By Maci Elkins, MSW, Behavior Interventionist

Lower Shore Early Intervention Program

Kids come in all shapes, sizes, and colors. Some are tall. Some are short. Some are skinny. Some aren’t. Some have black hair and brown eyes. Some have blond hair and green eyes. Some like veggies, some don’t. Some like The Wiggles, some don’t. Some like playing dress-ups, some don’t. Some have autism, some don’t.

As varied and unique as all children are, children with autism spectrum disorders (ASDs) are even more so. As a spectrum disorder, autism presents in a variety of ways, from mild to severe, and with a variety of symptoms and challenges. Autism is a biologically based neuro-developmental disorder that impairs an individual’s ability to interact socially, to communicate, and to enjoy or experience a wide range of activities and interests. The Autistic Spectrum encompasses the following disorders: Autism, Asperger’s Syndrome, Childhood Disintegrative Disorder, Rett’s Disorder, and Pervasive Developmental Disorder-Not-Otherwise-Specified (PDD-NOS). For more information on these specific disorders, see the Autism Speaks website at autismspeaks.org.

One child in 150 will be diagnosed with an autism spectrum disorder (CDCP, 2005). For some reason, autism effects boys four times more often than girls. The cause of autism spectrum disorders is not fully known. Heredity is definitely a factor, but some scientists also suspect environmental factors.

Children are typically diagnosed with an autism spectrum disorder by age 3. Parents are usually the first to notice something is "not quite right" with their child. To be diagnosed with an autism spectrum disorder, a child must present with six of twelve symptoms in three categories: 1) Social, 2) Communication, and 3) Behaviors and Interests. These symptoms must be problematic enough to hinder or interfere with the child’s daily functioning. If a child doesn’t experience "significant impairment" in all areas, but is still experiencing pronounced difficulties, a diagnosis of PDD-NOS may be appropriate.

Examples of some typical autistic behaviors are:

Lack of eye contact

Doesn’t understand sarcasm, idioms, analogies, metaphors, expression of speech

May walk on tippy-toes or walk with an odd gait

It is important to keep in mind that as a spectrum disorder, the symptoms are broad and varied. No two children with autism will experience the very same symptoms or challenges. However, all children with autism will experience sensory integration issues.

Sensory integration is how one’s brain processes information received from the senses. Not only are there the five senses of sight, smell, taste, touch, and sound, but there are also the vestibular (balance and equilibrium) and proprioceptive (awareness of the space around us) senses. Unfortunately, sensory perceptions are out of whack for kids with autism spectrum disorders because they typically "over-registers" senses. This means the senses are drastically heightened and magnified.

For example, the smell of glue may be too overpowering and too distracting for a child with autism to use while making a craft. The sound of applause may literally be painful for a child with autism. A child with an out-of-sync vestibular sense may be constantly falling down or bumping into things. Sensory integration can also be "under-registered." An example of this is, a high threshold for pain or a dulled sense of taste.

As Ellen Notbohm, mother of an autistic child and author of Ten Things Every Child with Autism Wishes You Knew, writes: "Sensory integration may be the most difficult aspect of autism to understand, but it is arguably the most critical. Cognitive and social learning cannot break through to a child whose world is intrusively loud, blindingly bright, unbearably malodorous and physically difficult to navigate."

Because children with autism spectrum disorders often lack flexibility (such as being able to change plans at the last minute) and lack the ability to communicate effectively, behavior issues may erupt. And erupt they do. Tantrums are common. Not because the child with autism is trying to be disobliging or difficult, but because he/she isn’t able to convey what his/her needs or wants are at the moment, or because he/she is over-stimulated with what’s going on in the environment. All behaviors have triggers, even if as parents we can’t see what those triggers are. Parents of autistic children who can learn what those triggers are will have more success at preventing tantrums from happening.

Early detection is crucial for children with autism. The earlier it is detected, the better. If you are concerned about your child, consult with a physician or psychologist. Strategies and interventions can be put in place that will teach your child essential life skills and offer support to you and your family. Though life with a child with autism may not be easy, it certainly can be an adventure.

Maci Elkins is acting program manager/behavior interventionist for the Lower Shore Early Intervention Program at the Lower Shore Child Care Resource Center, located at Salisbury University. Serving children ages birth to five, the program provides early childhood behavior interventions, assessments, and educational services for child care provi ders, families, early educators, and mental health clinicians. For more information, contact the Lower Shore Early Intervention Program at 410-677-6590.

Ten Things Every Child with Autism Wishes You Knew by Ellen Notbohm

Behavioral Intervention for Young Children with Autism; A Manual for Parents and Professionals, edited by Catherine Maurice

The Out-of-Sync Child: Recogniaing and Coping with Sensory Processing Disorder, by Carol Stock Kranowitz and Lucy Jane Miller

Building Bridges through Sensory Integration; Therapy for Children with Autism and Other Pervasive Developmental Disorders by Ellen Yack, Paula Aquilla, and Shirley Sutton

Asperger Syndrome and Difficult Moments; Practical Solutions for Tantrums, Rage, and Meltdowns by Brenda Smith Myles and Jack Southwick

Parenting a Child with Sensory Processing Disorder; A Family Guide to Understanding & Supporting Your Sensory-Sensitive Child by Christopher Auer and Susan Blumberg