Neurodevelopmental Disorders
Autism Spectrum Disorder
or more commonly known as ASD
Credit: The National Autistic Society
What is Autism?
There are many attempts to define Autism, each no less confusing than the last. At its heart, Autism is a developmental disability affecting how people perceive the world and interact with others
The creator of the term used it to describe withdrawal into one’s inner world — a phenomenon he observed in individuals with schizophrenia (you know, he coined the term 'schizophrenia' too!).
Features of Autism
Persons on the spectrum generally exhibit two main features:
Ψ difficulties in social settings in communication and interaction, and
Ψ repetitive or restricted patterns of behaviour or activities.
A large number of persons with ASD will also experience difficulties in sensorial processing (such as hypersensitivity or hyposensitivity) of their environment.
Every instance of Autism is different and exists somewhere along the Autism spectrum.
Just as how every fingerprint or retina is different and unique, no two cases of ASD are identical. Each instance of Autism brings with it its own special and peculiar features and are generally classified into one of three levels of severity: Requiring Support, Substantial Support, or Very Substantial Support. In severe cases, persons with ASD may require closer supervision round-the-clock close.
Autism in Children
Symptoms in most children are typically recognised between 12 and 24 months of age.
Children with ASD present with varying degrees of speech ability and the presence of unusual, repetitive behaviours, such as hand flapping, clapping, rocking, etc. A typical diagnosis of autism would see a child who dislikes eye contact and is entirely oblivious to social convention. ASD has also been shown to be more present among boys. He may also be incredibly rigid in the small routines that he has set up in his day to day. This could involve, for example, arranging his shoes in a certain manner before he might be persuaded to leave the house.
The Autism Diagnostic Interview–Revised (ADI-R) and Autism Diagnostic Observation Schedule™ (ADOS-2) are neuropsychological tests that a child clinical psychologist uses to assess if a child has ASD. Click here for more information on ASD assessments.
My child has been diagnosed with autism spectrum disorder – what can I do to help?
The prognosis for autism is a complicated and lifelong affair, and having support goes a long way. So, how can you support a loved one who has been diagnosed with ASD?
Individuals with autism often experience significant changes during puberty and while they are on medication.
Due to the high rates of comorbidity for individuals with autism, many sufferers become reliant on medication such as antidepressants, stimulants and more. These tend to lead to unpredictable changes in behaviour, where an individual may seem like an entirely different person. The reasons behind such changes are unclear. Parents or caregivers must speak with a psychiatrist or paediatrician and clarify any concerns before allowing their child to go on medication.
Ultimately, as parents and caregivers, it is important to be informed and to plan well. If one is aware of the options that society has available for the special child, then they would be able to adequately prepare their child to head down that road. In an arduous journey towards achieving some degree of independence, it is also important to set small goals and celebrate their little successes.
This path is often incredibly frightening and at times disheartening, especially when the end appears so unclear. In such moments it is also important to exercise self-care and to accept the fact that sometimes all we can do is love our child (while not being able to change very much else)—and that is okay.
Inclusivity and Support: (re)entry into society
Intervention for young children and young adults are different. While some keep up with mainstream education and eventually re-join the workforce, some are better suited on vocational or alternative paths. Stigma, arising from either the visible signs of ASD or from pursuing a vocational or alternative path, are real barriers for entry into society.
Young adults are usually encouraged to learn the skills needed to take on vocational roles, allowing them to earn a living and become less financially dependent on their family or loved ones. The eventual goal for skills building and psychoeducation is to allow young adults to cope in society in open or sheltered employment, or otherwise remain productively engaged in a day activity centre.
Ψ Sheltered employment refers to employment whereby there is a supervisor present to monitor and help the individual. Oftentimes, rather than taking place in a typical work environment, sheltered employment worksites are autism-friendly and highly structured. For example, a bank could extend sheltered employment to individuals with autism and open a special space for them where they could do data entry.
Ψ Open employment refers to typical part-time work. Individuals with autism there can work with neurotypical colleagues and receive minimal support from their supervisors. Such employment can be seen in shops like Starbucks and at hotels as well.
Ψ A day activity centre is as its name suggests and is simply a place where older individuals with autism can go to keep themselves occupied. Its residents are often individuals on the lower end of the spectrum who would be unable to keep up in the workforce and need substantial help with taking care of themselves.
Young adults on the lower end of the spectrum often need to be equipped with daily living skills. These involve simple things that may seem intuitive, such as upkeeping personal hygiene or buying food.
Parents or caregivers can offer support by identifying key skills required for these different routes of employment and work to hone them in their child. It is important, however, to note that these skills, while specific to the job, should also prepare the child socially as much as possible.
Additionally, some parents may be in a position to offer their child a less demanding job within their companies or businesses: it is important to ensure that the work environment is carefully audited to ensure that it is conducive for your child. This could involve including visual aids and implementing clear organisational and workflow structures.
Whether a family-owned or a commercial workplace, we recommend that an Occupational Therapist is consulted for professional advice on adapting your workplace and to ensure inclusivity.