DRAFT
WHAT IS AUTISM?
Autism is a condition that affects brain development, resulting in a distinct pattern of differences in socializing, communicating, thinking and behaviour. The term "autistic spectrum disorder" (ASD) reflects the view that each of these aspects of ASD may be more or less different from typical development. That is, some people with ASD are relatively mildly affected, and some severely.
All people wityh ASD face challenges in understanding and relating to others. Although they may be interested in socializing and forming relationships, some of the necessary skills may be hard for them. For instance, it may be very difficult to take another person's point of view.
For many people with ASD, problems understanding and using both language and gestures contribute to weak communication skills. Even when language is well-developed, communication difficulties may make someone with ASD less able to begin or keep a two-sided conversation going. People with ASD have less flexible patterns of thinking and behaviour than others, as well as limited but intense interests.
Research suggests that autism has many possible causes, but genetic causes are most likely. Note that genetic causes may be hereditary (that is, passed down in families) or not. Autism can also occur either alone or in combination with other medical conditions or syndromes.
HOW IS AUTISM DIAGNOSED?
In its more severe forms, autism is usually recognized by 2 or 3 years of age, usually because the child is not yet speaking, nor playing appropriately, and shows little interest in people. However, more subtle signs of ASD may not be recognized until much later, often after the child enters school.
Autism can be diagnosed by an experienced clinician (usually a clinical child psychologist or a specialist physician). The diagnosis is made by making systematic observations of the child's behaviour, and gathering in-depth information about the child's development from parents and others.
The clinician looks both for unusual behaviour that the child does (for instance, repetitive behaviour) and things that he or she doesn't do that would be expected of a typically-developing child (for instance, use gaze and gestures to communicate).
With earlier detection and a better understanding of both milder and more severe forms in people of all ages, diagnosis of ASD is becoming far more common. Recent estimates suggest that 1 in every 165 children may be affected. The impact of ASD can be overwhelming for many families, and for the health, education and community services that support them.
WHAT DO WE DO ABOUT AUTISM? CAN PSYCHOLOGY HELP?
Outcomes for many people with ASD are more positive than in past decades. Advances in pyschological research have improved our understanding of the fundamental challenges of autism. Improved methods of detecting, assessing, and treating ASD are available. Some people with milder forms of ASD may need relatively little support at some points in their lives.
Others require substantial assistance throughout life. Psychological assessment of children's ability profiles - areas of relative strength and weakness - can guide the development of appropriate programs for children with ASD. Treatments based on the psychological principles of learning (applied behaviour analysis, or ABA) are at the leading edge of autism intervention.
Research shows that early, intensive intervention based on ABA principles can help children with ASD, as part of a comprehensive, individualized treatment program. Parent education is crucial. Social skills, communication, daily living skills, self-management or coping skills, and family support are all key areas.
Promising approaches include teaching children using more natural ABA-based methods. These include incidental teaching (using teaching opportunities that naturally arise every day in the home and community). Structured teaching approaches emphasize organizing the person's surroundings; for example, by using schedules and defining spaces for activities.
Typical peers may be taught better ways to interact with a child with ASD, providing more positive chances to socialize. For many older and/or more able individuals with ASD, anxiety may be one of the challenges.
Cognitive-behavioural therapy (CBT), in which behaviour is changed by helping the person to think differently about problems, can be modified for persons with ASD.
Systematic progressive relaxation therapy can also help with management of anxiety. How much and what kind of psychological and other supports are needed varies widely among people with ASD. The goal is to help people with ASD become, and live, as independent, productive and happy adults.
WHERE DO I GO FOR MORE INFORMATION?
More information about autism and related disorders can be found at:
You can consult with a registered psychologist to find out if psychological interventions might be of help to you. Provincial, territorial and some municipal associations of psychology often maintain referral services. For the names and coordinates of provincial and territorial associations of psychology, visit http://www.cpa.ca/public/provincialandterritorialassociations. The Canadian Register of Health Service Providers in Psychology also has a listing service and can be reached through http://www.crhspp.ca.
This fact sheet has been prepared for the Canadian Psychological Association by Dr. Isabel M. Smith. Dr. Smith is a registered Clinical Psychologist and an Associate Professor in the Departments of Pediatrics and Psychology, Dalhousie University. She conducts research and provides clinical consultation and professional education at the IWK Health Centre in Halifax, NS. Her research and clinical interests are focused on children and adolescents with developmental disabilities, especially autistic spectrum disorders, and their families. She can be contacted at isabel.smith@iwk.nshealth.ca.
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