What is Autism Spectrum Disorder? And why is it often overlooked?

what is autism spectrum disorder

Takeaway: Children with autism have problems with social interaction, get stuck with repetitive behaviour, and are overloaded by sensory stimuli. But there’s such a variation in autistic behaviour that even doctors misdiagnose it. For example, they might notice your child’s short attention span and assume that her challenge is ADHD (attention-deficit/hyperactivity disorder). And once they’ve assumed this, they’ll likely ignore the underlying autism spectrum diagnosis. That’s why it’s important to take your child to an experienced multi-disciplinary team of specialists. 

Autism is a developmental difference that changes the way a person engages with the world.

By the age of three, a child with autism usually starts to behave differently from her friends. For example, she might get anxious and overwhelmed around crowds, loud sounds, and bright lights. Or she might prefer to play alone rather than with her friends. Or you might find her spending a lot of time lining up her toys, instead of playing with them. Perhaps she wants to take the same route to school every day? Or eat only foods of a certain colour? These are a cluster of traits that are caused by her brain developing differently. And this developmental difference is relatively common: more than one in a hundred people in the UK are on the autism spectrum. It’s important to note that autism isn’t an illness, though. And autistic children are just as intelligent as non-autistic children.

The thing is, there’s no one type of autism — only a range of common behaviour patterns. That’s why we call it the autism ‘spectrum.’

Each child experiences autism slightly differently, but we usually find these broad characteristics:

1. Finding it hard to get along with other people

This could be for many reasons:

  1. Trouble with language and speaking. She can understand what someone is saying to her, but might find it hard to respond. (If this is the case, she could benefit from learning sign language or using alternative forms of communication.)
  2. Trouble processing what’s been said. She might also find it hard to process abstract concepts.
  3. Trouble ‘reading’ other people. If she struggles to understand non-verbal communication, she’ll miss out on a lot of subtext like facial expressions, tone of voice, sarcasm, etc.
  4. Trouble showing emotion. Not only does she struggle to understand other people, but she finds it hard to express emotion. And this makes it hard for others to understand her in return. So, she might come across as insensitive or socially inappropriate.

2. Doing things in a particular way, and often repeatedly

A child with autism will often find herself overwhelmed and will use repetitive behaviour as a way of calming herself down.

  • Developing rituals. She might want to have the same breakfast at the same time and go to school using the same route every day. And changes in even the most minute details might upset her.
  • Setting up rules. Once she’s figured out how to do something, she might set up rules about how she’ll do it in the future. These rules usually help her relax because it’s a sign of order and routine.
  • Getting obsessed with a topic/object. As she gets older, she might show repetitive behaviour slightly differently. She might get obsessed with a special interest or subject. For example, drawing, music, computers, etc. Obviously, this can be a strength, if channelled right.

3. Highly sensitive to sounds, sights, smells, etc.

A lot of her overwhelm could come from the sensory inputs around her. So, heat, bright lights, strong smells, and vivid colours might trigger her anxiety. But it’s a fine balance because she might also be disturbed when there’s not enough sensory input, too. She might suddenly start touching and smelling things, to engage with her senses more.

Parents often notice the signs of autism early on.

Here are some parents’ early experiences with their children’s autism.

Gayle (Mother of Leo, Age 9)

“Leo is a twin, so I had another child to compare him to. When they were about 8 months old, I began to notice that the quality of his babbling was not the same as his sister’s. And there were moments when it was hard to hold his eye gaze. He’d look at me and smile, but it would be fleeting. He wasn’t inquiring through my face. At 11 months, I read What to Expect Your First Year and realized he wasn’t doing what he should be doing by that age.”

Cornelia (Mom of Lily, age 17)

“Lily is a twin, and for the first year, she was the faster-developing baby. And then around 12-13 months, the switch happened, though it was very subtle. She had language but stopped responding to her name. When Lily was two and a half, a friend of ours had seen a documentary on autism and had suspicions. We thought our friend was nuts but brought our daughter to see a nurse practitioner. By age three and a half, Lily no longer spoke.”

But even when a parent notices the signs of autism, doctors often overlook them.

There’s a list of things you’d observe in a child on the autism spectrum, so you’d think paediatricians would find it easy to make a diagnosis. But it’s not that simple. Because autism spectrum behaviours overlap with other development issues. For example, many preschoolers are overwhelmed by sensory stimuli, so even paediatricians might mistakenly conclude that your child’s main challenge is with sensory processing. Or if she has a short attention span, they might think she has ADHD (attention-deficit/hyperactivity disorder). And once they’ve decided that these are the things they want to address, it’s likely that the potential underlying autism spectrum will be ignored. Also, non-specialists might miss important things. For example, they might note that your child makes eye contact and smiles (encouraging signs), but will miss that she’s not doing these ‘right’ in social interactions.

That’s why you’ll need an experienced, interdisciplinary team to make the diagnosis.

They’re usually made up of a child psychologist and a speech and language therapist. And they won’t be rushing through a quick 15-minute session. The standard assessment tool, ADOS (the Autism Diagnostic Observation Schedule) alone takes half an hour to administer. And then there’ll be interviews with you about your child’s symptoms and problem behaviours.

But remember, your child is more than her autism diagnosis.

She can learn to be creative, productive, and excited about life. She might just do it differently to everyone else, though. It’s important to focus on her strengths, interests, and personality and help her do more of the things she loves. Remember, even if she has problems expressing emotions and feelings, it doesn’t mean she doesn’t have them. And even if she has problems with verbal communication, it doesn’t mean she has nothing to say. She’ll just need some extra help figuring these things out.

Do you think your child might have autism? Feel free to consult with us.

The Ed Psych Practice offers consultation, advice, and problem solving for parents, nurseries, schools, and colleges, in London.

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