AUTISM SPECTRUM DISORDER

The Autistic Spectrum Disorder is an umbrella term used to describe an array of sensory and social difficulties. Autism is a condition that is termed under the Autistic Spectrum Disorder and directly affects how children perceive the world around them, often children with autism struggle to engage socially, make friends and understand non-verbal communication.

PROBLEMS ASSOCIATED WITH THIS CONDITION

Autism is what's known as a 'spectrum' disorder, affecting different children in different ways. Children with autism are extremely unique and may experience few or many of the common symptoms below.

• Struggles to understand body language
• Finds social situations daunting or unusual
• Prefers things to be organised or done a certain way and becomes agitated to change
• Has difficulty organising and planning for school work
• Doesn't have many friends at school
• Dislikes change in routine and becomes upset if sudden changes occur
• Christmas and other holidays are unnerving for your child
• Takes pictures and phrases too literally
• Needs to know an exact plan of the day's events and gets upset if things change unexpectedly
• Dislikes meeting new people
• Little or no awareness of danger
• Occasionally runs away from home or school or when out in the community
• Distracted by blinds or enjoys moving the head to create flickering sunlight
• Finds patterned carpets or floors confusing to navigate across

It is also common for a child within the autistic spectrum to be either over-reactive to sensory responses (hypersensitive) or under-reactive (hyposensitive) alongside the usual symptoms above. It is likely that your child will experience just one type of sensory responses to light, heat, sound smell or taste. However it could be that your child is hypersensitive to light but hyposensitive to touch.

Hyper-Sensitivity

• Finds normal background sounds unbearably loud or distracting
• Over sensitive to heat, light, sounds or smells
• Prefers to focus on the detail rather than the whole
• Distorted vision, objects and bright lights can appear to jump around
• Likes spicy food
• Eats everything (grass, soil, play-dough etc.)
• Touch can be painful or uncomfortable
• Dislikes wearing shoes, socks or gloves
• Struggles with activities like sport
• Difficulty stopping quickly or movements overflow
• Poor fine motor skills
• Moves whole body to look at something

Hypo-Sensitivity

• Holds others tightly
• High pain threshold
• A central object is magnified but things on the periphery are blurred
• Poor throwing or catching (depth perception)
• Under-sensitive to heat, may not recognise when an object is too hot
• Poor sense of smell, fail to notice own body odour
• Dislikes people with distinct perfumes
• Enjoys rocking spinning around at a fast pace
• Bumps into people/objects often
• Stands too close to others
• Finds it hard to navigate rooms
• Simple and effective

HOW CAN THESE DIFFICULTIES IMPACT ON FUNCTION?

Autism can have a profound effect on a child's routine. The simple tasks that every day involves are difficult and require a high level of attention and effort. Some of the common difficulties that children with autism experience are listed below:

Home:

• Difficulty understanding instructions
• Can be overwhelmed by the smell of dinner cooking
• Becomes easily upset if surroundings change (at holidays or if new furniture arrives)
• Having guests over can be difficult
• Changing perfume or washing powder can result in child becoming agitated
• Difficulty sleeping in early hours of morning when the sun rises through the curtains

School:

• Classroom environment can become overwhelming and cause distress
• Routine changes can be difficult for your child to deal with
• Change in teacher can cause significant distress
• Can be fixated on displays and or objects within the classroom
• Struggles to make friends
• Difficulty completing activities in P.E or playground
• Finds it hard to navigate corridors, rooms and the school environment

OCCUPATIONAL THERAPY TREATMENT AVAILABLE

Occupational therapists have the knowledge and skills to provide effective treatment and management of the complex issues that a child with autism experience on a daily basis. Some of which are listed below:

• Sensory Integration
• Education and support for living with a child with Autism
• Home adaptations to improve sensory feedback
• School visits to improve learning environment at school
• Social improvement therapy, aimed at improving social understanding and body language
• Analysis of routine and offer advice on how this can be adapted to help your child deal with any changes
• Adaptive aids and equipment advice, such as weighted jackets for sensory support

The OT would be able to assess and provide treatment for your autistic child on a range of their symptoms. The therapist would analyse how your child copes across all areas of their life, be it in school, at home or regarding routines on a daily basis. They would work collaboratively with you in setting goals that both you and your child want to achieve and apply evidenced based techniques to provide treatment aimed at meeting these goals and most importantly improving function in your child in order to make your day to day life easier.

SPEECH THERAPY TREATMENT AVAILABLE

Since social communication impairments are a defined feature of the autism diagnosis, speech therapy is a common recommendation for children with autism. Speech therapy for autism will target improving the child�s social communication and interaction skills and helping them become more independent and confident in their environment. The following speech therapy goals are considered for all clients with autism spectrum disorders.

Speech Therapy Goal 1: Establish Functional, Spontaneous Communication

The first goal with any child who has autism is to make sure that he or she can communicate functionally, and spontaneously. This means that the child needs to be able to communicate his basic wants and needs to those around him without needing to be prompted through it (the adult shouldn�t have to say �what do you want?� or �use your words�).

Each child with autism will need this area of speech therapy to look slightly different. Some children will need alternative means to communicate because they won�t be able to speak. Others will speak just fine but will help learning the right words to use in the right situation. A speech-language pathologist will be able to customize therapy to meet the needs of each individual child with autism.

Helping Children Use Language Spontaneously (without being prompted):

Children with autism often have difficulty with using language spontaneously. They may speak when told to or in response to specific questions but won�t speak up when they need something or when they are upset.

For these children, it�s important to work on fading the amount of prompts that you are giving so that the child does more and more independently each time. For example, at first you may have to tell the child exactly what to say in each situation. Then, you can fade back to a prompt like �use your words�. Then, you can fade back to a visual cue like a picture that says �use your words� or shows someone talking. There are many ways to fade cues so that is just an example.

Speech Therapy Goal 2: Improve Social Communication Throughout the Day

The next thing that all children with autism will need to some degree is social instruction. Children with autism often have a problem with understanding socially acceptable behavior. They don�t always know how to act or behave in various social situations. Since school is basically just one big social situation, that can make learning environments especially hard for them.

Again, the specific therapy techniques and strategies for this area will vary depending on the child and their individual needs. But the key is for this social instruction and support to continue throughout the day. Children with autism often have difficulty transferring skills learned in one setting to a different setting. For that reason, they need to work on social interactions in more places than just during speech therapy sessions. Educators and caregivers should carry-over social instruction in other settings as well.

Direct Instruction of Socially Acceptable Behaviors:

It is important to teach children what behavior is socially acceptable in various environments. This includes what the child should do and say in social situations as well as how he should listen and attend. For young children, you will choose goals for basic skills like listening to a teacher, answering questions, and following directions. For older children, you will choose goals like group conversations and being a good friend. Again, the social skills chosen will depend on the needs of the child.

Speech Therapy Goal 3: Improve Peer Interactions

Since children with autism often have a difficult time with peer interactions, these skills must also be directly taught. All children with autism struggle with this to some extent as part of the nature of autism. However, you will target significantly different skills depending on the age and developmental level of the child you are working with.

Peer Interaction Goals for Younger Children: Here are some goals for children who are just beginning their peer interaction training:
• Play skills: Teach the child how to play with other children and get along during play.
• Responding to Name: Teach the child to respond when someone says his name.
• Establish Joint Attention: Help children tune into those around them.

Peer Interaction Goals for Older Children:

These activities are better for older children who are struggling with peer interactions:

• Target Conversational Skills: Look at social skills that the child is lacking during normal interactions with other students and adults.
• Teach Perspective-Taking: Help these children understand how to see things from another perspective

Speech Therapy Goal 4: Generalize Skills to the Regular Education Environment

One of the most common requests I hear from parents of children with autism is �My child needs more time with the speech-language pathologist�. I completely understand why they want this! The speech therapist is the person who is helping their child communicate better so more time with that person should equal better communication, right?

Unfortunately, that�s not exactly how it works.

Children with autism tend to have trouble generalizing skills. For example, if you teach a child with autism to count to 5 using the same 5 yellow cups at the kitchen table and you never practice counting anywhere else, the child will do great at counting to 5 in that exact situation but may not be able to transfer that to counting anything else.

The same goes for communication. If a speech-language pathologist teaches a child with autism to communicate with her in the speech therapy room, it doesn�t necessarily mean that the child will then start communicating with other people and in other settings.

Instead, the child must practice the same communication skills with a variety of different people and in a variety of different settings. For that reason, it is vital that the child does not spend every waking moment with the speech therapist. We want the child to communicate in any situation, not just when the speech therapist is present.