A child with autism is one who is born into a world of bewilderment and confusion. They do not make sense of the world as other people do. The child with autism will need to have the way the world works explained and taught to them step by step by step. A child with autism can help us appreciate the ease with which most children develop, learn and adapt to all that the world presents to them.
Autism is a complex developmental disorder that affects the way a person communicates and relates to other people and the world around them. People with autism usually have difficulty within 4 main areas:
Communication: A person with autism can have difficulty understanding spoken word and body language. Words may be taken literally or misunderstood. The feelings of others can also be difficult to understand.
Social interaction skills: Autism affects the ability of a person to interact and relate to other people, to form friendships and develop relationships. As a result some become withdrawn and isolated, others try hard to be accepted but often fail.
Social imagination: Autism affects imagination or put another way, flexible-thinking skills. Imagination is not just about play or being creative. Much of what we think about and know depends upon an ability to imagine - our ability to plan and organise, problem solving, seeing things from another person's point of view, our understanding of abstract concepts such as 'tomorrow' 'the future' etc. A person with autism will often have difficulties in these areas.
Sensory Issues: People with autism can be over or under sensitive to sound, smell, touch, taste, temperature and pain. Over sensitivity to sound for example can make outings to noisy places such as shopping centres or sports centres unbearable.
As a result of these social, communication and sensory impairments there can be a tendency for the individual to adhere to quite rigid routines and repetitive behaviours.
These may include:
Attachment to routine and repetitive patterns of behaviours helps bring a feeling of order and security to a world that seems confusing and difficult to understand.
Unfortunately being too attached to routine and ways of behaving limits how well a person can function in an ever changing and demanding world.
No two individuals with autism will present in the same way but all will share the common difficulties listed above but perhaps to different degrees. Many people with autism have intellectual disability. Some people with autism may have strong abilities in certain areas such as memory, drawing or music. A small percentage of people with autism will have exceptional abilities in certain fields.
Autism spectrum disorders are now reported to affect the lives of as many as in 1 in 166 people. Boys are 4 times more likely to be affected than girls. There has been a significant rise in the occurrence of autism in recent years.
We do not know what causes autism. Reports and research suggest that there is a genetic link. Studies also indicate that environmental factors may play a part. A number of possibilities have been suggested e.g. vaccinations, viral infection, difficulty before, during or immediately after birth, allergies. But there is a lack of scientific evidence to link autism with any particular factor (N.A.S. UK 2003). At present most cases are of unknown cause.
As yet there is no medical test for autism. Diagnosis is based on a detailed history of the child's development and observation of particular patterns of behaviour.
Early diagnosis: if you are concerned about your child or if people whose opinion you trust are expressing concerns, talk to your G.P. or Public Health Nurse and seek assessment for your child. Under the Disability Act 2005 any parent who feels that their child (aged under5) may have a disability can apply to the HSE for an independent a Assessment of Needs. (See Contacts.) The earlier a child is diagnosed and can avail of early interventions the better the long-term outcome will be. A detailed multi-disciplinary assessment will provide a proper diagnosis. The Childhood Autism Test (CHAT) can indicate those children for whom further assessment and advice should be sought. (See Contacts.)
Education: in general a combination of special education, speech therapy, occupational therapy and behavioural intervention will benefit a child with autism. Education is the primary area of intervention for a child with Autism. The earlier educational intervention can start the better the long-term outcome will be. These services can be accessed through the Department of Education Special Needs Education Organiser (SENO), local HSE Early Intervention Team (EIT) and pre-school services. (See Contacts.) Parents can also help by informing themselves about Autism and the services and supports that should be available for their child. Parents must be active in seeking out the services their child needs.
Child support: a child with autism looks like any other child but sometimes, out of frustration or anxiety, their behaviour can be difficult. The child with autism needs our patience and encouragement. We should consider that perhaps the child who appears to be behaving badly is finding things hard and not that their parents are failing to deal with the behaviour. When speaking to a child with autism speak simply and clearly, using as few words as necessary. Allow the child time to consider what has been said. By including the child with autism we can help the child to learn and be part of their local community. Ask the child's parents if the event is suitable for the child and what support the child needs.
Parent Support: this is critical as parents, who are their child's best teacher and support, are themselves dealing with very difficult circumstances. Local parent support groups, such as Laois Offaly Families for Autism (LOFFA), can provide information, advice, and an opportunity to talk and meet with other parents. (See Contacts.) Where available, respite care can allow parents to take a break from the responsibility of full time care knowing that their child is being looked after in a safe and home like environment. Relatives and friends can provide invaluable help by giving parents a break, even an hour or 2 for shopping or to go for a walk.
Adult Support: some adults with autism live independently and many can live independently with the support of family. Some adults with autism may require, on a part-time or full-time basis, residential facilities that provide care, support and meet the specific needs of people with autism. The development and provision of community based residential facilities is essential to ensure local needs are met.
Other interventions: various alternative therapies have been proposed for the treatment of autism. These include dietary intervention, vitamin therapy, music therapy, massage etc. While many report anecdotal evidence of improvements in behaviour and or development, to date none are scientifically proven to be effective or provide a cure for autism. Any intervention being considered can be discussed with a qualified medical or educational practitioner and with other parents who may have information or experience of the therapy.
Advocacy: although the child or adult with autism may have significant needs in terms of health, educational and care services all to often these services are not available where or when they are needed. Raising awareness of autism, the benefits of early intervention (in terms of quality of life and long term costs) and the duty of care we owe to all our citizens especially those with special needs, is a vital role.