FAQs

Autism, part of a group of disorders known as Autism Spectrum Disorders (ASD), is a complex neurodevelopmental disorder that typically lasts throughout a person’s lifetime. The disorder is characterized by varying degrees of impairment in communication skills, social abilities and also by repetitive behaviors.

According to the Centers for Disease Control, of the approximately 4 million babies born every year, 24,000 of them will eventually be identified as autistic. Also, recent studies suggest boys are more susceptible than girls to developing autism. In the United States alone, 1 out of 70 boys are suspected of being on the spectrum, with perhaps more going undiagnosed to this day. Studies have revealed that girls appear to manifest a more severe form of the disorder than their male counterparts.

No one knows for sure. Research says that there is a strong genetic base for this. Recent studies suggest a strong genetic basis for autism — up to 20 sets of genes may play a part in its development. Scientists also believe that environmental factors play a role in developing autism.

Each child with autism differs, but there are some signs that many of them share. Children on the spectrum generally have difficulty relating to others; they may hardly speak, and if they do, they may not communicate in ways that other people can easily understand (for example, they may scream loudly when they’re upset, instead of crying). They don’t usually sustain eye contact. It’s too intense and has trouble reading social cues. They’re also prone to repetitive behaviors, flapping their hands constantly or uttering the same phrase over and over again. Further, they may be more sensitive than typically developing children, or dramatically less so, to sights, sounds and touch.

The theory of Sensory Integration (SI) was developed in the 1960s by Dr. A. Jean Ayres, an occupational therapist who was a pioneer in the field of learning disabilities. She defined SI as the body’s capacity to organize sensory input, information and stimulation a person receives from his/her own body and the environment through the different sensory systems:

• tactile (touch)
• proprioceptive (joint and muscle impulses)
• vestibular (movement, visual, auditory)
• vision
• hearing and listening/auditory

This sensory information is then processed by the central nervous system and is used to help our body develop spatial awareness, muscle tone, postural stability and self-regulation. SI gives us the awareness of our body and the ability to use it as a tool to interact with others in our world. For those with Sensory Integration Dysfunction, the brain is not processing organizing the flow of sensory impulses properly. This can impact on a person’s functional, developmental and learning processes.

Signs of Sensory Integration Dysfunction include:
• Overly sensitive to touch, movement, sights or sounds
• Easily distractible
• Decreased awareness of surroundings
• Activity level that is unusually high or unusually low
• Impulsive, lacking in self-control
• Inability to unwind or calm self
• Poor self-concept
• Social and/or emotional problems
• Physical clumsiness or apparent carelessness
• Difficulty making transitions from one situation to another
• Delays in speech, language, or motor skills
• Delays in academic achievement
• Slow reaction to touch, movements, sights, or sounds

A Typical SI/OT Session A typical SI/OT session providing the right kinds of sensory stimulation helps in the normalization of sensory systems – tactile, vestibular, proprioceptive, auditory and visual as well as to provide the optimal state of alertness and attention. In addition, it helps to develop an adaptive response for daily functioning.

The goal of occupational therapy interventions is to enable individuals to participate in everyday occupations. This may be achieved through a range of therapy approaches such as modification of tasks and/or the environment to match individuals’ abilities, to develop skills such as posture and coordination, or for the development of daily routines and to facilitate adaptive behaviours (National Institute of Child Health and Development, 2005). Occupational therapists work with children in their natural settings; in the home with their families, in the school and in the community. Occupational therapy treatment has focused on two main areas: Sensory Motor Integration In the past, one of the more frequent sensory motor interventions in occupational therapy was sensory motor integration. However, there is evidence that children with autism do process sensory information differently from other developing children (National Institute of Child Health and Development, 2005).

Therefore, the focus in Occupational therapy has shifted to understanding how and when a child is reacting poorly to a sensory experience and structuring the environment to accommodate or minimize such reactions. Occupational therapists can use a mediator or consultation approach to work with parents and teachers providing strategies to prevent reactions to sensory experiences from limiting daily activities. For example, if a child with autism is upset by excess noise that may occur at end of a school day, they could get ready to go home before others leave. If a child is bothered by a specific clothing material (e.g. wool), this type of material could be avoided in their clothing. By adapting the tasks and environments as well as working with the families on how to teach new skills and build calming or alerting activities into their everyday routines, Occupational therapists can make a difference in the family’s day to day life.

In particular, occupational therapy focuses on self care issues, feeding, bathing, hygiene and sleep which are significant issues for children and enormous stressors for the family. In the school setting, a student’s occupational performance may be impaired by sensory, developmental, inattention and/or learning challenges .Occupational therapists may adapt classroom tasks and the school environment to promote a child’s participation. Occupational therapists can assist teaching caregivers and teachers with understanding the impact of sensory processing difficulties on daily functioning and how they can modify what they need do to maximize the child’s participation and reduce behavioural difficulties. There are 4 types of supports that could potentially have a positive impact on the lives of children with autism. The environmental supports suggested are: temporal supports (events over time – this would allow a child to prepare themselves in advance for a change in activity), procedural supports (including instructions for activities or relating people to events), spatial supports (allowing the child to organize themselves within the environment), and assertion support (aiding the child in social interactions).

Occupational therapists work with children with autism and their families to provide intervention that improves the child’s ability to participate in activities of daily living, play and school. In occupational therapy, the focus is on task analysis, breaking down a task into manageable steps for the child, teaching those steps to the key people in the child’s environment and structuring task and/or environment to support successful completion. For example, if a child with autism is having difficulty dressing himself, the occupational therapist could use a backward chaining behavioural approach which teaches skills by breaking the tasks down into manageable steps which are always performed in the exact same order.

There are five main components of ABA behavior sessions:

An ADHD diagnosis alone is not enough to qualify for disability benefits. If your ADHD symptoms are well controlled, you probably aren’t disabled, in the legal sense. But if distractibility, poor time management, or other symptoms make it hard for you to complete your work, you may be legally disabled. Legally, “disability” means a physical or mental condition that significantly limits a major life activity — in this case, works

DSM-5 Criteria for ADHD

People with ADHD show a persistent pattern of inattention and/or hyperactivity–impulsivity that interferes with functioning or development.

Inattention: Six or more symptoms of inattention for children up to age 16 years, or five or more for adolescents age 17 years and older and adults; symptoms of inattention have been present for at least 6 months, and they are inappropriate for developmental level:

Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities.

Often has trouble holding attention on tasks or play activities.

Often does not seem to listen when spoken to directly.

Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, side-tracked).

Often have trouble organizing tasks and activities.

Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework).

Often loses things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).

Is often easily distracted

Is often forgetful in daily activities.

Hyperactivity and Impulsivity: Six or more symptoms of hyperactivity-impulsivity for children up to age 16 years, or five or more for adolescents age 17 years and older and adults; symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for the person’s developmental level:

Often fidgets with or taps hands or feet, or squirms in seat.

Often leaves seat in situations when remaining seated is expected.

Often runs about or climbs in situations where it is not appropriate (adolescents or adults may be limited to feeling restless).

Often unable to play or take part in leisure activities quietly.

Is often “on the go” acting as if “driven by a motor”.

Often talks excessively.

Often blurts out an answer before a question has been completed.

Often has trouble waiting their turn.

Often interrupts or intrudes on others (e.g., butts into conversations or games)

Rett syndrome is a rare genetic neurological and developmental disorder that affects the way the brain develops, causing a progressive loss of motor skills and speech.  primarily affects girls.

Most babies with Rett syndrome seem to develop normally for the first 6 to 18 months of age, and then lose skills they previously had — such as the ability to crawl, walk, communicate or use their hands.

Although there’s no cure for Rett syndrome, potential treatments are being studied. Current treatment focuses on improving movement and communication, treating seizures, and providing care and support for children and adults with Rett syndrome and their families.

Stages of Rett syndrome

Rett syndrome is commonly divided into four stages:

  • Stage I: early onset. Signs and symptoms are subtle and easily overlooked during the first stage, which starts between 6 and 18 months of age and can last for a few months or a year. Babies in this stage may show less eye contact and start to lose interest in toys. They may also have delays in sitting or crawling.
  • Stage II: rapid deterioration. Starting between 1 and 4 years of age, children lose the ability to perform skills they previously had. This loss can be rapid or more gradual, occurring over weeks or months. Symptoms of Rett syndrome occur, such as slowed head growth, abnormal hand movements, hyperventilating, screaming or crying for no apparent reason, problems with movement and coordination, and a loss of social interaction and communication.
  • Stage III: plateau. The third stage usually begins between the ages of 2 and 10 years and can last for many years. Although problems with movement continue, behavior may have limited improvement, with less crying and irritability, and some improvement in hand use and communication. Seizures may begin in this stage and generally don’t occur before the age of 2.
  • Stage IV: late motor deterioration. This stage usually begins after the age of 10 and can last for years or decades. It’s marked by reduced mobility, muscle weakness, joint contractures and scoliosis. Understanding, communication and hand skills generally remain stable or improve slightly, and seizures may occur less often.

Rett syndrome signs and symptoms include:

  • Slowed growth. Brain growth slows after birth. Smaller than normal head size (microcephaly) is usually the first sign that a child has Rett syndrome. As children get older, delayed growth in other parts of the body becomes evident.
  • Loss of normal movement and coordination. The first signs often include reduced hand control and a decreasing ability to crawl or walk normally. At first, this loss of abilities occurs rapidly and then it continues more gradually. Eventually muscles become weak or may become rigid or spastic with abnormal movement and positioning.
  • Loss of communication abilities. Children with Rett syndrome typically begin to lose the ability to speak, to make eye contact and to communicate in other ways. They may become disinterested in other people, toys and their surroundings. Some children have rapid changes, such as a sudden loss of speech
  • Abnormal hand movements. Children with Rett syndrome typically develop repetitive, purposeless hand movements that may differ for each person. Hand movements may include hand-wringing, squeezing, clapping, tapping or rubbing.
  • Unusual eye movements. Children with Rett syndrome tend to have unusual eye movements, such as intense staring, blinking, crossed eyes or closing one eye at a time.
  • Breathing problems. These include breath-holding, abnormally rapid breathing (hyperventilation), forceful exhalation of air or saliva, and swallowing air. These problems tend to occur during waking hours, but breathing disturbances such as shallow breathing or periodic breathing can occur during sleep.
  • Irritability and crying. Children with Rett syndrome may become increasingly agitated and irritable as they get older. Periods of crying or screaming may begin suddenly, for no apparent reason, and last for hours. Some children may experience fears and anxiety.
  • Other abnormal behaviors. These may include, for example, sudden, odd facial expressions and long bouts of laughter, hand licking, and grasping of hair or clothing.
  • Cognitive disabilities. Loss of skills can be accompanied by a loss of intellectual functioning.
  • Seizures. Most people who have Rett syndrome experience seizures at some time during their lives. Multiple seizure types may occur and are accompanied by an abnormal electroencephalogram (EEG).
  • Abnormal curvature of the spine (scoliosis). Scoliosis is common with Rett syndrome. It typically begins between 8 and 11 years of age and increases with age. Surgery may be required if the curvature is severe.
  • Irregular heartbeat. This is a life-threatening problem for many children and adults with Rett syndrome and can result in sudden death.
  • Sleep disturbances. Abnormal sleep patterns can include irregular sleep times, falling asleep during the day and being awake at night, or waking in the night with crying or screaming.
  • Other symptoms. A variety of other symptoms can occur, such as thin, fragile bones prone to factures; small hands and feet that are usually cold; problems with chewing and swallowing; problems with bowel function; and teeth grinding.

There is no way to prevent autism spectrum disorder, but there are treatment options. Early diagnosis and intervention is most helpful and can improve behaviour, skills and language development.

Have regular check-up, eat well- balanced meals, and exercise during pregnancy. Make sure you have good prenatal care . Reducing exposure to toxins. The scientific community has discovered evidence that environmental factors often play a role in developing autism. Pregnant women can limit airborne toxins by wearing masks and staying indoors when air quality is low. For the duration of pregnancy, women should eliminate alcohol, tobacco, and caffeine. Switching to green personal care products is wise to lessen exposure to potentially harmful chemicals. Some doctors also suggest avoiding canned foods, plastic water bottles, and excessive cell phone use. Maintain a nutritious diet pregnant women can lower the risk for autism by eating colourful, organic diet rich in green vegetables and fruit containing antioxidants. Increasing intake of vitamin D has been linked to better neurological development in Foetuses’.

After birth if you’re concerned about your child’s development or you suspect that your child may have autism spectrum disorder, conduct routine check-ups, discuss your concerns with your doctor followed by an expert team for further interventions. The symptoms associated with the disorder can also be linked with other developmental disorders also.

If your child hasn’t really smiled or shown any type of eye contact or happy expression by 6 months or afterwards, this might be an early warning characteristic of autism.

  1. If your child hasn’t really smiled or shown any type of eye contact or happy expression by 6 months or afterwards, this might be an early warning characteristic of autism.
  2. If your child is 9 months old or older, he/she should be sharing sounds, smiles or other facial expressions.
  3. Once he/she has hit 12 months of age, your child should be pointing, showing, reaching or waving.
  4. By 16 months of age, your child should be saying at least a couple of words.
  5. By 2 years, your child should be expressing 2-word phrases by him/herself, (without imitating)
  6. If you notice any loss of speech, babbling or social skills at any age, this might be an indicator of Autism.
  7. If your child speaks with little variation in pitch, odd intonation, irregular rhythm or just a strange voice, this could be a sign of autism.
  8. Does your child repeat movements with objects over and over or repeat certain movements with his/her arms, hands, body or fingers? This is a possible red flag.
  9. If your child doesn’t want to hug or hold onto you. – but do not let this one be your sole indicator. Contrary to popular belief, some autistic children are quite affectionate.
  10.  If your child is not bringing objects to you to identify and is not pointing to objects by the time the first birthday is reached.
  11. If your child doesn’t want to interrelate with you and play games such as “peek-a-boo” or not exhibiting creative or imaginative play.
  12. If your child shows aggressive behavior on a normal basis or bangs his or her head against an object.
  13. If you notice your child  engaging in repetitive behaviors, such as opening or closing doors or drawers over and over or performing actions that are often repetitive and unchanging like twirling objects or rocking.
  14. If your child takes more fascination with parts of a toy than the action for which the toy was designed (Spinning the wheels of a toy car instead of driving it ).
  15. Learning difficulties i.e. he lacks in ability to learn inductively from surrounding events.
  16. Communication or speech problems.
  17.  Difficulty relating to people, marked by a lack of awareness of the feelings of others, indifferent to parents.
  18. Lack of social interaction.
  19. Short attention span.
  20. Reacting extremely to changes in the immediate environment.

If you are concerned, in any way, about your child’s development; speak with your child’s pediatrician. You will likely be referred to a specialist- either a child psychologist or a developmental pediatrician where your child will undergo further testing.

Your child may receive a diagnosis of ADHD, or Sensory Processing Disorder instead of Autism or in addition to autism. Sometimes the signs of ADHD may manifest or present as autism. And many autistic children also have underlying sensory issues.

It’s important to keep in mind that the earlier your child is diagnosed with autism, the earlier they can begin therapy,there will be better chance for improvement.

Attention-deficit/hyperactivity disorder (ADHD) is a chronic condition that affects millions of children and often continues into adulthood. ADHD includes a combination of persistent problems, such as difficulty sustaining attention, hyperactivity and impulsivity that interferes with functioning or development.

Inattention means a person wanders off task, lacks persistence, has difficulty sustaining focus, and is disorganized; and these problems are not due to defiance or lack of comprehension.

Hyperactivity means a person seems to move about constantly, including in situations in which it is not appropriate; or excessively fidgets, taps, or talks. In adults, it may be extreme restlessness or wearing others out with constant activity.

Impulsivity means a person makes hasty actions that occur in the moment without first thinking about them and that may have a high potential for harm, or a desire for immediate rewards or inability to delay gratification. An impulsive person may be socially intrusive and excessively interrupt others or make important decisions without considering the long-term consequences.

As children with ADHD get older, they’ll oftentimes not have as much self-control as other children of  their own age. This can make kids and adolescents with ADHD seem immature compared to their peers where they  outburst of anger and lack of self control occur frequently. The child is viewed as immature, irritable, disruptive, demanding and uncooperative by teachers. These children also have difficulty in establishing and maintaining satisfactory social relationships.

Also the child with ADHD might:

  • daydream a lot
  • forget or lose things a lot
  • squirm or fidget
  • talk too much
  • have trouble taking turns
  • have difficulty getting along with others
  • forgetfulness
  • make careless mistakes or take unnecessary risks
  • have a hard time resisting temptationAll children are going to exhibit some of these behaviors at some point. Daydreaming, fidgeting, and persistent interruptions are all common behaviors in children.You should start thinking about the next steps if:
  • your child regularly displays signs of ADHD
  • this behavior is affecting their success in school and leading to negative interactions with peersADHD is treatable. If your child is diagnosed with ADHD, review all king of treatment options.

Speech therapy is a training to help children with speech and language problems to speak more clearly. The professionals deal with disorders in communication, evaluation, diagnosis and rehabilitation Individual speech therapy sessions as well as group therapies are provided by 10 highly qualified speech therapists from various institutions.

Speech therapy is an intervention service that focuses on improving a child’s speech abilities to understand and express language, including nonverbal languages. Speech therapists or speech and language pathologists are the professionals who provide these services. Speech therapy includes two components – 1) Coordinating the mouth to produce sound, to form words and sentences. 2) Understanding and expressing language. The role of SLPs also includes swallowing disorders and all aspects of feeding.

Autism spectrum disorder (ASD) is a developmental disability that can cause significant social, communication, and behavioural challenges. The term “spectrum” refers to the wide range of symptoms, skills, and levels of impairment that people with ASD can have.  ASD affects people in different ways and can range from mild to severe. People with ASD share some symptoms, such as difficulties with social interaction, but there are differences in when the symptoms start, how severe they are, the number of symptoms, and whether other problems are present. The symptoms and their severity can change over time. The signs of ASD begin in early childhood, usually in the first 2 years of life, although a small minority of children may show hints of future problems within the first year of life.

Some autistic children are delayed in their use of language and some autistic adults don’t use speech. In those cases, other methods of communication need to be established. The person may appear not to hear what you say to them, not respond to their name, or appear indifferent to any attempts you make to communicate.

They may use some of the following to communicate with you:

  • Gestures
  • Crying
  • Taking your hand to the object they want
  • Looking at the object they want
  • Reaching
  • Using pictures
  • Challenging Behaviour
  • Echolalia (the repetition of other people’s words).

The picture exchange system (PECS) is a form of spontaneous communication for children with autism in which an individual selects a picture indicating a request.[10] PECS can be utilized in educational settings and at the child’s home

Applied Behavior Analysis (ABA) is a therapy based on the science of learning and behavior.

Behavior analysis helps us to understand:

  • How behavior works
  • How behavior is affected by the environment
  • How learning takes place

ABA therapy applies our understanding of how behavior works to real situations. The goal is to increase behaviors that are helpful and decrease behaviors that are harmful or affect learning.

ABA therapy programs can help:

  • Increase language and communication skills
  • Improve attention, focus, social skills, memory, and academics
  • Decrease problem behaviors

The methods of behavior analysis have been used and studied for decades. They have helped many kinds of learners gain different skills – from healthier lifestyles to learning a new language. Therapists have used ABA to help children with autism and related developmental disorders since the 1960s.

Applied Behavior Analysis involves many techniques for understanding and changing behavior. ABA is a flexible treatment:

  • Can be adapted to meet the needs of each unique person
  • Provided in many different locations – at home, at school, and in the community
  • Teaches skills that are useful in everyday life
  • Can involve one-to-one teaching or group instruction

Positive Reinforcement

Positive reinforcement is one of the main strategies used in ABA.

When a behavior is followed by something that is valued (a reward), a person is more likely to repeat that behavior. Over time, this encourages positive behavior change.

First, the therapist identifies a goal behavior. Each time the person uses the behavior or skill successfully, they get a reward. The reward is meaningful to the individual – examples include praise, a toy or book, watching a video, access to playground or other location, and more.

Positive rewards encourage the person to continue using the skill. Over time this leads to meaningful behavior change.

Antecedent, Behavior, Consequence

Understanding antecedents (what happens before a behavior occurs) and consequences (what happens after the behavior) is another important part of any ABA program.

Positive reinforcement is one of the main strategies used in ABA.

When a behavior is followed by something that is valued (a reward), a person is more likely to repeat that behavior. Over time, this encourages positive behavior change.

First, the therapist identifies a goal behavior. Each time the person uses the behavior or skill successfully, they get a reward. The reward is meaningful to the individual – examples include praise, a toy or book, watching a video, access to playground or other location, and more.

Positive rewards encourage the person to continue using the skill. Over time this leads to meaningful behavior change.

Antecedent, Behavior, Consequence

Understanding antecedents (what happens before a behavior occurs) and consequences (what happens after the behavior) is another important part of any ABA program.

The following three steps – the “A-B-Cs” – help us teach and understand behavior:

    • An antecedent: this is what occurs right before the target behavior. It can be verbal, such as a command or request. It can also be physical, such a toy or object, or a light, sound, or something else in the environment. An antecedent may come from the environment, from another person, or be internal (such as a thought or feeling).
    • A resulting behavior: this is the person’s response or lack of response to the antecedent. It can be an action, a verbal response, or something else.
    • consequence: this is what comes directly after the behavior. It can include positive reinforcement of the desired behavior, or no reaction for incorrect/inappropriate responses.

Looking at A-B-Cs helps us understand:

  1. Why a behavior may be happening
  2. How different consequences could affect whether the behavior is likely to happen again

Example:

  • Antecedent:The teacher says “It’s time to clean up your toys” at the end of the day.
  • Behavior:The student yells “no!”
  • Consequence: The teacher removes the toys and says “Okay, toys are all done.”

How could ABA help the student learn a more appropriate behavior in this situation?

  • Antecedent: The teacher says “time to clean up” at the end of the day.
  • Behavior:The student is reminded to ask, “Can I have 5 more minutes?”
  • Consequence: The teacher says, “Of course you can have 5 more minutes!”

With continued practice, the student will be able to replace the inappropriate behavior with one that is more helpful. This is an easier way for the student to get what she needs!

There are five main components of ABA behavior sessions:

  • Task analysis – Complex activities are broken down into a series of small steps and taught until the child can complete the task without assistance. Positive reinforcement enables child to use the new skills in future also. Years of conditioning has taught us as parents to use negative reinforcement as a method of disciplining but positive reinforcement has shown to be much more effective at achieving results.
  • Chaining – Several forms of chaining exist and the therapists at your applied behavior center for autism will determine which method of chaining is best for your child given his or her individual differences. The goal is to teach and make child self sufficient to complete entire chain independently.
  • Prompting – Different types of prompts are used by ABA therapist to help child learn new skills. Errorless teaching is an antecedent intervention style which helps in reducing the occurrence of an incorrect response. Chances of having mistakes are less as children are given (verbal, visual or physical gestural) cues.
  • Fading – When the child starts mastering a skill with the help of prompts, the prompts must be removed gradually as he or she moves toward independence. Prompting and Fading are usually done slowly and continue until the child can perform new skills on his or her own.
  • Shaping – Shaping reinforces attempts to complete a skill until the child can perform the action or skill independently.

ABA therapists use various techniques to help the children learn.

  • Generalization – The therapist takes what the child has learned in one setting and applies it to other settings to help them complete those tasks successfully.
  • Behavior Contracts – Behavior contracts are brief, three-part plans negotiated between the child and the ABA therapist. The contract starts by listing the positive behavior that the therapist wants to see. Then an outline is prepared on what ABA analyst is to do once the behavior is done. When long term rewards are set, behavior contract is finished. Putting behavioral expectations in writing in a contract and with enticing rewards can help motivate children.
  • Video Modeling – Helps in learning suitable behaviors by watching others. It shows a child how to behave and complete an activity. This helps in improving social skills, communication skills and play skills. Imitations are easily done by Children with Autism.

Social Communication Impairments

All individuals with ASD exhibit social communication impairments. In the first few years of life, salient signs of autism include lack of appropriate eye contact and inability to initiate or respond to joint attention (i.e., sharing social experiences with a communication partner). Common social difficulties include:

  • Demonstrating appropriate play skills, such as cooperative play with others. Some children with ASD may appear uninterested in playing with peers.
  • Some may reject or ignore the social approaches of others.
  • Responding to and initiating joint attention for social purposes. For example, many individuals with ASD are skilled at requesting items but are less likely to communicate for the purpose of sharing a social experience. Some individuals with ASD may lack interest in conversations that do not include topics of interests.
  • Using and interpreting body language. For example, individuals with ASD may have challenges understanding tone of voice or facial expression in social situations.
  • Staying on topic, turn-taking, and asking related or appropriate questions during conversations.
  • Taking their communication partner’s perspective, checking for understanding, or predicting what information may already be known about a concept or situation during conversations.

Speech/Language Impairments

Persons with ASD may have specific difficulties in the areas of receptive and expressive language. Receptive language is the comprehension of language (e.g., following directions), while expressive language is the ability to express desires and thoughts to other persons. Some individuals with ASD express their thoughts verbally, while others may be nonverbal and require a communication device.

Those who are nonverbal may demonstrate the following:

  • Delay in, or lack of, spoken speech/language, impacting approximately 20-30% of the population.
  • Lack of an effective way to communicate may lead to the need for the use of alternative augmentative communication (AAC), such as sign language, pictures, or a voice output device.

Those who are verbal may demonstrate the following:

  • Delayed or immediate echolalia as a means of conversation with others, for self-management, or for self-stimulation. For example, a dialogue from television programs or videos may be used as a means of conversation.
  • Stereotyped or repetitive use of non-echolalia language routines that serve various functions such as initiating or sustaining a conversation.
  • Use of idiosyncratic speech (e.g., inappropriate word use).
  • Grammatical structure which may appear immature (i.e., telegraphic speech, improper tense or use of pronouns) or grammatical structure which may appear pedantic (e.g., monologue, advanced vocabulary in an area of interest).
  • Abnormal use of pitch, intonation, rhythm or stress. For example, speech may be monotone or hypernasal, and declarative sentences may end with a rising tone to signal the asking of a question.

Both verbal and nonverbal individuals may demonstrate difficulties with receptive language such as:

  • Delayed vocabulary development;
  • Difficulty following directions;
  • Difficulty understanding abstract concepts; and
  • Difficulty interpreting social language, such as sarcasm and jokes.

 

Restricted Repetitive and Stereotyped Patterns of Behavior, Interests, and Activities

Although people with ASD may enjoy the same activities as typical same-age peers, the intensity and focus of their interests may differ. This may be due to the fact that some have a limited repertoire of alternative behaviors, or that they prefer and feel comfortable repeatedly performing certain tasks. Behavior under this category includes:

  • Stereotyped or repetitive motor movements such as hand flapping or finger flicking, use of objects such as spinning coins or lining up toys, or use of speech such as echolalia (delayed or immediate parroting of heard words), use of “you” when referring to self or stereotyped use of words or phrases.
  • Excessive adherences to routines and sameness such as being distressed by changes in the schedule, insisting on adherence to rules, or having inflexible thinking.
  • Ritualized patterns of behavior such as repetitive questioning or pacing.
  • Highly restricted, fixated interests that is abnormal in intensity or focus. A toddler may have a parent’s belt that they carry everywhere, a child may have a preoccupation with vacuums, or an adult may spend hours memorizing facts about their favorite baseball team.

In the DSM-5, sensory differences are categorized under restricted repetitive behaviors. Individuals with sensory differences will be under (hypo) or over (hyper) sensitive to a variety of sensory inputs:

  • Visual input sensitivities are staring at spinning objects, being bothered by fluorescent lights, or having trouble with keeping their place when reading.
  • Auditory input sensitivities are covering ears during loud noises, preferring loud music or none at all in the car, or not being able to respond to verbal prompts when in a noisy area.
  • Tactile input sensitivities dislike getting hands or feet messy, avoiding/preferring certain surfaces, textures, or fabrics, or finding specific types of touch aversive (light touch on the shoulder vs. deep pressure hug).
  • Taste/Smell sensitivities are not eating certain foods, licking or tasting non-food items, or finding strong perfume or cologne aversive.
  • Proprioceptive Input sensitivities are difficulties interpreting sensations from muscles, joints, ligaments, and tendons (e.g., putting too much pressure on pencil when writing or falling/crashing into things).
  • Vestibular input sensitivities are over or under sensitivities to balance and movement sensations, such as having trouble staying seated, constantly leaning head on hands and arms, or easily losing balance.

Executive Function Impairments

Executive functioning refers to advanced cognitive skills, such as attention, working memory, planning, reasoning, sequencing, and flexible thinking. In typically developing people, these skills benefit not only social interactions but also academics, learning, self-regulation, and activities of daily living.

  • Individuals with ASD may have difficulty with a wide range of executive functioning tasks, such as sequencing the order in which to dress themselves, tie their shoes, pack for a trip, or complete a homework assignment.
  • Rigid, inflexible thinking is a common characteristic of individuals with ASD, and therefore individuals may have trouble problem-solving or generating more than one solution to a problem.
  • Individuals with ASD may have executive functioning difficulties at more basic levels, such as sustaining prolonged attention to an activity, or dividing their attention between two activities at once.

Asperger syndrome (AS) is a neuro developmental disorder characterized by significant difficulties in social interaction and nonverbal communication, along with restricted and repetitive patterns of behavior and interests. Asperger Syndrome is a neurobiological disorder characterized by abnormalities in social interaction and language acquisition. Asperger Syndrome is considered to be on the mild end of the spectrum. People with Asperger Syndrome exhibit three primary symptoms: Having difficulty with social interaction, engaging in repetitive behavior, standing firm on what they think and focusing on rules and routines. Often, individuals diagnosed with AS have normal or above normal intelligence. In addition, people with this condition are frequently able to be educated in mainstream classrooms and hold jobs. Early diagnosis and intervention can help a child make social connections, achieve their potential, and lead a productive life. Symptoms vary from person to person, but children with AS often have an obsessive focus on a narrow topic of interest. Many people with AS find it hard to recognize other people’s feelings. It’s common for people with this condition to avoid eye contact when speaking with other. Genetic factors and exposure to environmental toxins, such as chemicals or viruses, have been identified as potential contributors to the development of the disorder. Boys are more likely to develop AS than girls. There’s no single test that can tell you whether your child has AS. In many cases, parents report developmental or behavioral delays or difficulties.

 

A lack of demonstrated empathy affects aspects of communal living for persons with Asperger syndrome. Individuals with Asperger Syndrome experience difficulties in basic elements of social interaction, which may include a failure to develop friendships or to seek shared enjoyments or achievements with others (for example, showing others objects of interest); a lack of social or emotional reciprocity (social “games” give-and-take mechanic); and impaired nonverbal behaviors in areas such as eye contact, facial expression, posture, and gesture. People with Asperger syndrome can display behavior, interests, and activities that are restricted and repetitive and are sometimes abnormally intense or focused. They may stick to inflexible routines, move in stereotyped and repetitive ways, preoccupy themselves with parts of objects, or engage in compulsive behaviors like lining objects up to form patterns.

The onset of Asperger syndrome commonly occurs after the age of 3. Some individuals who exhibit features of autism (a developmental brain disorder characterized by impaired social interaction and communication skills) but who have well-developed language skills may be diagnosed with Asperger syndrome. There is no specific course of treatment or cure for Asperger syndrome. Treatment, which is symptomatic and rehabilitation, may include speech therapy, occupational therapy and special education. Children with Asperger syndrome have a better outlook than those with other forms of pervasive developmental disorders and are much more likely to grow up to be independently functioning adults.

Asperger’s and autism are no longer considered separate diagnoses. People who may have previously received an Asperger’s diagnosis instead now receive an autism diagnosis. But many people who were diagnosed with Asperger’s before the diagnostic criteria changed in 2013 are still perceived as “having Asperger’s.” And many people also consider Asperger’s as part of their identity. This is especially considering the stigma that still surrounds autism diagnoses in many communities around the world. Yet the only real “difference” between the two diagnoses is that people with Asperger’s may be considered as having an easier time “passing” as neurotypical with only “mild” signs and symptoms that may resemble those of autism. Not all autistic children exhibit the same signs of autism or experience these signs to the same degree. That’s why autism is considered to be on a spectrum. There’s a wide range of behaviors and experiences that are considered to fall under the umbrella of an autism diagnosis. Here’s a brief overview of behaviors that may cause someone to be diagnosed with autism:

  • Differences in processing sensory experiences, like touch or sound, from those who are considered “ neurotypical’’
  • differences in learning styles and problem-solving approaches, like quickly learning complex or difficult topics but having difficulty mastering physical tasks or conversational turn-taking
  • Deep, sustained special interests in specific topics
  • Repetitive movements or behaviors (sometimes called “stimming”), like flapping hands or rocking back and forth
  • strong desire to maintain routines or establishing order, like following the same schedule each day or organizing personal belongings a certain way
  • Difficulty processing and producing verbal or nonverbal communication, like having trouble expressing thoughts in words or displaying emotions outwardly
  • Difficulty processing or participating in neurotypical social interactive contexts, like by greeting someone back who’s greeted them

Asperger’s syndrome was previously considered a “mild” or “high-functioning” form of autism. This means people who received an Asperger’s diagnosis tended to experience behaviors of autism that were often considered minimally different from those of neurotypical people. Asperger’s was first introduced into the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1994.  The symptoms are:

  • having difficulty with verbal or nonverbal communication, such as eye contact or sarcasm having few or no long-term social relationships with peers
  • Lack of interest in taking part in activities or interests with others showing little to no response to social or emotional experiences
  • having a sustained interest in a single special topic or very few topics
  • Strict adherence to routine or ritual behaviors
  • Repetitive behaviors or movements intense interest in specific aspects of objects
  • experiencing difficulty in maintaining relationships, jobs, or other aspects of daily life because of these previously listed sign
  • not having any delay in language learning or cognitive development typical of other, similar neuro developmental conditions

When they were considered to be separate diagnoses, Asperger’s was differentiated from autism in two main areas:

  • Severity. Those diagnosed with Asperger’s were higher functioning and typically had average to superior IQs, requiring less support than those diagnosed with autism.
  • Language. Those diagnosed with Asperger’s had no speech or language impairment

Children at all levels of the spectrum may have social awkwardness and experience isolation. People with Asperger’s have better language skills but still may have difficulty conversing with others. Identifying social cues can be difficult, although kids with Asperger’s often have an easier time making eye contact, which aids in social interaction. One similarity that all people across the spectrum have is the human ability to love, and the desire to be loved in return.

Appearing to be obsessively focused on objects and sameness, the children ranged from nonverbal to [having] language abilities like that of ‘little professors.’ This divergence in language abilities led to the split between autistic and Asperger’s, or low and high functioning.  There are many theories, but no conclusions, about the exact cause of Asperger’s syndrome and autism. A new brain-tissue study indicates that people with ASD have more connections (synapses) between their brain cells than neurotypical people do. ASD has no one cause, but is brought about by a combination of genetic and environmental factors. These may include:

  • Family history of autism
  • Familial or parental diagnoses of conditions such as bipolar disorder or anxiety disorder
  • Advanced paternal or maternal age
  • Being part of a twin or triplet set
  • Prematurity of less than 26 weeks
  • Low birth weight
  • Prenatal exposure to heavy metals and toxins

Pivotal Response Treatment (PRT) for autism spectrum disorders is derived from the principles of Applied Behavioral Analysis Therapy (ABA Therapy). Previously it was known as Natural Language Paradigm (NLP). This approach has been used since the 1970s. It is play-based and initiated by the child i.e., the child makes choices that direct the therapy. . Pivotal Response Training in ABA focuses on some pivotal behavior areas of a child’s development – motivation, responsiveness to multiple cues, self-management, and social initiations which then brings widespread, collateral improvements in other behavioral areas which are not directly covered under pivotal behavior. Both ABA and PRT can help in improving communication, social inclusion, academic skills, language learning and it also helps in decreasing certain behaviors such as self-stimulatory and self disruptive behaviors.

Goals of this approach are:

  • To develop communication and language skills
  • Enhancing positive social behaviors
  • Relief from behaviors that are disruptive and self-stimulatory

Jewel has an applied behavior center for autism that provides pivotal response treatment training for parents based on a focused pivotal response training manual. Applied Behavioral Analysis programs emphasize the role of parents as primary intervention agents. The program is customized to meet the goals and needs of the individual child and his or her everyday routines. The behavioral areas are targeted through both structured and unstructured interactions. The focus of each session changes as the person makes progress, to accommodate more advanced goals and needs.

Autism is not a disorder that affects all individuals equally or in the same manner. While individuals with autism spectrum disorder (ASD) typically have problems with social communication, the extent of these problems range can differ vastly, i.e., from the extreme behavior (non-verbal with aggressive) to comparatively mild issues such as those with vocal intonation, social interaction and body language can occur. In order to qualify as falling under the spectrum of ASD, certain symptoms need to be present. Therefore, even when a person is said to be on the lower end of the autism spectrum, he or she may have significant developmental and sensory challenges that are capable enough to hinder a persons normal range of activities and relationships. However, when the symptoms are relatively mild or when the individual only has a few symptoms, the person is said to have mild or very mild autism.
It is harder to notice the mild autism symptoms even though the symptoms would already be present. Signs of mild autism in adults are often easier to spot. Mild autism in toddlers or children under the age of 3 often goes undetected.

Mild autism in children can be observed from the following symptoms :

  • Problems with socializing and communication that may include difficulty with conversation, body language, eye contact, and/or facial expressions.
  • Difficulty in developing and maintaining relationships
  • Repetition of the same activities, actions, movements, or words again and again, even without having a particular reason.
  • Having a hypo-or-hyper reactivity approach to sensory input where a person is either overly sensitive to senses or is not at all responding to senses.
  • As with other types of autism, mild autism can be treated to help the individual to lead a better life. Applied Behavioral Analysis or ABA therapy for mild autism has proven to help the individuals to function better.

Speech and Language Therapy aims to help individuals communicate in functional and useful ways. Autism and speech disorders have an association and speech therapy for autism can help people with autism improve their verbal, nonverbal, and social communication. Specific benefits of speech therapy for autism include helping the child with autism and speech problems to articulate words well, communicate both verbally and nonverbally, comprehend verbal and nonverbal communication, understanding others’ intentions in a range of settings, initiate communication without prompting from others, to know the appropriate time and place to communicate something, develop conversational skills, exchange ideas, communicate in ways to develop relationships, enjoy communicating, playing, and interacting with peers and learn self-regulation.
There are various types of speech therapy for autism that therapists use based on the needs of the child. The methods to be employed are decided on by therapists from speech therapy and audiology after a thorough diagnosis. Based on this, verbal or nonverbal methods are adopted. Sometimes, music is used for therapy since autistic children respond better to songs. Speech therapy exercises are taught for better articulation. Nonverbal autism speech therapy activities involve using pictures or technology to communicate and is known as Alternative Augmentative Communication (AAC). The methods include the use of Sign language, Picture Exchange Communication System (PECS), iPads and Speech output devices. Infact, speech therapy for children and for adults have met with a lot of success.

Parenting is a difficult task in itself, let alone parenting a child on the autism spectrum. Parents can get stressed out when they feel helpless and this can affect the other members in the family as well as the family dynamics itself. Stress often surrounds the task of caring for the child and they remain due to the stigma around the disorder. Research has also shown that parents can feel caregiver overload, and this was seen especially among mothers. It is important to address the stress as it often interferes with the quality of life of the entire family. There are studies that show that the parents of children on the spectrum tend to have certain signs of depression and there is a link to low social support as well. Various aspects of one’s family life may be affected, including the finances, the marital relationship, physical health of the family members, limiting response required by the other children in the family, and in recreational/ leisure activities.

It is important to impart awareness to the parents regarding the condition of the child, they should feel that they are prepared to help the child. Research has also shown that addressing the marital relationship, familial support, and engaging in social activities can help in reducing
the impact on the family members.

Screening and diagnostic tools for diagnosis of autism are based on the child’s behavior and developmental history. In many cases, children don’t receive a final diagnosis until much older. This delay means children never get the help that they need early in their lifetime. Early detection, monitoring, screening, and evaluation of a child with autism enables them to make and receive the services and support they need to attain the maximal potential they can achieve. There are various sequences in this process. Recently, many pediatricians have begun screening for autism during well-baby checkups monitored in every scheduled check-up. The children who are diagnosed as autistic are advised to take treatment under specialists such as occupational therapists, speech therapists, special educators, and other support groups thus improving their quality of life and prognosis. If your child is suspected to have autism, you can request for a
qualified specialist referral.

Autism screening tools

Autism screening tools range from simple observation to formal assessment. The following are the screening tools commonly used:

  • The modified checklist for autism in toddlers, revised (M -Chart) is a 20 question test
    designed for toddlers between 16 -30 months old.
  • The ages and stages questionnaire (ASQ) is a general tool to examine developmental delay at specific ages.

The clinician may also perform:

  • Functional Behavioural Assessment
  • CARS(The child autism rating scale)
  • The Autism Diagnostic Observation Schedule
  • Autism Detection in Early Childhood
  • The Autism Diagnostic Interview-Revised ADI-R
  • The Social Communication Questionnaire
  • Gilliam Autism Rating Scale
  • Functional Skill Assessment to assess the current level of the child in various areas of gross motor, fine motor, communication, and self-care.

Occupational therapy and Sensory Assessment

Occupational therapist assessment is based on the child’s sensory processing issues. The sensory processing questionnaire addresses the sensory system in depth along with monitoring the child’s behavior and response.

There is a lot you can do to help children with autism overcome their difficulties. This information about childcare, treatment, and services can help. There are many treatments available to help children learn new skills and overcome various developmental challenges.
Speech therapy, AppliedBehavioral Analysis, Occupational therapy, Group therapy, Developmental education, etc will help you meet your child’s special needs and help them learn, grow, and succeed in life. Self-care is also important when caring for a child with ASD. When you are emotionally strong, you can be a better parent for a child in need. These tips can make life easier for children with autism.

It is best for parents of children with ASD or related developmental delays to start treatment immediately. Seek help as soon as you suspect a problem. Don’t wait for your child to understand or solve the problem. Don’t even wait for an official diagnosis. Young children with autism spectrum disorder are more likely to be successful with treatment earlier. Early intervention is the most effective way to accelerate your child’s development and reduce autism symptoms throughout life. Learning all about autism and participating in treatment can help your child in many ways.

The following tips will make your daily home life easier for you and your child with ASD:

Positive reinforcement can help children with ASD, so catch the kids doing something good. Praise them when they do the right thing or learn a new skill, and be very specific about the behavior they praise. Then Find other ways to reward them for good behavior by putting stickers on them or letting them play with their favorite toys. Create a private space in your home where your children can relax, be safe and enjoy. Children with ASD can learn to perceive the nonverbal cues they use to communicate. Pay attention to the sounds they make, their facial expressions, and the gestures they use when they are tired, hungry, or want to do something. They may use non-verbal cues to communicate their needs. Give attention to your child’s feelings. Many children with ASD are sensitive to light, sound, touch, taste, and smell. Some children with autism are “not sensitive enough”; to sensory stimuli. Find out which sounds, smells, movements, and touching are causing your child to behave “bad” or destructive, and which are positive. Understanding what affects your child will help you solve problems, avoid problem situations, and create successful experiences.

There is no treatment to cure ASD. But some interventions have been studied and used for young children to reduce symptoms, improve their cognitive ability and daily living skills and improve the ability of the child to function and participate appropriately in the community. In ASD each
the person is different and people with ASD have unique strength and difficulties in communication, socialization and their academic skills. The main problem area for a child with ASD is communication and social interactions. Through a multi-disciplinary treatment strategy, definite changes can be seen in a child. Most effective treatment and interventions are available now and it includes ABA (applied behavior analysis), Occupational Therapy, Speech Therapy, cognitive behavioral therapy, early intervention, school-based, and educational-based therapies.

Effort towards the early intervention for ASD has been encouraged more. Through early identification and early intervention, treatment results can be made much effective.

Children with Autism spectrum disorder need additional support to enhance their communication skills. There are no specific rules on how to communicate with a child with ASD. Children on the autism spectrum can be non-verbal, or pre-verbal, Irrespective of a particular child’s status, you can help children with autism communicate in several ways such as:

  • Using Visual: Visual communication methods such as to communicate with sign language, or an augmentative and alternative communication (AAC) device or the Picture Exchange Communication System (PECS).
  • Give them time to process: Be patient. If someone doesn’t respond immediately, we usually assume that they haven’t heard or understood, and we tend to repeat what we said or try to rephrase it. However, by counting to ten in our head, we give the child time to process what we said so that they involve them processing each word, whether it requires a response, and delivering into their memory banks to find the appropriate answer.
  • Keep it simple: It’s always better to communicate in a simple way with autistic kids. When we try to use few words, they will be able to process quickly. For example, to convey instruction, it’s much easier to process, “first open, then car” than it is to work out “open the cupboard and then take the ball” which is probably what we’d typically say.
  • Reinforcement: Children with ASD respond best to positive reinforcement. Make sure you talk about or reinforce good behavior often. Be generous with compliments for good behavior, be affectionate and respectful.
  • Believe in what the child can do: Don’t define a child with a diagnosis as they are a growing person with unknown possibilities. Therefore encourage their abilities rather than labeling them with their disabilities.

The best way to help children with ASD is by choosing the easiest way to communicate which can help them to reduce their frustration and communicate their needs.

According to average estimates, for a couple with the diagnosis of Autism Spectrum
disorder which is of an unknown cause, the current chance of recurrence in a
subsequent child is approximately 10% based on the most recent and advanced
studies.
And this value is so much higher than the 1% chance for a random couple in the
population to have a child with ASD. Due to this reason, the younger sibling of the
child need to undergo screening for ASD and should also be monitored closely
during the growing years. If the parent already has two or more children with ASD,
the chance of a subsequent child to have the disorder is as high as 32-35% (
Ozonoff et al., 2011). Therefore it is preferable to get a genetic testing done to know
if there is a genetic link with autism.
Both genetic and environmental factors can contribute to younger children
developing this disorder when they also have a sibling with the same problem. Some
studies also suggest that the risk of ASD in a later born child is more if the first
affected child is a girl. Many family studies have detected numerous candidate genes
that encode proteins involved in the function of neurodevelopment. Currently we
cannot trace a single gene mutation or a single chromosome abnormality that can be
a cause for Autism. It could be due to several mutated genes or maybe a
combination of many environmental factors and mutated genes.
The younger sibling or the second child can also have symptoms of mild social
impairment or repetitive behaviors that fade away eventually. The siblings of a child
with autism who do not having the condition themselves are more likely to have more
autistic traits than other children due to the exposure and other genetic factors. So to
conclude, parents need to be made aware of the risk in having a second child
with autism and essential counselling should be provided to handover knowledge
about the possible struggles and risk factors that they may have to go through while
bringing up the child.

All the children with special needs must have right to education like their non autistic counter parts. Autistic children are supposed to be treated as normal kids. Treating them as abnormal child will only affect their confidence and they might withdraw from people.
Autistic children can be send to regular schools but it completely depends on where the student with autism is on the spectrum (severity ).
Schooling is a major transition in any child’s life and for children with disabilities this transition can be highly challenging. Since children with Autism Spectrum Disorder has unique social, communication and behavioral difficulties when compared to neurotypical children, starting regular schooling will be highly challenging for this population. Children with Autism Spectrum Disorder have a greater risk of poor school outcomes due to their challenges. Bullying can be a major factor that may result in school exclusion or peer rejection. Therefore it is critical that protective factors and barriers to positive school transition in children with Autism Spectrum Disorder are identified and understood.
The transition process begins as early as from their pre school age wherein the child will be evaluated to find whether she/ he is ready for schooling. Meanwhile it is equally important that parents , teachers and schools are prepared for the needs of children with Autism Spectrum Disorder.
Here are few strategies for regular schooling children with Autism Spectrum Disorder.
Children with Autism Spectrum Disorder will benefit from a regular based schedule. They might need extra time to switch to a new activity or subject. Many of them learn best with visual schedule or visual instructions. Classroom or teaching area must have minimal distractions, there by the students are more likely to be able to stay focused.

Autism is considered as a disorder which affects the neuro-developmental functioning that which in turn affects three main areas of development usually referred to as Triad of impairments.

  1. Social interaction and understanding.
  2. All aspects of communication — verbal and non-verbal.
  3. Flexibility of thinking and behavior, including problems with imagination.

Many children may have several features in common, but its important to realise that Autism is a spectrum of disorders and every child with autism will be in different parts of spectrum. Similarly, development would be at different rate and severity for each child. Thus, a child may have chronological age as four but she/he may function at 2 years in language age and 1 year in social skills. It is also possible for their cognitive skills to be 4 at age which means development may not be uniform in all areas for children with Autism. Many children may have intellectual disabilities, but many others can have average to above average IQ as well. This states that ID does not play a part in diagnostic criteria for children with Autism.

INTELLECTUAL DISABILITY

Intellectual disability or ID was earlier known as Mental Retardation (MR). It is characterised by a below average level of Intelligence, lack of skills for day-to-day living and low mental ability. This does not mean that children with ID can’t do or learn new things, but they will be little slower comparing to others. They function at an age which is below their actual age. Degree of ID varies from Mild to profound.
A child with intellectual disability mainly has limitations in the following areas:

  • Intellectual functioning refers to a child’s ability to learn reason, make decisions, and solve problems.
  • Adaptive behaviours which include skills needed for day-to-day life such as effectively communicating, taking care of oneself, and interacting with others.

Compared with a normal child, a child with Intellectual disability takes more time to learn a language, develop skills in social interaction and develop self care skills. For them, learning will take more time and require more repetition. But they still can learn, develop and become a participating member of community.
IQ (Intelligence quotient) is measured by an IQ test. Average IQ Score is 100 The average IQ is 100, and majority will score between 85 and 115. If one scores below 70 to 75.
Mild Intellectual disability may not be identified until child begins schooling. Experts assessment is needed to confirm level of ID.
Within first years of life, Moderate intellectual disability (IQ 35-49) will become visible. Common signs here are speech delay. Considerable support is needed in school, at home and in society. Even when their academic potential is limited, they still can learn few basic skills needed for daily living.

The answer to this question is yes, a person with autism spectrum disorder can live independently as an adult. But not everyone can gain a same level of independence. Intervention service focus to help individuals in achieving their highest possible level of independence which may not look similar for everyone.
In ASD, symptoms differ in each person and therefore treatment plans should be tailor made focusing on each person’s skillset, interest and passion. There are various degrees and stages of independence. It depends on how early a person is diagnosed and began with treatment.
Autism independent living skills:

  1. Self-help and determination skills: Self-help and determination as the ability of individuals with ASD to be aware of themselves emotionally, physically, and cognitively to create and attain their goals.
  2. Functional communication: They must be able to express desires, feelings, and concerns to those they live or interact with.
  3. Reduction of problems: They need skills to acknowledge and manage their emotions safely and consistently
  4. Domestic and personal care: Individual with ASD will be able to live independently is their ability to perform personal and home-related tasks such as dressing and undressing, washing clothes
  5. Personal hygiene practices: Brushing hair, shaving, applying makeup, showering, menstrual care

Play is beneficial to the development of social skills. Deviances in play behavior are seen in children with autism, and these deviances may be linked to delays in social development. Children can improve not only physical skills but also cognitive and social skills through play.
Child play has different stages; manipulative, functional, symbolic or representational play. Toys are first handled orally and manipulatively by children, who feel, lick, sniff, turn, throw, and so on. This manipulation provides opportunity to learn about many things, relationships, and methods of interacting. Next stage, Functional play develops at approximately 14 months of age example, using a spoon to feed the doll, or placing a teacup on a saucer’. Around 24 months of age, symbolic play emerges which is a higher lever of play involving pretence.
Children with autism show a core deficits in social interaction. In children with autism who have a variety of atypical characteristics, the initial phase of play development, which involves exploratory/manipulative behavior of objects, occurs. They usually limit themselves to a small number of things while they play. They prefer touch and tasting objects over visual exploration. Other studies reveals that children with autism spend significantly less time playing functionally. show lower levels of appropriate object use, less variety in their functional play, more repetition, difficulties in symbolic play, When symbolic play is performed, their play behavior may be more like ‘learned routine’ rather than spontaneous play.
It has also been found that children that had a strong attachment spent more time playing. They also displayed greater symbolic play behavior and a higher level of play. Children who had a chaotic attachment relationship spent less time playing than those who did not.