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Autism spectrum disorder (ASD) in children

Pānga takiwātanga

Autism is a lifelong condition that affects communication, social skills and behaviour. Autism shows in many different ways, so we use the term autism spectrum disorder (ASD) to describe the whole range of symptoms and behaviours, from mild to quite extreme.

Tamariki (children) with autism have a wide range of challenges and strengths and these can vary with age and over time.

Autism usually becomes obvious before the age of 3, though people with mild autism can go through life without being diagnosed.

We still do not know exactly what causes autism, but research shows that genetic factors are important, meaning it's passed down in whānau (families).

Symptoms of ASD

Tamariki on the autism spectrum usually have difficulty in three distinct areas: social skills, communication and thinking and imagination.

Social skills

Tamariki with ASD find it difficult to make sense of social cues. This makes it hard for them to form and maintain relationships, even if they want to. They may behave in unusual or inappropriate ways.

Speech and communication

Tamariki with ASD have difficulty with non-verbal communication and sometimes with speech. They often find body language and facial expressions hard to figure out. They may speak in an unusual way, such as sounding formal.

Thinking and imagination

Tamariki with ASD find it hard to be flexible in how they think and behave. "Pretend" play can be difficult. They may also dislike changes to their routine.

Common ASD behaviour

Tamariki with ASD often find it difficult to process sensory information. This sensory information can come from within their own body (for example, balance) or from the world around them (for example, sights and sounds). They may be extremely sensitive to it, or they may not notice it at all.

Because we rely on our senses to feel safe and to relate to others around us, tamariki on the autism spectrum can find it very hard to take part in day-to-day life. They might be anxious or withdrawn, they may over-react or appear uninterested and unengaged. They might develop repetitive behaviours, such as flicking or flapping their hands as a way of coping with too much or too little stimulation.

They often have unusual interests. Some tamariki with ASD may find learning difficult, but many are of average or above-average intelligence.

Fussy or problem eating is common in tamariki with ASD. They may be sensitive to the taste, colour, smell and texture of foods. They may limit or totally avoid some foods and even whole food groups. Dislikes may include strongly flavoured foods, fruit and vegetables or certain textures such as slippery or soft foods. It may also be hard for a tamaiti (child) with ASD to sit down and eat a meal from start to finish.

Diagnosing ASD

There are several things that may indicate your tamaiti has autism. KidsHealth lists the signs and symptoms.

If you think your tamaiti may be on the autism spectrum, talk to your general practice team. Your general practice team will ask questions about your child’s history and behaviour and will watch your tamaiti playing. They will also check their general health and what they can and cannot do. Your general practice team may refer your tamaiti for hearing and sight checks.

If your general practice team think your tamaiti may have ASD, they will refer you to a child development specialist or paediatrician (specialist children's doctor).

A development specialist or paediatrician will also ask about your child’s history and behaviour, watch your tamaiti and do some neurological (nerve and brain) examinations.

They will diagnose your tamaiti after watching how they behave in different situations and listening to what you've noticed. They may speak to your child's teachers and other health professionals, such as a psychologist, speech-language therapist, and occupational therapist if they're involved.

If your tamaiti is very young, their diagnosis may change as they get older.

Supporting my tamaiti with ASD

Every tamaiti with ASD is different. You know your tamaiti best, but health professionals such as occupational therapists, speech-language therapists and dietitians can help you understand sensory, play, communication and eating behaviour differences. They can help you work out strategies that will help your tamaiti and will continue to support your tamaiti and help them manage their unique difficulties.

Autism New Zealand runs courses to understand your tamaiti and learn ways to help them.

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Written by a private occupational therapist, Canterbury. Adapted by HealthInfo clinical advisers. Last reviewed August 2021.


Page reference: 242462

Review key: HICDG-40335