Autism: Specialist interventions and support

Autism has historically been viewed as a disorder, but it is now being increasingly understood and recognised as a neurodivergence and a difference rather than a disability. Neurodiversity is a reference to the idea that neurological differences, such as those seen in autism, are a reflection of normal variations in brain development. According to diagnostic criteria, however, autism is a developmental disorder that affects how a person communicates, interacts, and behaves with others.

Autism is also known as autism spectrum disorder (ASD), because it varies widely in severity and presentation among individuals. According to the World Health Organization (WHO), about one in 100 children worldwide have autism. Autism can have significant impacts on a person’s life, such as their education, employment, health, and wellbeing. Therefore, it is important to understand what autism is, how it is caused, diagnosed and treated, and how autistic individuals can be supported and valued in society.

Here to provide an expert insight into autism and the different types of specialist interventions and support available is Dr Kaleem Baig, renowned consultant psychiatrist based in Winchester.

What is autism?

Autism is a complex neurodevelopmental disorder that affects behaviour, communication, and sensory processing.

Key features of autism include:

• Social communication challenges: Difficulty understanding and using verbal and non-verbal communication, such as gestures, facial expressions, and tone of voice. Difficulty initiating conversations, understanding humour, and grasping the nuances of social interactions.
• Repetitive behaviours and interests: Engaging in repetitive movements or behaviours. Displaying intense focus on specific interests, often to the exclusion of other activities.
• Sensory sensitivities: Heightened sensitivity or hypo-sensitivity to sensory stimuli such as light, sound, touch, taste, or smell. This can lead to sensory overload or a lack of response to certain stimuli.
• Rigidity and routine: A preference for routine and predictability, and distress when structured routines are disrupted. Difficulty adapting to changes in plans or unexpected events.
• Differences in processing information: Variations in information processing, leading to strengths (for example, strong attention to detail) and challenges (for example, difficulties with abstract concepts and shifting attention).

While these characteristics are common in people who have autism, it is important to know that the way they are expressed can vary widely.

How is autism diagnosed? What type of assessments or evaluations are typically involved?

The diagnosis of autism involves a comprehensive evaluation by qualified mental health professionals who specialise in neurodevelopmental disorders.

There are several stages involved:

1. Developmental history: The specialist will conduct an initial evaluation, which may involve finding out information about the patient's developmental milestones and academic history. This may include prenatal, birth, and early childhood data. During this process, parents, close family or schools may be involved. Completion of structured questionnaires and rating scales may also be used.
2. Clinical observation: The specialist will observe and evaluate the patient’s behaviour, social interactions, communication patterns and engagement with the surroundings, looking for characteristics such as difficulties with eye contact, repetitive behaviours, and sensory sensitivities. The assessment may be completed for children using structured instruments such as ADOS-2.
3. Complete psychiatric and medical examination: A complete psychiatric history and examination, as well as a review of medical history, is needed to rule out other co-morbid medical and psychiatric conditions.

The diagnostic process aims to assess the patient's behaviour, communication and developmental history to determine if they meet the criteria for autism.

What specialist interventions and support are available for autism?

Specialist interventions for autism are designed to address difficulties that can appear in areas such as communication, social interaction, behaviour, and sensory processing. These interventions aim to improve skills, promote independence, and enhance overall quality of life.

Some of the specialist interventions commonly used for autism include:

• Applied behaviour analysis (ABA): ABA is a structured approach that focuses on behaviour modification and skill development, by breaking down skills into smaller steps and using positive reinforcement. ABA focuses on understanding how behaviour works and how behaviour can be modified to improve functioning and quality of life.
• Behavioural therapies: Behavioural therapies play a significant role in the development of skills, the improvement of communication, and the enhancement of social interactions.
• Speech-language therapy: Speech therapy focuses on improving communication skills, including language development, speech articulation, non-verbal communication (gestures, eye contact), and social communication.
• Occupational therapy (OT): OT addresses sensory sensitivities, fine and gross motor skills, as well as daily activities, helping to develop skills needed for independent functioning.
• Sensory integration therapy: Sensory integration therapy provides exposure to various sensory experiences in a controlled and therapeutic environment.
• Cognitive behavioural therapy (CBT): CBT can help in the management of anxiety and the development of strategies to understand and regulate emotions.
• Medication: Medications may be used to manage specific symptoms associated with autism, such as anxiety, depression, hyperactivity, or behaviours which affect quality of life.
• Educational support: Individualised education plans in schools provide accommodations and support.

An individualised approach that considers each patient’s unique profile, preferences, and goals is crucial.

What are the benefits of early intervention?

Early intervention is crucial to ensure timely access to interventions that can help develop skills and strategies to navigate social interactions, communication, and daily activities more effectively, improving wellbeing and quality of life.

Some of the key benefits of early intervention include:

• Skill development: Early intervention targets critical developmental skills during a child's formative years, including communication, social interactions, and academic readiness. The brain’s plasticity is also highest during early childhood, meaning that it is more adaptable and responsive to learning during this period. Early intervention taps on this window of opportunity to facilitate skill acquisition and development for young children who already have a natural curiosity and readiness to learn.
• Social interaction: Early intervention can help children develop strategies to manage their behaviours and emotions, reducing challenging behaviours and promoting self-regulation. Addressing challenging behaviours early on can prevent them from becoming ingrained patterns, improving overall wellbeing and reducing stress.
• Family support: Early intervention often involves helping parents to implement strategies at home which support their child's development and create a supportive environment.
• Increased independence: Early intervention equips children with skills that enhance their independence. By targeting fundamental skills and addressing challenges early, children with autism have a better chance of participating more fully in family, school, and community life in the future.

Dr Kaleem Baig is a highly regarded consultant psychiatrist with over 20 years’ experience.

If you require expert assessment, diagnosis and support for autism, don’t hesitate to book an appointment with Dr Baig via his Top Doctors profile today.