What is Autism ?

Autism, is a Neurodevelopment Disorder, Characterised by challenges with social communication, and by restricted and repetitive behaviours. Autism affects information processing (which delays language processing in most cases) in the brain which causes many autistic children with learning and reading difficulties.

AUTISM Facts and Figures – Based on WHO Report, It is estimated that worldwide about one in 100 children has autism which translated to a number higher than 79 Million. This estimate represents an average figure while Some well-controlled studies have, however, reported figures that are substantially higher. In the 2000s, the number of autistic people worldwide was estimated at 1–2 per 1,000 people. It is diagnosed four to five times more often in males than females. The number of people diagnosed has increased considerably since the 1990s, which may be partly due to increased recognition of the condition

Autism spectrum disorders (ASD), are a diverse group of conditions. They are characterised by some degree of difficulty with social interaction and communication. Other characteristics are atypical patterns of activities and behaviours, such as difficulty with transition from one activity to another, a focus on details and unusual reactions to sensations.

The abilities and needs of autistic people vary and can evolve over time. While some people with autism can live independently, others have severe disabilities and require life-long care and support. Autism often has an impact on education and employment opportunities. In addition, the demands on families providing care and support can be significant. Societal attitudes and the level of support provided by local and national authorities are important factor.

Let us Answer some Key Questions on Autism

• What is autism?
• Autism Spectrum Disorder
• What are the symptoms of Autism Spectrum Disorder?
• At what age is the onset of autism?
• How is autism diagnosed?
• Can autism symptoms change over time?
• Outgrowing autism
• How does autism affect you as an adult?
• Autism Causes
• Some common misconceptions about autism
• Can diet affect symptoms of autism?
• If you suspect your child has autism, who should you go see?
• Is autism a mental illness?
• Treatment for autism
• If you have autism, how can you be your own advocate?
• If your child has autism, how can you be their advocate? How vocal should you be with your employer, teachers and more?
• Do children with autism need a special education program?
• At what age can you get an individual education plan (IEP)?

What is Autism?

Autism, also known as Autism Spectrum Disorder (ASD), is a neurodevelopmental disorder characterized by challenges with social interaction, communication, and repetitive behaviors. The term “spectrum” reflects the wide variation in symptoms and severity among individuals with autism. Some may require significant support in daily life, while others may live independently.

What is Autism Spectrum Disorder?

Autism Spectrum Disorder encompasses a range of conditions that share core symptoms but vary greatly in how they affect individuals. These include classic autism, Asperger’s syndrome, and pervasive developmental disorder-not otherwise specified (PDD-NOS). People with ASD may also have sensory sensitivities, unusual interests, and differences in how they learn, think, and solve problems.

What are the Symptoms of Autism Spectrum Disorder?

Symptoms of ASD typically appear in early childhood and can vary widely among individuals. Common symptoms include:

Social Communication Challenges:

• Difficulty understanding and responding to social cues.
• Limited eye contact or facial expressions.
• Difficulty forming and maintaining friendships.
• Challenges with conversation and understanding gestures or body language.
• Delayed language development or unusual speech patterns (e.g., echolalia, where the person repeats words or phrases).

Repetitive Behaviors:

• Engaging in repetitive movements, such as hand-flapping, rocking, or spinning.
• Insistence on routine and extreme distress over changes in routine.
• Intense focus on specific interests or topics.
• Repetitive use of objects or lining up toys in a particular way.

Sensory Sensitivities:

• Over- or under-sensitivity to sensory stimuli, such as lights, sounds, textures, or smells.
• Unusual responses to sensory input, such as covering ears or avoiding certain textures.

Cognitive and Learning Differences:

• Variability in intellectual functioning, with some individuals having above-average intelligence and others having intellectual disabilities.
• Uneven skill development, with strengths in certain areas (e.g., memory, attention to detail) and challenges in others.

At What Age is the Onset of Autism?

The symptoms of autism generally become noticeable in the first two years of life. In some cases, developmental delays may be observed as early as 12-18 months. However, some children may develop normally and then experience a regression, losing previously acquired skills, typically between 18-24 months.

How is Autism Diagnosed?

Autism is diagnosed through a combination of developmental screenings and comprehensive diagnostic evaluations.

Developmental Screening:

• This involves brief tests or questionnaires to assess whether a child is meeting typical developmental milestones.
• Pediatricians often perform these screenings during routine check-ups, typically at 18 and 24 months.

Comprehensive Diagnostic Evaluation: If a screening suggests potential developmental issues, a more in-depth evaluation is conducted.

• This may involve a team of specialists, including a developmental pediatrician, psychologist, speech therapist, and occupational therapist.
• The evaluation includes observing the child’s behavior, reviewing developmental history, and possibly administering standardized tests.
• The Autism Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview-Revised (ADI-R) are commonly used tools.

Can Autism Symptoms Change Over Time?

Yes, the symptoms of autism can change over time. With early intervention and appropriate support, many children with autism can develop skills that reduce the impact of their symptoms. However, challenges with social interactions and communication may persist into adulthood. Some individuals may also develop new symptoms or behaviors as they age, especially during transitions, such as puberty or changes in living situations.

Outgrowing Autism

While individuals may learn to manage symptoms and develop compensatory strategies, autism is generally a lifelong condition. The notion of “outgrowing” autism is a misconception, but early and continuous intervention can lead to significant improvements in functioning.

How Does Autism Affect You as an Adult?

• Autism continues to affect individuals into adulthood, often influencing their social relationships, employment, and independent living. Adults with autism may experience:
  • Social Challenges: Difficulty understanding social norms and forming relationships. Preference for routine and discomfort with social situations.
  • Employment: Adults with autism may excel in jobs that align with their interests and strengths, such as roles requiring attention to detail or pattern recognition. They may face challenges in jobs requiring strong social skills or flexibility.
  • Independent Living: Some adults with autism live independently, while others may require varying levels of support, especially in managing daily life and navigating social situations.

Autism Causes

• The exact causes of autism are not fully understood, but it is believed to be a complex interplay of genetic and environmental factors:
  • Genetics: Autism tends to run in families, suggesting a genetic component. Certain genetic mutations or syndromes (e.g., Fragile X syndrome) are associated with a higher risk of autism.
  • Environmental Factors: Prenatal exposure to certain drugs, chemicals, or infections may increase the risk of autism. Advanced parental age and pregnancy or birth complications have also been linked to a higher likelihood of ASD.

Some Common Misconceptions about Autism

• Vaccines Cause Autism: There is no scientific evidence linking vaccines to autism. The claim originated from a discredited study and has been widely debunked.
• People with Autism Lack Empathy: Individuals with autism may have difficulty expressing emotions, but many can experience empathy and care deeply about others.
• All People with Autism Have Intellectual Disabilities: While some individuals with autism have intellectual disabilities, others have average or above-average intelligence.
• Autism is the Result of Poor Parenting: Autism is not caused by parenting style. It is a neurodevelopmental condition with biological roots.
• People with Autism Cannot Live Independently: Many individuals with autism can lead independent lives, especially with early intervention and ongoing support.

Can Diet Affect Symptoms of Autism?

There is no conclusive scientific evidence that diet causes or cures autism. However, some parents report improvements in their child’s behavior or symptoms after dietary changes, such as eliminating gluten or casein. It’s important to consult with a healthcare provider or nutritionist before making significant dietary changes, as restrictive diets can lead to nutritional deficiencies.

If You Suspect Your Child Has Autism, Who Should You Go See?

If you suspect your child has autism, start by discussing your concerns with your pediatrician. The pediatrician may refer you to a specialist, such as a developmental pediatrician, child psychologist, or neurologist, for further evaluation. Early intervention is crucial, so seeking help promptly is important.

Is Autism a Mental Illness?

Autism is not a mental illness; it is a neurodevelopmental disorder. While it affects how the brain processes information, it is distinct from mental health conditions such as depression or anxiety. However, individuals with autism may also experience mental health issues, which can be managed with appropriate care.

Treatment for Autism

There is no cure for autism, but various interventions can help manage symptoms and improve quality of life:

Behavioral Interventions:

• Applied Behavior Analysis (ABA): A widely used approach that reinforces positive behaviors and reduces unwanted behaviors.
• Speech Therapy: Helps improve communication skills.
• Occupational Therapy: Focuses on developing daily living skills and fine motor skills.
• Social Skills Training: Teaches children and adults how to interact socially.

Medications: There are no medications to treat autism itself, but certain medications can help manage symptoms like anxiety, hyperactivity, or irritability.

Educational Support: Tailored educational programs, including Individualized Education Plans (IEPs), can support learning and development.

If You Have Autism, How Can You Be Your Own Advocate?

Self-advocacy involves understanding your needs, strengths, and challenges and communicating them effectively to others. Steps to advocate for yourself include:

1. Educate Yourself: Learn about your rights and available resources.
2. Communicate Your Needs: Be clear about what accommodations or supports you require in various settings (e.g., school, work, healthcare).
3. Seek Support: Connect with support groups or autism organizations.
4. Develop Social Skills: While challenging, developing these skills can help you navigate social situations more effectively.

If Your Child Has Autism, How Can You Be Their Advocate? How Vocal Should You Be with Your Employer, Teachers, and More?

Advocating for your child involves being their voice in settings where they might not be able to express themselves. Steps include:

1. Educate Yourself: Understand your child’s needs and the laws that protect their rights.
2. Communicate: Maintain open communication with teachers, healthcare providers, and employers. Explain your child’s needs and the accommodations they require.
3. Be Involved in Education: Work closely with your child’s school to ensure they receive appropriate support, including an IEP if necessary.
4. Join Support Networks: Connect with other parents, advocacy groups, and autism organizations to share experiences and resources.

Do Children with Autism Need a Special Education Program?

Many children with autism benefit from special education programs that are tailored to their individual needs. These programs provide structured environments, specialized teaching methods, and supports like speech or occupational therapy. An Individualized Education Plan (IEP) is often used to outline the specific goals and services that will support the child’s learning.

At What Age Can You Get an Individual Education Plan (IEP)?

An Individualized Education Plan (IEP) can be developed for children as early as age 3 if they are identified as having a disability that affects their learning. The IEP is reviewed and updated annually to meet the child’s evolving needs throughout their educational journey.

Highest AUTISM Spectrum Disorder Rate in 2022 – Top 22 Countries

Top 5 Counties with highest AUTISM Spectrum Disorder Rate (Per 10K Population) are Qatar, UAE, Oman, Bahrain, Saudi Arabia and Kuwait. India Stands at Number 22 in the list. Conclusion: Middle Easter Nations have the highest Autism Prevalence Rate (Per 10K)

Least AUTISM Spectrum Disorder Rate in 2022 – Top 15 Countries

Top 5 Counties with Lowest AUTISM Spectrum Disorder Rate (Per 10K Population) are France, Portugal, Iceland, Norway and Italy. It seems European Nations have lower Autism Rates as compared to Asian or North America. Conclusion: European Nations have the lowest Autism Prevalence Rate (Per 10K)

Autism: A view from neuroscience – A CCN public lecture

AUTISM Early Signs

As the research, experiences and studies indicate Autism impacts an individual throughout the lifespan. As per Autism Society USA, here are some common signs to look for:

• Speaks later than typical or not at all (nonverbal).
• Repetition in language or movement, such as repeating the same word or sounds, hand flapping, or any repeated movement. 
• Atypical nonverbal communication, including avoiding eye contact, giving few facial expressions, or having a monotone.
• Prefers solitary or parallel play rather than engaging in associative or cooperative play with other children.
• Extremely distressed by changes, including new foods or changes in schedule.
• Preference for predictable, structured play over spontaneous or make-believe play. 
• Strong, persistent interest on specific topic, part of a toy, or item.

How Does Autism Affect Communication?

According to WebMD, About 40% of kids with autism spectrum disorders don’t talk at all, and between 25% and 30% develop some language skills during infancy but then lose them later. Some children with ASD start talking later in life.Most have some problems with communication, including:

• Delayed speech and language skills
• Flat, robotic speaking voice, or singsong voice
• Echolalia (repeating the same phrase over and over)
• Problems with pronouns (saying “you” instead of “I,” for example)
• Not using or rarely using common gestures (pointing or waving), and not responding to them
• Inability to stay on topic when talking or answering questions
• Not recognising sarcasm or joking
• Trouble expressing needs and emotions
• Not getting signals from body language, tone of voice, and expressions

Some Videos on Early Signs and Possible Symptoms of AUTISM

Nutrition and Autism

“Children with autism are often very sensitive to tastes and textures, and thus have limited diets. It may be the case that they are lacking specific nutrients important to learning and social/intellectual growth. While improved nutrition may be a helpful therapy, it seems unlikely that malnutrition can cause autism” – Verywellhealth.com

Do vaccines cause autism?

There is no proven connection or research that shows any correlation between vaccines and autism. Numerous studies have been done comparing autism rates between vaccinated and unvaccinated children. No difference has been found. One study from Japan looked at the MMR vaccine, which was withdrawn from the country due to concerns about aseptic meningitis. In that study, a statistically significant number of children were found to have developed autism even though they had not received the MMR vaccine.

AUTISM Causes

“There is no known single cause for autism spectrum disorder, but it is generally accepted that it is caused by abnormalities in brain structure or function. Brain scans show differences in the shape and structure of the brain in children with autism compared to in neuro-typical children. Researchers do not know the exact cause of autism but are investigating a number of theories, including the links among heredity, genetics and medical problems”

“It also appears that some children are born with a susceptibility to autism, but researchers have not yet identified a single “trigger” that causes autism to develop. Other researchers are investigating the possibility that under certain conditions, a cluster of unstable genes may interfere with brain development, resulting in autism. Still other researchers are investigating problems during pregnancy or delivery as well as environmental factors such as viral infections, metabolic imbalances and exposure to chemicals.” – AUTISM SOCIETY USA”

Free Resources on the WEB and Apps

Managing ADHD, Autism, Learning Disabilities, and Concussion in School

In this Free Autism Online Course for Audit (by University of Colarado on Coursera), you will about the most common developmental and behavioural disorders affecting children such as ADHD, autism spectrum disorder, learning disorders, and concussions. We will focus on how schools can support children by recognising common symptoms and understanding the diagnosis process.

You’ll be introduced to scenarios that provide firsthand clinician experience working with children with ADHD. You’ll experience an interview and answer dialogue with Dr. Abigail Angulo, a Developmental-Behavioral Pediatrician at the University of Colorado. You will be introduced to the deficits in children with autism spectrum disorder (ASD). Next, you’ll explore symptoms and diagnosis of ASD. Finally, you’ll review the cause and management of autism.

Providing Social, Emotional, Behavioral, and Special Education Services in School

In this Free Autism Online Course for Audit (by University of Colarado on Coursera), the Course brief mentions that

” You will learn about how social-emotional skills, mental health, and learning are related. The Course will focus on how schools can support social-emotional learning and promote mental health for all students.We will walk through the reasons that schools should promote student mental health”

“Next, we’ll review school wide activities to support skill development and prevent social, emotional, and behavioural challenges. Then, we’ll identify strategies for students at risk of developing problems. Finally, we’ll highlight interventions that can be used for students who have significant mental health needs. We will emphasise the ways that schools think about mental health problems and provide services for students with disabilities, which is different than in medical or mental health settings”

University of Colarado on Coursera

Activities, Learning Programs and Resources for Children with Autism

A common characteristic of students with autism is trouble communicating or connecting with their classmates. This Article Link discusses Social and Fun Skills Activities, Sensory Activities, Calming Activities to Prevent Autism Meltdowns in Class and Effective Teaching Strategies for Children with Autism.

Internet Safety Guide for People with Autism

This Article guide is meant to help autistic people (and their parents, family, friends, and caregivers) learn about online risks and how to mitigate them. But it also highlights the positives to show how autistic people can use and enjoy the internet confidently and safely. Read More Here

Teaching Methods for Children with Autism

1. ABA and VBA (Applied Behaviour Analysis and Verbal Behaviour)
2. Relationship Development Intervention
3. Sensory Integration Therapy
4. TEACCH
5. eduBOSS

Important Teaching Methods for Children with Autism

Autism At Home

It is a non-profit initiative by The Hope Project, the non-profit arm of Early Autism Project (EAP) Malaysia. Autism At Home is an online resource platform aimed at providing simplified tips and strategies to help families of children with autism teach and support their children at home.

This platform will provide you with online training videos on effective ABA teaching strategies for autism, featuring role plays, pop quizzes, and home assignments.

Teaching a Child with Autism using ABA (Applied Behaviour Analysis)

Applied Behavior Analysis (ABA) is a well-established and scientifically validated approach to understanding and modifying behaviors. It is especially effective in teaching children with Autism Spectrum Disorder (ASD). ABA is grounded in the principles of behaviorism, which posits that behavior can be influenced by manipulating the environment and using reinforcement. This approach is highly individualized, focusing on the unique needs of each child, and can be applied in various settings, including home, school, and clinical environments.

Core Principles of ABA

1. Positive Reinforcement:
   ABA emphasizes the use of positive reinforcement to encourage desirable behaviors. When a child exhibits a behavior that is beneficial or appropriate, they receive a reward, which increases the likelihood of the behavior recurring. This reward can be tangible (like a toy or treat), social (like praise or a high-five), or activity-based (like extra playtime).
2. Antecedent-Behavior-Consequence (ABC) Model:
   The ABC model is a foundational concept in ABA, where:

• Antecedent: This refers to the events or stimuli that occur before a behavior.
• Behavior: The observable action or response by the child.
• Consequence: The event that follows the behavior, which can either reinforce or discourage the behavior. By analyzing the ABCs, therapists can understand what triggers certain behaviors and how to modify the environment to promote positive behaviors while reducing negative ones.

1. Task Analysis:
   ABA often involves breaking down complex tasks into smaller, more manageable steps. This process, known as task analysis, makes it easier for children with autism to learn new skills. Each step is taught sequentially, and the child is reinforced at each stage until they can complete the entire task independently.
2. Prompting and Fading:
   Prompts are cues or assistance provided to help the child perform a desired behavior. Over time, these prompts are gradually faded out to encourage independence. The goal is for the child to perform the behavior without any assistance.
3. Generalization and Maintenance:
   ABA ensures that learned behaviors are not only exhibited in the training environment but are also generalized to other settings and maintained over time. This involves teaching skills in various environments and with different people to ensure that the child can apply what they’ve learned in real-life situations.

Implementing ABA with Children with Autism

1. Assessment and Goal Setting:
   The ABA process begins with a comprehensive assessment to identify the child’s strengths, weaknesses, and specific needs. This assessment helps in setting individualized goals, which could range from improving communication skills to reducing disruptive behaviors.
2. Creating a Behavior Intervention Plan (BIP):
   Based on the assessment, a Behavior Intervention Plan is developed. The BIP outlines the specific behaviors to be targeted, the strategies to be used, and the reinforcements that will be employed. It also includes plans for data collection to monitor progress.
3. Data Collection and Analysis:
   ABA is data-driven, meaning that the child’s progress is continuously monitored through data collection. This data is analyzed regularly to determine the effectiveness of the intervention and to make necessary adjustments.
4. Direct Instruction and Discrete Trial Training (DTT):
   Discrete Trial Training (DTT) is a structured ABA technique that involves breaking down skills into discrete, teachable steps. Each step is taught through direct instruction, and the child is given multiple opportunities to practice the skill. Immediate feedback is provided, and reinforcement is used to encourage correct responses.
5. Natural Environment Teaching (NET):
   While DTT is structured, Natural Environment Teaching (NET) focuses on learning in more natural, less structured settings. This approach leverages the child’s interests and everyday situations to teach skills, making the learning process more engaging and applicable to real-world scenarios.
6. Social Skills Training:
   Social skills are often a key area of focus in ABA for children with autism. Therapists use role-playing, modeling, and reinforcement to teach skills like making eye contact, sharing, taking turns, and understanding social cues.
7. Communication Skills:
   Many children with autism have difficulty with communication, which can lead to frustration and challenging behaviors. ABA strategies, including the use of Picture Exchange Communication System (PECS) and verbal behavior techniques, can be employed to enhance communication skills.
8. Parent and Caregiver Involvement:
   ABA is most effective when parents and caregivers are actively involved. They are trained to use ABA strategies at home, ensuring consistency across environments. This involvement also empowers them to manage behaviors and support their child’s learning outside of therapy sessions.
9. Addressing Challenging Behaviors:
   ABA is also used to address challenging behaviors such as aggression, self-injury, or tantrums. By identifying the function of the behavior (i.e., why the child is engaging in it), therapists can implement interventions to reduce or eliminate these behaviors. This might involve teaching alternative behaviors that serve the same function but are more appropriate.
10. Ethical Considerations:
    The use of ABA has raised ethical considerations, particularly regarding the child’s autonomy and the intensity of the intervention. It is crucial that ABA is practiced with the child’s well-being as the foremost priority, ensuring that interventions are respectful, humane, and tailored to the child’s individual needs.

Effectiveness of ABA

Research has consistently shown that ABA is effective in improving a wide range of skills in children with autism, including communication, social skills, academic performance, and daily living skills. Many children who receive early and intensive ABA intervention make significant progress, with some even reaching levels of functioning that are comparable to their typically developing peers.

However, the effectiveness of ABA can vary depending on factors such as the child’s age, the intensity of the intervention, and the specific techniques used. It is also important to recognize that ABA is not a one-size-fits-all approach; it must be individualized to meet the unique needs of each child.

Challenges and Considerations

While ABA is a powerful tool, it is not without its challenges. Implementing ABA can be time-consuming and requires consistency and patience. Additionally, there is ongoing debate within the autism community about the potential for ABA to be overly rigid or to prioritize conformity over individuality.

Moreover, not all children respond to ABA in the same way, and it may need to be combined with other interventions, such as speech therapy, occupational therapy, or social skills groups, to address the full range of a child’s needs.

Conclusion

Teaching a child with autism using ABA is a highly structured and individualized process that focuses on promoting positive behaviors and reducing negative ones through reinforcement and data-driven strategies. While ABA has proven to be effective for many children, it is essential that the approach is tailored to the individual child and delivered in a compassionate and ethical manner. By involving parents and caregivers, ensuring generalization of skills, and addressing each child’s unique needs, ABA can significantly enhance the quality of life for children with autism and their families.

Important Links for Autism