Autism Spectrum Disorders (ASD)
Autism Spectrum Disorders are thought to affect around 1.1% of the UK population (which is more than 1 in 100 people). The number of people with an ASD seems to be increasing, perhaps because more people recognise the diagnosis and seek assessment. There is no single known cause of ASD, but we know that:
- Genetic factors are thought to be the most significant cause of ASD. Some genetic conditions are associated with ASD (e.g. Fragile X Syndrome).
- Children with difficult birth histories (e.g. hypoxia during childbirth, or low birth-weight) are more likely to develop ASD. However, it is uncertain whether these factors cause a child to develop ASD, or are themselves caused by the presence of ASD.
- Whilst extremely severe neglect can be associated with children who demonstrate features of ASD, ASD is not caused by 'bad' parenting.
- There is no evidence that vaccinations (e.g. the MMR) cause ASD. The one piece of research to suggest a link between vaccines and ASD has been widely discredited. Further research has shown no link between vaccines and ASD.
- ASD is a pervasive developmental disorder (PDD). This means that it is a lifelong condition, that affects many areas of a child’s development. Whilst there is no known cure for ASD, there are interventions that can help children to develop skills and reduce some of the difficulties associated with ASD.
The Triad of Impairments
ASD is characterised by impairments in three aspects of a child’s development, also some-times referred to as ‘the triad of impairments’:
The ability to express oneself, both verbally (what we say) and nonverbally (our facial expressions, our ‘body language’).
The ability to interact appropriately with other people, including interest in other people’s ideas and experiences, and the ability to empathise (understand) other people’s feelings.
The ability to think and behave flexibly and creatively, including tolerance of change, imaginative play and adaptive responses to situations.
Individuals with ASD may also show sensory sensitivities or interests. This means that they may find particular sensations (e.g. loud noises, strong smells, certain textures) overwhelming, or that they may seek out particular sensations (e.g. the feel of a particular item of clothing, watching something spin).
It should be remembered that all children and young people with ASD are different. Some children and young people have a learning disability as well as ASD, whilst some children and young people with ASD do not have a learning disability (e.g. Asperger Syndrome).
This diagram shows the triad of impairments. Children and young people with significant difficulties in all 3 areas (social interaction, communication and imagination) may have ASD. However, there can be other reasons for difficulties in these areas.
What can you do as a parent/carer?
Whilst there is no known ‘cure’ for ASD, there are lots of things that parents and professionals can do to support children and young people with ASD, and to help them to overcome their difficulties:
Children/young people with ASD can find relating to other people, and understanding their thoughts and feelings, very difficult. Parents and people around the child or young person can help by:
- Recognising these difficulties.
- Teaching the child/young person ‘social rules’ such as saying ‘hello’ or shaking someone’s hand, asking how they are, taking turns etc.
- Teaching the child/young person about feelings. This may include pictures, role-play, video and stories.
Some children and young people with ASD show very little interest in interacting with other people. Approaches such as intensive interaction (interacting with the child at their ‘level’, involving their sensory interests and actions) may be helpful for these children.
Children and young people with ASD can find it difficult to cope with change or new experiences. This may be because they struggle to understand the world around them, and what is expected of them in new situations. You can help by:
- Introducing routines. This makes the world predictable and reduces anxiety, which in turn can improve mood and behaviour.
- Visual timelines or timetables that the child can refer to can also be helpful as it makes what is happening clear to the child.
- Using social stories to help children and young people to understand the world around them. Social stories describe particular situations, what will happen, and what the child or young person is expected to do.
Some children and young people with ASD learn to speak, and some rely more upon symbols, pictures or signs (Makaton). When children/young people cannot communicate their needs or wishes, or how they feel, they can become frustrated. This, in turn, can lead to low mood, angry outbursts, and challenging behaviour. Communication can be improved by:
- Making verbal instructions simple and direct.
- Checking that you have understood a child or young person correctly, by repeating the phrase and seeking confirmation (or disagreement!) from the child or young person.
- Supplementing your communication with pictures or visual aids (e.g. PECS or Makaton), to help the child or young person to understand you. Even when young people with ASD have a good vocabulary, pictures can be reassuring and can reduce stress.
There is increasing evidence that individuals with ASD process sensory information in a different way from people without ASD. Efficient sensory processing is essential to our understanding of the world, and our ability to respond appropriately.
- Sometimes, difficult behaviour can be partly due to a child’s inability to ‘sort out’ the sensory input that they receive.
- Observe your child’s behaviour, and think about whether your child is seeking or avoiding a sensory experience.
- Allow space from environments that create sensory overload. For example, using ear defenders in noisy environments can be helpful.
- Children who find it hard to control their level of excitement or ‘arousal’ can benefit from massage or heavy muscle activities (‘deep pressure’), as these activities can be calming.
Further support, advice and self-help
The Royal College of Psychiatry information on Autsim.
The National Autistic Society provides information and support for people with Autism and their families and for professionals. They are a very active organisation and offer some really useful information about strategies and approaches for supporting people with Autism.
The British Institute of Learning Disabilities also have some useful information and further advice about a variety of common issues.
Local Offer is a Derbyshire-specific site which allows you to search for lots of different services, including parenting support groups, in the local area.