Autism Spectrum Disorder (ASD)

 

Autism spectrum disorders (ASDs) are  characterised by impairments in social interaction,  communication, stereotypical and repetitive  behavioral patterns and sensory sensitivities.

ASDs include autism, Asperger’s syndrome and pervasive developmental disorder – not otherwise specified. One can come across a diverse range of symptoms and characteristics in ASD ,with varying degrees of  severity. Therefore, the term ‘spectrum which encompasses the various disorders, with a diversity in their characteristics.

Research shows that about 1 in 110 children have an ASD and is more commonly found in boys than girls.   ASD may vary  widely in its severity and symptoms and may go unrecognized, especially in mildly affected children .

 

 

Early symptoms that could indicate presence of an Autism Spectrum Disorder:

 

• absence of  babbling

• absence of pointing by 12  months

• delay in first word(absence of first word by age of 16-18 months)

• unresponsive to name calling

• poor eye contact

• poor social interaction, lack of social responsiveness

• repetitive spinning of wheels of toys or lining up of objects

 

 

Indicators of ASD in later years:

• difficulty in  making  friends and maintaining friendships

• lack of initiative and sustenance of  conversation with others

• lack of imaginative  play

• repetitive and stereotypical use of language(may imitate  phrases heard in conversations or television  without context)

• restricted  interest which may seem abnormal in intensity or focus

• obsessive or compulsory focus on  certain objects or subjects

• compulsion to stick  to specific schedules or rituals.

 

The  three main impairments seen in ASD are:

 

1. impairment in social skills

2. impairment in communication skills

3. repetitive and restricted behavioral patterns

 

Sensory Sensitivities ,as hypo-sensitivity or hyper-sensitivity may be present in people with an autism spectrum disorder (ASD).The sensory sensitivities may be present for sight, sound, touch, taste, smell, balance and body awareness. These sensitivities may have  a profound impact in daily living activities.

 

Causes of Autism:

 

Scientists are not sure about what causes ASD, but it’s likely that both genetics and environment play a role. Genes associated with the disorder have been identified.  Certain studies have suggested that people with ASD have abnormal levels of neurotransmitters in the brain. Thus ASD could result from the disruption of normal brain development early in fetal development caused by defects in genes that control brain growth ,  possibly due to the influence of environmental factors on gene function.  The findings are yet inconclusive  and require further study.  The theory that parental practices are responsible for ASD has long been disproved.

 

 

Assessment and Diagnosis of ASD:

 

A comprehensive assessment of ASD makes it necessary to have a multidisciplinary team approach to facilitate the diagnosis of ASD.The team may include a pediatrician, psychologist, speech language pathologist, a neurologist, a physician and other professionals. The team members may do an in-depth assessment of the child’s growth, behavior, speech and language with a focus on the child’s social skills and pragmatic language (i.e. use of verbal and non-verbal language in different situational contexts) and cognitive assessment.

The diagnosis of an ASD will depend on the features exhibited by each disorder and may be classified as:  Regardless of the specific diagnosis given, individuals with an ASD will experience difficulties in many different social situations such as school and work.

 

 

Autistic disorder

 

Individuals with impairments in social interaction and communication , restrictive and repetitive interests, activities and behaviors, evident prior to three years of age, are generally diagnosed as having an autistic disorder.

 

Asperger’s  syndrome

 

Children with Asperger’s syndrome tend to exhibit milder symptoms of autistic disorder. They generally do not delays in language development, instead have  unusual language skills when it comes to vocabulary and grammar. however, they tend to exhibit lack of sustenance in conversational skills.  As speech usually develops at the expected age, Asperger’s is often diagnosed later than Autistic disorder.

 

Pervasive Developmental Disorder – Not Otherwise Specified (PDD-NOS)

 

A child presenting with a marked social impairment, but failing  to meet full criteria for either autistic disorder or Asperger’s syndrome, may be diagnosed as PDD-NOS. These children may exhibit communication difficulties and/or restricted and repetitive interests, behaviors.

 

 

Treatment and Intervention in Autism

There is no cure for ASDs.  interventions are designed according to the symptoms .The ideal treatment plan coordinates therapies and interventions that meet the specific needs of individual children.   Professionals agree that the earlier the intervention, the better the outcomes.

 

 

Speech language Intervention:

 

A speech pathologist can help to learn to use language to communicate ,which may in turn improve the ability to form relationships and lessen social isolation .Individualized programs are drawn to facilitate spontaneous communication in functional activities, understanding of verbal and non-verbal communication, facilitate access to various support services, literacy and academic instruction and develop conversational skills.

Educational/behavioral interventions: structured and  skill-oriented training sessions can help children develop social and language skills.

Family counseling for the parents and siblings of children with an ASD may help families cope with the everyday challenges of living with a child with an ASD.

 

 

 

Accessing funding in ASD

 

After  the paediatrician diagnoses  ASD, a referral will be provided to see an autism advisor.

An autism advisor will discuss and provide information with regards to eligibility criteria and your Childs needs, funding and support services.

After a check on eligibility, you will get a Letter of Introduction that will state your eligibility for funding.

You may then access a speech pathologist from the panel of Early intervention Service providers. The Speech Clinic is listed with the panel of Service Providers for ASD support services.

 

 

 

Early Intervention funding Package:

 

 

The funding is available to children who have been seen by an autism advisor before their sixth birthday and are found to be eligible by the advisor.

Children with ASD in the age bracket of 0 to 6 years , who are eligible for the early funding package, can access the support services of various allied health professionals as the psychologist, speech pathologist……  The funding makes the provision for accessing the funds allocated until the child turns 7 ( i.e. until their seventh birthday)

 

 

 

Medicare Items :

 

There are Medicare items that are available for children aged under 13  for assessments and towards intervention /treatment if aged under 15.

to be able to access rebates from Medicare, the  referral needs to be made by the Paediatrician.

Medicare provides 4 rebatable assessment sessions for children aged under 13 and up to 20 therapy sessions until the child turns 15.

Children with ASD are entitled to an EPC /CDM plan as autism is considered to be  a chronic condition.

 

 

Medicare items for speech pathology:

 

General Practitioner can make a referral for speech pathology sessions under the EPC (Enhanced Primary Care Plan) or the Chronic disease management Plan ,for children and adults with chronic care needs. Medicare rebate is available for 5 speech therapy sessions per calendar year.

rebates may also be claimed from your private health provider, depending on the extras covered by the health fund. To find out more about the rebates, you may contact the private health provider.

Medicare and private health insurance rebates may not be claimed for the same speech therapy session.

Rebates for Medicare and private health insurance can be claimed via the HICAPS at the speech Clinic.