autism spectrum disorder (ASD, which now includes previous diagnostic labels such as autistic disorder and Asperger syndrome) is a neurodevelopmental disorder long life. First, it manifests early in life, he begins to take shape in early childhood and preschool age.
is what’s on the outside that counts
There is no blood test or genetic ASD; Diagnosis is based on behavior.
Specifically, we look for three things when deciding whether a person has an autism spectrum disorder.
- Impaired ability to interact socially with others. The person may have reduced motivation and / or ability to relate to others. Precisely what we seek depends on their age and stage of life. During the school years, children may not seem as interested in their peers. Or they may be interested, but do not know how to build or maintain friendships.
- restricted, repetitive and / or sensory-seeking behaviors. Again, precisely what we seek depends on the age of the person. During the school years, children can enjoy activities or issues that seem very unusual (like flicking collecting rope or branches) or their interests may be appropriate for their age, but too intense. All children have special interests; Thomas the Tank Engine, Frozen and Minecraft come to mind. But the difference is that children with ASD engage more intensively or in very specific ways with their special interests, and can do so to the exclusion of others. Some children with ASD try to attract others to their interests, but do not realize when others are not so interested.
- Finally, we look to see that these social problems and restricted / repetitive behaviors have been there since early childhood. TEA is something inherent to the child, is not something that “catches” later in life.
Other features may also accompany an autistic disorder, such as anxiety disorders, eating and sleeping, hyperactivity and medical conditions such as epilepsy spectrum. Together, these can have a substantial impact on school performance.
growing awareness = earlier diagnosis
These days, ASD is often diagnosed in preschool. ASD affects about 1% of preschool children in Australia and most young children receive their diagnosis of ASD around their fourth birthday. However, ASD can be diagnosed reliably much earlier – often by the second birthday of a child -. If symptoms are clear and are knowledgeable professionals
At school age, however, some evidence suggests ASD affects 1.5% or more of children. This suggests that many children with ASD are lost during the preschool years. Later, the diagnosis can will occur because the child’s symptoms are subtle, or due to limited awareness or resources available in the area.
How to detect autism spectrum disorder
Teachers are well placed to detect possible ASD in children of school age. They have experience with the range of skills that children present at a certain age and can see children interacting together. Many school children are referred for evaluation by a specialist when teachers are concerned.
The process for making a diagnosis of ASD in childhood is a bit like that for the identification of a learning disability. We seek if the social skills of a child below its potential. Unfortunately, however, there is no simple test to find out if a child shows “appropriate social behavior for their age” in the way we test age-appropriate, such as reading or writing language skills.
A learning disability based on reading is diagnosed when the reading performance of a child is below what we hope for their general intelligence and for no other clear reason explains their misreading (such as lack of exposure to text). As ASD is a disorder of social skills, we assessed whether these are lower than expected for age and level of intelligence of the child, and rule out other possibilities.
If a child with poor social skills was severely mistreated early in life, this is not likely TEA. If a child is socially immature, but their social skills are in line with its mild intellectual impairment, this is probably not ASD.
ASD is diagnosed when the child’s social skills are lower than those of their peers of the same age and this will not only be explained by intellectual impairment or language that may also be present. Similarly, the restricted / repetitive behaviors child are more than expected for their age and intellectual level.
Not only are some less outgoing people?
Many human skills – intelligence, physical fitness, a musical ear – the fall in a “bell” or normal curve. We are all different, but most of us are grouped around a midpoint in our skill level, with only a few of us particularly impaired or excellent.
Sociability is no different. Some of us are more or less salient than others. We have established a point for people who have very limited social skills (age, etc.) “cut-off” and this may seem like an arbitrary method for diagnosing ASD. However, the cleavage is important; where social difficulties present a functional problem for daily life of the person. TEA is not just about being a little shy or reserved.
What’s in a name?
Many children without ASD benefit diagnosed with support to develop their social skills. And for children whose social difficulties are strong enough to be considered “symptoms”, a formal diagnosis can allow access to specialized support.
Some people consider unnecessary diagnostic workup, or even undesirable. After all, the diagnosis is just a label. However, a label can bring greater understanding – understanding of children of one, or oneself. And understanding often leads to greater acceptance, which is good for mental health.
Author: Kristelle Hurdy, Professor of Developmental Psychology, University of La Trobe
Courtesy: The Conversation