By Catherine Eldridge (Child and Adolescent Psychologist, Lakeside Psychology)
AMAZE (Autism Victoria) describes Autism Spectrum Disorder (ASD) as a developmental condition which impacts on aspects of a person’s brain and development. Symptoms of ASD usually become noticeable in early childhood, and while many children are diagnosed at this time, others whose symptoms are milder find themselves being diagnosed in adulthood.
“If you have met one person with autism, you have met one person with autism”. This well-known quote from Professor Stephen Shore summarises the experience of ASD well and how very differently it can present in different individuals. However, some examples of what to look for can include:
* Difficulties with peer friendships.
* Difficulties with social communication and typical ‘back and forth conversation’ skills.
* Difficulties with non-verbal communication (e.g., eye contact, body language and gestures).
* Difficulties with integrating verbal and non-verbal communication together in social situations (e.g., combining eye contact, body language or hand gestures with verbal communication).
* Having an unusually strong interest in a particular topic or object.
* Having unusual reactions to sensory environment (e.g., strong reactions to light, sound, noise or some clothing textures).
* Having a strong preference for routine and difficulties in adjusting to change.
While these are common symptoms, it is also widely accepted that ASD can present quite differently between males and females. Females are thought to better ‘mask’ their challenges and rote learn social cues and rules, thus making assessment a more difficult process.
The process of diagnosis
Previously, different names were used to describe the symptoms above, including Autism, Asperger’s Syndrome, and Pervasive Developmental Disorder. However, the most recent edition of the diagnostic manual (DSM-5), these terms were combined and Autism Spectrum Disorder (ASD) is now the diagnostic term used, and there are three levels used to provide an indication of the level of support required.
There are both public and private services that can help with the assessment and diagnosis of ASD. Amaze has a list of public services on their website (www.amaze.com.au) that can assist with assessment and diagnosis.
However, due to a high demand for public services they can sometimes have very long waiting lists (up to 18 months). There are also a range of private services to with assessment and diagnosis, which often come with much shorter waiting times.
Your child’s assessment will likely take place over several appointments that either you and/or your child will attend, where your paediatrician, psychologist and speech therapist will determine whether your child meets the diagnostic criteria for ASD. Your team of professionals will then be able to provide you with the results of your child’s assessment, discuss whether you child meets the criteria for ASD, provide recommendations for any support that your child may need, and let you know about any funding that you may be able to access to assist with such support.
What does a diagnosis mean for my child and my family?
Parents and families can have a range of different reactions to the possibility of ASD in their children. For some parents, initial suggestions from teachers or professionals that their child may have a difficulty and to consider an assessment can be an overwhelming and confusing experience.
Upon receiving a diagnosis, some parents experience a grief reaction, including feeling numb, feeling concerned for their child and what the future holds, and how they will be accepted by others. Some parents experience feelings of self-blame and responsibility for their child’s diagnosis.
For other families (and children at the right time), a diagnosis can bring a sense of relief and help to explain different challenges that the child has experienced and that these challenges are not due to the child being “naughty”, or a reflection on parenting.
Regardless of the outcome, it can be helpful to speak with your child’s professionals for support after your child’s assessment to help with any reaction you may experience.
It can also be helpful to consider how a diagnosis does not need to define a child, and to consider what strengths a child with ASD may have.
In fact, some children with ASD are known for being great story tellers through amazing attention to detail, others show amazing talents for mathematics, music or art, and others can be great employees as adults with high efficiency in their jobs.
What support does my child with ASD need?
As ASD can present very differently in children and adults, the treatment options are also varied. There is no known ‘cure’ for ASD, but a range of professionals can provide different evidence-based treatments to help children and their families cope more effectively. For some children, the world can be a confusing place when they don’t necessarily have the skills to manage social relationships and communication with others that come more naturally to other children.
Many families will speak of various challenging behaviours, including crying, screaming or tantrums when children with ASD experience difficulties in navigating our highly social world, or when there is an overload to their sensory environment or changes in their routine.
It is common for children to work with any combination of paediatricians, psychologists, speech/language therapists and occupational therapists to assist in supporting both the child and the family to best manage their specific challenges.
There are a range of different funding options to assist with providing treatment early in childhood, for primary school and secondary school aged-children, as well as in adulthood. Professionals that you work will be able to advise you further on any available funding options for you and your family.
What will the future entail for my child?
Many parents speak of concerns regarding the possible outcomes for their child and the impact of their disability on their life as an adult, including their ability to live independently, maintain employment and have meaningful personal relationships.
While the ‘severity’ of ASD can vary greatly, so can the outcomes for children in their adult lives.
Although there are some adults with ASD who may experience ongoing challenges, many others develop adaptive strategies to significantly improve their overall functioning. In fact, some large and very successful corporations are strategically targeting adults with ASD for their workplaces due to strengths identified earlier, including attention to detail, efficiency, and quickly identifying errors in patterns or other visual information, giving hope to some individuals with ASD and the ability to achieve success in their personal lives.
Why is early intervention treatment so helpful?
Research has consistently identified early intervention in childhood as helpful for achieving positive outcomes, including assisting individuals to develop helpful strategies to cope with their challenges as they get older.
Research has also identified that early intervention can positively impact on a child’s ability to relate, interact and communicate in relationships, can decrease parental stress and improve parent-child relationships.
While research has identified early intervention treatment to be influential in achieving positive outcomes for children with ASD, a wide body of research also identifies children’s brains to be ‘plastic’.
This means that even beyond the early intervention years, an individual’s brain is still widely able to change and mould as a result of the child’s environment.
This allows for continued hope for beneficial outcomes in later childhood, adolescence and adulthood for individuals with ASD.
What is happening with Research into ASD?
Research is always continuing with ASD. While no particular causes for ASD have been identified, research into the influence of an individual’s genetic make-up is continuing to be explored.
Recent research has further narrowed which genes are likely to be most influential in contributing to ASD, with a small number of genes reported with ‘high confidence’ to contribute to the risk of developing ASD.
Research is continuing in this area for further clarity regarding the role of genetic make-up in development of ASD.
Results from recent research for ASD using brain scans with adult men has also identified recent interesting information about subtle differences in the frontal lobe area of the brain, which is known to influence an individual’s social interaction and language functioning.
Such results continue to be in early phases of research, but provide interesting insights and have possible implications for assessment and diagnosis of ASD in the future.
Where to get help
If you have concerns for your child and whether you child may have ASD or want to explore support options for your child, it may be helpful to speak with a psychologist, or see your GP for a referral to a paediatrician.
To access an assessment, your paediatrician will most likely request the assistance of a psychologist and speech therapist to assist with the assessment and diagnosis process.
Your preferred private clinic can also assist you by explaining the process for a private assessment for your child.
Lakeside Psychology offers assessment, early intervention and ongoing treatment services for children with Autism Spectrum Disorder, as well as psychological treatment for a range of other health concerns for children, adolescents and adults. Please contact our friendly team for further enquiries about assessment and treatment services.
The following websites provide helpful information and support for ASD: www.amaze.org.au and www.raisingchildren.net.au
