- by R K Senthil Kumar - Occupational Therapist
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- Feb 05 2018
Autism Spectrum Disorder
It is a neurological and developmental disorder that begins early in childhood and last’s throughout a person’s life. It is called a “spectrum” disorder because people with ASD can have a range of symptoms. It affects how a person acts and interacts with others, communicates, and learns.
Some children show signs of ASD in early infancy, such as reduced eye contact, lack of response to their name or indifference to caregivers. Other children may develop normally for the first few months or years of life, but suddenly become withdrawn or aggressive or lose language skills they have already acquired. Signs usually are seen by age 2 years. Each child with ASD is likely to have a unique pattern of behaviour and level of severity, from low functioning to high functioning.
Some children with ASD have difficulty learning, and some have signs of lower than normal intelligence. Other children with the disorder have normal to high intelligence, they learn quickly, yet have trouble communicating and applying what they know in everyday life and adjusting to social situations.
Because of the unique mixture of symptoms in each child, severity can sometimes be difficult to determine. It's generally based on the level of impairments and how they impact the ability to function.
Below are some common signs shown by people who ASD:
• Fails to respond to his or her name or appears not to hear you at times
• Resists cuddling and holding, and seems to prefer playing alone, retreating into his or her own world
• Has poor eye contact and lacks facial expression
• Doesn't speak or has delayed speech, or loses previous ability to say words or sentences
• Can't start a conversation or keep one going, or only starts one to make requests or label items
• Speaks with an abnormal tone or rhythm and may use a singsong voice or robot-like speech
• Repeats words or phrases verbatim, but doesn't understand how to use them
• Doesn't appear to understand simple questions or directions
• Doesn't express emotions or feelings and appears unaware of others' feelings
• Doesn't point at or bring objects to share interest
• Inappropriately approaches a social interaction by being passive, aggressive or disruptive
• Has difficulty recognizing nonverbal cues, such as interpreting other people's facial expressions, body postures or tone of voice
• Performs repetitive movements, such as rocking, spinning or hand flapping
• Performs activities that could cause self-harm, such as biting or head-banging
• Develops specific routines or rituals and becomes disturbed at the slightest change
• Has problems with coordination or has odd movement patterns, such as clumsiness or walking on toes, and has odd, stiff or exaggerated body language
• Is fascinated by details of an object, such as the spinning wheels of a toy car, but doesn't understand the overall purpose or function of the object
• Is unusually sensitive to light, sound or touch, yet may be indifferent to pain or temperature
• Doesn't engage in imitative or make-believe play
• Fixates on an object or activity with abnormal intensity or focus
• Has specific food preferences, such as eating only a few foods, or refusing foods with a certain texture
• Genetics. Several different genes appear to be involved in autism spectrum disorder. For some children, autism spectrum disorder can be associated with a genetic disorder, such as Rett syndrome or fragile X syndrome. For other children, genetic changes (mutations) may increase the risk of autism spectrum disorder. Still, other genes may affect brain development or the way that brain cells communicate, or they may determine the severity of symptoms. Some genetic mutations seem to be inherited, while others occur spontaneously.
• Environmental factors. Researchers are currently exploring whether factors such as viral infections, medications or complications during pregnancy, or air pollutants play a role in triggering autism spectrum disorder.
Your child's doctor will look for signs of developmental delays at regular check-ups.
Observe child and ask about child's social interactions, communication skills and behavior have developed and changed over time.
Give your child tests covering hearing, speech, language, developmental level, and social and behavioral issues.
Present structured social and communication interactions to your child and score the performance.
Recommend genetic testing to identify whether your child has a genetic disorder such as Rett syndrome or fragile X syndrome
There is no cure for ADS. The goal of treatment is to maximize your child's ability to function by reducing ADS symptoms and supporting development and learning
The range of home-based and school-based treatments and interventions for ADS can be overwhelming, and your child's needs may change over time
Treatment options may include
Why is occupational therapy Important for children with ASD?
Occupational therapy management
Children with autism and attention deficit hyperactivity disorder (ADHD) tend to exhibit significantly different patterns of sensory processing to their peers and to children with other special educational needs (SEN).
Sensory overload can present itself in many ways, such as challenging behaviour, withdrawal and complete shutdown.
There are, though, a number of simple strategies that can be used in the home or classroom to effectively add the sensory filters that these students often require. Occupational therapists are key to this intervention
sensory system helps the child’s nervous system become more organised/regulated and therefore assists the child with attention and performance.
What is occupational therapy (OT)?
Occupational therapists work to promote, maintain, and develop the skills needed by students to be functional in a school setting and beyond. Active participation in life promotes:
In the case of autism, an occupational therapist works to develop skills for handwriting, fine motor skills and daily living skills. However, the most essential role is also to assess and target the child’s sensory processing disorders. This is beneficial to remove barriers to learning and help the students become calmer and more focused.
Sensory integration therapy is based on the assumption that the child is either “over stimulated” or “under stimulated” by the environment. Therefore, the aim of sensory integration therapy is to improve the ability of the brain to process sensory information so that the child will function better in his/her daily activities.
Occupational therapists will often recommend starting the day with a sensory circuit: a sensory–motor activity programme which helps children achieve a “ready to learn” state. Sensory circuits are a series of activities designed specifically to wake up all the senses. They are a great way to energise or settle children into the day. Each session includes:
• alerting activities (e.g. spinning, bouncing on a gym ball, skipping, star jumps) to stimulate the body's central nervous system in preparation for learning
• organising activities (e.g. balancing on a wobble board, log rolling, juggling etc.) which demand brain and body to work together
• calming activities (heavy muscle work and deep pressure e.g. wall pushes, push ups, using weights) to give an awareness of their body in space and increases the ability to self-regulate sensory input.
10 Simple Strategies
For the child who is overwhelmed by excessive noise, try offering them ear defenders or allow then to use an MP3 player whilst concentrating
For the child who becomes agitated by touch, allow them to stand at the front or back of the queue to avoid being bumped. Allow them to transition to the next lesson 3 minutes before others to avoid corridor collisions.
For the child who cannot sit still, include regular movement breaks, try alternative seating e.g. wobble cushion to allow fidgety movement.
For the child who seeks hugs try lycra undergarments, trial rash vests and rugby base layers that are cheaply available from many sports outlets.
For the child who struggles at the black print on a white background, change the paper to a buff colour and consider the font. This is less stressful on the eyes. Consider your presentation layout for PowerPoints too.
If a child is overwhelmed by smell, use a sweatband with a drop of oil, shampoo, aftershave etc. that they like. Allow the student to take this with them to mask the smell they find uncomfortable.
Food play should be encouraged for those children with a limited diet. There should be no pressure on the child and this should not be done at mealtimes. The aim is purely to reduce the fear of food.
The use of a quiet, calming room/space within the classrooms and at home are essential for calming. Use a pop up tent, blanket over a table or under a cabin bed. Add bean-bags, sensory toys etc.
For children who want to chew offer alternatives like commercially available chew toys, crunchy bread sticks or carrot sticks.
For children who dislike having their teeth brushed, try a vibrating toothbrush, Collis Curve toothbrush (this cleans all surfaces in one movement) and use unflavoured toothpaste such as Oralnurse.
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