Autism Spectrum Disorder (ASD) is a diagnosis given to people who find it very difficult to understand and interact with others.
Autism is on a ‘spectrum’, some people with autism have very severe difficulties whereas others have milder issues. Until recently people with less severe issues were given the diagnosis of Asperger’s Syndrome. The USA has stopped using the diagnosis of Asperger’s and instead recommends using the diagnosis Autism Spectrum Disorder for both mild and severe cases.
It’s estimated that about 1 in every 100 people has Autism Spectrum Disorder. More boys are diagnosed with the condition than girls.
What is Autism?
The key difficulties in Autism Spectrum Disorder include social communication and social interaction problems, understanding non-verbal signals, a need for routine, repetitive behaviour, highly focused interests and sensory sensitivity. More detail on these difficulties is given below:
Social Communication & Interaction Problems
People with autism struggle to see things from others’ perspective. This is a problem because people who do not have autism assume that others can ‘read between the lines’. Here’s an example:
- Teacher: ‘Can you pass me that book?’
- Child with autism: Says ‘Yes’ but makes no attempt to give the teacher the book.
- Teacher: ‘You are such a rude child’.
- Child with autism: Is upset and confused. The teacher didn’t tell them to pass the book. They only asked them if it was possible to pass the book. They told the teacher the truth. What did they do that was rude?
This is a simple example and some children with milder autism would have no difficulty in this situation. However, much of our communication relies on ‘unwritten rules’ and we don’t always say what we mean. Sometimes we don’t tell the whole truth because we want to be polite, sometimes we use jokes or sarcasm to get our message across. This makes social communication difficult for a person with autism because they assume that others mean exactly what they say. They may also come across as rude because they say exactly what they mean.
People with autism also find it difficult to understand and use non-verbal signals. This is unfortunate because we use non-verbal communication all the time. Think of all the information contained in:
- Facial expressions
- Tone of voice
- Body language
- Eye contact (people with autism often struggle to make eye contact)
- Personal space (how close should you stand to someone varies depending on how well we know them, how they are feeling, their rank etc).
Missing out on all this non-verbal information can make it very difficult to know what to do in a social situation. So people with autism may sometimes appear to behave ‘strangely’ or in a way that others see as socially inappropriate.
Need for Routine
The world can feel like a very unpredictable and confusing place to people with autism. They prefer routine so that they know what is going to happen. For example, they may insist on going to school using exactly the same route or they may eat exactly the same food for breakfast each day.
People with autism like rules to be used consistently. It may be difficult for them to take a different approach to something once they have been taught the ‘right’ way to do it.
People with autism tend not to like change but they can cope better if they are given advance warning.
Many people with autism have an extremely strong interest in a specific subject. For example, they may love trains, computers, bus timetables, Star Wars or even washing machines. They usually want to spend as much time as possible thinking, learning or talking about their interest. Their interests may change or stay with them for their whole life.
They may be able to make this interest part of their studies, paid work, volunteering, or other meaningful occupation. People with autism often report that the pursuit of such interests is fundamental to their well-being and happiness.
People with autism often report being over or under sensitive 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.
People with autism often find it difficult to manage their own emotions. They may experience emotions very intensely or not experience much emotion at all. However, with the right teaching they learn how to manage their emotions. Younger children or people with more severe difficulties may be best helped by changing their environment.
The friends and family of people with autism often feel that they are ‘stubborn’ or ‘inflexible’. It is true that many people with autism hold their views very strongly. From their perspective they usually have very strong logical reasons why they are correct. They may hold the views very strongly because a feature of autism is that it is difficult to see things from another’s persepective. They also tend to put little value onto emotional and social factors that others may think is really important. If you wish to challenge a person with autism’s views then you should be prepared to give strong logical reasons as to why it would benefit them to think differently.
What causes Autism?
The exact cause of Autism is unknown, but it’s thought that several complex genetic and environmental factors are involved. Autism is not the fault of the parents or carers.
It is also not due to the MMR vaccine. The doctor that first made that claim was later struck off the UK’s medical registry for his immoral behaviour. Many research studies, involving millions of children, were carried out to investigate the link between MMR and ASD and no evidence of a link was found.
In Malaysia, it is difficult to do the sort of comprehensive diagnostic assessments that are used in Western countries because the assessment tools have not been adapted for Malaysians.
There are also some risks to having a diagnosis. Sometimes people may make assumptions or treat people with a diagnosis badly. You can read more about my thoughts on diagnosis here.
Rather than use diagnosis my approach is to try to understand what problems the person is facing and then develop strategies to help specifically with those problems. For example, if a child is reacting badly when the classroom gets too loud I’d equip them with earplugs or work with the teachers to let the child go to a quiet place when the noise gets overwhelming. If a person with autism is struggling to interact with others I’d talk them through each social situation, explain why others are acting that way and teach them how to respond.
How can we help people with Autism?
There is no ‘cure’ for autism. However, people with autism can lead very happy, satisfying lives. There are a range of strategies that can be used to help them overcome difficulties that might otherwise be problematic.
Seeing things from the person with autism’s perspective
A key feature of Autism is that it’s difficult to take another person’s perspective. That also makes it difficult for a person with autism to explain their own thoughts, feelings and behaviour to others. Consequently, it’s helpful to imagine what it would be like to be them and to see the world as they do. This might help you understand what it is they need to know and why they may be behaving in a particular way.
Explaining Social Situations
I find one of the most useful strategies to help people with autism is to teach them how to respond to social situations. Most people ‘watch and learn’ because they can read the emotional responses of other people so they can work out what they are supposed to do. If someone with autism has a social encounter that goes wrong then it’s best to explain to them step-by-step exactly what happened and how they need to respond next time.
Online Guides to Strategies that can help People with Autism
The NAS also has excellent advice for parents and carers on how to support children with autism. I’d highly recommend looking at this page to find the advice that best fits you.
‘Treatments’ that should be avoided
A number of alternative treatments have been suggested for ASD. However, the UK’s National Health Service (NHS) has evaluated these and determined that they should be avoided, because there’s little or no evidence that they’re effective and some may even be potentially dangerous.
The NHS states the following treatments aren’t recommended for ASD:
- special diets – such as gluten-free or casein-free diets
- neurofeedback – where brain activity is monitored (usually by placing electrodes on the head) and the person being treated can see their brain activity on a screen and is taught how to change it
- auditory integration training – a therapy that involves listening to music that varies in tone, pitch and volume
- chelation therapy – which uses medication or other agents to remove metal (in particular, mercury) from the body
- hyperbaric oxygen therapy – treatment with oxygen in a pressurised chamber
If a ‘treatment’ sounds ‘too good to be true’ it probably is. It is not uncommon to find dishonest people selling fraudulent treatments. There are others who believe in what they are selling but the ‘treatments’ are harmful.
Any questions or comments?
Did you find this article helpful? If you have any questions on this topic write them in comments section at the bottom of this page and I’ll reply to you as soon as possible. It would also be good to read any comments or opinions you may have.
If you’d like more advice on how best to help manage your child’s difficulties feel free to arrange an appointment with us.
Further Information …
I’ve included some links to websites that I have found useful below. If you find any other useful sources of information please let me know and I’ll add them to the list.
Advice on autism from the UK’s National Autistic Society.
This page links to excellent advice for parents and carers of children with autism. Highly recommended.
The UK’s National Health Service (NHS) has a good guide which explains Autism, Asperger’s and how to help.
The National Institute of Mental Health’s advice on Autism.