What is Autism Spectrum Disorder (ASD)?
Autism Spectrum Disorder (ASD) is one of the most commonly diagnosed developmental disorders in Canada. It is characterized by challenges with social communication skills /interaction and restricted / repetitive behaviours. Autism is known as a spectrum disorder because characteristics vary greatly from person to person and everyone with a diagnosis of ASD has a distinct set of strengths and challenges. It is estimated that around one third of people with ASD also have an intellectual disability.
The cause of autism is not yet understood but doctors believe that it is caused by a combination of genetic and environmental influences. Because autism has been found to run in families this continues to be an area of interest to researchers. ASD is considered a lifelong disorder, however, supports and services can greatly improve how individuals are affected and can improve their ability to function day to day.
How is it manifested?
Signs of autism usually appear by the time a child is 2 or 3 years of age, but it can be diagnosed as early as 12 -18 months of age.
Parents and caregivers may notice that a child has missed language milestones such as not having any language by 16 months of age or no two- word phrases by their second birthday. Some children with ASD may lose language or previously acquired skills.
Children with ASD may experience a variety of sensory sensitivities to sounds, smells, light levels and textures. They can be sensitive to the fit of their clothing and be particular about what they wear. They may refuse to wear clothing that feels too tight or loose, has sleeves that are an uncomfortable length or has irritating tags or seams. Children with ASD may appear to have a high pain threshold and may be able to tolerate extremes of temperature without showing discomfort. Sensitivity to textures can also lead to challenges with feeding as children can develop very strong preferences for certain types of foods and refuse to eat other types.
Gastrointestinal issues, seizures, disrupted sleep patterns, anxiety and depression are some of the common physical and mental health effects experienced by children and youth with ASD.
Some behaviours that parents and caregivers may observe, the child
- may not point out or show things of interest to others. They may not attempt to get the attention of their parent or caregiver.
- may lack eye contact with people who are unfamiliar (directing the child to make eye contact may make them uncomfortable and upset)
- may not engage in back in forth verbal or non-verbal communication with others. They may not respond to the expressions on people’s faces and they may be observed to focus on objects.
- may not wave or greet others spontaneously.
- may appear to be content to spend extended periods of time on their own.
- may not consistently respond to their name being called.
- may avoid or ignore their peers or caregivers when they are approached and attempt to interact with them.
- may move their hands or fingers in repetitive ways, they may rock or pace or may be seen to walk on their toes.
- may show a lack of interest in toys or they may play in an unusual way – lining up toys, spinning or smelling them or repeatedly opening and closing a part of a toy. They may look for a prolonged period at an item and may like to hold things close to their eyes.
- may become preoccupied with light and movement – flicking light switches, opening and closing doors or watching fans and wheels go around. It may be difficult to distract the child or get them to move on from these interests once engaged.
- may experience difficulty with changes to their routine – they may have to perform tasks in a particular order, or they may become upset if things don’t follow the sequence.
Who is affected?
In 2018 the National Autism Spectrum Disorder Surveillance System (NASS) released the statistic that 1 in 66 Canadian children and youth aged 5-17 are diagnosed with ASD. Boys receive the diagnosis 4 times more frequently than girls although the ratio is likely closer to 3:1 as research suggests that girls with ASD, especially those without accompanying intellectual disability may be missed under current diagnostic procedures. Girls have also been found to be diagnosed with ASD at significantly later ages than boys.
How is ASD diagnosed or detected?
The first step in diagnosing ASD is for the family to discuss their concerns with child’s doctor or pediatrician. The doctor or pediatrician will refer the child to a developmental pediatrician for a formal developmental assessment to assess the following areas: social, cognitive, communication and motor skills. ASD is diagnosed when a combination of specific behaviours, communication delays, and/or developmental disabilities is confirmed.
In 2013, the American Psychiatric Association published the Developmental Statistical Manual 5th edition (DSM–5). In previous editions individuals could be diagnosed with Autistic Disorder, Asperger’s Disorder, Childhood Disintegrative Disorder or Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS). The DSM-5 now encompasses all four diagnoses under the umbrella of Autism Spectrum Disorder.
If the child receives a diagnosis of autism spectrum disorder, they will receive an accompanying severity level: Level 1 (requiring support), Level 2 (requiring substantial support), or Level 3 (requiring very substantial support).
Autism Ontario provides information about programs and services available to people with a diagnosis of autism in Ontario. Links are provided to different chapters in regions of the province with local information and events. https://www.autismontario.com/
They also provide a newsletter that can be signed up for using the link below. https://www.autismontario.com/newsletter
Autism Speaks Canada
Autism Speaks Canada is a national Canadian charity that offers information and support to persons with autism and their families. https://www.autismspeaks.ca/
They offer a wide variety of tool-kits in French and English including 100 Day Kits designed to support families following their child’s diagnosis of autism. There are also tool-kits that address challenging behaviour and challenges associated with getting dental care for children with autism. https://www.autismspeaks.ca/science-services-resources/resources/tool-kits/
Geneva Centre for Autism
The Geneva Centre for Autism provides programs, training and resources for people with an autism diagnosis as well as their families and caregivers. https://www.autism.net/
They also offer a newsletter that you can sign up for using the link below. https://www.autism.net/newsletter
Ontario.ca is the official website of the Ontario Government. The most up to date information on the Ontario Autism Program can be found at the link below. https://www.ontario.ca/page/ontario-autism-program
SNOW Inclusive Learning & Education
SNOW is a branch of the Inclusive Design Research Centre at OCAD University that focuses on Inclusive Education and Learning. They provide information and training about technologies and inclusive practices for both in and outside of the classroom. https://snow.idrc.ocadu.ca/
Surrey Place supports children and adults living with developmental disabilities, autism spectrum disorder and visual impairments.
They also provide Coordinated Service Planning for children and youth with multiple and/or complex special needs and their families through the support of a Service Planning Coordinator. https://www.surreyplace.ca/
The content contained in this document is for general information purposes. It is not the intention to diagnose or treat a child.