(This note used to pinned atop the consolidated "School Aged Children" board, before the board was segmented into ages 5-8 and 8-18. It can still be found on the 8-18 year old board, but I hope it can also be pinned here. Early primary school is a very common time for the signs of ASD to really come to the forefront).
In the past, I have posted related notes on the other kids & toddlers boards and have shared the information below in various forms on EB. I am trying to raise awareness of the warning signs of autism spectrum disorders (ASD), which are now Australia's most common set of developmental disorders. Now that another school year heading toward a close, it's a good time to remind parents of what some of the potential flags are in school aged children.
If you click on the link in my signature, you can see why I am particularly passionate about raising awareness of ASD.
ASD can be tricky to detect sometimes because there is no set profile for what autism looks like. It's called a spectrum precisely because the blend of symptoms, and the degree to which they affect a person, can vary dramatically. What people with ASD share are (varying degrees of): (1) differences/difficulties in social interaction, (2) differences/difficulties with communication, (3) restricted/repetitive interests and behaviors. Almost always, they show some sensory sensitivities as well.
Signs of possible ASD in school-aged children
It is not uncommon for ASD to go undetected until school age, especially when kids have (for lack of a better term) higher functioning profiles (like people with Asperger's).
For instance, ASD can be masked by giftedness. Or parents might mistake ASD for mere "quirkiness" or social awkwardness, while not fully recognizing the degree to which their child is struggling. Here are some of the more common ways that ASD might present itself in a school aged child (this list is representative, not exhaustive, and it's important to remember that not every child with ASD will show every sign):
Your child may:
* have had unusual language development when they were younger (used language that is different to that used by other children their age);
* sound unusual when they speak;
* repeat words or phrases that they have heard rather than responding to them;
* refer to themselves as "you," "she" or "he" after the age of three;
* use unusual words for their age; or
* use only limited language or talk freely only about things that interest them.
Your child may:
* not be interested in playing with other children;
* try inappropriately to join in with other children's play (for example, your child might seem aggressive);
* behave in a way that other people find difficult to understand (for example, they may not do as they are told);
* be easily overwhelmed by being around other people;
* not like people coming into their personal space or being hurried.
Interests and behaviors
Your child may:
* struggle to take part in pretend play with other children or play in which they need to cooperate or take turns;
* have difficulties in large open spaces (for example, they may stay round the edges of the playground);
* find it hard to cope with changes or situations that aren't routine, even ones that other children enjoy (for instance, school trips or the teacher being away).
You child may:
* have unusual skills (for example, have a very good memory or be gifted in math or music); or
might not like the sound, taste, smell, touch of certain things.
A Twist: ASD in Girls
Adding an extra wrinkle to the warning signs above is the tendency of girls with ASD to present differently than boys. Sue Larkey, an Australian expert in ASD, has written a terrific summary of the key ways in which ASD tends to "look" different in girls than in boys (again, bearing in mind that these are generalizations):
Ten Ways Girls with an ASD differ to Boys with an ASD
1. Their special interests are usually animals, music, art, literature.
2. They often have a very good imagination, which includes imaginary friends, games, being animals or taking on persona of other girls.
3. They often see speech therapists for their speech and may be diagnosed with specific language disorders however there is something different about this girl no one can quite put their finger on.
4. They often play with older children or much younger children. This play is sometimes unusual for example "Mums and Dads," but she will want to play the same role and game every time. She usually wants to be the pet or baby, whereas most girls want to be the Mum or Dad.
5. They often have hyperlexia -- the ability to read but comprehension does not always match their reading skills. They are often the class book worm or write stories but they write the same story over and over changing a few characters. Many have a special interest in literature.
6. They have unusual sensory processing, like the boys, however bigger fluctuations often going from one extreme to the other.
7. They get anxious like boys, however their anxiety is rarely physical or disruptive. In fact many have great copying mechanisms at school however the family see a very different child at home where the anxiety can explode.
8. Often their difficulties with social skills are called "shy," "quiet," "solitary."
9. They often like to organize and arrange objects. I watched one little girl spend hours seemingly playing "My Little Ponies," however on closer examination she was just arranging and re-arranging the horses over and over.
10. The main difference is there are MANY more undiagnosed girls/women than boys/men. Currently we only diagnose 1 girl to 7 boys. In the future it is thought by many psychologists the ratio could be more like 5 to 7 as we become more aware of this group.
Yet Another Twist: Gifted + ASD
Giftedness and ASD are not mutually exclusive — they can and do exist together in some individuals! In fact, giftedness can mask some symptoms of ASD, and ASD can hide some indicators of giftedness. The common term for someone who is gifted and has learning differences or learning disabilities is “twice exceptional” (2e). It is important to remember that IQ/cognitive testing provides only one slice of a child’s developmental profile and by itself cannot rule in or rule out ASD. A comprehensive assessment by a qualified specialist — ideally someone who has rich experience with twice exceptional profiles and will use gold standard assessment tools — is the best way to determine if a child has something “more than giftedness” in play.
What To Do If You Have Concerns
If you have concerns that your child might have ASD, the next step should be getting professional guidance. Talking to your GP can be a good place to start (and to get a referral to a specialist), but also be aware that not all GPs are up-to-speed on ASD. All the more reason for you to arm yourself with good information!
In younger children, the diagnosis process almost always involves a medical doctor (paed, developmental paed, or psychiatrist) or a panel approach that includes a medical doctor. For school aged children, it is not uncommon for psychologists to drive the assessment/diagnosis process (but be aware that several states require a medical doctor to be involved in order to get an educational diagnosis that will be recognized by the schools).
For more detailed information on how to seek an ASD assessment in your state or territory, check out:
There are also some terrific on-line resources to help guide parents. Two particularly valuable ones in Australia are:
http://www.autismawareness.com.au/ (includes state-by-state directory of professionals who are well versed in ASD)
Additionally, the mums who are active on the Special Needs/Disabilities board are very supportive and happy to share recommendations of great "ASD-savvy" professionals (via PM, because we aren't allowed to make explicit recommendations on the board), provide information, or answer questions. Your child doesn't have to have a diagnosis of anything for you to voice your concerns or ask questions.
(I am in Sydney and am always happy to pass along my suggestions of ASD professionals in this area).
Thanks for reading this far! style_emoticons/default/original.gif
Edited by baddmammajamma, 25 August 2013 - 10:47 AM.