About ASD

WHAT IS ASD?
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	Autism is a complex developmental disorder that typically appears during the first three years of life. It is a neurological disorder and occurs in approximately 1 in 500 individuals. Autistic Spectrum Disorder (ASD) describes individuals that fall onto a spectrum of symptoms and characteristics ranging from mild to severe.
People with autism can exhibit any combination of behavioural characteristics in any degree of severity. Consequently, two children with the same diagnosis can act very differently from one another and have varying skills. Children and adults with autism experience difficulties in three main areas, known as the triad of impairments:

Non-verbal and verbal communication Children with ASD find understanding and using language very difficult. They may be completely non-verbal, or repeat what is said to them over and over (echolalia). Non-verbal communication is especially difficult for a child on the autistic spectrum. Body language, gesture and facial expressions are not understood as clues to communication. In addition, children with autism will often not point to an object they want or use appropriate gestures, preferring to lead carers by the hand or look repeatedly at what they want. In verbal communication, jokes and sarcasm are not appropriate as the intentional tone is often not received and therefore the meaning is missed. For many children, certain words act as triggers (such as ‘no’) or in some, language is a cause of agitation. Many children can get ‘high’ from spoken language, using echolalia as a form of sensory stimulation. Some children have good receptive language but their inability to reply causes frustrations and this in turn can lead to anxiety and challenging behaviour. Many children benefit from alternative communication methods using pictures (PECS), objects, makaton sign language or written schedules with verbal prompting and exaggerated gestures. Social understanding and interaction The most severe impairment seen in this area is aloofness and indifference to other people. Most children show attachment on a simple physical level, others will show limited pleasure in social contact but will not initiate this contact and others approach people in an odd, stereotyped and repetitive way with little or no attention to the responses of the person. People (particularly children) with autism often have difficulties initiating and sustaining relationships with their peers. The child will have difficulty in understanding and reading others' intentions. It is often the case that children with autism can relate well to their parents and carers but not to other children. This is because, as adults, we can usually anticipate the needs of a child. Since other children do not have this ability, the autistic child struggles to interact with his/her peers. It is not that autistic children cannot make friends but often just do not know how. Teaching an autistic child social skills is critical to their development. Imagination and flexible thinking Children on the autistic spectrum often do not play with toys in the conventional way, choosing instead to flap, spin or line up objects, or concentrate on a certain part of the toy, such as a wheel, at the expense of the whole object. Many people argue that this shows a lack of imagination. However this is a pessimistic view. Children with autism are limited in how much they can achieve without guidance. Yet playing with toys in any way can be seen as using imagination – it’s just that this imagination is not shared with others and serves a purpose only for that child. Inflexible behaviour refers to the rigid routines observable in children on the spectrum. Many children will have stereotyped activities from rocking and flapping to teeth grinding and self-injury. They may show intense attachment to a particular object, or a desire to collect and hoard things such as pebbles and bottle tops. Changes in everyday routines such as going a different way to school may instigate a tantrum, as these changes that are meaningless to you or I are frightening and distressing to a child with ASD. They cannot marry the concept of what is expected to happen and what is actually happening. Theory of mind This is a complex theory which puts the autistic individual in a state of ‘mind-blindness’. “Theory of mind" refers to one's ability to realise that other people have their own unique point of view about the world. Many autistic individuals do not understand that others may have different thoughts, plans, and perspectives than their own, and sometimes act upon the world not as it is but as they believe it to be. For example, the autistic child will not understand that other people do not know exactly what they want when they are asking for an object (as they know what they mean so why don’t you!). They cannot ‘put themselves in another person shoes’ and attune their behaviour accordingly. Sensory problems People with autism tend to process information in a unique way. They often experience sensitivities in the five areas of touch, smell, taste, vision and hearing. More able people with autism have reported that everyday sounds such as hoovers, talking and chairs scraping can cause physical pain as their hearing is sensitive to this. Conversely, those with autism may sometimes be ‘tuned out’ and not respond to their name or an instruction, as if they were deaf. Some can find touch unbearable, especially in times of anxiety. Even the gentlest reassuring touch on the arm can be intensely overwhelming, and can cause physical discomfort. Others find touch extremely reassuring, and deep pressure massage or a simple squeeze of the hand can be incredibly comforting and/or pleasurable. With vision, children with autism often find eye contact incredibly difficult and stressful. Often the child will look past you or through you as this serves as a less intrusive interaction. Some children will not be able to talk and make eye contact at the same time as this overwhelms their senses and causes much distress. Some children will have aversions to bright lights, or colours and so on (photosensitivity) although this is not always the case. Stimulus overselectivity Many autistic individuals also have a narrow or focused attention span; this has been termed 'stimulus overselectivity.' In this way, the person’s attention is focused on only one, often irrelevant, aspect of an object. For example, they may focus on the colour of a utensil, and ignore other aspects such as the shape. In this case, it may be difficult for a child to discriminate between a fork and a spoon if s/he attends only to the colour. Since attention is the first stage in processing information, failure to attend to the relevant aspects of an object or person may limit the child’s ability to learn about objects and people in their environment. Priorities for helping children with autism Create a secure, predictable, structured environment for the child help the child learn and make use of a method of communication to get his/her needs met manage his/her behaviour by giving instructions and prompts to show him/her what to do rather than what not to do find ways of having fun. Autistic children will often have interests which may look obsessive but can be encouraged through play and utilised to teach new skills In communicating with the child it is important to: give the child’s name before giving an instruction speak in short phrases using keywords and use pictures, symbols or gestures to give further clues to what you are asking/saying give plenty of time for the child to process the instruction and respond be quiet and calm so as to avoid furthering the child’s anxiety offer fixed choices to avoid confrontation (do you want … or …?) use incentives to encourage the child to do what they are asked distract to another activity when s/he is upset give a clear idea of what is going to happen during the day, using schedules, now and then and so on give a warning when something is going to change (story now, then light off) Top of page

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