Autism Spectrum Disorder FAQS

WHAT IS AUTISM SPECTRUM DISORDER (ASD)

Since May 2016, the official diagnosis of Autism Spectrum Disorder (ASD) is being used. This was published in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Before that, ASD was named differently, namely, Pervasive Developmental Disorder (PDD), which includes: Aspergers Syndrome, Rett Syndrome, Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS) and Autism. Since the symptoms vary so much, it is named ‘Spectrum’.

ASD is characterised by multiple delays of many basic skills, such as the ability to socialise with others, to communicate, repetitive behaviors, and to use imagination. The most obvious signs of ASD tend to emerge between 12 and 18 months of age. Some infants and toddlers begin develop normally until the second year of life, when they lose skills a pattern called regression. About 25%-30% of the children diagnosed with ASD knows a few words up to the 12th/18th month, and then they loose those words.

CAUSES

There is no particular cause for ASD. Many theories have been developed based on decades of research. For example, scientists have identified a number of rare gene changes, or mutations, associated with ASD. However, most cases involve complex and variable combinations of genetic risk and environmental factors that influence early brain development.
Various risk factors can involve events before and during birth. They include advanced parental age at the time of conception (both mother and father), teenage pregnancies, maternal illness during pregnancy, a C-section,  extreme prematurity and very low birth weight and certain difficulties during birth, particularly those involving periods of oxygen deprivation to the baby’s brain. Also research has shown that mothers of children with ASD are two times more at risk to have pre-eclampsia as other mothers [Pre-eclampsia means that mothers have a high blood pressure at the end of their pregnancy.]
Further, a Finnish research (2014) showed that by increasing the timespan in between birth’s to 2-5 years, the risks of ASD will decrease.
Research also have shown that if a brother or sister has ASD, the risks for another child with ASS can be 10 times as much. Also pollution has shown to have a great effect on the development of the early brain and may have an effect on ASD.

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SYMPTOMS ASD

Symptoms must be present in the early developmental period, but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life.

For each person the symptoms are different. For example, each person with ASD has different communication skills. Some people can speak well. Others can’t speak at all or only very little. About 40% of children with an ASD do not talk at all. ASD symptoms can be:

Play and Social Skills:

  • Does not respond to name
  • Unusual focus on pieces: Children with ASD often focus on parts of toys, such as the wheels on a car, rather than playing with the entire toy
  • Preoccupation with certain topics for example license plates or numbers
  • A need for sameness and routines for example, a child with ASD may always need to eat bread before salad and insist on driving the same route every day to school
  • Trouble understanding other people’s feelings or talking about their own feelings
  • Avoid eye-contact
  • Prefer to play alone
  • Not point at objects to show interest (point at an airplane flying over)
  • Not play pretend games (pretend to feed a doll)
  • Only interacts to achieve a desired goal
  • Has flat or inappropriate facial expressions
  • Not understand personal space boundaries
  • Avoids or resists physical contact
  • Is not comforted by others during distress
  • Trouble understanding other people’s feelings or talking about own feelings
Verbal and non-verbal communication:
  • Delayed speech and language skills
  • Repeat words or phrases over and over (echolalia)
  • Reverse pronouns, for example, says You instead of I
  • Give unrelated answers to questions
  • Problem taking steps to start a conversation and continuing a conversation after it has begun
  • Not point or respond to pointing
  • Use few or no gestures, for example, does not wave goodbye
  • Talk in a flat, robot-like, or sing-song voice
  • Stereotyped and repetitive use of language
  • Difficulty understanding their listener’s perspective, for example, a person with ASD may not understand that someone is using humor, sarcasm or is teasing
Unusual Interests and Behaviors:
  • Line up toys or other objects
  • Very organized
  • Upset by minor changes
  • Obsessive interests
  • Follow certain routines
  • Flap hands, rock body, or spin self in circles
Other Symptoms:
  • Hyperactivity
  • Impulsivity (acting without thinking)
  • Short attention span
  • Upset with minor changes
  • Aggression
  • Self injury
  • Tantrums
  • Unusual eating and sleeping habits
  • Unusual mood or emotional reactions
  • Lack of fear or more fear than expected
  • Unusual reactions to the way things sound, smell, taste, look, or feel
  • Idiosyncratic phrases.
TREATMENT

There are thousands of treatment methods for ASD. Below we are just explaining the most popular methods of treatments currently used in the USA and Europe

  • Floor Time Therapy: The premise is that adults can help children expand their circles of communication by meeting them at their developmental level and building on their strengths. Floor time takes place in a calm environment. Formal treatment sessions range from two to five hours a day. They include training for parents and caregivers as well as interaction with the child.
  • Intensive Behavior Intervention (ABA): Focuses on various principles. Positive reinforcement is one such principle. When a behavior is followed by a reward, the behavior is more likely to be repeated. Through decades of research, the field of ABA has developed many techniques for increasing useful behaviors and reducing those that may cause harm or interfere with learning. Applied behavior analysis (ABA) is the use of these techniques and principles to bring about meaningful and positive change in behavior. ABA strategies can be incorporated within Early Intensive Behavioral Intervention, Intensive Behavioral Interventions (age 4 and up) and Behavioral Interventions with adults. ASPIRE provides these services
  • Early Intensive Behavioral Intervention (ABA): Involves a child’s (age 0-3 years old) entire family, working closely with a team of professionals such as speech therapists, occupational therapists and physical therapists. In some early intervention programs, Behavior Therapists come into the home to deliver services. This can include parent training with the parent leading intervention sessions under the supervision of the BCBA. Often the recommended number of hours of structured intervention is a minimum of 25 hours per week during the preschool period.
TIPS FOR PARENTS
  • Be consistent: Children with ASD have a hard time adapting what they have learned in one setting (such as the therapist’s office or school) to others. For example, your child may use sign language at school to communicate, but never think to do so at home. Creating consistency in your childs environment is the best way to reinforce learning. It’s also important to be consistent in the way you interact with your child and deal with challenging behaviors.
  • Schedule: Individuals with ASD tend to do best when they have a highly-structured schedule or routine. Again, this goes back to the consistency they both need and crave. Set up a schedule, with regular times for meals, therapy, school, and bedtime. Try to keep disruptions to this routine to a minimum. If there is an unavoidable schedule change, prepare for it in advance.
  • Reward good behavior: Praise for appropriate behaviors and when your child learns a new skill. Be very specific about what behavior they are being praised for. Also look for other ways to reward them for good behavior, such as giving them a sticker or letting them play with a favorite toy.
  • Create a home safety zone: Carve out a private space in your home where your child can relax, feel secure, and be safe. This will involve organizing and setting boundaries in ways your child can understand. Visual cues can be helpful (colored tape marking areas that are off limits, labeling items in the house with pictures). You may also need to safety proof the house, particularly if your child is prone to tantrums or other self-injurious behaviors.
  • Look for nonverbal cues: If you are observant and aware, you can learn to pick up on the nonverbal cues that persons with ASD use to communicate. Pay attention to the kinds of sounds they make, their facial expressions, and the gestures they use when they are tired, hungry, or want something.
  • Find out the need behind the tantrum: When individuals with ASD act out, its because they want to communicate something (food, activity, item, escape). A tantrum is their way of communicating.
  • Pay attention to your childs’ sensory sensitivities: Many individuals with ASD are hypersensitive to light, sound, touch, taste, and smell. Other’s are under-sensitive to sensory stimuli. Find out what sights, sounds, smells, movements, and tactile sensations trigger your kids challenging behaviors and what elicits a positive response

Finally, keep in mind that no matter what Autism treatment plan is chosen, parents’/caregivers’ involvement is vital to success. Parents/Caregivers can help their child get the most out of treatment by working hand-in-hand with the Autism clinical team and following through with the intervention sessions at home.

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