What is ASD?
According to the World Health Organization (WHO), 1 in 160 children has autism.
Autism spectrum disorder (ASD) is a neurodevelopmental disorder that is present in childhood and accompanies the person throughout their life. As its name indicates, it is a spectrum. It is varied and broad, so it cannot be generalized. Since we are not going to find two identical people, and with the same characteristics, each one from their particularity will have a way of being, communicating, thinking and acting, where the information process can occur in a different way.
In ASD we are going to find people who may have an associated intellectual disability and others who do not. Likewise, a large group of people with the condition may present a specific sensory profile, which has an impact on their own way of processing the different stimuli in the environment (Bogdashina, 2016).
It is important to highlight that the condition of ASD cannot be limited to a clinical vision of a disorder or an abnormal form of development, but on the contrary, as an expression of human diversity; in which the person travels a different route in the process of socio-cultural construction.
People with ASD present difficulties in 3 aspects:
Communication. Verbal language is not always the best form of communication for people with this condition; they may have different linguistic levels. A high percentage may present difficulties when communicating and they express this in various ways:
Comprehensive language:
- Understanding messages orally.
- Difficulty understanding non-verbal communication (gestures, indications, emotional expressions).
- Although they understand words separately, it is difficult for them to integrate them into a sentence and understand the full meaning.
- They have difficulty understanding jokes, jokes, metaphors or sarcasm.
Expressive language:
- They may have difficulty expressing what they feel or what they think
- They may find it difficult to finish a conversation when it is a topic of interest to them.
- They may use excessively formal language.
- Sometimes they may use language that does not fit the context.
- Some use intonation that is unusual.
Social interaction.
- They may have difficulty adapting their behavior to different contexts.
- Maintaining a conversation can sometimes be difficult.
- In some cases, there may be difficulty in non-verbal communicative behaviors, such as gestures, facial expression or maintaining eye contact.
- They can be very social, but sometimes they are not clear about how to interact with others.
Repetitive and restricted interests.
- Your interests in topics and/or objects can occupy an important part of your time and sometimes this will interfere with the activities you carry out.
- These behaviors can be verbal or non-verbal.
- They may have repetitive behaviors. (always follow the same routes or always greet and say goodbye with the same words, dress the same way, always go to the same cafeteria, etc.).
- Their way of thinking tends to be inflexible and concrete, so activities that require attention to details and repetition of patterns are performed very well.
Warning signs during the first 3 years of life:
According to the World Health Organization (WHO), 1 in 160 children has autism.
Autism spectrum disorder (ASD) is a neurodevelopmental disorder that is present in childhood and accompanies the person throughout their life. As its name indicates, it is a spectrum. It is varied and broad, so it cannot be generalized. Since we are not going to find two identical people, and with the same characteristics, each one from their particularity will have a way of being, communicating, thinking and acting, where the information process can occur in a different way.
In ASD we are going to find people who may have an associated intellectual disability and others who do not. Likewise, a large group of people with the condition may present a specific sensory profile, which has an impact on their own way of processing the different stimuli in the environment (Bogdashina, 2016).
It is important to highlight that the condition of ASD cannot be limited to a clinical vision of a disorder or an abnormal form of development, but on the contrary, as an expression of human diversity; in which the person travels a different route in the process of socio-cultural construction.
People with ASD present difficulties in 3 aspects:
Communication. Verbal language is not always the best form of communication for people with this condition; they may have different linguistic levels. A high percentage may present difficulties when communicating and they express this in various ways:
Comprehensive language:
- Understanding messages orally.
- Difficulty understanding non-verbal communication (gestures, indications, emotional expressions).
- Although they understand words separately, it is difficult for them to integrate them into a sentence and understand the full meaning.
- They have difficulty understanding jokes, jokes, metaphors or sarcasm.
Some signs that may occur in social interaction skills:
- Limited use of eye contact
- Diminished or absent social smile, the person does not usually smile when faced with friendly smiles generated by adults or only smiles if they are tickled.
- Little use of facial expressions to communicate.
- Demonstrates little shared pleasure in different social activities, with peers or adults.
- Limitation or lack of response to being called by name.
- He does not give flashy objects or toys to other people in order to share his interest, or only gives when he needs help.
- Does not show striking objects or events to other people, or does so very sporadically.
- He does not seem to follow the direction of the adult's gaze or his pointing to locate an object.
- The child has few social approaches to other people, or they only appear in situations where he needs help.
Support levels:
Currently, the DSM V refers to 3 levels of support that require
people with ASD, both for the area of communication and social interaction as well as repetitive and restricted interests.
People who are within the autism spectrum will need support throughout their lives, the intensity of which may vary. This will depend on the needs and difficulties that the person presents in communication and social interaction and in repetitive and restricted interests. Here it is important to highlight that support may be low at one time, but at another it may be high or vice versa. This is related to the abilities that the person has and the demands that the environment demands of them at certain times, where in a space or at an age of development, support may vary. These levels of support are generally described below:
Very substantial support (high)
Social comunication:
Marked commitment to verbal and non-verbal communication skills. (e.g. absence of speech)
Initiates no or very few interactions (only to satisfy basic needs)
He does not usually respond to social approaches, or only responds to those who are very direct.
Restricted interests and repetitive behavior:
Behavioral inflexibility, extreme difficulty coping with changes, or other restricted/repetitive behaviors markedly interfere with functioning in all spheres.
Very substantial support (medium)
Social comunication:
The person has developed some type of language, but only communicates in simple phrases.
Initiates interactions primarily related to your primary interests.
Responds in a particular or reduced way to the approaches of others.
Restricted interests and repetitive behavior:
Inflexibility of behavior and thinking is observable in different contexts and people, however its level of interference is lower than at the level of very substantial support.
Requires support (low)
Social comunication:
The person has developed skills to construct complete sentences and engage in communication however they may still fail in the back and forth flow of the conversation.
It may make it difficult to establish friendships or respond to certain social overtures from other people.
Restricted interests and repetitive behavior:
Inflexibility of behavior and thinking can interfere in one or some specific contexts (example: study, work, family life). Or the person may have difficulties planning, organizing their time or completing their tasks.
What to do if you suspect ASD:
When faced with warning signs of suspected developmental disorders, it is necessary for the family to attend a growth and development appointment. It is recommended to follow the route established in the clinical protocol for diagnosis, treatment and comprehensive care route for boys and girls with autism spectrum disorder. https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/DE/CA/Protocolo-TEA-final.pdf
Early detection. There are several tools that are used to diagnose ASD, one of them is the M-CHAT R (Modified Checklist for Autism in Toddlers), which seeks to detect children between 16 and 30 months.
Application of specific tests for ASD diagnosis. There must be a team of trained professionals who can observe and interact with the person, based on the application of observation tests that allow information to be collected, as well as a behavioral analysis. Among others, there are tests such as the ADIR (Autism Diagnostic Interview), ADOS (Autism Diagnostic Observation Scale), to determine according to the DSM V criteria, if the person may have the condition of Tea.
Intervention. Once the ASD condition is confirmed, this person must enter an intervention with professionals, who will be facilitators and generate strategies that help in the process of the child, adolescent and adult, for this the strengths and weaknesses must be known, and from They set clear objectives, in the short, medium and long term.
Early and timely intervention plays a vital role in the process of the person and their family. It is essential to consolidate a personal plan in which social interaction skills, play, management of possible challenging behaviors, autonomy skills, cleanliness, personal development, among others, are stimulated.
Such stimulation must be comprehensive and intensive, taking advantage of different programs that currently have extensive scientific evidence, for example the Denver Model of early care.
Likewise, it is essential to consider that there are three areas of special influence on the quality of life of the person with ASD and their family: communication, behavior and leisure (Simarro, 2015). In this sense, every comprehensive program must establish objectives and concrete actions that favor the development of skills, provision of support and the adaptation of environments necessary in these areas and the other dimensions of the quality of life of the human being (personal development, physical well-being, emotional well-being, rights, personal development, interpersonal relationships, social inclusion and material well-being.
Participation spaces. Participation in natural and everyday spaces is essential, where there is the opportunity to teach skills, share and learn. These spaces refer to the places that the child, adolescent and/or adult attends, where they can interact with people their age, and enjoy spaces such as parks, shopping centers, school, restaurants, university, work, among others.
For the success of the processes described above, it is necessary to take into account:
Trained professionals, who have knowledge about ASD, who provide strategies and tools to the person and their family. The training of both professionals and families is necessary to generate intervention and support programs based on scientific evidence, and it also helps to demolish myths and stigma that generally exist about ASD.
2. Know and identify the person as a being with strengths, weaknesses, dreams and goals.
3. Remember and keep in mind the person's life course.