Autism spectrum disorder (ASD)

Printer-friendly versionPrinter-friendly version

What is ASD?

ASD is a disorder of development that affects language, social skills and behaviour. Children with ASD are unable to interpret the world and what is happening around them in the same way that other children do.

There is a range of severity and intellectual ability, from the severely impaired child with classical autism, to a child with Asperger syndrome or high-functioning autism. Children with Asperger syndrome may have a high level of intelligence but have difficulty with social interaction.

The term ASD is used to refer to the group of pervasive developmental disorders which include:

  • classical autism
  • Asperger syndrome
  • those with similar features affecting children which do not fit into these diagnostic categories

What are the symptoms?

Children with ASD all have:

  • difficulties with communication
  • difficulties in social interaction or play
  • restricted, stereotyped and repetitive interests and / or behaviour

The earlier the diagnosis of ASD is made, the greater the impact early intervention has, resulting in fewer challenging behaviours and better outcomes for families.

However, for many high-functioning individuals the diagnosis may only be made at a much later age. The term Asperger syndrome (or disorder) presents particular difficulties because there is no international agreement on the distinction between this disorder and high-functioning autism.

What are the signs of possible ASD in a pre-school child?

You might observe (or a parent or others might describe) a child who:

Communication:

  • finds it hard to communicate what they want
  • has language skills that are behind other children of their age
  • may appear to not understand what people want or say
  • uses language in an unusual way (such as repeating words or songs, or using overly formal or academic language)
  • sometimes appears not to hear
  • uses objects, such as a cup or DVD, or leads by the hand to show what they want
  • seems very independent for their age (will not seek help from others)
  • has difficulty following directions

Social interaction or play:

  • prefers to play or be alone  
  • does not smile when smiled at 
  • difficulty initiating or sustaining eye contact
  • Ignores greetings and farewells (such as waving hello or goodbye)
  • appears disinterested in other children or people
  • does not respond when you play peek-a-boo or hide and seek games
  • never plays pretend or ‘make believe’ (talking on the phone or looking after a doll)
  • rarely bring toys and objects to share or show adults or other children
  • rarely attracts other people’s attention to what they are doing

Cognition or restricted or repetitive behaviour:

  • has very set and/ or unusual rituals or routines and can get very upset at changes in routine
  • likes to line things up or put things in a certain order
  • seems to get stuck doing the same thing over and over
  • has unusual movement patterns (such as hand flapping or walking on toes)
  • plays with toys in unusual ways (such as spinning the wheels on a car)
  • makes unusual movements near their face
  • shows attachments to unusual objects (such as a key ring or piece of string)
  • over-reacts to loud noises (puts hands over ears) or is very sensitive to particular smells, tastes or textures

What are the signs of possible ASD in a school-aged child?

You might observe (or a parent or others might describe) a child who:

Communication:

  • finds it hard to communicate what they want
  • uses an unusual tone or pitch or accent (very pedantic, a monotone or an unusual accent)
  • may appear to not understand what people want or say
  • might say ‘you’ or ‘she or he’ rather than ‘I’ (or vice versa)
  • is unaware of non-verbal communication like facial expression, body language or gesture
  • takes information or instructions ‘literally’
  • has difficulty with new instructions or settings

Social interaction or play:

  • prefers to spend time alone
  • has difficulty knowing if someone is joking
  • does not follow the usual social rules for ‘polite’ behaviour
  • has difficulty taking part in a two-way conversation
  • does not readily engage in role-play or joking around
  • sometimes has acquaintances, but very few friends
  • sometimes says or does things that are tactless or socially inappropriate

Cognition or restricted or repetitive behaviour:

  • has very set and/or unusual rituals or routines and can get very upset at changes in routine
  • likes to line things up or put things in a certain order
  • has a particular interest which they like to talk about and takes up a lot of time
  • will recite facts about their particular interest without consideration for the listener
  • has poor coordination or motor skills
  • over-reacts to loud noises or is very sensitive to particular smells, tastes or textures

How is it diagnosed?

Signs of ASD may be noticed by parents, doctors nurses and and teachers. The diagnosis is usually made by a paediatrician, child psychiatrist or psychologist. Growth and development of children is monitored at all Well Child visits to check if there are any concerns that parents / caregivers have about development and behaviour. If concerns are noted, prompt referral should be arranged.

Assessment is the process of gathering information about the health, education and care needs of a child and his or her family. This results in an identification of needs, a diagnosis where appropriate and a plan of action to meet those needs.

Regardless of the intervention, home, early childhood, school and community settings must all be involved to ensure the best possible outcomes for the child. However, this requires a high level of commitment and participation from parents and increases the demands on them. Parents and their professionals need to discuss this and agree on the roles and responsibilities each wishes to take when planning interventions.

How common is it?

There is no information on how common ASD is in New Zealand. Using overseas information, it is thought that there will be approximately 360 new cases of ASD diagnosed per year. There are likely to be around 6000 children under 16 years with ASD at any one time.

Where to go for more information and support

NZ Autism Spectrum Disorder guideline 
The New Zealand Guidelines Group (NZGG) created evidence-based guidance, useable tools and implementation approaches for people with ASD (Autism Spectrum Disorder). They also promoted the use of evidence in clinical and personal practice. See the NZ ASD guideline website for:

Ministry of Health www.health.govt.nz
See the Ministry of Health website for:

Altogether Autism www.altogetherautism.org.nz
An information and advisory service for people with ASD, their families, whanau and the wider New Zealand community.

Freephone: 0800 ASD INFO (0800 273 463)
 
Ministry of Education
The Ministry of Education website has a section on Supporting children with ASD and an ASD resource for educators. The resource is useful for people supporting children and young people with ASD, including parents. It introduces some of the challenges faced by young people with ASD, some of the characteristics of these disorders, and practical strategies for support. 
 
Australian website
 
Raising Children Network: The Australian Parenting Network raisingchildren.net.au
The Raising Children Network website provides comprehensive information on ASD in the section Children with Autism Spectrum Disorder. Please be aware that some of the content (such as information about services available, costs and information about funding of medications) applies only to Australia and may not be relevant to New Zealand. However, much of the information is relevant to New Zealand families. 
 
Other international websites

Great Ormond Street Hospital for Children, UK
The Great Ormond Street Hospital website provides the booklet Understanding and managing behaviour problems in children and young people with autistic spectrum disorders. The booklet has been written to offer an overview of some of the behavioural difficulties that may be experienced by children with ASD. It also offers guidelines on how to manage these behavioural difficulties. Some of the information may not relate to your situation because each child and their circumstances differ.

Visual strategies www.usevisualstrategies.com
Students with ASD and lots of other students with behaviour or communication challenges tend to be visual learners. They understand what they see better than what they hear. Therefore, they benefit significantly from the use of visual strategies.

The National Autistic Society  www.autism.org.uk
The National Autistic Society website provides information about Autism and Asberger Syndrome in other languages.

Acknowledgements

Our thanks to the Ministry of Health as the copyright owner, and the New Zealand Guidelines Group (NZGG) as the author, for access to all the resources on Autism Spectrum Disorder on the Ministry’s website.

References

New Zealand Guidelines Group. 2010. What does ASD look like? A resource to help identify autism spectrum disorder. Wellington: New Zealand Guidelines Group. http://www.health.govt.nz/publication/what-does-asd-look [Accessed 08/08/2014]

 

This page last reviewed 19 February 2013
© Paediatric Society of New Zealand and Starship Foundation 2005 – 2014
Printed on 31 October 2014. Content is regularly updated so please refer to www.kidshealth.org.nz for the most up-to-date version
Content endorsed by the Paediatric Society of New Zealand