Understanding the signs of Austism Spectrum Disorder in children

Autism Spectrum Disorder (ASD) is a complex neurological condition that primarily manifests through difficulties in socialisation, communication, and interpersonal abilities. It can be difficult to identify, and there is a lot of misconception about what the condition entails. It is a lifelong condition, that starts from birth, though it may not be obviously present in the first few years of life; some go their entire lives without ever getting a diagnosis. Though it comes with its own set of challenges and necessitates some concessions, children with autism — and the people in their lives — can thrive with ample education about this condition and a bit of compassion. Dr Raman Sakhuja, a leading psychiatrist in Cardiff, sheds light on children with ASD.

How does autism manifest in children?

Children with autism develop differently from their peers, and might exhibit behaviour that can be characterised as repetitive or restrictive in routines and processes. Children with autism may be obsessive about certain interests, toys, and activities. They may also have sensory issues, which can look like being extremely particular and picky about their food, needing their clothes to be a particular fabric or texture, or being sensitive to loud, shrill, or constant noises. These children may also have difficulties with understanding body language, humour, sarcasm, and hyperbolic expression. Children with autism tend to take things literally, and have a strong sense of justice and fairness which may mean they have difficulties sharing or playing with others. Though the symptoms may change as the child grows and develops, children with autism often struggle in school and social environments and may learn to “mask” (adopting behaviours as demonstrated by their peers and families) in order to cope. Children with autism try to mask to compensate for their differences in cognition and behaviour, but will still be significantly impaired by the condition. In fact, girls are less likely to be diagnosed with autism due to the differing social conceptions and expectations of behaviour between boys and girls.

ASD was historically categorised as two separate conditions: Autism, as in having language and communication difficulties; and Asperger syndrome, with no such language and communication impairment (and thus considered as high functioning). However, it is now recognised that the condition exists on a spectrum, and that those with autism are all unique in their experience and presentation of the condition.

Symptoms and behaviours as a result of ASD may be noticed in childhood but may be falsely attributed to their young age, and the child continues well into adulthood without having ever being diagnosed correctly — especially if the child consciously masks behaviours and cultural norms in order to attempt to make and maintain social connections with their peers. However, the symptoms become exacerbated once the child is pushed beyond their social or sensory capacity. This can result in burn-out, physical outbursts and tantrums, and generally cause a strain on your relationship with your child.

ASD is also sometimes misdiagnosed. Symptoms and behaviours of ASD have commonality with certain learning disabilities, language disorders, some genetic conditions, or issues that may have occurred during pregnancy or childbirth.  As children with undiagnosed autism approach adolescence and the masking may take its toll on their mental health, their condition may be misattributed to ADHD, anxiety disorders, depression, or bipolar disorder. Furthermore, ASD may even be comorbid with these conditions.

My child might have ASD — how can I find out for sure?

A good first step would be to consult with your child’s teachers or daycare guardians, as they spend a lot of time with your child and can witness them in different contexts and social environments than you would have at home. Ideally, school staff are trained in handling and observing non-normative traits in children and should be able to identify any differences in behaviour and or ways of thinking. Local parenting groups may also have resources to help with handling and adapting to your child’s behaviours, and provide insight into any arrangements that may be required for your child. Consult your child’s school nurse or your family’s GP to discuss getting a referral for autism diagnostic services.

How can ASD be treated?

ASD has no cure and there is no medication that can treat this condition specifically. Medication can be taken to treat any comorbid conditions, such as any mood or sleep disorders, which can help make the child feel more at ease, but it must be noted this condition manifests primarily as a social impairment. Cognitive behavioural therapy (CBT) may be used as a tool to help educate and mitigate negative behaviours or thoughts as a result of ASD. Families are encouraged to seek out support and information on raising a child with autism, and their school should be made aware of their condition so that appropriate accommodations to the child’s needs can be put in place.

If you have further questions regarding autism in children, Dr Raman Sakhuja is available for consultation, which can be booked via his Top Doctors profile.