By Nicole Chapman
April is here, bringing spring, flowers, and Autism Awareness Month. On social media, the American-based charity Autism Speaks reminds us to “Light It Up Blue” to raise both awareness and acceptance of Autism Spectrum Disorder, but surprisingly many people still do not know exactly what autism is, and what it looks like in young children.
Autism Spectrum Disorder (ASD) affects 1 in 66 children in Canada, according to a 2018 report by Public Health Services Canada.
It is a neurodevelopmental disorder, which means that the brains of children born with autism develop differently from their peers, resulting in deficits, delays, or regressions in communication, language, and social skills. Individuals with autism also have intense focused interests and unusual sensory preferences/sensitivities, and engage in repetitive behaviours.
The average age of diagnosis is 4 years old, but children can be reliably diagnosed with autism as young as 18 months old. Boys are affected approximately 3-4 times as often as girls, and younger siblings of children diagnosed with autism are at a 5% higher risk of also being diagnosed with autism.
Diagnosis is made based on behavioural observation and assessment, as there is currently no medical test for autism. Importantly, this also means that since we do not know the definitive medical cause(s) of autism, there is also no medical cure.
Some early indicators of a future autism diagnosis can be detected by parents as early as 6 months old, such as limited engaged eye contact and smiles.
By 9-12 months, these children also may not babble or engage in reciprocal sound play with adults, and may struggle to communicate effectively with gestures like pointing, showing, reaching, and waving. They may also be unresponsive to their own name and simple spoken instructions.
Children with autism also tend to engage in scripted, repetitive play instead of imaginative pretend play, and may use their toys in ways that are different from their typically developing peers. For example, a child with autism may line up their toys or fixate on only spinning the wheels of a toy car with their finger, rather than driving it around.
Autism exists on a spectrum, and affects each individual differently. Some early symptoms in children who develop speech may be more subtle. These children may struggle more than expected with transitions and change, leading to meltdowns and behavioural concerns that are more extreme than their typical peers.
Repetitive play may look more like re-enacting favourite TV shows or movies line-by-line. These children may also struggle to make same-aged friends, and may prefer to interact more with adults.
Although there is no medical cure for autism, children can make significant gains with Applied Behaviour Analysis (ABA)-based therapy, the most evidence-based treatment for autism, according to the 2015 National Autism Center Standards Report. ABA is an applied science that employs proven principles of behavior to improve socially significant human behaviour.
Although “behaviour” is in the name, ABA-based therapy is not solely focused on treating problematic behaviours, but is used to teach a wide variety of skills including language/communication skills, play/social skills, functional life skills (feeding, dressing, toilet training), fine/gross motor skills, early cognitive skills, academics, and more. Effective early intensive ABA programs are designed and supervised by Board Certified Behaviour Analysts (BCBAs), are implemented for 10-20 hours per week by specially-trained “tutors” called behaviour interventionists (BIs), and may include collaboration with a speech-language pathologist and/or an occupational therapist (OT).
Parents who are concerned about their little one can complete an online screener at https://www.autismspeaks.org/screen-your-child and share the results with their primary care physician if it indicates that the child should have further evaluation. Locally, Autism Community Training (https://www.actcommunity.ca/information) provides a wealth of information to parents, professionals, and para-professionals on autism and evidence-based treatment.
Nicole Champan is a Behaviour Consultant/Board Certified Behaviour Analyst (BCBA) living in Squamish. She has been supporting individuals with autism and developmental disabilities since 2004 in a variety of settings, including working as an education assistant for 5 years.
