Understand the Challenges of Autism Spectrum Disorder September 9, 2024 Chances are you may know someone with autism spectrum disorder, a condition that has become more widely recognized and diagnosed in the United States. Autism spectrum disorder (ASD) is a developmental disorder in which the brain functions differently, causing challenges with social skills, communication and behavior. Someone diagnosed with ASD whose brain functions differently than typical is defined as “neurodivergent.” Someone with a more common brain function is referred to as “neurotypical.” While the spectrum disorder part of ASD means that symptoms are different for everyone and occur in a range from mild to severe, there are common characteristics of ASD. How to Recognize ASD in Children As a developmental disorder, signs of autism spectrum disorder present early in children, often between the ages of 2 and 4. Signs of ASD can include the following: Avoids eye contact. Lacks facial expressions relative to the situation. Unable to play interactive games like “patty-cake.” Doesn’t engage in pretend play common for young children. Motor control issues, such as flapping hands, walking in circles, rocking in place. Extra sensitivity to how clothing touches them or food textures. Also, children may have unusual interests, noted Psychiatrist Pallav Pareek, MD, of Samaritan Mental Health – Circle Blvd. “Children with ASD may be extremely interested in not only cars, but the wheels of the car which they keep turning and playing with,” he said. “They may love something at the exclusion of everything else. For example, nearly every child is interested at some point in dinosaurs, but then moves on to other things. For children with ASD, their love of dinosaurs could last much longer than most children, and sometimes forever.” Since autism is a disorder on a spectrum, a person can be intellectually and socially low functioning or high functioning, or a range in between. “At the extreme end of the spectrum, a child with ASD may not have language and have high levels of impairment, which may require help with activities of daily living. At the other end of the spectrum, a child could be able to read much above grade level and have an extreme understanding of music or math, for example,” Dr. Pareek said. How to Recognize ASD in Adults Autism spectrum disorder is a lifelong condition. As a person with ASD ages, they can continue to be on a spectrum of symptoms. Some signs of ASD in adults can include: Difficulty making conversation. Unable to interpret body language. Lack of empathy or ability to recognize another’s emotions. Difficulty making friends. Inability to understand sarcasm, idioms or irony. Unable to deviate from routine. Uncomfortable or fearful in social settings. May need more time to process information, easily overloaded. “It’s important to note that although one with ASD may care for others around them, they may not possess the capability to grasp empathy or emotional dynamics within others,” said Dr. Pareek. “It’s a different language for them. An example I use is this: I don’t speak Mandarin, but if you place me in China, people may yell at me to do a certain thing. I’m not responding as much as they would like, because I don’t understand Mandarin. In this case, the children on the spectrum do not have the language of emotion reading, empathy or emotional expression.” No Cure for Autism Spectrum Disorder While there is no cure for ASD, treatments can help a person function better in daily living. It’s important to get a child screened if you have concerns about their developmental progress. Talk with your child’s health care provider about screening options. Additionally, Dr. Pareek notes that there is a form of psychotherapy called applied behavioral analysis, or ABA, which he finds helpful in patients to improve behavior issues and life skills. “In working with parents and children, this form of therapy uses cause and effect principles to reward certain behaviors over others,” he said. “I’ve seen it work very well, but it is very time intensive that not everyone can do.” Learning Over Time Additionally, as children age, they may learn to compensate for their disability, Dr. Pareek said. “If a person has certain social intelligence reserves, they will be able to learn appropriate social interactions by watching how others behave in certain situations,” he said. He uses an example from the popular television series, Big Bang Theory, in which the lead character, Sheldon, is an astrophysicist who also has autism spectrum disorder. “Sheldon is a good example I use often,” he said. “Sheldon learns from observation. Over the years he has seen that when someone is sad or hurt, another person will offer them hot tea or coffee. So, when his friend on the show, Penny, is feeling upset by something, he responds by asking her if she wants a warm beverage. He has made that connection in his brain. You can learn by seeing what other people do and learn to mask your disability.” Examples of Differences in Communication Neurotypical people not only communicate verbally, but also use body language, subtle social cues and other nonverbal ways to share understanding. A neurodivergent person lacks these nonverbal skills. “A neurotypical child may take an interest in Grandpa’s car collection because they know it’s polite to do so, but someone with ASD would not be able to pretend they like something they don’t. A better way to connect with them is to show interest in what interests them,” Dr. Pareek explained. Dr. Pareek offers another example: “A neurotypical person knows that it is not nice to point to someone in public and talk about their body shape, size or disability. But a neurodivergent person lacks a social filter. He doesn’t mean to hurt anyone. He just observes something and says it out loud. He wouldn’t feel any embarrassment about it and wouldn’t understand why other people are mad at him for saying it.” Tips for Effective Communication To communicate effectively with someone who has ASD: Use their name to get their attention first. Be patient and listen. They may need time to process what they want to say. Speak to quietly with a calm demeanor. Communicating when there are fewer people in a room is better. Processing conversation in large groups can be challenging for those with ASD. Use simple commands and be specific. Instead of saying, “sit down,” say “sit on the brown couch.” Say what you mean, without euphemisms. Don’t say: “Can you give me a hand with the trash.” Instead say, “Take out the trash please.” Avoid open-ended questions. Instead of, “How was your day?” ask about something specific: “Did you enjoy math class today?” Minimize your use of nonverbal cues, such as eye contact, gestures, facial expressions. Focus on their interests more than yours. “People often ask me if autism is a new thing,” said Dr. Pareek. “It’s not, but we do have a better understanding of autism and a better language to explain what impairment a person has. “A lot of us have people in our families — someone who isn’t good in social settings, someone who doesn’t get sarcasm — they’ve always been in our lives. We’re just talking more about it now,” he said. If you have concerns that your child has autism spectrum disorder, contact your health care provider to schedule a screening. Adolescent Psychiatrist Pallav Pareek, MD, sees patients at Samaritan Mental Health – Circle Blvd. To reach him call 541-768-1221.
