Autism is a spectrum disorder – meaning it has many forms that affect people in a variety of ways and in varying degrees. Each person’s experience with autism presents unique challenges, as well as strengths, which define the type of support needed to lead a fulfilling life. Some people with the disorder are able to succeed in traditional schools, hold jobs and perform functions of daily living with varying levels of support. Others have significant intellectual impairments and will need extensive support and assistance throughout their lives.
Autism is characterised by severe and pervasive impairments in several important areas of development: reciprocal social interaction and communication as well as behaviour, and imagination. In order to be diagnosed with autism, the behavioural symptoms in all of the above-named areas must be present by age 3.
Even if the parents often notice that something is wrong during infancy, it is very difficult to diagnose autism before the age of eighteen months. This is because the behavioural symptoms used to establish the diagnosis have not clearly emerged developmentally until that age.
What are the signs and symptoms of ASD?
People with ASD have difficulty with social communication and interaction and have restricted interests and repetitive behaviors. The list below gives some examples of the types of behaviors that are common in people diagnosed with ASD. Not all people with ASD will have all behaviors, but most will have several of the behaviors listed below.
Social communication/interaction behaviors may include:
- Making little or inconsistent eye contact
- Having a tendency not to look at or listen to people
- Rarely sharing enjoyment of objects or activities by pointing at or showing things to others
- Failing to, or being slow to, respond to someone calling their name or to other verbal attempts to gain attention
- Having difficulties with the back and forth of conversation
- Often talking at length about a favorite subject without noticing that others are not interested or without giving others a chance to respond
- Having facial expressions, movements, and gestures that do not match what is being said
- Having an unusual tone of voice that may sound sing-song or flat and robot-like
- Having trouble understanding another person’s point of view or being unable to predict or understand other people’s actions
Restrictive/repetitive behaviors may include:
- Repeating certain behaviors or having unusual behaviors, such as repeating words or phrases (a behavior called echolalia)
- Having a lasting intense interest in certain topics, such as numbers, details, or facts
- Having overly focused interests, such as with moving objects or with parts of objects
- Getting upset by slight changes in a routine
- Being more sensitive or less sensitive than other people to sensory input, such as light, noise, clothing, or temperature
- People with ASD may also experience sleep problems and irritability. Although people with ASD experience many challenges, they may also have many strengths, including:
- Being able to learn things in detail and remember information for long periods of time
- Being strong visual and auditory learners
- Excelling in math, science, music, or art
Although ASD can be diagnosed as early as 15 to 18 months of age, the average age of diagnosis is about 4.5 years, and some people are not diagnosed until adulthood. Various experts can make this diagnosis, including some psychologists, pediatricians and neurologists.
Psychologists (including neuropsychologists, who specialize in the relationship between the brain and human cognitive, behavioral and emotional functioning) are often involved in the diagnostic process. It is important that the expert making the diagnosis has extensive experience working with the wide range of symptoms associated with ASD.
To make a diagnosis of ASD, psychologists draw on a number of sources of information:
• Patient interviews
• Observations of the patient’s behavior
• Tests of cognitive and language abilities
• Medical tests to rule out other conditions
• Interviews with parents, teachers or other adults who can answer questions about the patient’s social, emotional and behavioral development
Treatment and Support
Given the complex nature of the disease, children with ASD benefit from interdisciplinary treatment teams made up of experts from various fields. Those teams typically include physicians, educators, speech therapists and occupational therapists, in addition to psychologists.
Applied behavior analysis (ABA).
ABA is a method that uses evidence-based teaching techniques to increase helpful behaviors and reduce behaviors that are harmful or interfere with learning. ABA therapy has been shown to improve communication, social and vocational skills.
Developmental individual-difference relationship-based model (DIR).
In the DIR model, also known as floor time therapy, parents and therapists follow the child’s lead in playing together while also directing the child to engage in increasingly complex interactions.
TEACCH Autism Program.
The TEACCH framework promotes engagement in activities, flexibility, independence and self-efficacy through strategies based on the learning strengths and difficulties of people with ASD. It’s important to have your child evaluated by a provider trained in diagnosing and treating autism, so that he or she can recommend the most appropriate interventions. Such interventions can be administered by psychologists, as well as by educators and board-certified behavior analysts.