Autism spectrum disorder (ASD) is characterised by impairments in social communication, social interaction and the presence of repetitive patterns of behavior. The signs and effects of autism vary widely so consequently the term spectrum is used. Autism can be diagnosed at any age; however it is described as a developmental disability as symptoms typically appear in early childhood.
There is high variability in prevalence estimates of autism worldwide, largely due to the methodological differences in sourcing data. The Centers for Disease Control and Prevention report the prevalence of autism to be about 1 in 54 children. These statistics are based on The Autism Developmental Disabilities Monitoring (ADDM) network surveillance program that estimates the prevalence of ASD in children aged eight living in 11 network sites in the United States. The reliability of this statistic has been questioned, but as the only surveillance system to currently track ASD prevalence over a period of years it’s identification of an increasing trend in prevalence rates is respected.
In the UK autism is reported to affect approximately one child in every hundred. Around four times as many boys as girls are likely to receive a diagnosis of autism.
The exact causes of autism are not known and research is continuing. Scientists believe that genetics and environmental influences are factors.
NICE Guidelines in the UK 2011 (under review) recommend that diagnostic assessment of possible autism should be conducted by a multidisciplinary group (the autism team). The autism team should include a paediatrician and/or child and adolescent psychiatrist, speech and language therapist and a clinical and or educational psychologist. We would also recommend that a BCBA also serve as part of the team. Together the team will make decisions on the assessment needs and the diagnosis.
By one year of age, children typically share with parents and others interesting events and activities in the environment. Failure to develop this joint attention may show through the absence of eye contact, pointing to items of interest, and being unresponsive when their name is called.
Language impairments may present through a lack of interest in communicating with others and a delay in language skills may be detected e.g. by 15 months, children may not emit single words and by 24 months they may not emit two-word phrases.
The presence of repetitive behaviors may be apparent in play, language, focused interests or movements. During play with toys unusual or repetitive behaviors may include lining up toys with the same pattern, or focusing on small parts of the toys e.g. repetitively spinning the wheel on a toy train rather than engaging in creative play with toys as they were intended. Repeatedly echoing the words and phrases of people or words and phrases from television and other technologies are examples of repetitive language. Repetitive behaviors may also appear in relation to an intense interest in certain areas e.g. letters and numbers, or topics e.g. train stations, washing machines.
Repetition of the same body movements in the form of rocking and unusual motor movements known as stereotypic behavior or stereotypies e.g. hand flapping, spinning, twirling fingers or toe walking may be detected in some children.
It is important to remember that not all children with autism show all of these signs, and equally children who do not have autism may exhibit some of the behaviors.
If parents have concerns about their child’s development with social, communication, play skills or repetitive behaviors, they should consult their Health Visitor, a Doctor or any other health professional your child sees for professional guidance and evaluation. Assessment and diagnosis can lead to appropriate services.
Although Applied behavior Analysis (ABA) is commonly associated with the treatment of Autism Spectrum Disorder (ASD), the Carbone Clinic also has experience providing evidence-based and individualized services to individuals with other developmental delays.