1. IS IT TOO EARLY TO GET A DIAGNOSIS FOR MY CHILD?

Best practices in both the United States and the United Kingdom support early identification. It is this that guides the policy and service development in both countries. A child can be diagnosed as young as 18 months of age. When we consider the formative years of learning, early identification and early intervention becomes paramount to provide children with the best possible opportunity to catch up on skills to support their successful integration into school as well as the community.

2. WHAT SHOULD I EXPECT WHEN RECEIVING A DIAGNOSIS?

Our diagnosing consultants from Wisconsin Early Autism Project (WEAP) have shared some useful points that you should look out for when receiving a diagnosis. They are:

  • The diagnosis needs to be made by psychologist, psychiatrist, neurologist, developmental pediatrician, or similar qualified medical professional.
  • No medical tests, diagnosis based on history and symptoms.
  • Gold standard for diagnosis: The Diagnostic and Statistical Manual of Mental Health (5th edition) (DSM-5).
  • Gold standard assessment tools:
    – Autism Diagnostic Observation Schedule (ADOS)
    – Autism Diagnostic Interview Revised (ADI-R)
  • A comprehensive diagnosis takes approximately 2 hours to complete and should include:
    i. Observations of your child
    ii. A thorough interview with parents/caregivers
  • It will entail a comprehensive discussion on developmental history of your child.
  • You should receive a detailed report
  • A diagnosis needs to be made as early as symptoms present clear diagnosis.
  • It is also important to remember that as a Spectrum Disorder: may be higher functioning or more challenged.

3. WHY IS IT IMPORTANT TO START EARLY?

Research has shown that early intervention is best. This is because a child’s brain is malleable at a younger age and thus able to learn better. It is also important for a child to be able to learn before entering school. This ensures a more positive experience of school when the time arrives. Furthermore the gaps between a child with autism in comparison to their peers their age is less at a younger age and easier to close. Lastly, inappropriate behaviours (whether self-stimulatory behaviours, tantrums or aggression) are easier to be redirected and stopped at an earlier age. Self-stimulatory behaviours in particular become more established over the years if not addressed.

4. HOW IS APPLIED BEHAVIOURAL ANALYSIS (ABA) DIFFERENT FROM OTHER TREATMENTS?

According to Schreck & Miller’s (2010) research, “Applied Behavioural Analysis (ABA) has been extensively documented by researchers, national and state governments, and the US Surgeon General as the gold standard and most empirically validated of treatments for autism spectrum disorders”.

ABA is in essence the only teaching approach for autism supported by controlled studies and post treatment follow up data. There have been over 1000 scientific and peer-reviewed journal articles which have shown successful outcomes for treating children with autism. It develops communicative speech and improved social relatedness in 90% of those treated. This program produces virtually normal social interaction, communicative and cognitive abilities in 40% to 50% of children with autism (Lovaas, 1987, Smith, 1993).

We work to address the needs of each child individually through a comprehensive curriculum that covers all major areas (Early Learner skills, Communication and Language, Social skills, Play skills, Daily Living skills, Academic and Cognitive skills, and Generalization of skills).

ABA has been proven by research to be effective because it employs 4 characteristics important in teaching children with Autism – individualised programs, one-to-one teaching, intensive hours (sufficient practice to teach new skills and promote retention of skills), and parental involvement. The basics of ABA are – breaking skills down, pairing it with reinforcement and providing sufficient practice for a child to learn new skills and to retain those skills.

5. WHY 1:1 THERAPY?

Children with autism find learning challenging. It is thus more difficult for children with autism to learn incidentally from the natural environment. The 1:1 learning environment however provides structure and makes teaching of specific skills easier. The therapist is able to give the child their full attention and focus on using every opportunity for learning. Also children with autism typically struggle with attention and being in a 1:1 environment helps reduce distractions. Additionally, children with autism typically feel more comfortable with adults which make learning easier in a 1:1 setting.

6. WHY IS RESEARCH IMPORTANT?

In times where there is a multitude of treatments available, it is important to ensure that the treatment chosen for your child is effective and perhaps more importantly does not have an adverse effect on your child. The efficacy of treatments must be supported by observable outcomes. The increasing discourse on evidence based practice supports this contention.

Applied Behavioural Analysis (ABA) is one such treatment supported by observable outcomes in children with autism. In both researches published by Dr. Ivar Lovaas (1987) and Dr. Glen Sallows and Tamlynn Graupner (November 2005), ABA was found to be the most effective intervention currently available for improving outcomes for children with autism and related disorders. Because of this research, we know our programmes are designed to meet the needs of this special group of children and make a difference in their learning.

It is also crucial that a parent is confident of the treatment programme you are enrolling your child into as the learning opportunity at a young age is precious, and we are unable to turn back time. Furthermore, it is important to know of treatments that are have inconclusive evidence or worse still, be detrimental or harmful to your child.

7. WHAT ABOUT SCHOOL?

We acknowledge the importance of education in a child’s life. It is our philosophy that every decision made should be in the child’s best interest. From this premise, we tailor our programmes to ensure that the child will be successful in school. From the same premise, we believe that before a child is enrolled in school, s/he should be equipped with the pre-requisite skills to enjoy a positive schooling experience. Some examples of this prerequisite skills include; the ability to attend in a group, the ability to follow group instructions, the ability to learn in a group environment, the ability to be independent, and the ability to communicate and participate in social interaction. This may mean deferring school whilst we teach these pre-requisite skills in therapy. Recognising that school is a life experience, the decision made should consider creating a positive journey and meaningful school experience for the child. A child can be enrolled in a school and be physically present but not be making the most of their learning time if they are not able to follow group instructions, participate in group activities and most of all learn from the teacher.

Reference

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Autism Act 2009, United Kingdom.

Autism Service Guidelines Revision Committee: Service Guidelines for Individuals with Autism Spectrum Disorder through the Lifespan: 2011. Retrieved from http://ddc.ohio.gov/pub

Early Autism Project Malaysia, EAP Malaysia, Kuala Lumpur, Malaysia.

Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Leventhal, B. L., DiLavore P. C., Pickels, A. & Rutter, M. (2000). The Autism Diagnostic Observation Schedule–Generic: A standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30(3), 205-230.

Rutter, M., Le Counteur, A. & Lord, C. (2003). Autism Diagnostic Interview-Revised (ADI-R). LA, California: Western Psychological Services.