AUTISM SPECTRUM DISORDER (ASD)
WHAT IS AUTISM?
Autism spectrum disorder (ASD) is a developmental disability caused by differences in the brain. Signs typically appear during early childhood and affect a person’s ability to communicate and interact with others. ASD is defined by a certain set of behaviors and is a “spectrum condition” that affects individuals differently and to varying degrees. Some of the behaviors associated with autism include delayed learning of language; difficulty making eye contact or holding a conversation; difficulty with executive functioning, which relates to reasoning and planning; narrow, intense interests; poor motor skills and sensory sensitivities. Again, a person on the spectrum might follow many of these behaviors or just a few. The learning, thinking, and problem-solving abilities of people with ASD can range from gifted to severely challenged. Some people with ASD need a lot of help in their daily lives; others need less.
People with autism are just as unique as everyone else with their own personalities, likes and dislikes.
The vast majority of people on the autism spectrum have difficulty managing their sensory input. They may over or under react to visual, tactile, and aural input which can make it very difficult to participate in typical life activities. Sensory processing difficulties cause people to experience interactions in different ways. SPD affects the way their brains interpret the information that comes in; it also affects how they respond to that information with emotional, motor, and other reactions.
There is no known single cause of autism, but increased awareness and early diagnosis, intervention and access to appropriate services and supports lead to significantly improved outcomes.
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Autism is the fastest growing
developmental disorder,
yet the most underfunded​
Autism affects 1 in 36 children
in the US, boys are identified at higher rates than girls
Early intervention can improve learning, communication and social skills, as well as brain development.
DIAGNOSIS
There is no medical test to diagnose autism. Doctors look at the child’s behavior and development to make a diagnosis. Your child's pediatrician should do a developmental screening which is a short test to tell if children are learning basic skills when they should, or if they might have delays. During developmental screening the doctor might ask the parent some questions or talk and play with the child during an exam to see how he or she learns, speaks, behaves, and moves.
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In some cases, the primary care doctor might choose to refer the
child and family to a specialist for further assessment and diagnosis.
Specialists who can do this type of evaluation include:
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Developmental Pediatricians
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Child Neurologists
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Child Psychologists or Psychiatrists
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If your child receives an autism diagnosis the next step is to look into the services available. Services are provided through a number of local, state and federal programs, not to mention private professionals working in the medical, nutritional, educational and therapeutic fields. Additionally, the age of the person with autism will determine where to begin the process, as a variety of agencies, including public schools, are responsible for supporting people with disabilities as they grow. Also, families and loved ones of people with autism might also wish to seek assistance, information or guidance through support groups, conferences or other helpful sources.
LEARN THE SIGNS
The most important thing you can do as a parent or caregiver is to learn the early signs of autism and become familiar with the typical developmental milestones that your child should be reaching. Autism impacts an individual throughout their lifespan.Research shows that early diagnosis and intervention lead to significantly improved outcomes.
POSSIBLE SIGNS OF ASD
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No response to their name by 12 months of age
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Not pointing at objects to show interest (point at an airplane flying over) by 14 months
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No “pretend” play (pretend to “feed” a doll) by 18 months
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Avoids eye contact and wants to be alone
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Delayed speech and language skills
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Repeating words or phrases over and over (echolalia)
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Gets upset by minor changes
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Has obsessive interests
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Flaps hands, rocks body, or spins in circles
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Unusual reactions to sound, smell, taste, look, or feel
The CCD Center for Disease Control
Diagnostic Criteria for Autism Spectrum Disorder.
If you have concerns about your child's development, don't wait. Speak to your doctor now about screening your child for autism.
DEVELOPMENTAL MILESTONES THAT PARENTS SHOULD LOOK FOR
The American Academy of Pediatrics now recommends that the 18 & 24 month well check-ups also include developmental screening for autism spectrum disorders for all children.
EARLY INTERVENTION
The first three years of life are crucial to a child’s development. Children make several visits to their pediatrician during this period for well-baby/child check-ups and general developmental screenings.
Early identification of autism is important, as it means early intervention services can begin, making a huge impact on a child’s behavior, functioning and future well-being.
Currently, the average age of diagnosis in the United States is between 3 and 6 years of age, though some children can be diagnosed as young as 18 months. It is important for parents to discuss the diagnosis with their medical practitioner(s) and devise a plan that best addresses the needs of child and family.
EARLY STEPS
Early Steps is Florida's early intervention system that offers services to eligible infants and toddlers, age birth to 36 months, who have or are at-risk for developmental disabilities or delays. Early intervention supports families and caregivers to increase their child’s participation in daily activities and routines that are important to the family. Positive early learning experiences are crucial for later success in school, the workplace, and the community. Research shows that children’s earliest experiences play a critical role in brain development.
15 Local Early Steps (LES) throughout the state receive referrals from various primary referral sources. Infants and toddlers are assessed in the following developmental domains to determine eligibility: physical, cognitive, communication, social-emotional and adaptive.
Each child receives an Individualized Family Support Plan (IFSP) that meets his or her unique needs. Families also receive support to develop the skills and confidence needed in helping their child learn and develop. Services will support children in their communities where they live, learn and play. There is no income requirement to qualify for the program and although families may choose to allow access to insurance or Medicaid benefits, families are not charged for services.
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Early intervention for children with ASD is made up of therapies or interventions and services. Therapies or interventions are the programs or sessions aimed at helping your child’s development. Services are the places and organizations that offer these therapies. Types of therapies include but are not limited to Applied Behavior Analysis (ABA), DIR; also called “Floortime”, Occupational Therapy, Sensory Integration Therapy, Speech Therapy, and The Picture Exchange Communication System (PECS).
SCHOOL AGE
The school years bring innumerable challenges for a child with autism, but they also hold incredible opportunity for growth. For parents, the challenge is to discover and leverage resources to maximize the child’s avenues of academic learning, social experience and physical fitness. Having a team of professionals is essential throughout this long life stage. Getting help from those who know the system can reduce stress on the family and improve outcomes for the child with autism.
There are many approaches available to school-aged children with autism - Applied Behavior Analysis, occupational therapy, a range of supplemental therapies, dietary regimens and more. Similarly, there are many different educational programs that provide stimulating learning environments to children with different needs and abilities.
The Individuals with Disabilities Education Act
IDEA, reauthorized as the Individuals with Disabilities Education Improvement Act of 2004, a federal educational mandate that guarantees students with disabilities a free, appropriate public education, is the most important tool a student with autism has in securing the appropriate placement, supports and accommodations.
An IEP Individualized Education Plan for a student with disabilities can include “related services” to help him or her learn and thrive in school.
Young Adulthood
Entering adulthood is challenging and exciting. Advance preparation and plenty of support are needed so the young adult with autism can get a good start to the next chapter of his or her life.
Transition planning should begin when the student turns 14. The Transition IEP must include a statement of the student’s desired
post school outcome, a statement of needed transition services (specifically course work). By the age of 16 a full transition plan should be developed covering all aspects of the transition, including vocational services, needed support and postsecondary education. In Florida, there is a Transition Individualized Education Plan (TIEP), which is often a separate plan from the IEP, but can be a section of the IEP. This should detail what the student wants to do in the future, their strengths and weaknesses and any required preparations for the activities they want to do as they get older. It must be reviewed annually. Students have a right to Free Appropriate Public Education (FAPE) until the age of 22.
Guardianship/Conservatorship At the age of 18 the rights to make decisions will transfer to the student. The TIEP must include an informed statement that says that the parents and students understand that the rights will be shifted upon the child’s 18th birthday. This should be placed in the TIEP at the age of 17. There are a variety of guardian and advocate options. If the person is receiving services through the Agency of Persons with Disabilities (APD), they can choose to appoint a family member or friend as a Client Advocate to help the client make decisions, but cannot make the decisions for them. However, this is not recognized by the state. The individual can also receive a proxy health care surrogate to make medical decisions for the individual. One can also appoint a Guardian Advocate for the individual, without deeming the individual incapable of making decisions, who will perform certain complicated tasks that the individual cannot understand. Full guardianship is also an option in Florida.
Vocational Rehabilitation (VR) is a federal-state program that will works to prepare them for, gain or retain employment. The Department of Vocational Rehabilitation offers a variety of services.
Directory of Local VR Offices: www.rehabworks.org/office_directory.shtml
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Social Security It's important that the social security office be contacted well in advance before the student’s 18th birthday to understand the eligibility and application process. Benefits should be applied for before the student’s 18th birthday and then be reevaluated after the student’s 18th birthday. Applicants may apply online or by contacting Social Security directly.
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Local Social Security offices can be found using SSA's office locator or by calling 800-772-1213.
Social Security Administration: www.socialsecurity.gov
Social Security Benefits for People with Disabilities: www.ssa.gov/disability
Adulthood
Asperger's
Children and adults previously referred to as having Asperger’s Disorder may have average to well above average cognitive and receptive and expressive language skills. To the untrained observer, this person may seem like someone who is neurotypical, but behaving differently. People with Asperger’s may want to fit in and interact socially but lack the executive functioning and social skills necessary.
The American Psychiatric Association publishes the Diagnostic and Statistical Manual of Mental Disorders (DSM) to guide healthcare professionals in diagnosing mental health conditions. The manual’s fifth edition DSM-5 took effect in May 2013. The DSM-5 states, “Individuals with a well-established DSM-IV diagnoses of autistic disorder, Asperger’s disorder or pervasive developmental disorder not otherwise specified should be given the diagnosis of autism spectrum disorder.” Since 2013, Asperger Disorder is no longer a stand-alone diagnosis, but rather falls under the classification as ASD. This change is meant to help families and individuals on the spectrum obtain needed services and supports.​
