Autism Spectrum Disorders

Autism is characterised by a triad of impairments in the areas of:

  • social interaction (failure to develop peer relationships appropriate to developmental age; lack of social and emotional reciprocity; impairments in eye-to-eye gaze, facial expression, body postures and gestures to regulate social interaction)
  • communication (delay in, or lack of the development of spoken language, stereotyped and repetitive use of language, lack of varied and spontaneous make believe play or social imitative play)
  • restricted, repetitive and stereotyped patterns of behaviour, interests and activities (preoccupation with one or more stereotyped and restricted pattern of interest that is abnormal in intensity and focus, inflexible adherence to specific, non functional routines, persistent preoccupation with parts of objects, stereotyped and repetitive motor mannerisms)

Difficulties in the above three areas can range from severe to mild and hence the term “autistic spectrum” has been adopted.. A child with autism can be described as “mindblind” in that he/she has difficulties with processing stimulus (auditory, visual and sensory) and “thinking” in a different way. This different thinking typically manifests in struggling to generalise concepts and literal thinking dominates. Children with autism need to be understood from “within”. Specialised educational intervention and understanding is paramount to the success of children and support for their families.
Diagnosis includes a thorough historicity of the child, including a paediatric assessment. Interviews and observation including rating scales and behavioural observation schedules of the child in more than one setting is often used in determining diagnosis.

Asperger Syndrome (AS) is characterised by:

  • failure to develop peer relationships at age appropriate developmental level. Younger children typically show a lack of interest in social interaction and older children show an interest and willingness to make friends but lack understanding of social conventions of social interactions.
  • Restricted interests that are pursued with great intensity and to the exclusion of other activities (collections and adherence to ritual and routine are common).
  • No clinically significant delay in language (single words by 2 years and communicative phrases by 3 years). Literal thinking is common.
  • No clinically significant delay in cognitive development or the development of self-help skills.

Concerns are normally only voiced by parents after 3 years or when the child is exposed to a play group or pre-school where social difficulties become apparent. Many children are only diagnosed with AS when they are at school. Diagnosis involves a thorough historicity of the child as well as a psychometric or neuropsychological assessment to rule out other disorders which may share common symptoms. Support for the child and his family within the schooling environment is an essential aspect of helping the child with AS.