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Better understanding

Autism Spectrum Disorder (ASD)

Understanding Autism Spectrum Disorder (ASD): Symptoms, Variability and Prevalence

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder. The disorder manifests itself in difficulties with social interaction and reciprocal social communication, as well as restricted and repetitive behaviors or interests. These symptoms are generally present from early childhood, but their impact can become more evident as social demands increase.

Since the publication of the DSM-5, Autism Spectrum Disorder (formerly known as Pervasive Developmental Disorder), groups together the different forms of autism, such as Asperger's syndrome, autism, pervasive developmental disorder not otherwise specified and childhood disintegrative disorder. The term spectrum is used because manifestations of the disorder vary greatly from one person to another, depending on the severity of symptoms, the age of the individual and his or her level of development.

According to the Public Health Agency of Canada report (2018), approximately 1 in 66 children is diagnosed with ASD. The prevalence is said to be higher in boys than in girls. The exact causes of ASD are not yet known. However, current research suggests, among other things, genetic origins.

Signs of Autism Spectrum Disorder (ASD)

In children aged 1 to 2, early signs that may prompt an assessment include :

  • Absence of babbling, pointing or communicative gestures
  • Rare or poorly modulated eye contact
  • Rare smiles
  • Lack of response to first name or reaction when spoken to
  • Failure to share interests (e.g., does not show objects) or ask for help
  • Difficulty relating to others, indifference to others
  • Lack of imitative, symbolic or imaginative play
  • Unconventional games (e.g. alignment, repetitive actions)
  • Angry outbursts for no apparent reason
  • Difficulty being consoled

In school-age children, for example, we can observe that :

  • Does not initiate, respond to or enter into interaction in an atypical manner
  • Interacts more in response to requests or own interests than to seek social exchange
  • Little sharing of interests or emotions
  • Has difficulty initiating or sustaining a conversation
  • Little understanding of jokes or second-degree humor
  • Specific language (e.g., repetitive or "plated" language, formal language, monotonous intonation)
  • Evasive eye contact
  • Little use of gestures to accompany speech
  • Shows little facial expression
  • Prefers solitary activities
  • Has difficulty making friends and understanding the implicit rules of relationships
  • Little adaptation to different social situations
  • Little fantasy play, alone or with a friend
  • Has interests that stand out for their intensity or theme
  • Repetitive movements of the body or parts of the body
  • Demonstrates behavioral rigidity, having difficulty adapting to change and novelty
  • Presents sensory sensitivities

In adolescents and adults, the signs of ASD are often more subtle, as people have learned various strategies and behaviors. However, social relationships often remain complex to manage. Indeed, the lack of social reciprocity, as well as difficulties in understanding the implicit aspects that govern exchanges and social relationships, often persist.

Assessment

At CERC, theevaluation of ASD is carried out in several sessions. First, we conduct an in-depth interview with the parents to retrace the person's developmental history and identify particularities in social communication, social interaction, behavior and play. During the second meeting, an assessment of intellectual potential is carried out. The person is then placed in social situations to assess reciprocal social interactions, understanding of social relationships and emotions, as well as certain aspects of play and creativity. At CERC, we use standardized and recognized tools (ADI-R, ADOS-2), which are international references for the diagnosis of ASD.

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