By Shannon Grassby, Clinical Psychology Registrar
Autism is a different way of thinking. People with autism have a range of strengths and challenges, and these differ for each individual. Some autistic children may benefit from therapeutic support to manage life’s challenges, such as learning social skills or developing the emotional skills to deal with change. Find out more about autism in children, including signs to look out for, how to get a diagnosis and early intervention services.
What is autism?
Autism, or Autism Spectrum Disorder, is a neurodevelopmental difference in how an individual’s brain develops and is ‘wired’.
There are some key neurodevelopmental differences which occur in autism and these differences fall into the categories of either social communication, or restrictive and repetitive interests.
Autistic people can struggle with the social aspect of communication, including:
- understanding their own and other people’s emotions
- understanding different perspectives
- understanding or being able to implement non-verbal communication such as gestures and eye-contact
- understanding and participating in imaginative play or turn-taking and sharing.
These difficulties are usually accompanied with challenges coping with change, strict adherence to routine, and sensory seeking and avoiding behaviours. Generally, individuals with autism can be highly focussed on a particular interest area, which they find soothing and calming.
Autism is referred to as a “spectrum”, as each person with autism is an individual with their own strengths and challenges. Importantly though, the “spectrum” is not a gradient from not autistic to very autistic, but rather a term that tries to identify the diversity and uniqueness of each autistic person.
What are the signs of autism in children?
Some early signs which may indicate that it is worth seeking an assessment for autism, for boys and girls includes:
- Differences in imaginative play. A child may not play pretend games at all and may prefer to line up or categorise toys. Alternatively, if they are within the realm of imagination, they may play the same game over and over, a recreate the scene from a movie.
- Differences in gestures or eye-contact. Children may need to be ‘coached’ or ‘reminded’ to wave, say hello or blow a kiss, or they may not gesture even to point at all. Children may have difficulty making eye-contact with unfamiliar people, or may never make eye contact.
- Differences to social engagement. Children may want to be involved in playing with other children, but need help introducing themselves or getting started, or they may show no interest in other children. They may not know how to make friends and rely on others to introduce them to friends. They may be “followers” in their relationship with others, or they may “dominate” the social interaction.
- Differences in sensory seeking or avoidance. Children may get immense pleasure or feel soothed when engaged in rocking or swinging sensations or may seek out sensory activities such as swimming or bathing.
- Differences in coping with change. Children may become very distressed and consistently distressed when things don’t go according to plan, when others don’t follow rules, when things are moved or changed in the house. Children may insist on following strict routines.
It is important to remember that each autistic person is different, so if you have met one person with autism, then you have met one person with autism.
It is also important to know that autism is girls can present differently to boys, which often leads to a diagnosis later in life, commonly around end of primary school or early high school.
How do I get an autism diagnosis for my child?
An assessment is required to receive a diagnosis of autism. Any assessment that is conducted should include, at minimum, a developmental interview and a behavioural observation.
Trained and qualified psychologists can perform the required assessments, as well as trained paediatricians and developmental paediatricians.
An autism assessment should be an in-depth process, which includes a developmental interview targeted to the specific criteria and features of autism, a formal behavioural observation as well as a cognitive assessment (to adhere to the diagnostic criteria or ruling in or out intellectual disability). It may also include an assessment of daily living or adaptive behaviour and other mental health screeners and assessment as needed.
What causes autism?
There is no specific or single cause of autism.
However, there are some risk factors that can increase the likelihood that a person may have autism. A large risk factor is genetics, as autism tends to run in families. However, a person with no family history may still be autistic. There are some other small risk factors including premature birth or advanced parent age.
How is autism in children treated?
There is no “treatment” or “cure” for autism, as autistic people are born with neurological differences, just as anyone is born with other kinds of differences.
However, the differences of an autistic brain can be very challenging to manage, particularly if that individual is seeking to or required to participate with the neurotypical world.
But there are different skills a person with autism may wish to learn in order to help them manage anxiety, social interactions, their sensory needs and unexpected changes.
These goals for therapy should be established with the individual, and aligned to their goals. The individual may be supported in these goals by a range of professionals including psychologists, occupational therapists, psychiatrists or paediatricians or even speech pathologists.
Also, many autistic people have additional neurodiverse presentations such as ADHD, or, co-occurring mental health challenges such as anxiety or depression. These challenges may also be the focus of support with psychologists, psychiatrists or paediatricians.
How can I help my autistic child?
Children can be supported in many ways in the home.
- Allow children to engage in their interest area and be supportive of this interest. It is calming and soothing for them.
- Allow children to engage in “stimming” behaviour as this is also calming and soothing. “Stimming” refers to a repetitive behaviour which helps to regulate emotions and sensory input, and may look like hand flapping, swinging or rocking.
- Try to stick to the same routine to help your child manage their anxiety and create a greater feeling of control over their environment.
- Encourage discussion of feelings and body signs associated with specific emotions and perspective taking to help your child identify what they are feeling and what others might be feeling.
How can I get support?
It is important to raise any concerns you have regarding your child’s development with your GP or paediatrician and ask for an assessment. Where possible, it can be helpful to consult with a doctor who is “neuroaffirming”, that is, understanding and accepting of brain differences.
Though a diagnosis is not necessary to access support, (at time of writing) a diagnosis is required to access the National Disability Insurance Scheme (NDIS). Every individual is different, and some families may not wish to access the NDIS.
If your child or young person is experiencing anxiety or depression, they may be eligible for a Mental Health Care Plan to access Medicare-rebated sessions with a psychologist (at time of writing). Psychologists can assist with areas such as emotional regulation, behaviour regulation, social skills, mental health management.
You may also consult with other allied health professionals including occupational therapists (OT) or speech pathologists. OTs can assist with managing sensory challenges and communication strategies. Speech pathologists can assist with language and communication challenges, and some also help with eating issues.
It is important to also work with your child or young person’s school to understand how they can assist with areas such as learning support, spaces to assist in regulation, or assisting with social relationships.
Spencer Health is able to offer comprehensive assessments for autism, and specialises in the assessment of autism in girls. We regularly work therapeutically with autistic children, helping them to navigate their lives. We also offer KidsLink social skills groups for neurodiverse children, to help them in learning emotional regulation skills and social skills, within a creative and art-focussed group environment.
If you would like any further information on our services and how we can assist, please contact Spencer Health at support@spencerhealth.com.au