Autism Spectrum Disorder

Art by Eliza Mantyh's 
				second-grade class, American School of The Hague, 2012

Considered a neurodevelopmental disorder, autism spectrum disorder (ASD) is usually diagnosed at an early age.

The term spectrum means that signs and symptoms vary in occurrence and severity, and each individual is affected differently along that span. It is more prevalent in boys than girls, but the acceptance of a consensual body of theories around its origin has proved elusive so far, with new scientific articles on the subject coming out every month.

Symptoms affect three major areas, namely social interaction, communication, and behavior (stereotypical and repetitive patterns of interest and activities), and vary widely. Some individuals might be severely affected while others are not. Parents are usually the first to notice certain reactions/absence of reactions, patterns, or behaviors that indicate something isn't quite right with their child. More to the point, sometimes it is difficult to get a diagnosis, which considerably increases the parents' anxiety and pain.

Certain aspects of ASD have an intense effect on the child's and the family's everyday life. A child with ASD, for instance, might have a hard time coping with routine changes, such as a different car route to school, a new tooth brush, or a different brand of peanut butter. This difficulty can lead to very intense and uncontrollable tantrums that can occur in the family's home or at the supermarket, for example. Children might not be able to follow daily routines involving hygiene or feeding and might need constant support or supervision. Self-stimulatory behaviors (such as echolalia, flapping, or jumping) affect the child's ability to learn and integrate into his/her surrounding environment.

To face these challenges, several therapeutic interventions have been developed since the 1960s and 1970s, such as the Son-Rise Program, Greenspan Floortime, TEACCH, Applied Behavior Analysis (ABA), and Pivotal Response Training. Parents also try nutritional changes and hippotherapy, therapy with dolphins, or music therapy as complementary approaches.

Whatever the approach, one must keep in mind the goals we have for the child. Do you wish to decrease self-stimulatory behaviors to help the child better adapt to society's rules and expectations? Or do you view these as means of expression and accept them as part of the child's way of dealing with anxiety? Do you go for a more restrictive or a more comprehensive approach? Which one will best prepare your child for an independent life? And which will bring more happiness?

How can counseling help?

  • Counseling can provide coping strategies for all the family members, observing and making suggestions for changes in daily routines and transitions so that they become as smooth as possible.
  • One-on-one work with the child helps improve skills and changes inadequate behaviors, providing a space and time for creativity and expression.
  • Making psychotherapy available to family members helps them cope with emotional issues, such as anxiety and depression.