What is Autistic Spectrum Disorder (ASD)?

Autistic Spectrum Disorder (ASD) is a pervasive developmental disorder that is identified through a significant amount of abnormal or impaired development in social interaction and communication skills and a very restricted range of activities and interests.

What are some of them most common features of Autistic Spectrum Disorder (ASD)?

• Children on the spectrum often have difficulties socialising and engaging with friends. 
• Some of these children may have difficulties developing and maintaining relationships due to them having difficulties with empathy and relating to others. Their social awareness and social skills may be limited and they can have difficulties understanding and responding to various social situations. 
• Children on the spectrum sometimes have difficulties understanding the world around them and have difficulty knowing how to engage appropriately in it. They often have limited or absent imaginative play skills.
• Some of these children have difficulties understanding both verbal and nonverbal communication e.g. gestures, facial expressions, body language. They can find it difficult to change games and want to continue to do their own thing regardless of what others want. They may not have an understanding of instructions, questions or jokes and therefore appear vacant, defiant or uninterested
• Poor understanding of “normal” of social interaction. With friends and family and as a result they may have difficulties developing and maintaining relationships.
• Some children on the autistic spectrum will have stereotyped or repetitive speech, motor movements or use of objects (e.g. echolalia, repetitive use of objects, hand flapping).
• Some of these children will have the need for excessive adherence to routines and rules. They are very resistant to change, and rigid in their routines.
• They may present with hyper- or hypo-reactivity to sensory input. They may have an unusual interest in sensory aspects of the environment.
• The child may show a severe preference for solitary play and actively avoid others around them. The child may not be able to initiate conversation with others even if they appear to want to.
• A child on the autistic spectrum can be impulsive or aggressive.

Some strategies that can support the child with Autistic Spectrum Disorder (ASD) 

• Routines, planned and structured events are good. Provide visual information about the activity and allow they child to be aware of what is happening in advance where possible.
• Take the time to establish a good knowledge of the child’s strengths and weaknesses, interaction preferences and early signs of distress so that early intervention and anticipation can occur to diffuse potentially difficult situations. 
• Make good use of social stories to help the child learn how to act in specific situations. These can also be used to help the child learn how to initiate communication with peers.
• Where ever possible make use of visual cues to describe the daily routine. These visual cues can help prepare the child for a change in their routine.

How can Therapy help support a child with autistic spectrum disorder?

• Occupational Therapy can help a child expand their abilities by helping them develop a range of skills across all areas.
• Providing advice and suggestions to the school to help the child develop their social skills e.g. through the use of social stories and role play. 
• Occupational Therapy can assist supporting the child with their transitions through school years and moving to different schools at various stages through and liaising with teachers and other professionals as required.
• Occupational Therapist can help provide visual cues that can be utilised to support routines, introduce new activities, or a change in tasks.
• Providing ideas and education around how to help the child structure their daily routines so that they feel comfortable and able to manage their daily acuities and cope with changes to their routine.
• Occupational Therapist can help the child develop and improve their strength and coordination which will enable them to participate in a group activities e.g. sports groups. These skills are valuable to the child and encourages them to participate in social situations.
• Occupational therapy can help improve the child’s sensory processing skills so they are able to cope in a wider variety of activities and environments.
• An Occupational Therapy assessment will help the family to understand how the child is processing, understanding, learning and using language and communication and this will help them to develop a better understanding of their child and how they engage in the world.
• Occupational Therapy will provide the family and school with strategies and techniques to help improve and enhance communication with the child.
• By helping the child to understand the environment, routines and language, they will be more able to participate more effectively with self-care and daily activities.
• Occupational therapy can help improve and enhance the child’s communication and social engagement skills. These include helping the child develop their vocabulary and conversation skills including turn taking and open questions. The development of concept skills, especially abstract concepts, such as time (e.g. yesterday, before, after). The use of non-literal language, developing an understanding of metaphors and sarcasm.
• They can help the child to understand different emotions and to recognise these emotions in themselves and others as well as improving their understanding of empathy (i.e. being able to identify with someone else’s feelings).
• Occupational Therapy can introduce the use of visuals which can be used to help the child with understanding and their ability to express their needs, wants and thoughts. They can enhance verbal and non-verbal communication including natural gestures, speech, signs, pictures and written words.
• Therapy can teach alternative forms of communication such as the Picture Exchange Communication System (PECS) and Key Word Sign whilst verbal language is developing. Make use visual information to help understand, organise and plan the routine for the day.

What are some of the difficulties a child with  Autistic Spectrum Disorder (ASD) may have difficulties with if not provided witht the right support

• Engaging and following instructions within the home, nursery or school may be difficult.
• The child may become agitated and frustrated at not having the language skills to be able to express themselves effectively.
• The child may struggle socially and not be able to play successfully witht heir peers. 
• They may have difficulties understanding jokes and figurative language during interactions with others.
• They may struggle with verbal communication, learning to talk, speak intelligibility and with clarity and meaning.
• The school day may be too difficult to manage due to poor strength and endurance.
• Participation in sporting activities may be too difficult, resulting in an inactive lifestyle, increasing the risks of other health related issues such as obesity, diabetes, cardiovascular disease or similar conditions.
• The child may be at risk of being bullied when others become more aware of the child’s difficulties – at times the child can be scapegoated as they try hard to “fit in”
• They may experience difficulties with fine motor skills (e.g. writing, drawing and cutting) due to poor core stability, meaning they do not have a strong tummy muscles to support the use of their arms and hands.
• They may have difficulties completing self-care tasks (e.g. doing up shoelaces, buttons, zips, using cutlery).
• The child may have difficulty with self-regulation and behaviour. They may be unable to appropriately calm themselves and attend to a task for an extended period of time.
• They may have difficulty following the school  curriculum because they are unable to attend to tasks long enough to complete the assessment criteria, if the work then provided it too easy or difficult it may result in unwanted behaviour.
• The child may become social isolated because they are unable to cope in group situations or busy environments. This again affects their ability to form and maintain friendships.
• The child may develop stress and anxiety leading to difficulty reaching their academic potential and impacting on their emotional health and well-being.
• The child may struggle with social communication, such as eye contact, appropriate distance when talking to someone, turn-taking within a conversation, this can make developing friendships even trickier. 
• The child may struggle with academic performance, especially in relation to their literacy skills such as reading and writing and coping in the classroom situation with the rules; noises and various distractions.