Autism Spectrum Disorder (ASD)
A guide for parents and teachers
by Gaby Aviles, Erin Catalano, and Kent Frosch
What is Autism Spectrum Disorder (ASD)?
Autism Spectrum Disorder (ASD) is a heterogeneous disorder which means it presents in different ways and varying levels of function. The term ASD is an umbrella term for a group of neurodevelopmental disorders that are characterized by deficits in social reciprocity, impaired communication, and repetitive restricted patterns of behavior or interests. Deficits in social reciprocity and impaired communication make it difficult for individuals with autism to interact and collaborate with others.
Different ways to gather information have shown varying percentages of occurances from 1.5 to 3.0 cases per 100 children. These methods include Screening and evaluating all children in a population; Examining data from national surveys, registries, and administrative sources; and Reviewing health and education records of children in a chosen population. However, all sources have seen dramatic upticks in the number of cases over the last 20 years. For example, “[t]he prevalence of ASD in the US more than doubled between 2000–2002 and 2010–2012 according to Autism and Developmental Disabilities Monitoring Network (ADDM) estimates”. (Baio et al. 2014)
Symptoms of ASD and ways to recognise potential learning disabilities:
The CDC provides the following Social Communication and Interaction that may be related to ASD:
- Avoids or does not keep eye contact
- Does not respond to name by 9 months of age
- Does not show facial expressions like happy, sad, angry, and surprised by 9 months of age
- Does not play simple interactive games like pat-a-cake by 12 months of age
- Uses few or no gestures by 12 months of age (for example, does not wave goodbye)
- Does not share interests with others by 15 months of age (for example, shows you an object that they like)
- Does not point to show you something interesting by 18 months of age
- Does not notice when others are hurt or upset by 24 months of age
- Does not notice other children and join them in play by 36 months of age
- Does not pretend to be something else, like a teacher or superhero, during play by 48 months of age
- Does not sing, dance, or act for you by 60 months of age
People with ASD have behaviors or interests that can seem unusual. These behaviors or interests set ASD apart from conditions defined by problems with social communication and interaction only. They may do some or all of the following:
- Lines up toys or other objects and gets upset when order is changed
- Repeats words or phrases over and over (called echolalia)
- Plays with toys the same way every time
- Is focused on parts of objects (for example, wheels)
- Gets upset by minor changes
- Has obsessive interests
- Must follow certain routines
- Flaps hands, rocks body, or spins self in circles
- Has unusual reactions to the way things sound, smell, taste, look, or feel
Types of ASD
1. Autistic Disorder- diagnosed when a person shows six or more symptoms across the three core areas of communication, reciprocal social interaction and behaviors that are restricted and repetitive in nature.
2. Pervasive Development Disorder- diagnosed when there is presentation of five or fewer symptoms.
3. Aspergers- diagnosed in children who have difficulties with restricted interests and social interactions.
Children diagnosed with all three types of autism have impairments with social reciprocity, which means they struggle to communicate their needs, maintain social relationships, and understand the dynamics of relationships in all areas of life.
Common Tests
- M-CHAT
- AQ
- ADOS
DSM-5 provides criteria for pediatricians and healthcare professionals to use when diagnosing ASD. During healthcare visits, doctors provide developmental screenings such as M-CHAT (Modified Checklist for Autism in Toddlers) and AQ (Autism Spectrum Quotient). Psychologists and developmental specialists may observe the individual in different settings to assess behaviors using ADOS, the Autism Diagnostic Observation Schedule.
Daily life for an individual with ASD:
As Autism Spectrum Disorder (ASD) occurs on a spectrum, the manner in which it presents will vary from person to person. The varied severity of symptoms may result in a late diagnosis and delay appropriate interventions. Many children with ASD are diagnosed prior to entering elementary school although it is not uncommon to see identification later in childhood.
Living with Autism can impact a person’s ability to communicate effectively or regulate emotions due to frustration or overstimulation. Routines are necessary and deviations from routines may cause upset and outbursts. Many people with ASD have no trouble with academics; however, it is possible for motivational issues to arise. Those with intellectual disabilities, often suffer from social isolation. Repetitive behaviors and echolalia can cause social awkwardness when present.
Classroom needs:
Teachers and professionals who work with people with ASD can support these students by implementing some of the following measures:
- Visual Schedules that include pictures and words
- Velcro choice boards
- Speak clearly and avoid inference
- Small group instruction
- Positive peer support
- Consistent schedules
- Adjusting lights and sounds as needed- noise cancelling headphones, quiet space in class
- Graphic organizers
Common Interventions or accommodations
- Antecedent-Based Interventions- strategies that alter the environment prior to known triggers
- Applied Behavior Analysis- an approach based in behaviorism, uses behavioral theories to alter behaviors
- Assistive Technology
· Augmentative & Alternative Communication (Communication device)- a broad approach to supplementing speech & language impairment. This may include but is not limited to: picture boards, gestures, sign language, finger spelling, speaking devices
· Music mediated Interventions (music therapy)
· Sensory Integration- an introduction of sensory input in effort to help organize sensory information
· Visual Supports
Personal Experience working with children and adults with ASD
Interactions with individuals with ASD can be very rewarding but also very frustrating. Here are some things that have helped ease interactions:
- Using Literal speech. Individuals with ASD have difficulty with abstract language including metaphors and similes. Slang is difficult for them to understand.
- Token Economies where individuals are rewarded for learning a new skill or decreasing a maladaptive behavior.
- Velcro boards can be very useful in getting responses.
- Routines are crucial and preparation for deviations are essential.
- Learn triggers for overstimulation to avoid escalation.
- Many children with ASD cannot understand social cues. It is important not to try to make this a requirement. They can learn appropriate behavior, but it may not be something that is intrinsic or motivated by empathy.
References
Autism Speaks inc. (2023). Tips for Using Assistive Technology Devices. Autism Speaks. https://www.autismspeaks.org/tips-using-assistive-technology-devices
Baio J, Wiggins L, Christensen DL, et al. Prevalence of autism spectrum disorder among children aged 8 years — autism and developmental disabilities monitoring network, 11 sites, United States, 2014. MMWR Surveill Summ 2018;67:1–23. 10.15585/mmwr.ss6706a1
Blenner, S., Reddy, A., & Augustyn, M. (2011). Diagnosis and management of autism in childhood. BMJ: British Medical Journal, 343(7829), 894–899. http://www.jstor.org/stable/23052223
CDC, (2023, March 23). Autism Data Visualization Tool. CDC. https://www.cdc.gov/ncbddd/autism/data/index.html#data
Faras, H., Al Ateeqi, N., & Tidmarsh, L. (2010). Autism spectrum disorders. Annals of Saudi medicine, 30(4), 295–300. https://doi.org/10.4103/0256-4947.65261
Farlex, (2023). The Free Library. https://www.thefreelibrary.com/
Hill, E. L., & Frith, U. (2003). Understanding Autism: Insights from Mind and Brain. Philosophical Transactions: Biological Sciences, 358(1430), 281–289. http://www.jstor.org/stable/3558141
