Wednesday, 12 November 2014

Autism spectrum disorder (ASD)

Autism spectrum disorder (which includes autism, Asperger syndrome and pervasive developmental disorder not otherwise specified (PDD-NOS), is a complex disorder that affects a person’s ability to interact with the world around them. ASD has wide-ranging levels of severity and varying characteristics. No two people with ASD are alike.

Signs of ASD include difficulties in social interaction and communication, and restricted or repetitive behaviours, interests and activities.

It is often difficult to understand the behaviour of people with ASD, and the world can be a confusing place for the person involved. ASD affects around one in 100 to 110 people, with males being around four times more likely to be affected than females.


ASD is a developmental disability thought to have neurological or genetic causes (or both). However, the cause is not yet fully understood and there is no cure. A person with ASD has difficulties in some areas of their development, but other skills may develop as normal.

People with ASD will have difficulties in the two main areas of:

    social communication and interaction
    restricted or repetitive behaviours, interests and activities.

Communication for people with ASD

People with ASD often have difficulty with communication. They may have difficulty expressing their needs, wants, ideas, experiences and opinions. Some people with ASD never develop language, while others might have good verbal language skills.

For those who do develop language, they may have difficulties using appropriate grammar and vocabulary, and in constructing meaningful sentences. They may misunderstand words, interpret them literally or not understand them at all. Other people’s feelings and emotions can be difficult to understand.

Social interaction for people with ASD

Social interaction is an essential part of life for most people. However, one of the most significant problems for people with ASD is difficulty with social skills and social communication.

This may mean that they appear disinterested in others, ‘aloof’ or unable to engage in social interactions. They may have difficulty using or interpreting non-verbal communication (such as eye contact, gestures and facial expressions), have difficulty establishing and maintaining friendships, or appear disinterested in the experiences and emotions of others.

Some people with ASD appear to be withdrawn and can become isolated – others try very hard to be sociable, but may not seem to get it right. There is a range of help available, including assessment, education programs and family support.

Characteristics of ASD

There is a range of behaviours commonly linked with ASD. These may include:

    language – absent, delayed or abnormal patterns
    play – isolated, repetitive, a preference for predictable play, difficulty with flexible thinking, such as pretending that a box is a boat or a stick is a horse
    body movements – stereotypical behaviour, such as flapping and toe walking, and other behaviours that may cause self-injury, such as hand biting
    restricted or obsessive behaviour – with favourite topics, objects, places, people or activities
    rituals and routines – bring some order to chaos and confusion. A change to routine can result in the person displaying high levels of stress, anxiety or acting out
    tantrums – can be a way to express extreme confusion, stress, anxiety, anger and frustration when unable to express their emotions in another way
    sensory sensitivities – to certain sounds, colours, tastes, smells and textures.

Assessment for ASD

A detailed assessment is crucial to ensuring an accurate diagnosis. It will be carried out by a multidisciplinary team of a paediatrician (where appropriate), psychologist or psychiatrist, and speech pathologist.

Some children will demonstrate signs of ASD by the age of two, but a firm diagnosis may not be possible until three or older. There is a significant amount of research indicating that early intervention maximises outcomes and gives people with ASD the best possible chance of developing skills.

Education programs for people with ASD

The educational needs of individual students vary greatly. Intensive, specialised programs may be desirable for some students with ASD, while other students may be suited to mainstream programs and services. It will depend on the student’s level of functioning and need.

Family support for people with ASD

The family members (parents and siblings) of someone with ASD are also likely to need some support. Having a child with ASD can have a significant effect on parents, who may react to the diagnosis in a variety of ways, including relief, shock, grief, anger and guilt. Feelings of stress, confusion and anxiety are also common in parents who are caring for a child with ASD.

Parents may need specialised services, such as respite and residential care (child care help), social skills training and living skills training. It can also be valuable for parents to consider joining a support group or participating in counselling.

Research has shown that while having a brother or sister with ASD can at times be stressful and difficult, it can also be rewarding, positive and enriching. Offering siblings support and information can help them adjust to having a brother or sister with ASD. There are a number of groups and organisations who provide support to both child and adult siblings.

No link between ASD and immunisation

Any link between immunisation and ASD has been completely discredited.

During the 1990s, concern in the community about a possible link between the measles, mumps, rubella (MMR) vaccine and ASD was generated by the findings of research (known as the Wakefield study) conducted in London in 1998. The Wakefield study has since been discredited and withdrawn by the journal that originally published it. Dr Wakefield’s registration as a doctor in the United Kingdom has also been cancelled.

Concerns have also been raised about thiomersal (also known as thimerosal), a mercury-based preservative used in some vaccines. Concern about child safety prompted researchers around the world to investigate any possible link between the MMR, other vaccines and ASD, but extensive research conducted globally for a decade did not establish any link between vaccines and ASD.

Despite this finding, as a precaution, it has been withdrawn from the standard childhood vaccines in Australia and many other countries.
  • People with ASD find communication and socialising difficult.
  • Parents and siblings of children with ASD need support and regular breaks.
  • Any link between immunisation and ASD has been completely discredited.

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