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Autism spectrum disorders (ASDs)

Autism spectrum disorders (ASDs) are a group of lifelong conditions that affect how a person communicates with and relates to other people.

This information is for both parents of children with an ASD and adults who have the condition. For simplicity, we refer to your child throughout.

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Symptoms of autism spectrum disorders 

ASDs include conditions such as autism and Asperger syndrome. The word 'spectrum' is used because the symptoms of ASDs vary widely in nature and severity between people who are affected. It’s believed about 1 in 100 children have an ASD and it is 4-5 times more common in boys.

Generally, children who have an ASD don’t develop the social and language skills that other children of the same age do. As a result, they find relating to other people difficult. Children with an ASD may also have unusual behaviours and learning disabilities.

Autism

Children with autism have difficulty communicating and interacting with others. This is often first noticed around the age of two, though there can be signs earlier that can often be missed by parents. Some children with autism may have a learning disability, such as dyslexia (a condition that hinders the development of language-based skills, including reading, spelling and writing).

Asperger syndrome

Asperger syndrome is similar to autism, but children with Asperger syndrome generally communicate better than those with autism and have average or above average intelligence. They don't usually have the learning disabilities that children with autism may have.

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About autism spectrum disorders 

Children with an ASD can have three main sets of symptoms that affect their communication, social skills, interests and behaviour. These characteristics can vary widely. If you’re concerned your child might be showing one or more signs of an ASD, talk to your GP or child and family health nurse.

Communication

Children with autism don’t develop the usual speech or non-verbal skills, such as pointing and waving that other children of the same age do. They also have trouble understanding the meaning of spoken or written language.

You may first notice that your child has communication difficulties if he or she:

  • can’t babble (echo, mimic or make words, sounds or phrases without meaning) by the age of one
  • can’t point or use gestures by the age of one
  • has difficulty following simple instructions such as ‘Give me the train’
  • hasn’t learned any single words by 16 months of age, or two-word spontaneous phrases by 24 months.

Your child may take words exactly as they mean – that is, he or she will have a very literal sense of language and won’t be able to understand jokes or sarcasm. He or she may also find it difficult to read body language and facial expressions.

Older children, or those diagnosed with Asperger syndrome, may have an unusual use of language, such as speaking in an overly formal manner, and have difficulty starting or keeping up conversations.

Children with severe autism may not speak at all, but can be helped to communicate in other ways, such as through signing or using pictures.

Social skills

Children with an ASD have difficulty engaging with other people, making friends and getting on well with their peers. They may be unable to cope with new situations. For example, if your child has an ASD he or she may:

  • not respond to his or her name
  • not share interests or enjoyment with others, rarely pointing at anything or showing interest in what other people point out
  • prefer to spend time on his or her own, rather than play with other children
  • not understand other people's thoughts and emotions
  • find it difficult to accept simple social rules, which can cause problems at school
  • find it difficult to manage his or her emotions, which may be expressed as outbursts of anger or aggression.

Behaviour and interests

Children with an ASD may show very little or no interest in play that involves pretending or imagination. Instead, they may be more interested in repetitive behaviours, activities and interests, such as rocking, flapping, or lining up objects.

Your child with ASD may have very narrow and intense interests (eg trains or dinosaurs). Older children or those with strong verbal skills may talk obsessively about their favourite topics.

Other symptoms

Apart from problems that affect your child’s communication, social skills, interests and behaviour, he or she may also:

  • like sticking to the same routines, and may get very upset if these are disturbed
  • be over or under-sensitive to sight, sound, smell, touch and taste.

Many children with an ASD can also have other conditions such as attention deficit hyperactivity disorder (ADHD), dyspraxia (difficulty co-ordinating and organising thoughts and movements) or epilepsy (a condition that causes seizures).

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Causes of autism spectrum disorders 

The exact causes of ASDs aren't fully understood at present. It’s thought that they are caused by a combination of factors, including the genes we inherit from our parents.

There is no scientific evidence to support the theory that there is a possible link between autism and the measles, mumps and rubella (MMR) vaccine. This was originally a theory put forward by a group of researchers in 1998, though they stated in their paper that this link between autism and the MMR vaccine had not been proven. Parents often start to notice signs of autism when their child is around one to two years old. As the MMR injection is given at around this age, it's easy to understand why some parents think they might be linked.

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Diagnosing autism spectrum disorders 

If you notice your child might be showing signs of an ASD, contact your GP or child and family health nurse.

They will ask about your child’s behaviour and may also carry out a screening interview known as a Checklist for Autism in Toddlers (CHAT) if he or she hasn't started school yet.

If your GP thinks your child may have an ASD, they will refer your child to a paediatrician, child psychiatrist, or developmental assessment service to identify any specific needs. You and your child may need to see a range of professionals including a paediatrician, a child psychiatrist, a speech therapist, an occupational therapist, a psychologist and an educational expert such as a specialist teacher.

A tool commonly used by specialists to diagnose ASDs is the Autism Diagnostic Observation Schedule (ADOS). This is a group of structured tests that can be tailored to different age groups.

If your child is diagnosed with an ASD and under the age of 6 years you may be eligible for some financial support for early intervention through the Australian Government’s Helping Children with Autism package. You will need to first consult an autism adviser, employed by your state or territory autism association, who will provide post-diagnostic support and information on early intervention services in your local area.

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Treating autism spectrum disorders 

There isn’t a cure for ASDs, but children who are affected can be helped to manage their symptoms in a number of different ways. The following have some supporting scientific evidence to justify their use.

It’s important to remember that one therapy may work for one child but not for another, as all children have different levels of needs and abilities. It is likely that an approach that combines different therapies will be most effective.

Behavioural therapies

Therapies such as Applied Behaviour Analysis (ABA) may help to improve your child's social and communication skills by helping them learn new behaviours. This involves your child seeing a psychologist or trained therapist who uses a technique that involves rewarding good behaviour. Your child’s psychologist or therapist will also set out a consistent and structured way of dealing with challenging or harmful behaviour. ABA is the best researched therapy to date for ASDs.

Developmental therapies

Developmental therapies aim to help your child form positive and meaningful relationships by focussing on social and communication skills. In developmental therapies the parent or carer is the primary therapist. Examples of developmental programs include Floortime and Relationship Development Intervention (RDI). New therapies such as the Early Start Denver Model and the SCERTS (Social Communication, Emotional Regulation and Transaction Support) Model combine elements of behavioural and developmental therapies.

Treatment and Education of Autistic and related Communication-disabled Children (TEACCH) program

The TEACCH program uses activity schedules to give your child a more predictable and organised teaching environment and emphasises teaching using visual cues. One of its aims is to help children understand how daily life operates to encourage them to be more independent. This program is not currently available in its entirety in Australia, although parts of the TEACCH approach are used in combination with other therapies offered in Australia. Your local autism adviser can advise you on the Australian programs that incorporate TEACCH as part of their program.

Therapy-based interventions

These therapies focus on specific difficulties that are individual to your child and include:

  • occupational therapy to help your child adapt to his or her living environment
  • speech and language therapy to help your child to communicate better.

Family-based therapies

These therapies are a growing area of research in ASD. They are designed to provide guidance, training, information and support to family members who are taking a key role in their ASD child’s development. Examples of these programs include More than Words and Preschoolers with Autism.

Medicines

Sometimes, your child’s paediatrician may prescribe a medicine for him or her to take in the short-term to reduce symptoms such as agitation, aggression or hyperactive behaviour. However, as with all medicines, these medicines can have side effects. Always ask your doctor for advice and read the consumer medicine information leaflet about your child’s medicine.

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Help and support 

Health professionals involved in your child's care can provide help and support for you and your child's carers. For example, respite breaks give you a chance to rest while somebody else looks after your child – these may be provided by a variety of social services.

Some families are also entitled to benefits such as the Carer Allowance to help cover the extra expenses involved in caring for a child with an ASD. Details of exactly what support is available to you, including specific support for children with ASDs (Helping Children with Autism package), can be found on the Department of Families, Housing, Community Services and Indigenous Affairs website that is listed in the Further Information section below.

Further support can also be obtained from your state or territory autism association.

School

Children with an ASD often need an educational assessment and special support. Your child may go to a special school, a support class in a mainstream school or, if possible, attend a regular class in mainstream school that employs extra help to teach children with ASD.

In general, autistic children do better if classroom activities are very structured. Many schools use the Treatment and Education of Autistic and Communication-disabled Children (TEACCH) approach outlined earlier. Parents can work closely with teachers, using the same techniques at home.

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Further information 

Raising Children Network (special needs section)
http://raisingchildren.net.au

Your state autism association. Contact details can be found at:
http://raisingchildren.net.au/articles/state_autism_associations.html

Department of Families, Housing, Community Services and Indigenous Affairs — Helping Children with Autism
http://www.fahcsia.gov.au/our-responsibilities/disability-and-carers/program-services/for-people-with-disability/helping-children-with-autism

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Sources 

Australian Government. Department of Families, Housing, Community Services and Indigenous Affairs. Helping children with autism. [Online] Canberra, ACT: Department of Families, Housing, Community Services and Indigenous Affairs. [Last updated August 2012, accessed 12 September 2012]. Available from: http://www.fahcsia.gov.au

Better Health Channel. Autism. [Online] Melbourne, VIC: State Government of Victoria. c1999-2011 [Last reviewed June 2012, accessed 13 September 2012]. Available from: http://www.betterhealth.vic.gov.au

Mayor S. Rapid response: authors reject interpretation linking autism and MMR vaccine, BMJ 2004; 328:602.

O’Reilly B, Smith S. Australian Autism Handbook, Sydney, Jane Curry Publishing, 2008.

Raising Children’s Network. Autistic disorder. [Online] Raising Children’s Network Australia c2006–2012 [Last updated November 2010, accessed 12 September 2012]. Available from: http://raisingchildren.net.au

Raising Children’s Network. Types of interventions for children with ASD. [Online] Raising Children’s Network Australia c2006–2012 [Last updated February 2009, last reviewed August 2011, accessed 12 September 2012]. Available from: http://raisingchildren.net.au

Raising Children’s Network. Treatment and Education of Autistic and related Communications-disabled Children (TEACCH). [Online] Raising Children’s Network Australia c2006–2012 [Last updated March 2010, last reviewed September 2012, accessed 12 September 2012]. Available from: http://raisingchildren.net.au

Scottish Intercollegiate Guidelines Network (SIGN). Assessment, diagnosis and clinical interventions for children and young people with ASDs – a national clinical guideline. [online] Edinburgh, Scotland: SIGN. July 2007 [Accessed 7 July 2011] Available from: www.sign.ac.uk

Virtual Medical Centre. Autism. [Online] Osborne Park, WA: Virtual Medical Centre c2000–2012 [Last modified March 2011, last reviewed November 2007, accessed 12 September 2012]. Available from: http://www.virtualmedicalcentre.com

Women’s and Children’s Health Network. Parenting and Child Health. Autism. [Online] Adelaide, SA: Government of South Australia, Child and Family Health. [Last updated May 2012, accessed 12 September 2012]. Available from: http://www.cyh.com

Women’s and Children’s Health Network. Parenting and Child Health. Autism spectrum disorder. [Online] Adelaide, SA: Government of South Australia, Child and Family Health. [Last updated September 2011, accessed 12 September 2012]. Available from: http://www.cyh.com

Women’s and Children’s Health Network. Parenting and Child Health. Asperger syndrome. [Online] Adelaide, SA: Government of South Australia, Child and Family Health. [Last updated May 2012, accessed 12 September 2012]. Available from: http://www.cyh.com

Last published: 30 November 2012

Tags: autism, Asperger, ASD, autism spectrum disorder

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