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What is Autism

"Autism is a lifelong, complex condition that occurs as a result of disordered brain growth, structure and development. Autism is believed to stem from a genetic predisposition triggered by environmental factors and affects 4-5 times more boys than girls. There are a vast number of ways that a person can manifest their autism and as a result this condition is now more often referred to as "Autism Spectrum Disorders" (ASD).


Autism Spectrum Disorder is a lifelong, extremely complex condition that appears to result from a genetic predisposition that is triggered by environmental factors. Autism occurs in every race group and in every country on earth. The prevalence of Autism is increasing – Autism South Africa has indicated that 1 child in every 150 has one of the identified autism spectrum disorders.


Autism spectrum disorder is a new DSM-5 name that reflects a scientific consensus that four previously separate disorders are actually a single condition with different levels of symptom severity in two core domains. ASD now encompasses the previous DSM-IV autistic disorder (autism), Asperger's disorder, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified. ASD is characterized by 1) deficits in social communication and social interaction and 2) restricted repetitive behaviours, interests, and activities (RRBs). Because both components are required for diagnosis of ASD, social communication disorder is diagnosed if no RRBs are present.


Early detection, diagnosis and intervention are crucial to successful treatment of a child with autism. Currently, in most parts of South Africa, especially in rural areas, children with autism often go undetected, misdiagnosed and untreated. Many children are diagnosed after the age of three years, when the window of opportunity for early intervention has already shut.

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Quadrant of Impairments

Regardless of the manifestation of Autism Spectrum Disorder, ALL people on this spectrum, are affected in different degrees, by the "Quadrant of Impairments" that causes a disturbance in quality of development in the following areas:-


1. Language and Communication. 40% of people with "Kanner/Classic autism" never speak nor understand verbal communication. Even those across the full spectrum who do have speech, often still have severe problems understanding the normal process of reciprocal communication;

2. Social Interaction. People with autism, due to the altered chemistry and functioning within the brain, literally cannot fully understand other people's emotions, reactions and the complexity of social relationships (Mindblind). This can result in people with autism reacting inappropriately by our "normal" standards, thus being shunned by society, which sadly can then result in these people becoming confused and isolated from those around them;

3. Imagination and Creative Play. A person with autism usually becomes trapped by rigid thought patterns and behaviours, a limited range of imaginative activities, as well as a poor understanding of day-to-day concepts, jargon and the abstract.

4. Sensory Disturbances. All people with ASD will have either heightened or lowered sensory perception; this may affect one or more senses.

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Red Flags for possible Autism

Warning Signs of Autism in Early Childhood
Parents should ask their child's family doctor for referral to a developmental paediatrician for assessment if there are concerns with any of the following:

Communication Red Flags


• No babbling by 11 months of age
• No simple gestures by 12 months (e.g., waving bye-bye)
• No single words by 16 months
• No 2-word phrases by 24 months (noun + verb - e.g., "baby sleeping")
• No response when name is called, causing concern about hearing
• Loss of any language or social skills at any age

Behaviour Red Flags


• Odd or repetitive ways of moving fingers or hands
• Oversensitive to certain textures, sounds or lights
• Lack of interest in toys, or plays with them in an unusual way (e.g., lining up, spinning, opening/closing parts rather than using the toy as a whole)
• Compulsions or rituals (has to perform activities in a special way or certain sequence; is prone to tantrums if rituals are interrupted)
• Preoccupations with unusual interests, such as light switches, doors, fans, wheels
• Unusual fears

Social Red Flags


• Rarely makes eye contact when interacting with people
• Does not play peek-a-boo
• Doesn't point to show things he/she is interested in
• Rarely smiles social


It is important to note that people with autism may have other disabilities or conditions, eg Epilepsy, Bi-Polar Mood Disorder, Cerebral Palsy, Sight Disorders, Difficulties with Sensory Integration, Hearing Impairment and that these need to be addressed also.

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What does someone with autism look like?

Autism is treatable, but incurable. A child with autism will therefore grow up into an adult with autism. In fact, it is more correct to refer to autism spectrum disorder (ASD) rather than autism, since the autism spectrum encompasses five different conditions. Within this spectrum, people with autism range between severely mentally disabled and intellectually brilliant. An example is Daantjie Badenhorst, who suffers from autism. Thanks to his exceptional and focused knowledge of music, he made a clean sweep of the TV programme 'Noot vir Noot'.


Someone who is autistic but nevertheless functions well, is often only diagnosed when they become an adult. Such a person may have suffered considerable emotional and academic damage, since the lack of a diagnosis probably went hand in hand with incorrect treatment. When autism is finally detected, such an adult usually suffers from other conditions, such as depression due to difficult circumstances, problems with aggression, etc. Although savants do occur within the autism spectrum, all people living with autism present complex and varied mental conditions and impairments and although those within the spectrum of autism display a myriad of similar behavioural characteristics, no two people with autism have the same abilities or disabilities. For example, some have the amazing ability to draw in the most detailed three dimensional ways, whilst others have extremely poor grip and cannot even draw or write in the most basic way. Some are adept in an "academic" area but lack the most basic relationship, social and communication skills. This is extremely detrimental to their quality of life and hampers attempts at employment. They, too, require a safe and understanding environment in which to develop to their full potential and to work.

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What does a speech therapist do to help ASD?

Screening: Speech-language pathologists play a critical role in screening and early detection of individuals at risk for ASD and makes referrals to experienced professionals for diagnosis and intervention services.


Diagnosis: Speech-language pathologists who acquire and maintain the necessary knowledge and skills can diagnose ASD, typically as part of a diagnostic team or in other multidisciplinary collaborations, and the process of diagnosis should include appropriate referrals to rule out other conditions and facilitate access to comprehensive services.


Assessment and Intervention: Speech-language pathologists should prioritize assessment and intervention in those aspects of development that are critical to the achievement of social communication competence and that honour and adapt to differences in families, cultures, languages, and resources. Speech-language pathologists should recognize the guidelines and active components of effective, evidence-based practice for individuals with ASD. They should draw on empirically supported approaches to meet specific needs of children with ASD and their families, thereby incorporating family preferences, cultural differences, and learning styles. Speech-language pathologists should assist communication partners in recognizing the potential communicative functions of challenging behaviour and designing environments to support positive behaviour. Embracing a broad view of communication, speech-language pathologists should assess and enhance the following:


1. the initiation of spontaneous communication in functional activities across social partners and settings
2. the comprehension of verbal and nonverbal communication in social, academic, and community settings
3. communication for a range of social functions that are reciprocal and promote the development of friendships and social networks
4. verbal and nonverbal means of communication, including natural gestures, speech, signs, pictures, written words, functional alternatives to challenging behaviours, and other augmentative and alternative communication systems
5. Access to literacy and academic instruction and curricular, extracurricular, and vocational activities.

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The information in this article was kindly provided by The South African Speech, Language, Hearing Association. For further information kindly contact them on: 0861 113 297 or email: This email address is being protected from spambots. You need JavaScript enabled to view it.