- Clinical Focus
- Crisis Support
Autism Spectrum Disorders
What is Autism?
Autism is a neurological condition characterized by difficulties with verbal and non-verbal communication, social interaction, and restricted and repetitive behaviors and interests. Autism is considered a “spectrum disorder,” which means symptoms occur on a continuum and can vary in degree of severity. Autism Spectrum Disorders (ASDs), range from a more severe form known as Autistic Disorder (also referred to as “classic autism”), through Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS), to a milder form known as Asperger’s Syndrome (AS). The Centers for Disease Control’s most recent report indicates that approximately 1 in 88 children have an ASD.
ASDs can be associated with difficulties related to sensory processing, motor skills, cognitive impairment, mood and anxiety disorders, and gastrointestinal issues. It is important to note that individuals on the spectrum often have special talents and strengths (e.g., music, art, science, computers, research, memory, sense of humor, to name a few). Each individual with autism presents with unique differences, abilities, and challenges and this is why it is important to take the whole person into account when conducting an assessment and providing effective treatment.
ASDs appear to have their roots in early brain development and symptoms typically emerge in the first two to three years of a child’s life. Recent research has given us a better understanding of the neurological difficulties associated with ASDs. There seems to be a consensus that autism is a “disorder of brain connectivity.” That is, the brain of an individual on the spectrum has impaired synchronization between various important parts of the brain, which leads to difficulties processing and integrating information between the various brain regions.
A Word About Diagnoses: How do you distinguish between Autistic Disorder, AS and PDD-NOS?
I first want to point out that it is crucial we don’t get overly caught up in diagnostic labels—a diagnosis is simply a snapshot of an individual’s symptoms and there is so much more to a person than their “symptoms.” Diagnoses can be helpful in that they may assist an individual on the spectrum and his/her family in gaining a better understanding of their experiences and lead them to seek out effective treatment. Unfortunately, diagnoses also may determine what support services one is able to access and not access (e.g., through Insurance companies, the Regional Center, etc.).
The behavioral symptom triad of impaired communication, social interaction, and narrow range of interests has always been central to the diagnosis of Autistic Disorder. The main distinction between Autistic Disorder and Asperger's Syndrome is that individuals with AS do not have a history of language delays and do not show symptoms of cognitive impairment. It has been estimated that approximately 70% of persons diagnosed with Autistic Disorder have some form of cognitive impairment, with 40% of individuals displaying a severe intellectual impairment. Another factor distinguishing the two disorders is that persons with Autistic Disorder exhibit a delay in the development of age-appropriate self-help skills and often do not show as much curiosity about their environment; whereas, in peers with AS, these symptoms are not present.
PDD-NOS is a diagnostic category used when there is a clinically significant impairment in the development of verbal and non-verbal communication skills and reciprocal social interaction skills, or when stereotyped behavior, interests, and activities are present, but the full criteria are not met for Autistic Disorder or AS.
You may have heard the term “High-Functioning Autism” (HFA) used before. While this is not a clinical diagnosis, it is often used to refer to individuals who present with milder symptoms of autism. A teenager with HFA can appear relatively similar to a teenager with AS, in that they may be highly verbal, have academic success, and possess exceptional knowledge on certain topics; however, the individual with HFA likely has a childhood history of some language delay or delays in self-help skills. HFA and AS share similar features and are helped by similar treatment approaches.
Treatment of Autism Spectrum Disorders
Tidelands Counseling provides individual and family therapy for children, adolescents, and adults on the autism spectrum. Therapy is tailored to meet each client's developmental needs and capitalize on their strengths and interests. Through a collaborative process, we work with clients and their parents/caregivers to address areas of challenge and help clients reach their fullest potential.
We use a variety of empirically-supported interventions in our work with clients, including Cognitive Behavioral Therapy (modified for working with this population by Dr. Tony Attwood), Michelle Garcia Winner's "Social Thinking" model, Dr. Stanley Greenspan's DIR/Floortime model (D=Developmental Capacities, I=Individual Differences, R= Relationship-Based), and therapy based on the principles of Theraplay. The client is viewed as a "whole person" and careful attention is paid to any sensory processing issues, learning difficulties, and speech and language challenges.
Based on the needs of each client, therapy may focus on building skills in some or all of the following areas: increasing engagement, joint attention and shared affect; back and forth social interactions; regulation and coordination of sensations, emotions and movement (goal is to create optimal level of arousal for client); social skills/social cognition; expression of feelings and needs; managing interpersonal conflict; assertiveness; problem solving skills; initiation of communication and action; and strengthening skills related to executive functioning. Adolescent and adult clients also have the option of participating in Tidelands' Teen Social Group and Tidelands’ Adult Social Group, which can serve as an adjunct to individual therapy by giving them the opportunity to practice skills with peers in a supportive environment.
Since symptoms of anxiety and depression often co-occur with ASDs, therapy may also focus on helping clients develop coping skills to reduce such symptoms and increase overall quality of life.
In addition to providing individual therapy, we recognize the importance of working closely with family members to support them in understanding their loved ones’ symptoms and needs. We also provide family therapy to enhance family communication, support families in working through conflict and coping with stressors, and to strengthen family relationships. Collaboration with other care providers is equally important and we contact relevant doctors, psychiatrists, occupational therapists and others who are involved in providing care to our clients.