Autism brings difficulties
Generally autism brings difficulties in three main areas:
- Communication: Development of language is often delayed in children with an ASD. Both verbal and non-verbal (e.g. gestures) communication can appear unusual. Children may make fewer gestures than “normal” children, such as pointing. They often struggle to make eye contact with others. Conversation with a child on the autistic spectrum may feel disjointed and not synchronised with the person they are talking to/with. Such children may struggle with the “to and fro” nature of a two-way conversation, and may dominate or avoid conversations. People on the autistic spectrum tend to be “black and white thinkers”, and struggle to understand phrases that are not concrete or where the meaning is not obvious.
- Social interaction: Every environment has social rules, such as turn-taking and good manners. People with ASD can struggle to see others’ perspectives, so rules like turn-taking are often difficult to grasp. Some rules may seem illogical and confusing to a child with ASD. Why would you use different words when you’re talking to a child as opposed to an adult? Why are there rules about who you can play with in the playground and who you can’t? Why do I have to wait my turn?
- Obsessions and Rituals: Because they often find the world unpredictable and scary, and are good at focusing on fine detail, people with ASD often develop intense and specialist interests. These interests may become obsessions. Common ones are trains/ Thomas the Tank Engine, and science fiction, but they can be almost anything. An obsession can be positive as it gives a child a “specialist subject” which they can be expert on. They can help build a child’s self-esteem as well as being enjoyable. If an obsession begins to take over a child’s life in a negative way however, and other things get pushed out, it’s important to seek help.
One autism spectrum disorder is Asperger’s syndrome. Children with this syndrome can have significant difficulties in social interaction, and sometimes repetitive patterns of behaviour and interests. Children with Asperger’s can have highly functioning speech and ability. Physical clumsiness and peculiar use of language are also frequently seen.
Are there any quick tests?
This is understandably a big step for parents. On one hand, having a formal diagnosis can enable the family to move forward and plan how best to support the child’s strengths and weaknesses. On the other hand, parents are often worried that having a ‘label’ will be a negative thing for their child. There is no easy answer to this dilemma however a diagnosis is often a positive thing for the family.
How do we assess for ASD at Everlief?
At Everlief our assessments are conducted with input from a multi-disciplinary team. We base our approach on that used by the ‘Lorna Wing centre for Autism’ in Bromley (National Autistic Society). There are four parts to the assessment, the largest of which is the DISCO. Through many years of research and practice Dr Judith Gould designed the DISCO along with Lorna Wing and colleagues. We usually combine this with a ADOS-2 (Autism Diagnostic Observation Schedule Version-2), OT assessment and finally an observation in a different setting. The range of assessments is designed to ensure accuracy of diagnosis. We have three ASD assessors led by Dr Lucy Russell. Dr Russell led the autism specialist service in a local NHS CAMHS team and also has a brother with Asperger’s Syndrome. This theory with ‘real life’ experience is very valuable. It is important to note that the assessments can never guarantee a diagnosis. If your child does have autism then this will come out through the assessments. Whether or not a diagnosis is given, the comprehensive set of reports will focus on helping your child with their difficulties. Details on the assessment
At the start one of the team would meet you and your child for an hour. This would be to go through a general background and to make the decision about whether to proceed with the full ASD assessment.
If we proceed with the full ASD assessment it will consist of:
- DISCO (Diagnostic Interview for Social and Communication Disorders) which is completed with the parents – Parents only – At clinic or via zoom.
- ADOS-2 (Autism Diagnostic Observation Schedule, Version 2) (OR occasionally cognitive assessment WISC-V (Wechsler Intelligence Scale for Children, Version Five) – for your child- At Everlief (with social distancing)
- Input from school – School observation or class teacher interviewed
- Occupational therapy (OT) assessment with our partners Leap Children’s Therapy – for your child – At Leap Children’s Therapy (with social distancing)
- Write up and generation of comprehensive report pack including diagnostic decision and recommendations
- Complimentary follow up appointment to discuss recommendations
Will Everlief be there to help after diagnosis?
Absolutely. We will start by being there to answer any questions you have after reading the reports. Next, there may be some prioritisation to be done on the recommendations. Finally, we can support your child therapeutically (for instance with social skills, anxiety or obsessions). We are also continually expanding our network of other therapists (e.g. music, yoga, nutrition) to ensure we can recommend others who can help your child get the support they need.
How much impact can therapy make?
Every child is different and so this is a really difficult question to answer. The aim of therapy will be to reduce the impact of your child’s difficulties. With our help your child should be able to learn how to cope and adapt to minimise the difficulties. In our experience this can have a very positive knock on effect on how they build friendships and their general happiness.