Autism & mental health

Autism & mental health

Autism & mental health 2000 1333 Team Mindsum

This is the second section and covers:

– The signs of ASD

– Managing ASD

The signs of ASD

The signs of ASD are usually there before the age of 3 years old. This includes difficulties in social interaction, communication and repetitive and restrictive behaviours. These difficulties cause challenges in the everyday life of the child or young person. For example, people with ASD generally have a hard time understanding and knowing how to react in the social world.

Difficulties with social interaction or communication can include:

  • Avoiding eye contact

  • Not pointing at objects to show interest (e.g. not pointing at an aeroplane flying over)

  • Not looking at objects when another person points at them

  • Not able to pretend play

  • Taking things literally

  • Rarely using spoken language

  • Talking at people, rather than engaging in a back and forth conversation

  • Taking a long time to process information

  • A hard time understanding sarcasm

  • Difficulty understanding other people’s feelings and intentions

  • Discomfort with physical touch and other sensory issues

  • Appearing by others to behave strangely or not appropriate for the situation (e.g. smiling at someone crying)

  • Lose skills they once had (e.g. stop saying words they were using)

The world is full of unwritten rules and can make it unpredictable and confusing for people with ASD. For this reason, they often prefer to do things the same way. Repetitive and restrictive behaviours can include:

  • Preferring the same clothes, food or travel to school

  • Repeating movements (e.g. hand flapping, rocking)

  • Repeating or echoing words or phrases said to them

  • Repeating actions (e.g. opening and closing door, turning the TV on and off)

  • Feeling stressed out or anxious when there is a change in routine

  • Having an intense interest in a particular topic from a young age

  • Having a sensitivity to loud noises, lights, taste or touch

It is common for people with ASD to feel extremely anxious and overwhelmed, especially in social situations and when things change. They can easily shutdown or go into a meltdown when things become too much. In this case, the child or young person might lose control, scream, shout, cry or get extremely quiet and switch off.  It is important to support children and young people with ASD so that they are able to develop ways of coping to prevent serious problems in mental health.

Case study

“Andy is a 6-year-old boy. He has been diagnosed with ASD since he was 3 years old. Before he was diagnosed, his mother was concerned when he did not engage with her. Whenever she tried to play with him, he always avoided her eyes and looked straight at the wall. Now, Andy enjoys maths lessons at school, but often he feels extremely overwhelmed when other pupils talk loud in class. He has difficulties playing with others and prefers to sit alone. Andy’s parents consult a specialist regularly to continue to learn the best ways to support him.”  

Managing ASD

There is no cure for ASD. It is a life-long condition that needs to be managed. However, research shows that early intervention programmes can improve a child’s development. There are many interventions for ASD, depending on how severely ASD affects the child or young person. This includes psychological, behavioural and educational programmes. These interventions are usually tailored to the specific needs of the child or young person. All interventions focus on:

  • Reducing impairments caused by ASD (e.g. in attention, concentration, engagement)

  • Improving functioning (e.g. ability to take the school bus alone, making friends)

  • Reducing behaviours that cause problems in everyday life (e.g. meltdowns, aggression when stressed out)

These are examples of the common interventions used to manage ASD:

Psychotherapy

Therapy or counselling will focus on helping the child or young person cope with the difficult feelings such as anxiety, that is common in children and young people with ASD. Therapy might include Cognitive behavioural therapy, which helps to understand how feelings, thoughts and behaviours work and teaches specific skills to manage these.

Applied behavioural analysis (ABA)

ABA is a specialized group of interventions that focuses on encouraging helpful behaviours and reducing harmful ones. This is commonly used with children or young people that have ASD, especially in the early years. ABA helps children and young people learn to use language and communication skills. It also focuses on improving attention and positive behaviours. This intervention uses reward systems that encourages the child to keep up helpful behaviours.

Social skills training

Social skills training teaches the child or young person how to interact with others and manage in the social world. This can include role-modelling, learning conversational skills and problem-solving skills.

Parent/carer training programmes

This programme helps to support parents/carer in understanding ASD and learning new skills that will help the child succeed in their everyday life. This can include communication skills, positive reinforcement skills and play activities between the parent/carer and child.

There are other helpful habits that can make a difference in the child’s everyday life. This can include:

  • Using the child’s name, so that they know they are being spoken to

  • Reading available online forums on autism and communication skills

  • Keeping language clear and simple

  • Using gestures or images to make it easier to understand what you are saying

  • Making sure your child has a regular bedtime

  • Connecting with other parents of children with ASD on local support groups

Assistive Technology

Assistive technology, including devices such as communication boards and electronic tablets, can help people with ASD communicate and interact with others. For example, the Picture Exchange Communication System (PECS) uses picture symbols to teach communication skills. The person is taught to use picture symbols to ask and answer questions and have a conversation. Other individuals may use a tablet as a speech-generating or communication device.

Developmental, Individual Differences, Relationship-Based Approach (also called “Floortime”)
Floortime focuses on emotional and relational development (feelings and relationships with caregivers). It also focuses on how the child deals with sights, sounds, and smells.

Occupational Therapy
Occupational therapy teaches skills that help the person live as independently as possible. Skills may include dressing, eating, bathing, and relating to people.

Speech Therapy
Speech therapy helps to improve the person’s communication skills. Some people are able to learn verbal communication skills. For others, using gestures or picture boards is more realistic.

There is no medication for ASD

There are no medications that can cure ASD or treat the core symptoms. However, as per NHS, there are medications that can help some people with ASD function better. For example, medication might help manage high energy levels, inability to focus, anxiety and depression, behavioural reactivity, self-injury, or seizures.

Medications might not affect all children in the same way. It is important to work with a healthcare professional who has experience in treating children with ASD. Parents and healthcare professionals must closely monitor a child’s progress and reactions while he or she is taking a medication to be sure that any negative side effects of the treatment do not outweigh the benefits.

Screenshot 2020 10 13 at 20.27.54
Click here for an illustration from Rebecca Burgess to understand the Spectrum

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