Developmental and Neurological Disorders
Autistic Spectrum Disorder
Autism is a complex developmental disability that causes problems with social interaction and communication. Most parents of autistic children suspect that something is wrong by the time the child is 18 months old and seek help by the time the child is age 2. Children with autism typically have difficulties in pretend play, social interactions and verbal and nonverbal communication. Some children with autism appear normal before age 1 or 2 and then suddenly "regress" and lose language or social skills they had previously gained. Symptoms can range from moderate to severe. The cause of autism is not completely known at this time but research is ongoing. There is clearly some genetic component and there are likely many different causes. It is more common in boys than girls. People have had concerns that vaccinations are the cause of the increase in cases of autism but no direct link has been found to support this theory. Intensive and early intervention results in improved outcomes. People with autism often also struggle with attention, aggressive behavior, anxiety and mood issues. A clear diagnosis critical in order to access appropriate services.
Communication problems may include:
- Cannot start or maintain a social conversation
- Communicates with gestures instead of words
- Develops language slowly or not at all
- Does not adjust gaze to look at objects that others are looking at
- Does not refer to self correctly (for example, says "you want water" when the child means "I want water")
- Does not point to direct others' attention to objects (occurs in the first 14 months of life)
- Repeats words or memorized passages, such as commercials
- Does not make friends
- Does not play interactive games
- May not respond to eye contact or smiles, or may avoid eye contact
- Prefers to spend time alone, rather than with others
- Shows a lack of empathy
Response to sensory information:
- Has heightened or low senses of sight, hearing, touch, smell, or taste
- May find normal noises painful and hold hands over ears
- May withdraw from physical contact because it is overstimulating or overwhelming
- Doesn't imitate the actions of others
- Prefers solitary or ritualistic play
- Shows little pretend or imaginative play
- "Acts up" with intense tantrums
- Gets stuck on a single topic or task (perseveration)
- Has very narrow interests
- Shows aggression to others or self
- Shows a strong need for sameness
This is a continuum of problems with varying degrees of severity that can include awkward or unusual social responses, preoccupation with a single interest, rigidity (an intense to desire to follow the rules), bodily defensiveness, flat affect, lack of emotional reciprocity, poor abstract reasoning and awkward motor skills. Unlike people with autism, individuals with Aspergers do not typically have language difficulties. Aspergers is the extreme of a non-verbal learning disorder.
Accurate diagnosis is important in obtaining services through the school and through local regional centers. ADHD and mood disturbances are common in individuals with Aspergers and need to be addressed. Many interventions are needed to help these individuals achieve their full potential. They should at least include instruction on social skills. These children often do best if they are taught “scripts” of how to act in various situations, as they are very good at following the rules. In addition, physical therapy, school interventions and medication may be useful depending on the individual.
This is a pervasive developmental slow down affecting language, motor skills, cognitive processing and interpersonal skills. The impact on the individual, the family and other relationships can be extensive. This is not a static disorder and there can be improvement given appropriate interventions, which can include appropriate school placement, academic support and help with social relationships. As the child grows, focused behavioral issues can come up – therapy is often helpful for the family and the child.