What is Autism Spectrum Disorder (ASD)

Autism Spectrum Disorder (ASD) is a developmental disorder related to brain function that encompasses a broad range or spectrum of developmental conditions. Autism is characterised by social communication, behaviour and sensory processing challenges.

• Social communication and interaction challenges may include:
  • developing, understanding and maintaining relationships
  • expressing emotions and understanding the feelings of others
  • preferring to be alone, especially when faced with a crowd
  • varying levels of verbal communication ranging from complete lack of verbal speech to delayed development of speech, language and comprehension
  • difficulty with non-verbal communication.
• Behavioural – challenges may include:
  • repetitive movements such as rocking and flapping hands
  • repetitive speech/words or sounds
  • repetitive non-verbal behaviour e.g. specific facial expressions or gestures
  • low tolerance for change, which can sometimes result in a meltdown e.g. a change in routine can lead to anxiety and distress
  • extreme variations in temperament and mood such as being extremely happy or very upset
  • limited preferences for activities or food.

• Sensory processing challenges may include:
  • difficulty receiving, processing, understanding and responding to sensory input in their environment
  • heightened sensitivity (hypersensitivity) or reduced/lack of response (hyposensitivity) to sensory input which could be from any or all the senses, including:
    • sight
    • hearing
    • smell
    • touch
    • external body awareness (proprioception) e.g. typing without looking at one’s fingers
    • internal body awareness (interoception) e.g. hunger and pain
    • balance, movement and spatial orientation (vestibular) e.g. balance while walking.

Other Health Conditions

• Autism is often associated with other health conditions such as:
  • gastrointestinal issues
  • sleep difficulties
  • seizures or epilepsy
  • anxiety
  • depression.

Channeling Strengths and Interests

• All children with autism benefit greatly from having their sensory needs and interests channeled into hobbies, which sometimes turn into rewarding careers e.g.
  • an interest in cooking can lead to a vocation as a chef
  • creative strengths can lead to a career in art
  • an attraction to computers can lead to developing programming skills.

• Some children with autism exhibit the Savant Syndrome, where they exhibit extraordinary abilities (savant skills) in areas such as:
  • memory
  • mental calculations
  • imagination
  • creativity
  • musical talent.

Myths about Autism

Myth: Autism is a childhood condition

Fact: Although the signs and symptoms of ASD typically become apparent in early childhood, the condition lasts lifelong. However, with interventions such as rehabilitation and training, the ability to function independently can be strengthened, and these individuals can learn to live as effective contributing members of society.

Myth: Autism is a contagious disease

Fact: Autism is not a contagious disease. It is a neurodevelopmental disorder.

Myth: Individuals with autism have difficulty building relationships

Fact: Social interaction and communication are often impaired in autism, but children with autism can form meaningful relationships with family and friends. It is important for non-autistic individuals to understand these children to help facilitate relationship building. With adequate support, children with autism can develop social skills.

Myth: All children with autism have challenges with learning

Fact: As children with autism may have challenges with sensory processing, fine motor skills, auditory processing or language expression, standard ways of learning can be challenging for them. However, with appropriate therapies and the right training they can excel in learning and academic performance.

Myth: All individuals with autism struggle with verbal and non-verbal communication

Fact: While many children with autism may have difficulty with verbal and non-verbal communication, the degree of difficulty can vary significantly in severity. Communication abilities can range from poor comprehension and communication skills to a complete lack of speech. With appropriate support, individuals on the spectrum can improve their language and comprehension skills, leading to better communication abilities.

Myth: Individuals with autism do not have emotions

Fact: Individuals with autism do experience emotions and feelings. However, they have difficulty expressing emotions. Therapy and interventions can help children learn to express emotions and also understand emotions of others. It is also important that the family and the connected social circle make an effort to understand the challenges and strengths of the child with autism, and adapt interactions accordingly.

Myth: All children on the spectrum have special talents or are savants

Fact: While some children on the spectrum may exhibit extraordinary and exceptional skills such as a remarkable memory or the ability to do advanced mental calculations, not all do. They may have their own interests and hobbies which, with sustained systematic training, can be developed into a skill or career of their interest.

Myth: Children with autism are more hyperactive and violent

Fact: It is not true that children with autism are more hyperactive or violent than other children. Their difficulties with communication and expression of emotions can sometimes lead to behaviours that might be perceived as violent.

Myth: Children with autism need to be more disciplined

Fact: All children on the spectrum have difficulty understanding social norms and cues. This can result in challenging behaviours which can be reduced and managed with support from a professional. It is also important that parents learn strategies such as emotional regulation techniques, making and telling social stories and Antecedent, Behaviour and Consequence (ABC) techniques.

Myth: Autism only affects boys

Fact: Autism is prevalent in both males and females. However, as girls are often better able to mask their symptoms, they tend to get diagnosed less/later than boys.

Myth: Autism is caused by bad parenting

Fact: Autism is a neurodevelopmental disorder. Parenting styles can influence a child’s development, they do not directly cause autism.

Myth: Excessive screen time can cause autism

Fact: Unrestricted and unsupervised prolonged screen exposure creates a condition in children that mimics autism in young children (virtual autism). This condition is not permanent and does not directly lead to the diagnosis of autism. However, excessive screen time can intensify the symptoms associated with the condition.

Myth: Autism can be diagnosed through laboratory tests indicating chemical imbalances

Fact: No laboratory tests are available to diagnose autism. Diagnosis is made by clinical evaluation.

Myth: Vaccines cause autism

Fact: A contributing factor towards this myth is the fact that diagnosis of autism is typically made after the age of receiving all childhood immunisations. No causal relationship has been found between ASD and vaccines in a meta-analysis of 10 studies in 1.25 million children.

References:

Geoghegan, O’Callaghan and Offit., Vaccine Safety: Myths and Misinformation; Front Microbiol, Mar 17, 2020

Taylor L, et al.  Vaccines are not associated with autism: an evidence-based meta-analysis of case-control and cohort studies, Vaccine, 2014;32:3623-3629

Myth: Autism can be cured or go away as a child grows

Fact: Autism is a disorder, not a disease. Hence, it cannot be ‘cured’. However, individuals with autism can learn strategies to cope with their characteristics and lead a fulfilling life in society.

Myth: Autism can be cured with special diets and naturopathy

Fact: Autism is a neurodevelopmental disorder. As the brain and nervous system evolve throughout life (neuroplasticity), therapies and improving the child’s health may support their development. However, as it is not a disease to be cured, any treatment that promises a 100% cure should be assessed carefully.

Early signs to watch for

ASD can be diagnosed in early childhood. In some instances, children may initially reach developmental milestones normally but might regress after a particular age e.g. 2 or 3 years.  The regression can manifest as loss of speech/eye contact, repetition of words without understanding (echolalia), etc.

• Some early signs of developmental delays before one year of age may include:
  • lack of joyful expressions, including smiles, by 6 months
  • poor attention to human faces or reduced infant-parent attention/engagement
  • absence of back-and-forth exchange of communicative sounds, smiles or other facial expressions by 9 months
  • no babbling or repetitive sounds, such as ba-ba or da-da, by 12 months
  • lack of communicative gestures, such as waving goodbye or nodding, by 12 months
  • lack of eye-contact.

• Some early signs of developmental delays before two years of age can include:
  • Inability to speak single words by 16 months
  • Limited vocabulary acquisition related to functional communication
  • Absence of meaningful two-word phrases by 24 months such as requesting water through, “Mumma water”
  • Delay in verbal or non-verbal communication
  • Difficulty in understanding tone of voice
  • Lack of joint attention between the child and another person.

• Some signs of developmental delay that can occur at any age are:
  • significant loss of language or social skills e.g. forgetting words that the child had previously used
  • unresponsive to social cues, such as smiles, facial expressions
  • difficulty in receiving and reciprocating physical or verbal affection
  • failure to consistently respond to one’s name
  • inconsistent responses to sounds e.g. does not respond to his/her name being called but comes running to softer sounds of their choice like rhymes or phone ringtones
  • limited to no eye-contact during interactions
  • repetitive behaviours with hands, gestures or sounds, such as flapping hands, walking on toes, grunting, staring at specific objects, etc.
  • decreased imitation of actions, facial expressions or hand gestures
  • difficulty in gross motor and fine motor skills
  • difficulty playing with others and showing limited interest in other children
  • limited engagement in a broad repertoire of functional play activities, often engaging in repetitive play, not involving or inviting others to play and struggling with pretend/imaginative play.

Early intervention can lead to improved outcomes later in life. Many children with ASD lead fulfilling, independent adult lives.

Source and Attribution of images: All images used in the above Assets and Aids are originally created.

This digital material has been developed by the Sri Sathya Sai Vidya Vahini Inclusive Education Project, a unit of Sri Sathya Sai Central Trust, Prasanthi Nilayam, as a collaborative offering in the service of our nation.