Autism Spectrum Disorder is a lifelong disability of neurological origin.
This means the brains of individuals with the disorder are different from typical brains.
Structural differences include greater volume, with a rapid growth spurt occurring around three to four months.
Scientists hypothesize that such rapid growth may not provide the time needed for the development of connections between different parts of the brain.
Autism Spectrum Disorder is genetic in origin but the genes responsible for the condition have not yet been identified.
Also, scientists suspect that the way the autistic genes display themselves may be affected or modulated by environmental conditions.
The origins of Autism Spectrum Disorder are coded into the baby’s development from the moment of conception.
As the baby grows and develops, the impact will be gradually revealed as they fail to meet developmental milestones.
A crucial milestone is the development of language between the ages of nine to 18 months.
Typically developing babies will communicate with their caregivers by cooing and babbling long before they can say their first word.
They show pleasure in being with their usual caregiver and will signal their needs even before they can speak.
A delay in language development, especially after two years of age, can signal a wide variety of developmental difficulties, including autism, and should always be discussed with a pediatrician.
A diagnosis can take a long time and the average age of diagnosis of autism is currently five and a half years.
Why so long?
The rate at which children develop is variable and it can be difficult to differentiate between normal stages of development and autistic behaviour.
Also, language delay is not sufficient for a diagnosis of autism.
The child must also demonstrate difficulties with social interaction and display repetitive or unusual behaviours.
Difficulties with social interaction emerge slowly over the course of the toddler years.
Unusual behaviours are often noted but are seen as a passing phase or unique to the child.
Some children develop language appropriately and in accordance with the usual rate of development.
Their difficulties come later and with more challenging linguistic demands.
Asperger’s Syndrome children may have a very good vocabulary but only like to converse about their favourite topics (like Pokemon cards, dinosaurs, warships and cars).
They have difficulties in the give-and-take of conversation and frequently wander off topic.
Asperger’s Syndrome children also like order and routine and can be quite inflexible or rigid.
Many do not develop self-control consistent with expectations for their age and level of intelligence.
Again, parents and teachers may see this as a passing phase or part of the personality of the child and diagnosis may be delayed.
Currently, the average age for diagnosis with Asperger’s Syndrome is 11.
Children who are identified as Pervasive Developmental Disorder — Not Otherwise Specified will usually have some peculiarities of language such as echolalia (repeating what you say or the conversations they’ve heard in movies).
They can also have a tendency to mix up personal pronouns referring to a girl as “him” or a boy as “she” even when they are perfectly aware of the gender of the person.
Pervasive Developmental Disorder —Not Otherwise Specified children will also have difficulties with socialization but do not display the stereotypical behaviours characteristic of classical autism to any degree.
Because Autism Spectrum Disorder is neurological in origin children will not grow out of it.
Yet we know there is plasticity in the brain — that all through childhood and into late adolescence, the brain is continuing to grow and to develop more neural connections.
Early intervention in Autism Spectrum Disorder seeks to capitalize on this neural plasticity.
The idea is to teach directly the things that the child does not learn spontaneously, like language and how to connect socially with others.
We also know that the sooner we intervene when a child’s development is atypical, the better the outcome will be for the child and the family.
Intervention reduces the burden of suffering for each individual child and their family and provides long-term benefits to society by reducing the levels of care or services needed later.
When we think of early intervention, we tend to think of young children.
But clearly, with the Autism Spectrum Disorder population, many will not be diagnosed until relatively late in their development (at the beginning of adolescence).
Is elementary school or high school too late to intervene?
The short answer is no.
The long answer is that it would have been better to intervene sooner but with Autism Spectrum Disorder, better late than never is the key.
So much can be done for older children, adolescents and adults to reduce the development of secondary symptoms.
Secondary symptoms arise because the original disability prevents the young person from developing the skills to cope with life’s daily challenges.
A major secondary disability in Autism Spectrum Disorder is depression.
Individuals with disorder are prone to anxiety and when they are unable to connect with others depression is often the outcome.
Intervention for older children, teens and adults focuses on developing social interpersonal skills and ways to solve life’s daily problems.
Dr. Webster is an Educational Psychologist who consults locally and internationally on children and youth with special educational needs. More information about her activities is available at www.janetbwebster.com.