There is an overlap of difficulties between the disorders: ADHD (attention deficit hyperactivity disorder), language and semantic (meaning of words) disorders, dyslexia, dyspraxia (motor skills difficulties), pragmatic language disorder (how language is used in context), and autistic spectrum disorders.
Autistic spectrum disorders are characterised by a triad of impairments:
- Social communication difficulties: ranging from non-verbal to verbal abilities but with poor understanding of other people’s body language, emotions, ideas, and the child/teen/young adult takes language literally i.e. ‘Pull up your socks’ – means do that action and not ‘do better’ as the idiom is intended.
- Social interaction difficulties: it is difficult to initiate and sustain a social relationship; there appears to be indifference and aloofness. As social situations are hard to ‘read’, the child acts in ways that seem inappropriate and unexpected.
- Social imagination difficulties: there is rigidity of thought and behaviour, and limited imaginative play. The child may carry out ritualistic actions or focus on minor details e.g. lining up toys or focussing on a part of a toy rather than the whole.
We used to talk about Asperger’s syndrome which was viewed as a less severe form of autism on the autistic spectrum continuum. There is now a more recent diagnosis of social communication disorder. However, there are some similarities between them.
Other characteristics that may or may not be present are:
- sensory processing difficulties i.e. over sensitive, under sensitive or both over/under sensitive to sensations i.e. touch, taste, light, sound, smells and colours
- love of routine and avoidance of change, and associated anxiety and anger
- special interests or obsessions
- poor attention
- inability to understand someone else’s thoughts i.e. ‘mind-read’
- inability to see beyond the ‘here and now’
Children with social communication disorders have social communication difficulties but do not show the repetitive and/or disruptive behaviours associated with autism.
The nature of the autistic spectrum disorders means that children can range from requiring specialist care and provision to being successful in mainstream education, and in later adult life. This highlights the importance of individual assessment and intervention planning; not making assumptions or generalisations about individuals’ behaviours, skills and future prognoses, if they receive this diagnosis.
The causes of autism spectrum conditions are still being investigated. Further information can be found on the website for the National Autistic Society www.autism.org.uk More than 1 in 100 people have autism in the UK.
The key issues affecting children/teens/young adults in various ways with these diagnoses are:
- Theory of mind deficit: the child cannot easily understand the feelings, knowledge or beliefs in other people, which adversely affects social communication.
- Stimulus over-selectivity: responding to a part rather than the whole, or the whole social situation rather than an individual, which adversely affects social interaction or social imagination.
- Central coherence is limited: inability as above and to read contexts or generalise tasks across contexts.
- Lack of gaze monitoring: an absence of joint attention by the speaker and listener on the same object at around 18 months and poor eye contact in joint communication would be an early indicator of social communication and interaction difficulty.
- Literal use of language: not understanding double meanings of words or idioms
- Concreteness: not being able to see toys or objects as representations of other things i.e. cardboard tube can be used a telescope, which adversely affects social imagination.
If you would like to know more about autism and social communication disorder relating to your child/teen/young adult, or any aspect of speech, language, literacy, learning and social emotional communication, please contact Jacqui.
Independent Highly Specialist Speech and Language therapist, Jacqui Wright, has over 24 years’ experience in South Africa, the U.S.A. and the UK. She is author of ‘Cracking the Literacy Puzzle’, RCSLT Bulletin, March 2006. Here, Jacqui from Childhood Communication Consultancy, based in Carlton, discusses autism spectrum and other related disorders. Childhood Communication Consultancy (CCC) specialises in assessing and treating children ages 0-25 years old with speech, language, listening, literacy, learning and social emotional communication difficulties. The aim of the assessment is to discover where the breakdown is occurring, to what extent, to do therapy and also advise on strategies to support the child/teen/young adult.