Autism Spectrum Disorder ASD Mental Health

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Leo Kanner, a clinician working in America, first identified Autism in 1943. Hans Asperger, another clinician who was working in Austria in 1944, identified a group of children who showed similar characteristics to those described by Kanner, but with one important difference; there were no accompanying learning difficulties.

The term autism comes from the Greek “autos” meaning ‘self’ and reflects a distinct quality of personality which Kanner and Asperger noticed in some of their patients. The quality could reasonably be described as being ‘in a world of their own’, or ‘completely wrapped up in themselves’ with little interest in other children, socialisation or activities. Children and adults with autism often appear to be quite different from one another which raises the question as to whether autism is one disorder or several similar but separate conditions that in combination present similar tendencies.

A useful way to think of these difficulties is as a spectrum disorder which can be present to varying degrees in different individuals ranging from being severely disabling through to the most able individuals with autism who are able to live, work and function independently.

The autism spectrum disorders can typically be detected by the time a child turns 3 years of age and in some cases as early as 18 months. Studies suggest that many children can be accurately identified by the age of 1 year. The appearance of any of the warning signs of ASD is reason to have a child evaluated by a professional who specialises in Autism at the earliest possible age.

Possible Indicators of Autism Spectrum Disorders

• Does not make noise, point, or make meaningful gestures by the age of 1
• Does not speak at all by age 16-months
• Does not combine two or more words by age 2-years
• Does not respond when called by name
• Has very limited language or social skills

Other Indicators

• Poor eye contact with people
• Has problems playing with toys
• Excessively lines up toys or other objects
• Is attached to one particular toy or object
• Doesn't smile or display facial gestures
• At times may appear to have a hearing impairment

Social Symptoms

From the very early stages of life, infants developing normally are social beings in that they gaze at people, respond to voices, grasp a finger and smile or make facial gestures.

By contrast, most children with ASD have difficulty learning to engage in everyday human interaction. From the very first few months of life, many do not interact and appear to avoid eye contact. They appear indifferent to other people, and appear to prefer being left alone often resisting attention or rejecting hugs and affection. Later, they seldom seek comfort or respond to parents' displays of anger or affection in a way that most people would accept as normal.

Research suggests that although children with ASD are attached to their parents, their expression of this attachment is unusual and difficult to understand with parents reporting that their child appears to have no attachment at all. Parents who looked forward to the joys of cuddling, teaching, and playing with their child can feel crushed by this lack of the expected and typical attachment behaviour.

Although not universal, it is common for people with ASD to have difficulty regulating their emotions. This can take the form of apparent immature behaviour such as crying in class and verbal outbursts for no apparent reason that seem inappropriate to those around them.

The individual with ASD might also be disruptive and physically aggressive at times; often in public places that makes social relationships very difficult. They have a tendency to lose control in strange or overwhelming environments or when angry and frustrated. It is common for people with ASD to break things, attack others, or hurt themselves. Out of frustration, some bang their heads, pull their hair, or bite their arms.

Treatment

Most behavioural treatment programs include:

• Giving clear instructions to the child
• prompting to perform specific behaviours
• immediate praise and rewards for performing those behaviours as instructed
• gradually increasing the complexity of reinforced behaviours
• definite distinctions of when and when not to perform the learned behaviours

It is generally accepted that there is no cure for autism; however, with appropriate treatment and education, many children with the disorder can learn and develop. Early intervention is seen as vital and can often reduce challenges associated with the disorder, lessen disruptive behaviour, and provide some degree of independence for the child and relief for parents or care givers. Once the diagnosis has been made, parents, care givers, doctors and medical specialists should discuss what is best for the child. In most cases, parents are encouraged to take care of the child in a supportive, stable home environment.

Treatment very much depends on the individual needs of the patient and in most cases, a combination of treatment methods is more effective, although Autism usually requires lifelong treatment.

There are several methods of behaviour modification used to treat inappropriate, repetitive, and aggressive behaviour and to provide autistic patients with skills necessary to function to a reasonable level in their environment. Most types of behaviour modification are based on the theory that rewarded behaviour is more likely to be repeated than behaviour that is ignored – a theory known as Applied Behaviour Analysis (ABA).

Behaviour modification typically involves highly structured, skills oriented activities based on the needs of the patient taking into account their specific interests. It usually requires intense, one-on-one training with a therapist and extensive caregiver involvement.

Sensory integration therapy is a form of behaviour modification therapy focusing on helping autistic patients cope with sensory stimulation that may include having the patient handle materials with different textures or listen to different sounds.

Communication therapy is used to treat autistic patients that are not able to communicate verbally, or to initiate language development in young children with the disorder. Speech therapy may in more severe cases be used to help patients gain the ability to speak.