Understanding Autism Spectrum Disorder (ASD)

Austism_S01ASD is a long-life brain-based developmental disorder, characterized by great difficulty in social interaction and communications. It can be very terrifying of having your child diagnosed with or suspected of having ASD. Many parents do not have the slightest idea of what ASD is about and some may even harbour misconception about the disorder. If you’ve recently learned that your child might be or have been diagnosed with ASD, do not be panic and learn about ASD as much as you can so that you make informed decision for your child.

When I was teaching, many parents would get very defensive when I advise to go for further assessment. One of the most common rebuke I’ve come across is, “How do you know my child has ASD? You are not even medically trained!” Yes, the parents are correct. We are not medically trained, but we are aware of the early signs and symptoms. Hence, it is important to listen to the teacher on what he/she has to say. After all, besides the parents, the next person that the child spent most of their time with would be the teachers. Based on the parents’ and teachers’ observation on the child’s daily behaviour, it would give some clues as to whether the child displays any early signs of ASD.

Autism S03


So what are the signs and symptoms that we look out for?

When we look for signs and symptoms of autism, we are looking for children having difficulties in three areas – social and emotional, verbal and non-verbal
communications and inflexibility
.

Social Difficulties

Children with ASD usually have problem interacting socially with other and is usually deemed as a loner or living in their own world.

  • Prefer not to have any physical contact
  • Does not seems to hear when people are talking to him or her
  • Does not participate in play that involves others or dramatic play
  • Has difficulty expressing feelings or empathize with others
  • Does not show interest of the surrounding people or environment

Verbal and Non-verbal Communications

Autism S04Children with ASD usually have speech delay and have trouble understanding and using body language.

  • Absence of eye contact
  • Limited body language
  • May be hyper or hypo sensitive to sights, smells, textures and sounds
  • Display abnormal way of moving
  • Does not display appropriate facial expression that matches his/her speech
  • Speaks with an abnormal intonation
  • Could not understand and follow simple instructions
  • Repetition of speech
  • Have difficulty answering simple questions
  • Refer to themselves in the third person
  • Has difficulty expressing needs
  • Could not understand sarcasm, humour and irony in speech

Inflexibility

Autism M01Children with ASD are often very inflexible, and can be very obsessive in their behaviours, interest and activities.

  • Could not tolerate any changes in routines
  • Frequent repetition of a certain action or movement
  • Shows unusual interest to certain toys or strange object
  • Immerse on one or two topics only
  • Often engross in lining things up or arranging things in a certain order

This list above is non-exhaustive. Every child is unique and hence, the symptoms might differ from each child as well. While possessing a few of these signs mentioned above might not necessarily means that the child has ASD, it is best to bring the child for a proper assessment done by professionals. Afterall, early diagnosis means early treatment which is beneficial for the child.

Where can I bring my child for assessment?

If your child’s teacher has approach you regarding your child showing early signs of ASD, chances are she already has a set of observation records that she will be using to back up what she is going to say to you. It would be beneficial if you could get the observation records and a referral letter from the principal. You could then proceed to any polyclinic and then a referral to the following hospital where the diagnostic test would be conducted:

KKH Child Development Unit
Health Promotion Board, Level 2,
3 Hospital Drive S168937
Tel: 6327 6900    Fax: 6327 6901
NUH Child Development Unit
Jurong Polyclinic, Level 3,
190 Jurong West Ave 1 S609788
Tel: 6665 2530    Fax: 6665 0158

Alternatively, if you find the referral procedure too tedious, you could also go directly to a private psychologist to get the assessment. However, it is going to be more expensive.

My child is diagnosed with ASD! What happens next? 

Mother and daughter playing blocksAlong the autism spectrum, there are 3 forms of disorder – Autism, Asperger Syndrome and Persuasive Developmental Disorder (PDD-NOS). Treatment for autism involves therapy targeting on behavioural issues, medication or both.  The first and foremost thing you need to do would be work with your child’s teachers and doctors to get information on the following:

  • Child’s behaviour, developmental profile, abilities, strengths, interests and learning styles
  • Child’s deficits (attention, stimuli control, generalization, communication, perspective taking, etc.)
  • What might trigger the child’s sensory overload

With all this information, it would form a baseline assessment of the child’s academic, social and communication performance and it could aids the therapist and yourself to tailor an intervention program that could address your child’s needs. Although the results of the intervention might vary, children would benefit from it.

Where can I get early intervention?

There are several places where early invention is available. You might want to check with your child’s current school as some mainstream preschools have trained therapist to come down and conduct early intervention programs for the special needs children. Here are a few other locations that offer early intervention for children as well as other related services such as financial assistance, library of autism related resources, counseling, etc.:

Autistic Association (AAS – Singapore)
BLK 138, Clementi Avenue 5 #01-398 S(120138)
Tel: 6774 6649  Fax: 6774 6957
http://www.autismsg.org
Autism Children’s Centre (Clementi)
Blk 374, Clementi Avenue 4 #01-182 S(120374)
Tel : 6774 6649   Fax: 6774 6957
Email address: autism@singnet.com.sg
Autism Children’s Centre (Simei)
Blk 148, Simei Street 1 #01-121 S(520148)
Tel: 6783 7066  Fax 6783 4855
Email address: autism@singnet.com.sg
Autism Resource Centre (ARC – Singapore)
No.6, Ang Mo Kio Street 44, S(569253)
Tel: 6323 3258
Website: http://www.autism.org.sg
Pathlight school
5, Ang Mo Kio Avenue 10, S(569739)
Tel: 6459 9951  Fax: 6459 3397
Website: http://www.pathlight.org.sg
AWWA Resource Centre
Level 3, ACCESS Building 11 Lorong Napiri S(547532)
Tel: 6511 5310  Fax: 6511 5311
http://www.awwa.org.sg

What could I do to help my child?

Family involvement is essential at this point of time. Family members would have to work closely with the professionals and be involved in the therapy process when necessary, as it is important for family members to reinforce what have been learnt at home so that the invention would be more effective.

Here are also some tips for parents with children diagnosed with ASD:

  • Ensure that the home environment is neat and has clear visual or physical boundaries
  • Take note to minimize visual and auditory distractions
  • Impose a visual time table of what activities to do, when and where will it take place and who is involve.
  • Reward or praise your child if they behave appropriately or learn a new skill
  • Prepare your child before “finishing” of task such as showering, eating etc. E.g do a countdown
  • Give short and concise instruction
  • Use pictures or gestures to show the child what you are trying to convey
  • Speak slower, stressing key words
  • Do not let your child wait for more than 5 minutes
  • Avoid crowded places
  • Allow your child to make choice and do not force your child
  • Take note of all your child non-verbal cues and understand what they represent.
  • Do not condemn meltdown, instead find out the reason why your child is throwing a tantrum so you know how to prevent it in the future
  • Teach your child to complete task by breaking it down into a series of simple steps

As a mother myself, I acknowledged that parenting is not the easiest job and parenting a child with ASD can be even more challenging. Do not be afraid to seek help like counseling or alternative child care if you find the situation too stressful for you. You might also want to join an autism support group whereby you can get lots of information, advice and emotional support from other mothers who are in the same boat as you. My personal message to all parents out there is, do not be discourage, children diagnosed with ASD can learn, grow and thrive like any other typical child would, so do not give up!