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Autism Spectrum Disorder

Definition

Autism spectrum disorder (ASD) is a complex developmental disability; signs typically appear during early childhood and affect a person's ability to communicate, and interact with others and go beyond a restricted stereotyped, repetitive repertoire of interest and activities. ASD is defined by a certain set of behaviour’s and is a “spectrum condition” that affects individuals differently and to varying degrees.It is the third most common developmental disorder, more common than Down’s syndrome.


Characteristics

The characteristics manifest themselves in Three Main Areas mentioned below:

1) Communication

  • Child has delayed language acquisitions. He may respond to a question by repeating it immediately, may repeat certain words out of context and repeat them over and over again.
  • He may not use conversation meaningfully and have difficulty conveying needs such as hunger, pain etc.

2) Socialization

  • Frequently enjoys playing alone, may or may not mix with other children of his age & may not be interested in making friends.
  • The child may not look at others straight in the eye.
  • The child may not enjoy being cuddled or cuddling others.
  • The child does not like to indulge in 'Pretend Play'.
  • The child may exhibit socially unacceptable behavior for his age such as smelling people, objects.

3) Unusual Behaviours

  • The child may do certain things in the same manner every time, such as taking the same route to school.
  • He finds it difficult to adjust to change in routine.
  • May be attracted to spinning or rotating objects such as wheels & fans.
  • May indulge in self stimulatory activities like spinning, rocking, flapping of objects as well as own body.
  • May laugh or become upset without apparent reason.
  • May show unusual responses to sensations; one may be oversensitive, other may be undersensitive.
  • The child may be oblivious to danger.

Causes

Though there are no definitive answers known what causes autism, it may result from a combination of factors including genetic and environmental influences.

Types

Autism is a Spectrum Disorder i.e. the symptoms & the characteristics of Autism may manifest themselves in a wide variety of permutations and combinations & also in varying degrees of severity. It affects different people in different ways, making it difficult to generalise. This spectrum covers whole range of people with autism who never learn to speak, are non-verbal to verbal, who have fewer problems with language.

  • Classic Autism

    They are withdrawn in their own shell (characteristics mentioned above).
  • Asperger’s Syndrome

    It is named after the doctor who discovered the syndrome. It applies to people with autism who are high functioning, having average or above average intelligence. They do not shun human contact and want to be sociable but find it hard to interpret the signals like facial expressions while interacting. Thus their social development is most affected.


Treatment Management:

There have been certain techniques that have been found to work more efficiently on children with autism. Depending on the child's difficulties, he may need a special educator, speech therapist, occupational therapist and a sensory integration therapist.

Self-help skills and Activities of Daily Living (ADL)

Teaching the child by breaking down the task and then teaching him one step at a time is useful in developing social skills , language, self-help and other basic skills such as toilet training, bathing & eating on their own. These skills are important to make him achieve maximum independence.

Communication and schooling

A structured classroom setting with clear expectations and goals have proved very beneficial for the child. Besides behaviour therapy, structured instructions, other educational approaches are also used. Most professionals agree on is that Early Intervention is important.

Behaviour Modification

This involves rewarding a child for positive behaviour
thus, encouraging him to repeat the same.

PECS

Picture Exchange Communication System In this method, a child hands over a relevant card with a picture, e.g. a picture of a cake if he is hungry & gradually learns to build a sentence.

SPELL

Structure, Positive, Empathy, Low Arousal & Links
  • Structure: The child knows what is going to happen and what is expected. There is predictability, so the child feels safe.
  • Positive: Provide rehearsals, reinforce when the child accepts new experience, build on child's interest and strength.
  • Empathy: Inculcate a habit to see the world from child's perspective.
  • Low Arousal: Allow few distractions, keep noise level to minimum, give attention to preferred colours, arrangements etc.
  • Links: Holistic approach should be applied by developing links between parents, teachers & therapists.


  • TEACCH

    TEACCH stands for Treatment and Education of Autistic and Communication Handicapped Children. It is a complete program of services for autistic people which makes use of several techniques, of several methods in various combinations depending upon the person's needs and emerging capabilities. The main focus is on improving communication skills and education. The main goal of TEACCH for children with autism is to help them grow up to a maximum autonomy at an adult age.

    Dietary interventions

    Dietary interventions are based on the idea that
  • Food allergies cause symptoms of autism, and
  • An insufficiency of a specific vitamin or mineral may cause some symptoms of autism.

  • A diet that some parents have found to be helpful to their child is a Gluten-free, Casein-free diet. Gluten is a family of proteins that is found in cereals like wheat, oat, rye, and barley. Casein is the principal protein in milk. Some parents feel that vitamin supplement like B6 with magnesium makes the vitamin effective. The result of research studies is mixed; some children respond positively, some negatively, some not at all or very little.

    Applied Behavioral Analysis (ABA)

    is a system of autism treatment based on behaviorist principles which in simple terms state that behaviors can be taught through a system of rewards and consequences.ABA has become synonymous with the methods and research of Dr. IvarLovaas. (This is why ABA is sometimes called "Lovaas" Method). ABA starts with "discrete trials" therapy. A discrete trial consists of a therapist asking a child for a particular behavior (e.g. "Raj, please pick up the spoon"). If the child complies, he is given a "reinforce" or reward in the form of a tiny food treat, a high five, or any other reward that means something to the child. If the child does not comply, he does not receive the reward, and the trial is repeated.

    Son- Rise therapy

    Son-Rise is a home-based program for children with autism spectrum disorder sand other developmental disabilities. The program emphasizes eye contact, accepting the child without judgment, and engaging the child in a non-coercive way, and it believes that children on this program will become non-autistic due to personal motivation to learn non-autistic behaviour. However, there are no enough studies ti prove the same.

    Floortime

    Floor time is a well-regarded form of therapeutic play originated by Dr. Stanley Greenspan, a psychologist based in Maryland. Floor time has two great advantages. First, it can be implemented by a parent with minimal training. And second, it can be fun.

    Brain Gym

    Brain Gym founded by Paul Dennison, is a training program which focuses on brain body integration. It claims that any learning challenges can be overcome by finding the right movements, the use of which will create new pathways in the brain. They claim that the repetition of the 26 Brain Gym movements "activates the brain for optimal storage and retrieval of information.

    Relationship Development Intervention®

    (RDI) is a family-based, behavioural treatment designed to address autism’s core symptoms. Developed by psychologist Steven Gutstein, Ph.D., it builds on the theory that “dynamic intelligence” is a key to improving quality of life for individuals with autism. Dr.Gutstein defines dynamic intelligence as the ability to think flexibly. This includes appreciating different perspectives, coping with change and integrating information from multiple sources (e.g. sights and sounds). RDI aims to help individuals with autism form personal relationships by gradually strengthening the building blocks of social connections. This includes the ability to form an emotional bond and share experiences.

    RDI’s six objectives are:

  • Emotional referencing: The ability to learn from the emotional and subjective experiences of others
  • Social coordination: The ability to observe and control behaviour to successfully participate in social relationships
  • Declarative language: The ability to use language and non-verbal communication to express curiosity, invite interactions, share perceptions and feelings and coordinate with others
  • Flexible thinking: The ability to adapt and alter plans as circumstances change
  • Relational information processing: The ability to put things into context and solve problems that lack clear cut solutions
  • Foresight and hindsight: The ability to anticipate future possibilities based on past experiences
  • (RDI Source- www.autismspeaks.org)

    Tips to Parents

    Set a routine. Follow a pattern of daily activities in a fixed manner with least changes. If there are any changes in the set timetable due to unavoidable circumstances, be there for your child to provide support. For a child with autism, if there are changes in school timetable, inform the Buddy to take care of him.