Frequently Asked Autism Questions
Last Updated October 2001

• What is Autism?
• What Causes Autism?
• Who Does Autism Affect?
• What Does Autism Look Like in Young Children?
• How Does Autism Affect High Functioning Children And Those With Asperger Syndrome?
  • Social Deficits
  • Perseverating
  • Imposing routines in activities
• Is There A Cure For Autism?
• What Should I Look For In An Early Intervention Program?
• Are There Interventions for Older Children and Adults?
• Will My Child Ever Be Able to Live Independently?
• Is There Help For People With Autism?
• What Can I Do As A Parent?

What is Autism?

Autism is a neurological disorder that affects the functioning of the brain. There are no medical tests for autism. It is a diagnosis based on a child’s behaviours. Often it is evident before the child turns three years old. It is a spectrum disorder, which means there is a wide variation in what autism can look like. Autism Spectrum Disorder (ASD) includes Autistic Disorder, Asperger's Syndrome Rett's Syndrome, Childhood Disintegrative Disorder and Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS). The 'classic' form of autism is referred to as Autistic Disorder. These individuals are often very withdrawn and cannot talk. This with other ASD's may speak but have great difficulties in holding a meaningful conversation. Some people with ASD have below average or above average intelligence. One of the hallmarks of ASD is that a person's abilities will be very uneven. For example, capable of doing a puzzle above their age level but unable to discriminate colours. They all share a profound social disability in that they have great problems interacting appropriately in ordinary social situations.

What Causes Autism?

Poor parenting does not cause autism, although its symptoms can be confused with abuse or neglect. Autism is a biological condition that can be triggered by a number of factors, most of which are not yet understood. One cause is rubella, which can affect the fetus if the mother is exposed during pregnancy. There are also chromosomal abnormalities including Fragile X and conditions that affect newborns, like infantile spasm, herpes simplex encephalitis and other rare conditions, are also associated with autism. Some people believe that immunizations may cause autism but recent research does not support this theory.

The genetics of autism is now being intensively researched. There is general agreement that there is unlikely to be one single gene that causes autism. Instead it is likely to be an interplay of a number of genes. If a family has one child with autism, the risk of recurrence with other children ranges from 3-8 percent.

Who Does Autism Affect?

Autism occurs across the world, in every social class and every race. 4 out of 5 people diagnosed with autism are male. There is controversy surrounding just how common autism is. The latest international research points to about 1 person in every 160 as having an Autism Specturm Disorder and 1 in 600 as having Autistic Disorder. Some of these people, especially those who have been previously misdiagnosed with other conditions because they are so high-functioning may be receiving inappropriate psychiatric services or interventions for the learning disabled that do not address the central probelm of autism. All could benefit from interventions geared to their individual needs.

What Does Autism Look Like in Young Children?

One of the great difficulties in diagnosing autism is that you can not tell if a child has autism simply by looking at them. Instead, you have to observe the person’s behaviours. The following may be some signs of autism. One need not have all of them.

• Seems disinterested in sharing enjoyment with others.
• No speech or very few words; appear to understand very little.
• May seem deaf. Doesn't respond to speech.
• Unusual sensitivity to light or sound; flickering lights or a vacuum cleaner can provoke uncontrolled screaming.
• May walk on their toes. When excited may flap hands.
• Usually do not make eye contact as typical people do.
• May resist cuddles and hugs.
• Frequently tantrum when required to do anything new or when asked to change activities without advance warning.
• May line up toys and obsess on strange objects.

How Does Autism Affect High Functioning Children And Those With Asperger Syndrome?

While autism is difficult enough to detect in young children, it can be very complex to diagnosis in older children especially when the child appears very intelligent and can speak. According to Lorna Wing, an internationally recognized researcher, children on the spectrum:

"share a triad of impaired social interaction, communication, and imagination, associated with a rigid, repetitive pattern of behaviour...The triad can be recognized at all levels of intelligence and can occur alone or together with any other physical or psychological disorder." -- Wing, L. (1996) Autistic Spectrum Ddisorder. British Medical Journal, 312.

The subtle but equally problematic characteristics of 'high-functioning autism' or Asperger's Syndrome include:

Social Deficits:
Although they may be very intelligent, they are socially naïve. They have great difficulty understanding that someone else may have a hostile intent to them and will often follow instructions clearly aimed at getting them into trouble. This presents particular problems for school age children who are often the victims of bullying.

Perseverating:
Many children become expert on very narrow topics on which they amass detailed information that they repeat excessively. They do not understand the concept of turn taking and are insensitive to the need for other people to have their interests integrated into a conversation.

Imposing routines in activities:
For example, insisting on one route to school without tolerating deviations. Insisting on all doors and windows being closed, regardless of the weather.

Is There A Cure For Autism?

There is no known cure for autism. However, autism can be treated and those with autism can learn to communicate and to share in family life. Most parents try a variety of interventions to find what is effective with their child. Research has shown that Applied Behavioural Analysis (ABA) can be very successful with people with ASD, ideally at as early an age as possible.

The Government of British Columbia is establishing an Early Intensive Behavioural Intervention Program for preschool children which uses the teaching methods and principles of ABA. It incorporates multiple intervention techniques including Speech/Language Pathology, Occupational/Physical Therapy, Positive Behavioural Support and natural teaching strategies.

Some people who appear classically autistic as young children are able to overcome their symptoms and achieve high functioning, usually as a result of their needs being met through an effective early intervention program. Research has shown that the functional ability of most people tends to improve with age. However, if they are not taught communication skills, frustration can lead to severe behaviour problems.

What Should I Look For In An Early Intervention Program?

Sunny Hill Health Centre for Children in Vancouver has done an excellent synopsis of an early intervention program as researched by G. Dawson & J. Osterling. (Dawson G. & Osterling, J. (1997) Early Intervention in Autism In M.J. Guralnick, (ed.) The Effectiveness of Early Intervention) These include:

• Highly structured, predictable and routine
• Direct interaction with a teacher, 1:1 or 1:2 at first
• Minimal distractions
• Holds the child’s attention with repetition, predictability, interesting materials
• Provides modeling opportunities
• Uses physical prompts
• May require hand over hand guidance at first and gradually move to modeling or a prompt
• Teach social behaviour first with an adult then gradually move to practice it with 1-2 other children
• Change only one feature of the environment at a time during the process of generalization
• Involve the family
• Child is in the program at least 15 hours a week
• Use of visual cues
• Use of written words, pictures, visual schedules
• Give warning of changes
• A functional analysis of behaviours if problematic

Are There Interventions for Older Children and Adults?

• If people with autism have not had access to appropriate intervention programs when they are young, they can exhibit severe behavioural problems as they reach puberty, particularly if they have never developed language. Frequently, outbursts can be linked to their frustration due to their lack of communication skills.
  
  
• One of the important roles of a behavioural consultant is to come up with ways of allowing a person with autism to communicate their needs. Often this is accomplished through building a visual communications system.
  
  
• It is essential to set up a consistent behaviour management plan where clear limits are set for behaviours but where the individual with autism has the opportunity to make meaningful choices about how they are going to live their life. The person with autism’s physical health should not be neglected. Often behavioural outbursts can be traced to concrete physical ailments which have gone undiagnosed.
  
  
• For children who can communicate verbally but engage in inappropriate or dangerous behaviour, there are a variety of interventions that can allow them to better understand the implications of what they are doing. Social skills training is essential for many very able people with autism.

Will My Child Ever Be Able to Live Independently?

• Many people with autism do flourish and go on to hold responsible jobs and live independently. Others have the intellectual abilities to do the same jobs but are held back by their inability to adapt socially to the stresses of everyday life.
  
  
• The focus of every intervention program for the person with autism should be to work on helping them adapt to living in society. Their ability to function is far more important than how they do on an I.Q. test.

Is There Help For People With Autism?

• There is help for people with autism but it varies throughout B.C. For a description of the problems currently facing people with autism in British Columbia, you can contact the Autism Society of B.C. for the following briefs presented to the Government: "The Crisis in Services for People with Autism in British Columbia", and "An Autism Care Pathway: The Need for 'Cradle to Grave' Treatment of Children and Adults with Autism Spectrum Disorders".
  
  
• For more information on the services and therapies currently offered in British Columbia, please contact our Information Resource Worker.

What Can I Do As A Parent?

• The priority for parents has to be to educate themselves about autism and to become a strong advocate for their children. No-one knows your child better than you. No-one loves your child as much as his or her parents.
  
  
• Treat your child as normally as possible. Have high expectations of him or her. Make it clear to professionals that you are an essential part of your child’s team.
  
  
• You will need guidance at first. Other parents can assist in pointing you in the right direction to competent professionals. They can also shed light on the intricacies of the school system and the way in which services are delivered in your community.
  
  
• Join an ASBC Community Group to learn more and meet others with an interest in ASD.

Your Feedback Matters to Us

We are always looking for new ideas and/or new ways to do things. If you have an idea or a service which you think might be beneficial to the membership, please send us an e-mail. We'd love to hear from you. =)