By Dr. Fauziah Zainal Abidin
Consultant Paediatrician with special interest in Developmental Paediatrics
Gleneagles Kota Kinabalu Hospital 088-518 888
“Ahmad’s mother has been concerned about him for sometime now. At three years of age, he has not started talking like the rest of his siblings. He has not even called her “mama” and sometimes she was not even sure whether he can hear well. He hardly looked at her or responded to her calls. He would be quite happy being on his own rather than playing with his siblings.
He somehow finds watching the wheels of a moving car or the turning of a fan more fascinating than anything else. She is also concerned with his feeds. He does not like anything else with his rice and efforts to feed him the fried chicken or meatballs have resulted in almost battlefield like scenes and a
meltdown for Ahmad. She had talked to her husband and her own mother about her concerns but she would be reassured that he would “grow out of it” as one of her cousin’s did before.”
What is Autistic Spectrum Disorder?
Autism Spectrum Disorder (ASD) is a developmental condition which affects an individual in the areas of communication, social interactions and having restricted, repetitive patterns of behaviour, interests or activity. This affects the individuals ability to interact with others and they often find the world to be a confusing place as they have difficulty adjusting and adapting to new and unfamiliar people and surroundings.
They may also have sensitivity issues, either being too sensitive or less sensitive in any of the five senses, hence the preference for or avoidance of certain foods, noises, clothing or even certain lights. Every individual with ASD is also different. The term itself reflects that no two people with ASD are alike, even though they all have difficulties in communication and socialisation, each will have a unique combination of character and so may seem quite different.
ASD affects around one in every 100 people and is diagnosed 4 to 5 times more common in boys than in girls. Although it is a life long condition and there is no cure, early intervention can have a tremendous results in helping those affected to live to their full potential.
What are the causes?
There is no known direct cause of Autism. Much research is being done to try to find out more of the cause but at this point it is believed to result from changes in the brain development which may be caused by a combination of genetic factors and environment. ASD is known to run in families but no specific genes have been determined so far. ASD is not caused by parenting or social circumstances. Various reputed research has been done to prove than ASD is NOT cause by vaccines or other medical treatments.
Assessments and diagnosis
Whilst receiving a diagnosis can be distressing or a heartbreak for most families, sometimes it can come as a relief to all their questions and worries before. For the young children, diagnosis leads to acceptance and empowerment for their parents to seek assistance and can dramatically improve their outcome. There are no laboratory or imaging tests that diagnose Autism. Diagnosis are made based on the ability of the individual in the main area of concern ie. social and communication and behavioural patterns.
For older children and adults, a diagnosis can help to explain why they feel different and allow them to access support and assistance to improve their quality of life. Developmental Paediatricians, Psychiatrist, Clinical Psychologist are trained to diagnosed individuals through a series of clinical evaluation and assessments.
Experts disagree about the true increase in ASD prevalence. More awareness about ASD leads to parents become more likely to take their children to be diagnosed and more doctors now are able to properly diagnosed ASD.
Living with ASD
ASD causes individuals to struggle to understand and relate to other people and environments. This can often result in extreme behaviour, such as tantrums in a young child or rudeness in older individuals. It is the only way they can cope with their stresses and feelings of anxiety. Parents on the other hand are often perceived as bad parents who are unable to control their children from behaving badly.
Adults with ASD also struggle with social situation and ‘small talk” They may appear rude, overly critical and awkward. They will have difficulty in forming relationships and maintaining friendships. Parents may feel unprepared or doubtful of their ability to provide the necessary care and education.
On a positive note, there are many treatment options, social services and programmes that can help. The problem is usually how to get access to them. Meeting with a healthcare provider or an educator can be a good source of information. Talking to an Autism Support group can help find local resources.
Meeting with a Paediatrician can help evaluate a child’s development and rule out other problems that may be helped and subsequently referred to the other experts who will develop an intervention plan for the child. Going through the transition to adulthood should be dealt with together with family members, healthcare service providers and other professionals.
Communications and reports should be kept well. Some adults with ASD are able to achieve independence to a certain extent thus self-advocay is an important aspect for individuals and family members with ASD. Through Self advocay, they may take on more responsibility for their education, employment, health care in their own community and else where.
For more information about this topic, please feel free to contact Gleneagles Kota Kinabalu Hospital at 088-518 888