Autism Spectrum Disorder
Autism is considered a complex neuropsychiatric disorder that varies clinically from subject to subject.
It can be defined as a biologically determined behavioural syndrome with onset in the first 3 years of the person's life, which sees communication skills, social interaction and imaginative activity affected (Roberto Militerni, 2015).
The components that characterise the disorder at an early age are:
A deficit in social-emotional reciprocity can be expressed with an abnormal social approach, where the adult generally performs the function of a tool. Usually, the child does not initiate a conversation. Lack of joint attention is another possible warning sign for autism, as well as failure to engage in simple social games.
A deficit in non-verbal communicative behaviours, which are functional for social interaction, includes a poor tonic-postural control. That translates into a difficulty in adapting one's posture to another, and also in impairments in social use of eye contact, facial expressions and understanding of gestures.
Deficits in understanding and maintaining relationships appropriate to developmental level, translated in an inability to see other’s perspective (Theory of Mind), inappropriate expression of emotion (laughing or smiling out of context) and difficulties in making friends and playing with peers.
All of those can still be associated with crying anomalies (which will not play a role of early communication signal with a function of social pre-adaptation) and anomalies of the sleep-wake rhythm.
THE INTERPERSONAL RELATIONSHIP (PARENT-CHILD)
IS NEVER COMPLETELY ABSENT,
BUT OFTEN LIMITED TO A REQUEST
OR TAKES PLACE WITHOUT THE SHARING OF
INTERESTS, NEEDS AND EMOTIONS
We can observe an impairment in social interaction during the first year of life, more specifically we will notice a lack in mutual gaze with the adult, present only in some circumstances and rarely on the spontaneous initiative of the child.
The communication impairment is represented by an alteration or absence of language on the expressive and comprehension level.
In the circumstances in which the language is developed, it is however inadequate, with the presence of:
-alterations of prosody
Altered behaviour patterns, characterised by repetitive, stereotyped and restricted interests, represent the third diagnostic criteria.
Atypical behaviours can be presented under a variety of aspects:
Directed towards objects (e.g., flipping objects, tearing off paper; pouring water from one container to another; lining up toys or objects; repetitively opening and closing doors etc.) or body parts (e.g., clapping, finger flicking, spinning)
Insistence on sameness (e.g adherence to a routine lacking in flexibility; difficulty with transitions; repetitive questioning about a specific topic)
Interests limited and abnormal in intensity or focus (e.g attachment to unusual objects; obsessions; unusual fears; preoccupations with numbers, letters or symbols)
A hypo or hyper reactivity to sensory stimuli (visual, auditory, olfactory, gustatory, tactile, vestibular, proprioceptive, interoceptive), which may generate a sequence of unusual responses (e.g., aversion to have a haircut, brushing teeth; preoccupation with texture or touch; licking or sniffing objects or not edible items such as paint, play dough or shaving foam; unusual squinting of eyes)
TO FACILITATE THE AUTISTIC CHILD IN UNDERSTANDING
THE APPROPRIATE BEHAVIOURAL MODALITY, WE WILL USE “SOCIAL STORIES”
TO BE ADAPTED ACCORDING TO THE CONTEXT IN WHICH THEY ARE
(HOME, SCHOOL, COMMUNITY, HOSPITAL, CARE HOME ETC.)