Autism Spectrum Disorder: Not Disability but Different Ability

” AUTISM did not stop EINSTEIN, MOZART, NEWTON or TEMPLE GRANDIN and it won’t STOP our people on the spectrum either.”

148 children out of 10 000 in Lebanon are diagnosed with Autism, with a ratio of 1.13 boys for one girl. (D.Saab & Al, 2016)

Autism spectrum disorder is a neurodevelopmental disorder characterized by weakened social communication and interaction, repetitive behaviors, limited interests and persistence on sameness. ASD is not a mental health disorder, it is just another wiring in the brain development.

ASD has different levels of severity. As we go from light to moderate to severe:

• The required level of support becomes more substantial
• The social communication becomes more marked by deficits in initiating conversations, limited interest in social interactions and very minimal response to social overtures of others
• The inflexibility affects more than one area of functioning and the difficulty coping with change increases

Three main spheres are affected in ASD:

1- Altered social interactions

• People with autism have little or no visual contact (but at least they don’t stare!)
• As you may already know, children learn by imitation (so you should lead by example!), children on the spectrum have limited imitation capacity
• Children with ASD lack emotional reciprocity (may not respond back to “I love you” for example)
• Poor sharing of pleasure with others

2- Altered communication

• Difficulty initiating or maintaining a conversation
• No background setting when telling a story
• Rare or no usage of pronouns (refer to themselves by name not I)
• Language delay or absence
• Repeat the same words (immediate or delayed echolalia)

3- Stereotyped behaviors and restricted interests

• Excessive preoccupation for one subject and components of objects. (A child with autism passionate about cars is capable of spending 30 minutes spinning the wheel of the match box car)
• Compulsive attachment for a routine and resistance to change (rigidity)
• Motricity peculiarity (self-stimulation, flapping)
• Limited interest but in excess

 There are many difficulties associated with ASD such as attention deficit, impulsivity, aggression, feeding difficulty (very picky), sleeping difficulty, obsession, abnormal emotional reaction, tantrum or meltdown, [unload sensibility or sensory overload].

The cause of ASD is still unknown, however, there are many risk factors:

•  Advanced paternal age, over 40. (not maternal age like in Down Syndrome)
•  Poor maternal physical and mental health, prenatal medication use (selective serotonin reuptake inhibitors — family of antidepressants), exposure to chemicals
• Preterm birth, complications during birth, low birth weight
• Jaundice, post birth infections

 “… autism is a complex disorder resulting from the combination of genetic and environmental factors.”

Five warning behaviors for ASD Evaluation (NICHD):

• Does not babble or coo by 12 months
• Does not gesture (point, wave, grasp) by 12 months
• Does not say single words by 16 months
• Does not say two-word phrases on his/her own by 24 months
• Has any loss of any language or social skills at any age

 Screen for ASD at 18 and 24 months during general wellness checks. Physicians use an array of formal and informal autism screening tools. These can range from simple observations to formal assessments. (ADOS, M-CHAT, CARS, STAT, ADI-R, SCQ, WISC-5)

 Autism diagnosis doesn’t change who you are, it explains why you think differently

There is no “cure” for autism but the earlier the intervention, the better. Parental guidance is essential to help the child in his or her development

Communication and speech- related challenges vary from person to person.  Speech therapy can help individuals with autism improve their verbal, non-verbal and social communication skills in order to be able to communicate in more useful and functional ways.

• Augmentative and Alternative Communication (AAC) system that uses symbols, communication books, specific prompting, and reinforcement. PECS (picture exchange communications system)
• Video based instructions 

Where do I start?

• Establish a relationship with the child
• Use reinforcers
• HAVE FUN! Always stay positive
• Don’t be pushy, be patient
• Interact through physical activity
• Be affectionate and respectful
• Show your love and interest
• Ignore irritating attention-getting behaviors

 Frequently asked questions

•  Do vaccines cause autism?

 MYTH

A scientific review by the Center for Disease Control (CDC) and the Institute of Medicine (IOM) concluded that “the evidence favors rejection of a causal relationship between thimerosal – containing vaccines and autism”

• Are all ASD children savant?

 MYTH

While the media tends to portray the extreme ends of the autism spectrum (Movie RAIN MAIN), individuals with ASD have a variety of strengths and needs. Only one in ten people with autism have any savant abilities

It is important for teachers to provide students with personalized interventions that are based on their unique pattern of needs rather than their diagnosis alone because as Temple Grandin said “No two  children with autism are alike… The goal is to observe and find the specific pattern of response each child exhibits…”

References:

NOURHAN EL ZEIN, F., HAJJAR, A., & NADIA JRADI, F. (2021). AUTISM AWARENESS AMONG THE LEBANESE POPULATION. Retrieved 1 April 2021, from [Here]

Lebanese Autism Society. (2021). Retrieved 1 April 2021, from [Here]

Open Minds (2021). Retrieved 1 April 2021, from [Here] [Here]