Autism Spectrum Disorder in Kids and Teens: FREQUENTLY ASKED QUESTIONS from Parents

 1. Are individuals with ASD more likely to be involved in criminal activities?

Some individuals with ASD have found themselves before the criminal justice system for a variety of offenses that are usually related to their special interests, sensory sensitivity or strong moral code. If a person's special interest is of a dangerous nature it can sometimes lead them into unusual crimes associated with that interest. The courts are becoming increasingly aware of the nature of ASD and are responding accordingly. More often than not, individuals with the disorder are more likely to be victims than offenders. Their naivety and vulnerability make them easy targets.

2. Can ASD occur with another disorder?

The simple answer to this question is YES. The symptoms of ASD have been recognized in individuals with other conditions and disorders. Once a single diagnosis of ASD is confirmed, it is wise to continue the diagnostic process to see if there is another specific medical condition.

3. Can ASD occur with ADHD?

These are two distinct conditions, but it is possible for a youngster to have both. They have specific differences, but there are some similarities, and a youngster can have a dual diagnosis and require treatment for both conditions.

4. Can the person develop normal relationships?

In early childhood, a youngster with ASD may need to be given instructions on the different ways of relating to family members, to a teacher, to friends and to strangers. Teenagers on the spectrum can be delayed in their social/emotional maturity compared to the other kids in their class. It may be necessary to repeat some school programs on human relationships and sexuality when the person with ASD has reached that stage of their emotional development. 
 
With a prolonged emotional adolescence and delayed acquisition of social skills, the person may not have a close and intimate relationship until much later than their peers. Many individuals with ASD have loving relationships, but the partners may need counseling on each other's background and perspective. One could describe these relationships as similar to those between individuals of two different cultures, unaware of the conventions and expectations of the other partner.

5. Could a difficult pregnancy or birth have been a cause?

Some studies state that quite a high percentage of cases had a history of natal conditions that might have caused damage. But, in general, pregnancy may well have been unremarkable. However, the incidence of obstetric abnormalities is high. No one factor can be identified, but labor crises and neonatal problems are recorded with a significant number of kids with ASD. There is also a greater incidence of babies who are small for gestational age, and mothers in the older age range. It is recognized that there are three principal causes of ASD - genetic factors, unfavorable genetic events, and infections during pregnancy or early infancy that affect the brain.

6. Could ASD be a form of schizophrenia?

These are again, two distinct conditions. The chances of a person with ASD developing schizophrenia are only marginally greater than for any individual. Some individuals with the disorder are wrongly diagnosed with schizophrenia, when they have extreme stress, anxiety and depression related to their ASD. A false diagnostic trail is easily created and it is important to re-trace the steps and see what is causing the stress and anxiety for the person with ASD.

7. Could ASD be inherited?

Some research shows that there are strikingly similar features in first- or second-degree relatives on either side of the family, or the family history includes "eccentric" individuals who have a mild expression of the disorder. There are also some families with a history of kids with ASD and classic Autism. Should a relative have had similar characteristics when younger, they have a unique advantage in helping the youngster - they know what they are going through. There is no formal identification of the precise means of transmission if the cause is genetic, but we do have some suggestions as to which chromosomes may be involved. As our knowledge of genetics improves, we may soon be able to predict the recurrence rate for individual families.
 
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8. Could the pattern be secondary to a language disorder?

If a young child has difficulty understanding the language of other kids and cannot speak as well as their peers, then it would be quite understandable for them to avoid interactions and social play, as speech is an integral part of such activities. However, the youngster with autism has more complex and severe social impairments, which identify the disorder from other disorders.

9. Could we have caused the condition?

ASD is not caused by emotional trauma, neglect or failing to love your youngster. The research studies have clearly shown that ASD is a developmental disorder due to a dysfunction of specific structures and systems of the brain. These structures may not have fully developed due to chromosomal abnormalities or may have been damaged during pregnancy, birth or the first few months of life.

10. Do girls have a different expression of the disorder?

The boy to girl ratio for referrals for a diagnostic assessment is about ten boys to one girl. However, the evidence indicates that the actual ratio of diagnosed kids is four boys to one girl (this is the same ratio as occurs with classic autism). Why are so few girls referred for a diagnosis? In general, boys tend to have a greater expression of social deficits, whereas girls tend to be relatively more able in social play and have a more even profile of social skills. Girls seem to be more able to follow social actions by delayed imitation because they observe other kids and copy them, perhaps masking the symptoms of ASD.

11. How can you reduce the person's level of anxiety?

A person with ASD is especially susceptible to high levels of anxiety, and this can only be reduced by practical strategies to cope with the issues causing the anxiety. Sensory issues, social skills and the need for structure and routine can cause unbearable stress and anxiety and this increases the expression of their ASD itself, thus causing a vicious circle. Stress management programs can help minor levels of anxiety - providing a sanctuary without social or conversational interruption and using relaxation techniques.

If a person becomes increasingly anxious or agitated, it may help to start an activity that requires physical exertion (e.g., a trampoline or swing). Offering a youngster an alternative to the playground at break-time can be invaluable, and using specific ways (such as sending the youngster to the school office with a message) to give the youngster a break from the classroom. It helps if the teacher can establish a special code with the youngster with ASD, so that they can signal their anxiety without drawing attention to themselves. We recommend Cognitive Behavior Therapy as an excellent way to reducing anxiety for individuals with ASD.
 
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12. How do you share the news?

This varies according to each youngster and their circumstances. For some it may help if the diagnosis becomes public, while for others it may be preferable that they are not distinguished from other kids. A principle of who needs to know is considered to be useful. There are classroom activities that can be used to help other kids to understand the condition, and how to help their classmate with ASD. At home, it will become apparent to siblings that a diagnosis has been reached, and it is important to explain things properly to them. There are some useful books on this topic; also, local help groups may run workshops for siblings. How do you tell the youngster themselves that they have ASD?

The answer may be to tell the youngster when they are emotionally able to cope with the information and want to know why they have difficulties in situations that other kids find so easy. It is important to give the person with ASD a sense of their many positive qualities, and to give examples of the many scientists and artists who have the disorder and have used these qualities for great achievements. Once the person knows they have ASD it can provide a sense of relief and understanding.

13. Is the person likely to become depressed?

Clinical evidence shows that there is a greater risk of depression in individuals with ASD. In early childhood the person may be less concerned about their differences to other kids. During adolescence they start to become more interested in socializing with others and become acutely aware of their difficulties. The most common cause of depression is the person with ASD wanting to be like others and to have friends, but not knowing how to succeed. Should one suspect that the person with on the spectrum is depressed, it is essential that they obtain a referral to a psychiatrist who is knowledgeable in autism spectrum disorders and obtain treatment. Treatment for depression involved conventional medicine, but should also include programs to deal with the origin of the depression.
 
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14. Is there a specific area of the brain that is Dysfunctional?

There is increasing evidence to suggest that the frontal and temporal lobes of the brain are dysfunctional.

15. What are the advantages of using the term ASD?

If the term ASD-Level 1 is used, it can avoid misunderstandings in relation to the use of the term autism. Many individuals have a negative association with the term autism, so it is good to use a different one. When a youngster is said to have ASD-Level 1, the usual response is "I've never heard of that. What is it?" The reply can simply explain that the youngster has a neurological condition which means that they are learning to socialize and understand the thoughts and feelings of other individuals, have difficulty with a natural conversation, can develop an intense fascination in a particular area of interest, and can be a little clumsy.

16. What are the changes we can expect during adolescence?

The physical changes of adolescence are likely to occur at the same age as for their peers, but young people with ASD may be confused by such changes. During the hormonal changes and increased stress associated with adolescence, the teenager may have a temporary increase in their expression of ASD. Moms and dads need to be supportive and patient, and remember that this is a difficult time for virtually all kids.

Some of the emotional changes of adolescence may be significantly delayed in teens with ASD, and while other teenagers are intent on romance and testing the rules, the teenager with ASD still wants simple friendships, has strong moral values and wants to achieve high grades. They can be ridiculed for these qualities, but it is important to explain that they are valuable qualities, not yet recognized by others. Some traits of adolescence can occur later than usual and extend well into a person's twenties; thus, the emotional changes of adolescence are often delayed and prolonged.

17. What is the difference between High-Functioning Autism and classic autism?

Some kids have the features of autism in early childhood and then develop the ability to talk using complex sentences, develop basic social skills and an intellectual capacity within the normal range. This group was first described as having High- Functioning Autism. It is most likely to be used as a term for those who had a diagnosis of autism in their early childhood. It is less likely to be used for kids whose early development was not consistent with classic autism. Both autism [level 3] and ASD [level 1] are on the same seamless continuum, and there will be those kids who are in a diagnostic "grey area", where one is unsure which term to use.

18. What is the difference between the disorder and the normal range of abilities and personality?

The normal range of abilities and behavior in childhood is quite extensive. Many kids have a shy personality, are not great conversationalists, have unusual hobbies and are a little clumsy. However, with ASD, the characteristics are qualitatively different. They are beyond the normal range and have a distinct pattern.

19. What should we look for in a school and teacher?

What are the attributes of a good school? Most important is the personality and ability of the class teachers and their access to support and resources. It is not essential that the teacher has experience of similar kids, as each youngster with ASD is unique and a teacher uses different strategies for each individual. It is very important to find as small-sized a class as possible, to have a quiet, well-ordered classroom, with an atmosphere of encouragement not criticism, and to have practical support from the school administration. It is important to maintain consistency for the youngster with ASD, so try not to change school unless absolutely necessary once a youngster is settled.

 

Resources for parents of children and teens on the autism spectrum:
 

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