, however, all children with ASD will show difficulties in three main areas.

1. Social interaction and relationships
Children with ASD will appear to be uninterested in social contact with others. They:

  • might not respond when people speak or gesture towards them, even when their names are called out
  • often make little eye contact with others and usually won’t copy other people’s actions, like clapping or waving
  • usually don’t share interests with others, rarely pointing at anything or showing interest in giving or sharing
  • are not very interested in chatting or playing, especially with other children.

2. Communication and language
Children with ASD usually take longer than the average child to learn language. That means knowing fewer words, not using their words to communicate with others, or not speaking at all.

Children with ASD will find it hard to comprehend language, so understanding simple instructions and social norms can be difficult.

When children with ASD do have language skills, they:

  • will talk about their own special interests, and rarely use language skills to communicate with others
  • might focus on categorising everything around them, such as labeling all their toy trains
  • might echo what they hear, repeating patterns of words without attaching any meaning to them
  • rarely use non-verbal gestures, like nodding their heads or hand gestures, to communicate.

3. Repetitive behaviour and routines
Even from a young age, children with ASD will often prefer the same routines – feeding, sleeping or leaving the house needs to be done the same way every time. They might be upset by changes like moving furniture or altering the usual familiar travel route.

Many children with ASD also like to repeat behaviour, sometimes in an obsessive way, like lining their toys up in a particular way over and over again. Younger children might like to collect things like twigs, string or balls. They will clutch tightly to their favourite objects and become upset if they are removed.

Older children with ASD might have very narrow and intense interests. For example, they might be interested in trains, always choosing a toy train over other toys, labelling every train in their surroundings, and insisting on watching cartoon train videos over and over. If they have strong verbal skills, they might talk only about trains.

Different types of ASD

Children with autistic disorder have difficulties with interaction and communication with others. The condition is often diagnosed when it becomes clear that a child’s social behaviour and language aren’t developing in a typical way.

Common characteristics
Children with autism have difficulties relating to and communicating with other people.

When they are babies, they don’t look at others a lot. By two years of age, they often won’t respond to their name, babble without changing their pitch or tone or smile at others. Also they won’t imitate others with behaviour like clapping or waving.

Children with autism will often repeat a particular behaviour over and over, or become fixated on an object. For example, they might repeatedly turn lights on and off, or focus on the wheels of a toy car, rather than playing with the whole car and engaging in pretend play.

Many children with autism also have unusual sensory issues, although this is not required for a diagnosis. They might:

  • be especially sensitive to sound, which is why they raise their hands to their ears to block out noise
  • like the feel of objects, and smell and sniff at everything around them
  • want to eat only foods with a certain texture – they’ll be happy to eat soft, smooth food, for example, but will refuse anything lumpy
  • use their peripheral vision a lot, or tilt their heads to look at objects from a particular angle.

Some children with autism have below-average intelligence. Others will have intelligence within the typical range – often called ‘high-functioning’ autism.

Autistic disorder can be diagnosed at about two years of age in most children. At this age, it can usually be seen whether a baby or child’s development is conforming to accepted, age-based milestones, particularly in relation to social and emotional interaction and communication.

Signs of autism
Social interactions
Children with autism might:

  • seem to be in their own world
  • show little eye contact (for example, during interaction, or to draw attention to something)
  • not use gestures (for example, lifting arms to be picked up)
  • not share enjoyment or interests (for example, they might not point to an object or event to share it)
  • show little emotion or empathy
  • not respond to their names
  • show no interest in other children or peers.

Children with autism might:

  • have little or no babble
  • have little or no spoken language
  • not engage in pretend play (for example, they will not feed a baby doll)
  • have ‘echolalia’, which means they echo or mimic words or phrases without meaning or in an unusual tone of voice
  • have difficulty understanding and following simple instructions (for example, ‘Give me the block’ might be difficult for them).

Repetitive or persistent behaviours
Children with autism might:

  • have intense interest in certain objects (will become ‘stuck’ on one particular toy or object)
  • focus narrowly on an object (for example, on a detail like opening and closing the door on a toy bus rather than pretending to drive it)
  • insist on following routines and be easily upset by change
  • show repetitive body movements or unusual body movements (for example, back-arching, hand-flapping, walking on toes).

Sensory issues
Children with autism might:

  • be extremely sensitive to sensory experiences (for example, they might be easily upset by certain sounds, or only eat foods with a certain texture)
  • seek sensory stimulation (for example, they might like deep pressure touch or vibrating objects like the washing machine)
  • like to flutter their fingers at the side of their eyes to watch the light flicker.

Asperger’s disorder
Children with Asperger’s disorder have trouble with social interaction, often misunderstanding social cues. At the same time, they might have highly developed language skills and can often communicate at great length on their favourite topics.

Common characteristics
As children, people with Asperger’s disorder are sometimes described as ‘little professors’. This is because they can be extremely knowledgeable about their favourite topics, and might also have advanced language skills for their age. Unlike children with autism, they might start discussions, and their language abilities can lead to one-sided conversations.

People with Asperger’s disorder often miss social cues and can misinterpret language. For example, they can have difficulty understanding jokes, or they might take things too literally.

Signs of Asperger’s
Social interaction
Children with Asperger’s disorder might:

  • initiate interactions with others but have difficulty in sustaining social interaction
  • interact with people if they need something or to talk about something that interests them, but not for the sake of being social or out of genuine interest in others
  • interact in an awkward and stilted way (for example, they might avoid eye contact while speaking or interpret things literally)
  • interact more easily with adults than with children
  • not show emotion or empathy.

Communication and language
Children with Asperger’s disorder might:

  • be very verbal (for example, they might label everything in a room)
  • join words together at the usual developmental stage (around two years)
  • communicate with others about their own interests
  • use a flat or monotone voice
  • answer questions, but not initiate questions if the topic doesn’t interest them.

Repetitive or persistent behaviours
Children with Asperger’s disorder might:

  • have restricted or obsessive interests that make them seem like ‘walking encyclopaedias’ about particular topics
  • prefer routines and rules
  • be fascinated by shapes like hexagons and octagons.

Pervasive developmental disorder – not otherwise specified (PDD–NOS)
Pervasive Developmental Disorder – Not Otherwise Specified (PDD–NOS) is the least severe form of autism spectrum disorder (ASD).

Children with PDD–NOS have symptoms like those associated with autistic disorder and Asperger’s disorder. But children with PDD–NOS will have fewer and less severe symptoms than children with autism or Asperger’s.

What does a diagnosis of PDD–NOS mean?
To be diagnosed with autism or Asperger’s disorder, a child must have a certain number of symptoms relating to their social and communication skills, and also show some repetitive behaviour. When a child has only some of these symptoms, they might be diagnosed with PDD–NOS.

Common characteristics
Like children with autism or Asperger’s disorder, children with PDD–NOS will have difficulties relating to and communicating with other people or show repetitive behaviours. Although these difficulties are noted, social skills are generally less impaired than with autism or Asperger’s disorder.

Source: Raising Children Network: The Australian Parenting Website

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