Education/Development

Autism – What is it?

Many of you may have heard about autism or you know of an autistic child. Your child may have even been diagnosed with autism, or you may be worried that your child has it. So – What exactly is it? Here is some information about Autism that might help you understand it more.

What is it?

Autism is a lifelong developmental disability that affects how people perceive the world and interact with others. Autistic people see, hear and feel the world differently to other people. If you are autistic, you are autistic for life; autism is not an illness or a disease and cannot be “cured”.

Autism is a spectrum condition. All autistic people share certain difficulties, but being autistic will affect them in different ways. Some autistic people also have learning disabilities, mental health issues or other conditions, meaning people need different levels of support. All people on the autism spectrum can learn and develop – so with the right support, all can be helped to live a more fulfilling life of their own choosing.

How common is autism?

Autism is much more common than most people think. People from different nationalities, cultures, religions and social backgrounds can be autistic. It is how aware people are of it, that makes the difference. In India, a lot of people don’t openly talk about, or even recognise autism. If they do, it is often seen as a severe disability and many children are shunted because of this.

How do autistic people see the world?

Some autistic people say the world feels overwhelming and this can cause them considerable anxiety. In particular, understanding and relating to other people, and taking part in everyday family, school, work and social life, can be harder. Other people appear to know, intuitively, how to communicate and interact with each other, yet can also struggle to build rapport with autistic people. Autistic people may wonder why they are ‘different’ and feel their social differences mean people don’t understand them.
Autistic people often do not ‘look’ disabled. Some parents of autistic children say that other people simply think their child is naughty, while adults find that they are misunderstood.

What causes autism?

The exact cause of autism is still being investigated. Research into causes suggests that a combination of factors – genetic and environmental may account for differences in development. Autism is not caused by a person’s upbringing or their social circumstances and is not the fault of the individual with the condition.

Diagnosis

A diagnosis is the formal identification of autism, usually by a diagnostic team, often including a speech and language therapist, paediatrician, psychiatrist and/or psychologist.

The benefits of a diagnosis

Getting a timely and thorough assessment and diagnosis may be helpful because:
• It helps autistic people (and their families/teachers) to understand why they may experience certain difficulties and what you can do about them.
• It allows people to access services and support.

How autism is diagnosed

The characteristics of autism vary from one person to another, but in order for a diagnosis to be made, a person will usually be assessed as having had persistent difficulties with social communication and social interaction and restricted and repetitive patterns of behaviours, activities or interests since early childhood, to the extent that these “limit and impair” everyday functioning.

Persistent difficulties with social communication and social interaction

* Social communication
Autistic people have difficulties with interpreting both verbal and non-verbal language like gestures or tone of voice. Many have a very literal understanding of language, and think people always mean exactly what they say for example if someone said “gosh, its really raining cats and dogs out there” – They might literally believe cats and dogs are falling from the sky. They may also find it difficult to use or understand:
• facial expressions
• tone of voice
• jokes and sarcasm.
Some people may not speak, or have fairly limited speech. They will often understand more of what other people say to them than they are able to express, yet may struggle with vagueness or abstract concepts. Some autistic people benefit from using, or prefer to use, alternative means of communication, such as sign language or visual symbols. Some people are able to communicate very effectively without speech.
Some autistic people may have good language skills, but they may still find it hard to understand the expectations of others within conversations, perhaps repeating what the other person has just said (this is called echolalia) or talking at length about their own interests.
It often helps to speak in a clear, consistent way and to give autistic people time to process what has been said to them.

* Social interaction
Autistic people often have difficulty ‘reading’ other people – recognising or understanding other peoples feelings and intentions – and expressing their own emotions. This can make it very hard for them to navigate the social world. They may:
• appear to be insensitive
• seek out time alone when overloaded by other people
• not seek comfort from other people
• appear to behave ‘strangely’ or in a way thought to be socially inappropriate.
Autistic people may find it hard to form friendships. Some may want to interact with other people and make friends, but may be unsure how to go about it.

Repetitive behaviour and routines
The world can seem a very unpredictable and confusing place to autistic people, who often prefer to have a daily routine so that they know what is going to happen every day. They may want to always travel the same way to and from school, or eat exactly the same food for breakfast.
The use of rules can also be important. It may be difficult for an autistic person to take a different approach to something once they have been taught the ‘right’ way to do it. People on the autism spectrum may not be comfortable with the idea of change.

Highly focused interests
Many autistic people have intense and highly focused interests, often from a fairly young age. These can change over time or be lifelong, and can be anything from art or music, to trains or computers. An interest may sometimes be unusual. One autistic person loved collecting rubbish, for example. With encouragement, the person developed an interest in recycling and the environment.

Sensory sensitivity
Autistic people may also experience sensitivity (mild or severe) to sounds, touch, tastes, smells, light, colours, temperatures or pain. For example – they may find certain background sounds, which other people ignore or block out, unbearably loud or distracting. This can cause anxiety or even physical pain. Or they may be fascinated by lights or spinning objects.

Is there a cure?

There is no ‘cure’ for autism. However, there is a range of approaches and strategies – methods of enabling learning and development – which people may find to be helpful.

Do you think your child may have autism?

As a parent, you’re in the best position to spot the earliest warning signs of autism. You know your child better than anyone and observe behaviours that a paediatrician, in a quick visit, might not have the chance to see. Your child’s paediatrician can be a valuable partner (but don’t discount the importance of your own observations and experience). The key is to educate yourself so you know what’s normal and what’s not.

Monitor your child’s development. Autism involves a variety of developmental delays, so keeping a close eye on when/if your child is hitting the key social, emotional, and cognitive milestones is an effective way to spot the problem early on. While developmental delays don’t automatically point to autism, they may indicate a heightened risk.

Take action if you’re concerned. Every child develops at a different pace, so you don’t need to panic if your child is a little late to talk or walk. When it comes to healthy development, there’s a wide range of “normal.” But if your child is not meeting the milestones for his or her age, or you suspect a problem, share your concerns with your child’s doctor immediately. Don’t wait.

Don’t accept a wait-and-see approach. Many concerned parents are told, “Don’t worry” or “Wait and see.” But waiting is the worst thing you can do. You risk losing valuable time at an age where your child has the best chance for improvement. Furthermore, whether the delay is caused by autism or some other factor, developmentally delayed kids are unlikely to simply “grow out of” their problems. In order to develop skills in an area of delay, your child needs extra help and targeted treatment.

Trust your instincts. Ideally, your child’s doctor will take your concerns seriously and perform a thorough evaluation for autism or other developmental delays. But sometimes, even well-meaning doctors miss red flags or underestimate problems. Listen to your gut if it’s telling you something is wrong, and be persistent. Schedule a follow-up appointment with the doctor, seek a second opinion, or ask for a referral to a child development specialist.

Regression of any kind is a serious autism warning sign
Some children with autism start to develop communication skills and then regress (usually between 12-24 months). For example, a child who used to enjoy sociable games such as ‘peek a boo’ but then stopped because they found themselves uncomfortable is a form of regression. Another example of regression is if your child was communicating with words such as “Mama” and “Papa” and they then stop all language and verbal communication. Any loss of babbling (babies), speech, gestures, or social skills should be taken very seriously, as this type of regression can be a big warning sign.

Signs and symptoms of autism in babies and toddlers

The earlier you detect autism, the better. If autism is caught in infancy, treatment can take full advantage of the young brain’s remarkable plasticity. Although autism is hard to diagnose before 24 months, symptoms often surface between 12 and 18 months.
The earliest signs of autism involve the absence of normal behaviours, not the presence of abnormal ones, so they can be tough to spot. In some cases, the earliest symptoms of autism are even misinterpreted as signs of a “good baby,” since the infant may seem quiet, independent, and undemanding. However, you can catch warning signs early if you know what to look for.

Early signs could be that your baby or toddler doesn’t:
• Make eye contact, such as looking at you when being fed or smiling when being smiled at.
• Respond to his or her name, or to the sound of a familiar voice.
• Follow objects visually or follow your gesture when you point things out.
• Point or wave goodbye, or use other gestures to communicate.
• Make noises to get your attention.
• Initiate or respond to cuddling or reach out to be picked up.
• Imitate your movements and facial expressions.
• Play with other people or share interest and enjoyment.
• Notice or care if you hurt yourself or experience discomfort.

Developmental delays to look out for:
By 6 months: No big smiles or joyful expressions.
By 9 months: No back-and-forth sharing of sounds, smiles, or other facial expressions.
By 12 months: Lack of response to name, no gestures, such as pointing, showing, reaching, or waving and no babbling or “baby talk”.
By 16 months: No spoken words.
By 24 months: No meaningful two-word phrases that don’t involve imitating or repeating.
The following delays call for an immediate evaluation by your child’s paediatrician.

As a parent, having a child with autism can be tough, there is no denying that. However- having a positive attitude can really help. The challenge lies in finding a way to love and harness your child’s uniqueness and find a way to facilitate their participation in society in a meaningful and rewarding way.

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