1) What is Autism Spectrum Disorder?
A person with Autism Spectrum Disorder has a pervasive developmental disorder which can lead to difficulty with social communication and/or interactions. It can present restricted and/or repetitive behavior, interests, or activities.
Social Communication Difficulties:
a) Deficits in social reciprocity such as:
• Doesn’t initiate conversations with others
• One-sided conversations
b) Deficits in non-verbal communication such as:
• Lack of eye contact
• Difficulty understanding or noticing others gestures
• Difficulty understanding euphemisms, metaphors, jokes or sarcasm
Restricted Behaviors and Repetitive Behaviors, Interests, or Activities can include:
a) Repetitive movements such as:
• Lining up toys
• Repeating words
b) Insistence on sameness, inflexible and/or adherence to routines, ritualized patterns, verbal and/or nonverbal behavior:
• Extreme distress at small changes
• Difficulties with transitions
• Rigid thinking patterns
c) Highly restricted, fixated interests that are abnormal in intensity or focus:
• Knows a lot about trains, airplane patterns, specific bands and/or singers, historical facts
d) Hyper- or hypo-reactivity to sensory input or unusual interests in sensory aspects of the environment
• Apparent indifference to pain/temperature
• Adverse response to specific sounds or textures
• Excessive smelling or touching of objects
• Visual fascination with lights or movement
2) What’s the difference between Autism Spectrum Disorder and Social Pragmatic Communication Disorder?
With the release of the DSM-5 there have been changes to some of the diagnoses under the developmental disorders. One change is that Autism Disorder is now under the heading of Autism Spectrum Disorder. Under this new umbrella is what used to be known as Asperger’s Syndrome. Another change is the addition of the diagnosis Social Pragmatic Communication Disorder. So, what is the difference?
To be diagnosed with Autism Spectrum Disorder, one must have social communication difficulties AND restricted and/or repetitive behaviors or interests.
To be diagnosed with Social Communications Disorder, one must only have social communication difficulties. Your child might be able to speak very well but may have difficulty having a two-way conversation and frequently misunderstands what others are communicating.
To have this diagnosis the four following criteria must be met:
a) Persistent difficulties using verbal and nonverbal communication cues across several contexts:
• Greeting others and sharing information that’s appropriate for the situation
•Matching the listener’s needs:
- indoor versus outdoor voice - formal versus informal language use - talking to kids versus talking to adults
• Following conversation and story telling rules:
- taking turns during conversations - rephrasing information when listener doesn’t understand them
• Understanding information that is not explicitly stated:
- Metaphors, humor, or recognizing words or phrases with multiple meanings.
b) Communication difficulties:
• The inability to effectively communicate with family, friends and their community in a home, school, or any other setting
c) Delayed milestones at an early age:
• Delays in reaching speech or language milestones • Disinterest in talking
d) Challenges are unrelated to other medical or language difficulty:
• Communication issues are not linked to another general, neurological, medical, or specific language difficulty. Such as an intellectual disability, global developmental delay, or autism spectrum disorder.
Children who are screened for social pragmatic communication disorder are evaluated on their ability to do the following:
• Respond to others
• Talk about their feelings and emotions
• Take turns speaking and responding to others
• Stay on topic
• Use gestures and hand movements to express themselves (waving hello/goodbye, pointing, expressive gesturing, etc.)
• Adjust their speech according to the situation or environment (speaking quietly in a library or learning to speak differently to toddlers as opposed to adults)
• Ask questions or make comments that relate to the conversation topic
• Make and keep friends
• Use words for a variety of purposes, from greetings and requests to conversations and expressing emotions
3) How do I know if my child has Autism?
Autism can be daunting for many parents. Mostly because there is still a lot to learn about the cause, the diagnosis, and treatment. However, knowing what to look in your child is critical for early intervention. The American Academy of Pediatrics (AAP) says some subtle, early signs of autism to look for before baby is 12 to 18 months old include:
• Your child doesn't turn when you say his or her name by 12 months
• Your child doesn't turn to look when you point and say, "Look at…"
• Your child doesn't point to show you interesting objects or events • Your child doesn't engage in back-and-forth baby babbling
• Delay in smiling and laughing
• Your child doesn't make and keep eye contact with people
If your child is older and you are worried about tantrums or social skills, there are local psychologist that can test your child for ASD. Also, starting at the age of 3, most school districts are required to test any child free of charge whose parent requests in writing psychological testing.
4) I found out my child has Autism, now what?
A quote to consider: “Once you meet one kid with Autism, you met… only one kid with Autism.” Every child with Autism has different strengths, interests, and needs. Many parents get nervous after hearing the diagnosis “Autism Spectrum Disorder,” leading them to hire a speech therapist, occupational therapist, and behavioral therapist. These may not be needed. The first thing for parents to do is breathe. Just breathe.
The person who gave you the diagnosis should give you referrals to professionals that can help. Take your time with choosing what professional is right for your child. You want your child to feel comfortable in order to build a relationship. Also, you may want to ask for therapist or support group referrals for yourself. Many parents put a lot of resources into their child and forget about themselves. It is important for parents to also receive support in order to better understand the diagnosis, help with behavioral issues, and just have someone who will listen when things get tough.
5) What resources are available for children at our practice?
We have multiple therapists that work with children and adolescents diagnosed with Autism Spectrum Disorder as well as Social Pragmatic Communication Disorder. They can be seen individually to work on specific individual goals or there are also social skills groups where they can learn and practice new social skills with peers with similar experiences.
6) What resources are available for parents at our practice?
Rogers Counseling and Play Therapy Center offers individual and group sessions for parents. Parents can schedule an appointment with a therapist for parent support where they get one on one support. Parents can also enroll in a group that meets at the same time as their child’s social skills group. This group allows parents to learn how to support their child as well as to transfer skills learned in group to other areas of life. They meet other parents in similar situations and are able to connect.