What causes ASD?
There is no clear explanation about what causes ASD. However, family studies have shown that genes play a role. For example, if one identical twin has autism then the other has around a 75 per cent chance of also having autism. In non-identical twins, there is a five to eight per cent chance that both twins will have autism. ASD also tends to occur more often than expected among people with certain medical conditions. Researchers are investigating the link between children whose mothers had problems during pregnancy or delivery, as well as the contribution of viral infections, dietary imbalances, and exposure to environmental chemicals.
If you feel that you, or someone you know, would benefit from professional assistance to address problems associated with ASD, you can contact a clinical psychologist.
How is ASD treated?
No single treatment program has been found to be successful in treating all individuals with ASD. Health professionals plan treatment to match the person’s particular needs, their strengths and difficulties. In treating ASD in children it is important to begin the treatment early on in the disorder, plan a treatment program to meet the child’s needs, treat both behaviour and communication problems, and involve parents and other primary caregivers. Early intervention focuses on teaching social skills, developing motor and communication skills, reducing problem behaviours (e.g., emotional outbursts, head-banging, interrupting) and promoting positive behaviours (e.g., turn-taking in social situations).
Medication is sometimes used to improve attention span or reduce unwanted behaviours, such as hand-flapping. However it is important to explore other ways of reducing these behaviours because some medications have harmful side effects, especially if taken over a long period of time. Psychological treatment, including behavioural interventions has been shown to improve the functioning of people with ASD. Mineral and vitamin supplements and special diets might also be used but there is no scientific evidence to support their effectiveness in treating ASD.
When seeking treatment it is important to consider treatments that have scientific evidence supporting them. There is a long list of possible treatments for ASD, some of which have no evidence to show that they work. Effective treatment programs for ASD should include psychological treatment to address difficulties in behaviour and attention and promote the development of language and communication and social skills.
What difficulties do individuals with ASD experience?
Children and adults with ASD have difficulties that are usually grouped into three areas.
1. Verbal and non-verbal communication
Communication skills vary depending on the intellectual and social development of the individual child or adult. Some people with ASD have little, if any, speech and others appear to have normal speech. However, those that do have speech often find it difficult to communicate effectively.
For example, a person with ASD may say odd and inappropriate things, repeat verbal statements made by another person (called ‘echolalia’), talk about one specific topic for long periods of time with no awareness that others have lost interest, or say things that are not relevant to the current conversation. The unusual communication style of those with ASD can sometimes lead to children and adults with ASD being the victims of bullying.
In addition, those with ASD may find it difficult to keep eye contact with others and understand non-verbal communication such as facial expressions and hand gestures including pointing. They often do not respond when others are talking to them and in some instances may not react to their own name.
2. Social awareness and interaction
Children and adults with ASD often have difficulty following social rules, which may make them appear unfriendly. For example, they tend to avoid looking at the person talking and do not appear to be listening. When interacting with others, those with ASD may not follow common social behaviours. For example, they may touch and even lick others, or make blunt and impolite comments.
What signs might suggest someone has an ASD?
Typically, ASD is identified before a child starts school and many children are now diagnosed from a very young age. Usually parents, a health professional or a childcare worker will have noticed something unusual in the child’s development. Examples include failure to respond with appropriate social behaviours such as smiles or other facial expressions, poor language development, and a lack of other forms of communication such as pointing and waving. Some children are not diagnosed until they are at school, with concern often raised by teachers. Less commonly, a diagnosis may occur in late adolescence or adulthood. Those diagnosed at an older age are generally higher functioning and have less severe symptoms. However, they still experience social, communication and behaviour difficulties.
It is important to seek professional advice about suitable treatment strategies for people with ASD. The age of the person, and the severity of their difficulties are both important factors to consider when deciding on what can help. Listed below are some strategies that can be put in place to assist parents and other carers of people with ASD.
- Provide a reasonable level of daily structure through the use of a daily or weekly diary and prepare the person for any changes to their routine. When a significant change is going to happen, spend time prior to the event talking to the child or adult about what is going to happen and ensure that they have support to manage any anxiety. This may help them cope with change more easily.
- Give a step-by-step list of instructions for completing everyday activities, such as getting ready for school or taking a shower. A wall chart with pictures illustrating each step can be a good way to present this information. This can be helpful for higher functioning children and adults.
- Develop a regular routine for the day including set times for meals, activities and sleep. Once a routine is in place, avoid changing it if possible. Children and adults with ASD can become extremely upset if their routine is changed.
- Provide instructions in simple language allowing time for the individual to absorb the information and respond. Try not to use phrases such as “pull your socks up” or “it’s raining cats and dogs” because people with ASD often take things literally. If an appropriate response is not given it is helpful to check that the person has understood.
- Provide visual cues such as pictures or a story outline to support communication. For example, when giving instructions or setting up a daily diary use pictures to demonstrate tasks and to help understanding.
- Teach and practise social ‘rules’ such as turn-taking and how to greet people, and provide opportunities for the individual to interact with others. Strategies such as role-plays can be a useful way of helping the person to learn new social skills.
- Seek help when family issues arise. Raising a child or supporting an adult with ASD can be difficult and stressful. Family assistance and treatment can improve outcomes for both the person with ASD and those around them.