Although commonly spoken of as simply “autism” or “autistic,” it is important to note that this occurs on a continuum as is better described as “autistic spectrum disorder” (ASD). This is a multifaceted lifelong developmental disability affecting how a person communicates and relates to people around them. The continuum or spectrum is defined by deficiencies in social interaction, social communication and social imagination and involves a constricted, repetitive series of activities.
To look at these in more detail, children with ASD struggle to participate in mutual social interactions. A large proportion of individuals with more severe autism fail to develop useful speech or have difficulty using speech to communicate with others; many children do not respond to their name being called. Eye contact is often fleeting or absent and the use of non-verbal interactions (facial expressions and gestures, even social smiling) can be impaired. Pretend play tends to be absent in children with ASD and many develop rigid and repetitive behaviours, such as lining up toys, spinning the wheels on a toy car, hand flapping or even head banging. Many children on the spectrum develop preoccupations, such as being obsessed cars, dinosaurs or buttons. ASD children rarely try to engage or direct the attention of someone else, rarely calling their parents to look at something, for example.
There are also behavioural concerns connected to ASD, as children on the spectrum may have excessive temper tantrums or display oppositional behaviours. They may be hyperactive and uncooperative with unusual attachments to toys, even though the toy may not be played with as expected. Oversensitivity to textures and sounds is common and some children walk on their toes.
Everyone who is considered to be on the autistic spectrum is different, for examples, cognitive or intellectual functioning ranges from severely learning disabled through to above average and even gifted levels of intelligence. By the same token, language skills vary from people who are mute all the way to those who have complex vocabularies and grammatically correct speech.
People often ask what the cause of ASD is and, unfortunately, there is no answer to this question, though research continues to try and find an answer. What we do know is that it can be caused by a variety of conditions which affect brain development and which occur before, during or after birth, for example, lack of oxygen at birth, maternal illnesses and even complications from some childhood illnesses, such as whooping cough and measles. There is some indication of a genetic link, following twin and family studies but no specific genes have been identified.
ASD is a lifelong disability but with early diagnosis, the correct interventions, individual education programmes and approaches, as well as structured support and even therapeutic intervention, a child can be helped to get the most out of their abilities and achieve their potential as adults. It is equally important for families and caregivers to be given appropriate services and professional support.
In terms of diagnosis, in most situations, there are indications of developmental problems within the first year and difficulties with communication, social skills and imaginative play are evident within the first three years of life. However, as ASD is so complex and no two people with have the same pattern of symptoms or difficulties, it is possible for the condition to go undiagnosed for a longer period of time. In addition to this, because autism is on a continuum, those who are more mildly affected with subtle signs can go undiagnosed for a longer period of time.
To conclude: Autistic spectrum disorders are a group of developmental disorders and children with autistic spectrum and related disorders will require extra help educationally and therapeutically. Behaviour modification is useful to assist with behaviour management and, for some children, psychiatric treatment may be necessary to deal with any co-occurring conditions.