Autism Spectrum Disorder (ASD)
Autism spectrum disorders (ASDs) are lifelong developmental disabilities characterised by marked difficulties in social interaction, impaired communication, restricted and repetitive interests and behaviours and sensory sensitivities.
The word ‘spectrum’ is used because the range and severity of the difficulties people with an ASD experience can vary widely. ASDs include autistic disorder, Asperger’s disorder and pervasive developmental disorder – not otherwise specified, which is also known as atypical autism. Sometimes the word “autism” is used to refer to all ASDs.
Research shows that about 1 in 100 children, almost 230 000 Australians, have an ASD and that it is more prevalent in boys than girls. The effects of an ASD can often be minimised by early diagnosis and with the right interventions, many children and adults with an ASD show marked improvements.
The three main areas of difficulty are:
1. Impairment in social interaction
- Limited use and understanding of non-verbal communication such as eye gaze, facial expression and gesture
- Difficulties forming and sustaining friendships
- Lack of seeking to share enjoyment, interest and activities with other people
- Difficulties with social and emotional responsiveness
2. Impairment in communication
- Delayed language development
- Difficulties initiating and sustaining conversations
- Stereotyped and repetitive use of language such as repeating phrases from television
- Limited imaginative or make-believe play
3. Restricted and repetitive interests, activities and behaviours
- Unusually intense or focused interests
- Stereotyped and repetitive body movements such as hand flapping and spinning
- Repetitive use of objects such as repeatedly flicking a doll’s eyes or lining up toys
- Adherence to non-functional routines such as insisting on travelling the same route home each day
In addition to these main areas of difficulties, individuals with anASD may also have:
- Unusual sensory interests such as sniffing objects or staring intently at moving objects
- Sensory sensitivities including avoidance of everyday sounds and textures such as hair dryers, vacuum cleaners and sand
- Intellectual impairment or learning difficulties
What are the different types of ASD?
The term ASD is an umbrella description which refers to three different diagnoses. Regardless of the specific diagnosis given, individuals with an ASD will experience difficulties in many different social situations such as school and work.
Autistic disorder (sometimes referred to as classic autism)
The diagnosis of autistic disorder is given to individuals with impairments in social interaction and communication as well as restricted and repetitive interests, activities and behaviours which are generally evident prior to three years of age.
Asperger’s disorder (sometimes referred to as Asperger’s syndrome)
Individuals with Asperger’s disorder have difficulties with social interaction and social communication as well as restricted and repetitive interests, activities and behaviours. Individuals with Asperger’s disorder do not have a significant delay in early language acquisition and there is no significant delay in cognitive abilities or self help skills. Asperger’s is often detected later than autistic disorder as speech usually develops at the expected age.
Pervasive Developmental Disorder – Not Otherwise Specified (PDD-NOS) (sometimes referred to as atypical autism)
The diagnosis of PDD-NOS or atypical autism is made when an individual has a marked social impairment but fails to meet full criteria for either autistic disorder or Asperger’s disorder. These individuals may also have communication impairments and/or restricted and repetitive interests, activities and behaviours.
How is ASD diagnosed?
ASD is diagnosed through an assessment which includes observing and meeting with the individual, their family and service providers. Information is gathered regarding the individual’s strengths and difficulties, particularly in the areas of social interaction and communication as well as restricted and repetitive interests, activities and behaviours.
Such information may be obtained by administering standardised tests or questionnaires. ASD is usually diagnosed in early childhood, but assessments can be undertaken at any age. There is no single behaviour that indicates ASD. There are no blood tests that can detect ASD.
Developmental paediatricians, psychiatrists and psychologists with experience in assessing individuals with ASD are qualified to make a diagnosis. When making a diagnosis, the clinician will usually first determine whether an individual meets the criteria for autistic disorder. If all the criteria are not met, they may consider Asperger’s disorder, or PDD-NOS (atypical autism).
If you have concerns, your GP may refer you to a developmental paediatrician or diagnostic assessment service in your area. Alternatively, you may contact Autism Spectrum Australia (Aspect) about the Aspect Diagnostic Assessment Service on 02 8977 8300.
What causes ASD?
Currently, there is no single known cause for ASD, however recent research has identified strong genetic links. ASD is not caused by an individual’s upbringing or their social circumstances.
Is there a cure?
There is presently no known cure for ASD. However, early intervention, specialised education and structured support can help develop an individual’s skills. Every individual with ASD will make progress, although each individual’s progress will be different. Progress depends on a number of factors including the unique make up of the individual and the type and intensity of intervention. With the support of family, friends and service providers, individuals with ASD can achieve a good quality of life.
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