Supporting Your Autistic Child: Next Steps for Parents

     'Flapping arms, avoiding conversations, and avoiding eye contact' might sound unfriendly at first. For some children, it is impossible to notice anything unusual just from the outside. However, through deeper conversations or closer looks, you might realize that certain things seem out of the ordinary.

Sometimes, they repeatedly focus only on specific objects, as if completely disconnected from everything else. These signs are concerning. What should parents do to observe and care for their child when they find out their child has autism?

The Meaning Behind the Word 'Autism'

     The word 'Autism' originates from a Greek word meaning 'self'. It was used by Swiss psychiatrist Eugen Bleuler to describe the behavior of individuals who withdraw from everything to enter their inner world. Therefore, autism is a condition that makes patients prefer isolation within themselves, appearing unimaginative, almost like robots.

What is Autism?

     Autism or 'Autism Spectrum Disorder' (ASD) is a developmental disorder affecting the brain and nervous system. It impacts language development, communication, and social interactions with others, and is characterized by repetitive behavioral patterns and narrow, intense fixation on specific things. Symptoms vary widely across the spectrum.

How to Observe Symptoms in Your Child

• Delayed speech in early childhood, along with little to no eye contact.
• Lack of cooperation at school, preferring isolation.
• Failure to point out objects to share interest with others.
• Using 'gibberish' or unrecognizable language.
• Preferring solitary play over playing with others.
• Rarely imitative or engaging in pretend play.
• Engaging in purposeless repetitive behaviors, such as hand-flapping, toe-walking, spinning in circles, or lining objects up.
• Obsession with specific topics, such as a extreme interest in national flags to the point of knowing every country's flag.
• Lack of flexibility, becoming anxious when changing the route home.
• Difficulties with emotional regulation.
• Hypersensitivity to sensory inputs like sight, taste, smell, touch, and vision, resulting in 'sensory avoidance' behaviors; conversely, they might also respond slower than usual.
• In cases of hyposensitivity (under-responsiveness), the child will actively seek more sensory stimulation.

Upon entering adolescence, they may face social adjustment issues, leading to alienation and making them easy targets for bullying, which can result in stress and depression.

Factors Leading to Autism

Although the exact cause of the condition remains unclear, several factors are known to contribute to Autism Spectrum Disorder, including:

1. Genetics

     Autism is a condition that can be passed down through genetics. In some cases, advanced parental age at conception poses a higher risk. Autism occurs significantly more often in boys than in girls. Evaluations often reveal brain impairments, particularly in regions linking social skills and emotional processing.

2. Environment

     Toxic environments, alongside complications before, during, and after birth, directly affect the child. Factors like oxygen deprivation during delivery, premature birth, chemical imbalances in the body, or exposure to lead post-delivery increase the likelihood of developing autism later in life.

Virtual Autism

     Even without typical congenital brain developmental abnormalities, a child can still develop autistic-like behaviors. If left in an unsuitable environment with improper care, this condition can manifest. 'Virtual Autism' refers to a state where a child lacks human interaction, resulting in delayed communication and social development. With proper attention, play, and regular conversations, the child can return to normal.

Diagnosis

Physicians begin with a medical history review before using behavioral observation, interaction assessment, and comparing developmental milestones against peers. Parents can generally notice unusual development starting from 1 year of age.

• Behavioral Observation during Interaction: Checking for eye contact or responses to their name. If they do not turn, look, or show any response, abnormalities may be present.
• Other Medical Evaluations: Including hearing and vision tests, genetic screening to identify defects, and neurological/psychological assessments. Following this, a developmental-behavioral pediatrician will formulate an appropriate treatment and therapy plan.

Levels of Severity

Generally, it can be categorized into 3 levels:

• Mild Autism: Also known as the High-functioning group, individuals possess normal or superior intelligence. They sometimes carry hidden talents or savant abilities but still lack social skills and difficulty reading people's emotions and facial expressions. This encompasses sub-syndromes such as Asperger syndrome.
• Moderate Autism: The intermediate group where language, communication, and social learning are significantly delayed, but they remain capable of self-care to an extent. This accounts for 50% - 75% of cases.
• Severe Autism: The group with severe developmental delays, often accompanied by co-occurring conditions like intellectual disability. This is a critical stage requiring close care from pediatricians, parents, and surrounding individuals.

Co-occurring Conditions

     Individuals with autism often experience co-morbidities such as epilepsy, depression, anxiety, or ADHD. Some experience sleep disorders and self-harming tendencies; therefore, medical professionals and guardians must monitor them closely.

Source: World Health Organization (WHO)

Treatments for Autism

1. Medication

     Physicians utilize medications to balance neurotransmitters to manage behavioral expressions. Generally, medical teams use combination therapies tailored to the specific developmental limitations.

2. Speech Therapy

     Speech therapy targets communication deficits, aiming to enhance language comprehension and speech. This intervention is also used for individuals who have lost communication abilities due to a stroke.

3. Communication Skills Training

     Therapists incorporate group dynamics to reinforce positive social interaction and self-care skills, empowering children to communicate their needs and integrate with others.

4. Occupational Therapy

     Providing dedicated spaces for children to develop social interactions through play. Specialized occupational therapy programs for children with special needs are utilized to stimulate development. This offers excellent results in motor skill training and optimizes brain neural connections.

5. Promoting Development at Home

     Following professional care from a pediatrician, guardians should collaborate to build an environment that facilitates learning, such as reading illustrated storybooks together.

Read more: Occupational Therapy and Special Needs Child Development

Autism and Genius: A Thin Line Between Worlds

     'Woo Young-woo', whose name reads the same forward and backward, stands as a prominent representative of the autistic community. Sometimes, we might not realize that subtle autistic traits can be hidden among seemingly ordinary individuals. Many times, beneath a quiet or detached exterior lies a hidden genius waiting to emerge once given the proper direction and understanding.

Pediatric Center is Ready to Care Your Child

     Pediatric Center at Ramkhamhaeng Hospital is dedicated to supporting children's development so they can grow and thrive happily in society. Guided by clinical psychologists, occupational therapists, and pediatricians specializing in child behavior, we firmly believe that every child harbors a unique spark waiting to shine brightly when provided with the correct, specialized care.