Subject: Quinn, an ~18 month old boy with auti...

Children with autistic spectrum disorder (ASD) have difficulty expressing their emotions or understanding other people’s emotions. They find it hard to make friends and to communicate with others and they have problems reading people’s facial expressions. They are also less likely to engage in imaginative play, for example, they would find it hard to pretend that a wooden block is a train or a rocket. They can also be quite sensitive to stimuli in their environment such as loud noises.

There can be speech and language difficulties in children with ASD but not always. Examples of speech and language difficulties are: not speaking by 16 months, repeating words and phrases over and over again, repeating questions rather than answering them, not being able to communicate their desires and not understanding humour.

Children with ASD can be quite inflexible, for example, they do not cope well with changes in routine. Other signs of ASD are: attachments to strange objects such as wires or keys, lining up toys or spending long periods of time staring at moving objects such as a wheel spinning on a car. Some children with ASD can also show an amazing memory for facts such as train schedules.

ASD may lead a child to feel anxious. Many autistic people have certain routines that help them deal with their anxieties e.g. wearing the same clothes, eating the same foods and repeating the same movements (hand flapping, finger flicking).

So what are the signs of ASD in babies? One of the major signs of ASD in babies is lack of eye contact. Babies with ASD often do not babble or mimic facial expressions. Very young babies cannot smile but if babies are not smiling by six months, it can be a sign of ASD. Another sign of ASD is when older babies do not use gestures to communicate such as pointing or waving goodbye.

Some babies will develop normally but then regress between 12 and 24 months. A toddler who stops using words or stops playing social games such as peek-a-boo could have ASD. If your child regresses, it is a good idea to speak to your doctor or health visitor as this is an indicator of ASD.

Simon Baron-Cohen suggests that children with ASD have problems understanding that other people have different thoughts to them. He developed the Sally-Anne task to test for ASD. It is possible to use an adaptation of this task at home with children over 4 years old, although a diagnosis should always be done by professionals. You can put two puppets together and say that both puppets are watching whilst a toy is placed in a basket or container. You then tell your child that one of the puppets is going out of the room. The next step is to explain to your child that the second puppet is going to hide the toy in a different place. You bring the first puppet back into the room and ask your child, where the first puppet thinks the toy is. Children over 4 years older who do not have autism should be able to understand that the first puppet thinks the toy is still in the original place. However, children with ASD tend to think that the first puppet will know the new hiding place for the toy. This is because children with ASD have difficulty understanding that others do not always know what they do. They have trouble comprehending that other people can have different thoughts and feelings to them.

So what can parents do if they think their child has ASD? First of all, you need to get a diagnosis of ASD. The Peach Charity recommends early diagnosis and intervention to improve communication skills. Parents may be told not to worry by GPs and health visitors but if you suspect your child has ASD, it is a good idea to push for diagnosis. Your child may then be assessed by 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 or educational psychologist.

One intervention programme that has been found to be effective is ABA (Applied Behaviour Analysis). ABA involves teaching children with ASD the skills to communication effectively and interact with others. The programme also involves rewarding children for appropriate behaviours such as waiting for their turn in a game.

So what does the research say about parental involvement? McConachie and Diggle (2007) argue that parents should be given training in how to help their children with ASD. They say that parents can benefit from the increased skills especially as children with ASD can be difficult to manage. They also point to research that says that training parents in groups can help them to form a support network with other parents (Baxendale, Frankham, & Hesketh, 2001; Symon, 2001). They reviewed a number of studies and concluded that training parents in how to use ABA at home helped children’s communication skills and behaviour. They also point to studies that suggest that parental training can reduce parental stress levels and even lower the incidence of mothers developing depression. Some parents report that being trained in how to deal with ASD also helped them with their other children (Laski et al. 1988).

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