Autism spectrum disorders

Also known as asperger syndrome, autistic disorder

Autism spectrum disorders (ASD) is the name for a group of conditions that affect the way people make sense of the world. ASD’s are life-long issues that affect social and communication skills as well as the way those with ASD think and behave.

Because there is such a range in the way people experience ADS it is called a spectrum. Autistic disorder (autism) and Asperger syndrome are both ASDs.

Some may experience significant impairment with classic autism, while those with Asperger’s may be highly intelligent but socially uncomfortable. There is a huge variation in how people are affected in between these two extremes, for example, some may have accompanying learning disabilities, some not so much. But, whatever their general level of intelligence, everyone with the condition shares a difficulty in making sense of the world.

People with ADS will communicate, interact, behave, and learn in ways that are different from most other people, with some being severely challenged in problem-solving and thinking.

Some people with ASD need a lot of help in their daily lives; while others need less.

Who gets an autism spectrum disorder?

ASDs are usually noticed from an early age, from birth to three years old. If you suspect your child has an ASD, early identification is important to ensure they receive appropriate treatments and support as soon as possible.

Special education programmes and support of family/whānau play an important part in helping the child achieve their full potential as they grow into teenagers and adults. Without this, it has been shown that children experiencing ASD will not develop as well as they possibly could. This will affect them for the rest of their lives.

What causes these disorders?

Even though a lot of research into ASD has gone on around the world, the exact cause is still unknown.  It’s known that genes somehow play a part with certain gene patterns making it more likely that a child will have ASD.

Studies have also shown that brothers or sisters of children with ASD have a greater chance of having it as well. Also children born to older parents are have a higher chance of developing ASD than those born to younger parents.

Signs to look for (symptoms)

Symptoms of ASD can vary widely from one person to another. There is no single feature that defines ASD.

An overall picture or pattern of behaviour needs to be built, because a child with ASD may occasionally behave just like any other child, by perhaps making eye contact or speaking perfectly. It’s more important to understand what happens most of the time, not what happens occasionally.

Key areas of difference for those experiencing ASD are in the ways they communicate and  interact with others, and the way they play and engage in make believe. A child with ASD will have some or all of the following behaviours.

As babies and infants they may:

• prefer not to be held or cuddled, or cuddle only when they want to
• appear to be unaware when people talk to them, but respond to other sounds
• have delayed language skills for their age and they may use language in unusual ways, such as speaking very formally or repeating words
• not look at objects when another person points to them
• prefer to play alone, and not be really interested in others
• not make eye contact
• ignore greetings, such as hello or goodbye
• not respond to children’s games such as peek-a boo or hide and seek
• not play “pretend” games (for example, pretending to “feed” a doll)
• over-react to loud noises or dislike intensely some tastes or smells.

At school they may:

• repeat actions over and over again
• avoid eye contact and want to be alone
• have trouble understanding other people’s feelings or responding to their expressions or emotions
• have very set and/ or unusual routines and can get very upset at changes in routine
• like to line things up and have things set out in a particular way
• appear to get stuck doing the same thing over and over, and if it’s something they are interested in they may talk about it endlessly
• have unusual movement patterns (such as hand flapping or walking on toes)
• have trouble expressing their needs using typical words or motions
• not respond or appear to understand requests.

Some people with autism spectrum disorders, who may be severely impaired in most ways, will sometimes display an exceptional talent for, say, maths or music. Some have a remarkable memory for numbers or dates as well as other things that particularly interest them. 

How the doctor determines if your child has ASD (diagnosis)

An initial diagnosis is made by your doctor based on whether your child has some or all of the typical symptoms, and the length of time they have had them. For this reason it’s important that your doctor spends time with you and your child to get a full understanding of the difficulties they have had.

At this point your doctor will refer your child to a mental health professional for confirmation of ASD. The specialist in ASD will talk with you, your child and possibly their teacher. They may look at sending your child to some other specialists to help understand your child’s condition, such as specialists in hearing, speech, physiotherapy or even a specialist pediatrician. If ASD is confirmed, a treatment plan will be tailor-made for your child.

In addition, your doctor or mental health professional can provide you a referral to agencies that can offer financial support, respite and assistance with interventions even without a diagnosis.

Treatment options

There is currently no cure for ASD. For that reason, it’s really important that children with ASD get help early in life so they can learn to manage their ASD and develop the skills and confidence they will need to lead a happy and fulfilling adult life.

A team of specialists, under the guidance of a mental health professional with experience in ASD, will develop a plan for your child which may contain the following components:

Medication

Some medications can help people experiencing ASD function better. These are designed to help your child concentrate better, be less impulsive, feel calmer and be able to learn and practise new skills. It’s important that the progress of a child on medication for ASD is checked and the treatment reviewed regularly with your doctor.

If your child is prescribed medication you are entitled to know:

• the names of the medicines
• what symptoms they are supposed to treat
• how long it will be before they take effect
• How long the child will have to take them for and what their side effects are (short and long term).

Therapy, such as talking therapies

Therapies that provide structure, direction and organisation for the child, in addition to family involvement, are very helpful for a child with ASD. Your doctor will explain what is available locally and which type of talking treatment is most suitable for your child.

Education

Education about ASD can be extremely important to help you, your family/whānau and supporters. There are websites listed in the resource section, and your health specialist will provide information to you as well.

There are numerous well designed programmes for children and families that can help. These can be found through your local branches of Autism NZ and the Children’s Autism Foundation.

At School

It’s best to keep up with your child's school programme and inform teachers of any changes in behaviour or treatment.

Talk to the school about getting assistance from the Ministry of Education’s Special Education Service for help with your child's classroom behaviour and learning needs.

Thanks to Janet Peters, registered psychologist for reviewing this content.Date last reviewed:  September, 2014.