What is Autism Spectrum Disorder?

Autism Spectrum Disorder (ASD) is a lifelong, developmental disability that affects how a person communicates with and relates to other people, and how they experience the world around them. The effects of Autism and the severity of symptoms are different in each individual, but the main characteristics are:

• persistent impairment in reciprocal social communication and
• social interaction (e.g. eye contact, smiling, use of gestures, spoken language, recognising and expressing emotions, taking turns, understanding personal space, etc); and
• restricted, repetitive patterns of behaviour, interests, or activities (e.g. rocking/ flapping/ spinning of body, spinning wheels, lining up objects, resistance to changes in routine, etc).

What are some conditions that can occur with Autism Spectrum Disorder?

Close to ¾ of children with autism also experience another medical condition. This is called ‘comorbidity’. Comorbid conditions may occur at any time during a child’s development. Some conditions might not occur until the person reaches adolescence or adulthood. It is important to consult a pediatrician to identify the condition, in order to find the most effective way to treat both autism and the comorbid condition. Common comorbid conditions include sensory issues, sleep problems, gastrointestinal symptoms, attention deficit hyperactivity disorder (ADHD), bipolar disorder, anxiety disorder, clinical depression, down syndrome, intellectual disabilities, OCD, seizures and epilepsy, macrocephaly and microcephaly and immune disorders. If you would like to find out more information about each condition, please visit https://www.babybonus.msf.gov.sg/.

What is Asperger Syndrome? How is it different from Autism Spectrum Disorder?

Asperger syndrome, or Asperger’s, was a previously used diagnosis on the autism spectrum. In 2013, it became part of one umbrella diagnosis of ASD in the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5). Individuals with Asperger Syndrome have strong verbal language skills and intellectual abilities. Similarly to individuals with ASD, they tend to experience difficulty in social interaction, desire for sameness and restricted interests. However, their strengths may include exceptional focus, persistence and attention to detail.

What are some signs of Autism Spectrum Disorder?

Although children develop at different rates, there are some early signs that can be observed in children with autism. Some red flags may include:

• Inconsistency with responding to his/her name

Who can diagnose Autism Spectrum Disorder?

Autism Spectrum Disorder can be diagnosed by psychologists, child psychiatrists, or developmental paediatricians who are familiar with and have clinical experience in diagnosing ASD.

Why is it important to diagnose my child?

It can help you obtain needed services (eg. early intervention, therapy), set appropriate goals, and gain an understanding of your child and the stresses your family may face. If you have any concerns regarding your child’s development, speak to a family doctor, your General Practitioner (GP) or a paediatrician immediately. If the healthcare professional did not express any concerns about your child’s development, but you still feel worried, feel free to seek a second opinion. The earlier you discover what condition your child is facing, the earlier you can provide the most appropriate help your child needs. For example, children with ASD may experience meltdowns due to sensory issues. Children who are not diagnosed may be misunderstood as being “naughty”. However, with a diagnosis, you and your child will be able to receive the right support; you will be able to get access to the correct strategies to manage meltdowns.

What causes Autism Spectrum Disorder?

There is currently no known cause for Autism Spectrum Disorder. However, research suggests a combination of genetic and nongenetic, or environmental influences. These influences suggests an increased risk of a child developing autism. However, it is imperative to understand that increased risk is not the same as cause. E.g. Some changes in gene linked with autism are similarly identified in people who do not have autism. Similarly, not everyone exposed to an environmental risk factor for autism will develop the condition. Genetic risk factors Research shows a possible genetic link, as autism and related conditions seem to run in families. If one identical twin is diagnosed with autism, the other twin has a high probability of also having autism. Environmental risk factors Research found that prematurely born children and those with older parents are at a slightly higher risk of autism. Studies have also shown early brain overgrowth in children with ASD. This means that the brain grows faster than average so that different parts of the brain don’t communicate with each other in a typical way. Over the last two decades, scientists have conducted extensive research to determine whether there is any link between childhood vaccinations and autism. It is clear that vaccines DO NOT cause autism.

How common is Autism Spectrum Disorder?

In Singapore, 1 in 150 children has autism. Statistics have also revealed that the prevalence is 5 times more common among boys than girls.

How does Autism Spectrum Disorder affect learning and development?

Most children with ASD find it hard to communicate and pay attention to others. The ability to pay attention is crucial in learning anything- if a child is not paying attention, he is not able to absorb anything that a teacher or a parent is teaching him. Behaviours, such as being able to sit for an extended duration of time, sustained attention, waiting, eye contact and joint attention, emotional regulation, etc, are essential for effective learning to take place. These are what we call “learning to learn” skills and is a major focus at Our Special Story. Children with autism may also find it hard to take perspective. This affects their ability to pick up social cues, predict others’ behaviours or understand complex situations; which results in difficulty in making and maintaining friendships with their peers.

What does special needs mean?

‘Special needs’ is an umbrella term for a wide array of diagnoses. Individuals with ‘special needs’ may have issues with learning, behaviour, developmental, medical, intellectual or mental health. Besides Autism Spectrum Disorder (ASD), some of the more common conditions may include Attention Deficit/Hyperactivity Disorder (ADHD), Down Syndrome, Dyslexia, Cerebral Palsy, or Hearing loss.

What is Special Educational Needs?

Special Education is the practice of educating students in a way that addresses their individual differences and needs. The term ‘Special Educational Needs’ is used to describe learning difficulties or disabilities that make it harder for children with special needs to learn than most children of the same age.

How do I know if my child has Special Educational Needs?

According to the Ministry of Education, a child is considered to have Special Educational Needs (SEN) when: - He/she has been diagnosed with a disability; and - He/she requires different or additional resources beyond what is generally available for the majority of his peers of the same age - He/she shows greater difficulty in learning as compared to the majority of same-aged children. These difficulties may include academic, social, language, or physical abilities.

What is early intervention?

Early intervention is a term used to describe the services and support available to babies and young children with developmental delays and disabilities. These may include speech therapy, occupational therapy, physical therapy, psychological evaluation, Applied Behaviour Analysis (ABA) therapy and others.

Why is early intervention important?

Research has generally shown that the first seven years of a child’s life is a critical period for his/her development intellectually, socially and emotionally. Intervention is likely to be more effective and less costly when it is provided earlier in life rather than later. Positive early experiences are essential prerequisites for later success in school, workplace, and the community.

How does early intervention support a child's development?

Early intervention to young children have shown to positively impact outcomes across developmental domains, including language and communication, cognitive, and social development. Research found that non-verbal children who begin early intervention in preschool years are more likely to become verbal, as compared to those who begin intervention over the age of 5.

What is ABA?

Applied Behaviour Analysis (ABA) is a type of therapy based on the science of learning and behaviour. The methods and techniques of behaviour analysis have been used and studied for over 40 years, and it is considered an evidence-based best practice treatment for Autism Spectrum Disorder by the US Surgeon General and by the American Psychological Association. Click on ‘Infographics’ under our ‘Resources’ tab to learn more!

What is ABA therapy used for?

ABA techniques can be used to increase positive and decrease undesired behaviours. It can also help to increase language and communication skills, improve attention, focus, social skills, memory and academics.

Who can benefit from ABA?

ABA can be applied to individuals of all ages, including typical children and adults. It has been scientifically proven to be effective for individuals with Autism Spectrum Disorder, Attention Deficit Hyperactivity Disorder (ADHD), Down Syndrome (DS), Global Developmental Delay (GDD) and related developmental delays.

How does ABA therapy work?

As the saying goes, “If you have met one person with Autism, you have met one person with Autism.” At Our Special Story, we do not believe in a cookie-cutter approach. Programs and strategies are individualised and formulated by Behaviour Consultants according to each child’s unique learning styles. Skills and desired behaviours are positively reinforced to increase their occurrence. We also adopt a child-centred and naturalistic approach to ensure that your child is able to be functionally independent and generalise the skills in their daily routines.

What do ABA therapists do?

ABA therapists typically works one-on-one with a child with special needs. During each session, our therapists are constantly breaking down skills into smaller tasks to help students understand skills and concepts in a more effective way. Therapists are also trained to assess antecedents and consequences with every behaviour and are guided by Behaviour Consultants to implement strategies according to your child’s needs.

When do you use ABA?

ABA is a dynamic and flexible approach. It can be utilised in various settings, including homes, schools, clinics, workplaces and in the community. You can use ABA to teach any skill that you would like your child to acquire and perform independently. You can even use ABA to reinforce your spouse for being on time or motivate your staff to work harder!

Does ABA really work?

Yes! More than 20 scientific studies have established that intensive and long-term therapy using ABA principles improves outcomes for children with autism. These studies show improvement in the children’s intellectual functioning, language development, daily living skills and social functioning. A 5 year study by the University of Washington investigated the benefits of ABA-based early intervention. They found that children who participated in the ABA-based early intervention program displayed an improvement in IQ by an average of 18 points, while children who only participated in community-based intervention showed an improvement in IQ by an average of 4 points.

Why does ABA therapy require intensive hours?

The purpose of intensive therapy hours is to provide children with structured intervention. The environment is systematically manipulated to help a child remain successful while teaching new skills quickly. Children with special needs also tend to learn better with consistent repetition. Frequent therapy allows teaching and learning to be as effective as possible, because the child will be able to retain the skill or information taught better, allowing quicker progress; while irregular or low frequency of therapy may lead to the re-teaching and re-learning of previous learned skills and targets, thus not utilising time, effort and cost effectively.

What is inclusion?

Inclusion means embracing everyone regardless of race, age, gender, disability, religious and cultural beliefs and sexual orientation. Inclusion means removing all barriers, discrimination and intolerance. Inclusion means making everyone feel accepted, valued and supported, no matter the environment they live in. Inclusion is about how we structure our schools, classrooms and lessons. An inclusive classroom allows all learners to participate and learn together in a supportive environment, including those with learning differences or disabilities. Inclusivity also means respecting people from all backgrounds and cultures. By emphasising on the importance of this, we can all help to build a more tolerant and understanding community in classrooms, schools, as well as in the society.

What are the advantages of inclusion in schools?

Children in inclusive classrooms have more opportunities to develop empathy for others and to learn how to look out for their peers. Children with special needs also benefit from inclusion because they are able to observe and emulate same-aged children. It is important for children to have a typical school experience to provide them an opportunity to learn appropriate social behaviours and to learn from their peers. Of course, some children may find such skills challenging; thus it is also crucial to assess your child’s behaviour and ability before you decide which school is best for him/her.

What can I do to promote inclusivity?

Think about your own values and thoughts to disability, gender, race, etc. Do you tend to make stereotypical judgments of people? By using stereotypes (unconsciously or consciously), you may be alienating and marginalising people. Do you accept or encourage different perspectives, ideas and experiences that strays from the norm or your own? By being open and respectful, you can help promote diversity and equity. Do you treat your students as individuals and acknowledge the experiences of students from different backgrounds and abilities? Similarly, by creating an open, honest and respectful classroom that accept differences and promote understanding, all students can feel supported and valued.

How can I help my child to be successful in an inclusive classroom?

Parents can play a big part in helping your child to succeed in an inclusive classroom. The school needs to be informed that your child has Special Educational Needs (SEN), so that the school is able to do the necessary preparations. It is important to arrange for a meeting with the school’s principal and teachers involved to provide them with relevant background information about your child. Specific goals can then be set in the child’s Individualised Education Program (IEP). Certain schools may not have enough resources and support to work with children with special needs. Parents may also provide support by hiring shadow teachers. Shadow teachers from Our Special Story will work together hand-in-hand with your child’s school teachers to support his academic learning and social situations.

How can shadow teachers help my child in a mainstream setting?

Shadow teachers are able to provide individualised attention to a child with SEN when necessary, and fade herself in situations where the child can be independent. Children with Autism Spectrum Disorder tend to have greater difficulty socialising with their friends; shadow teachers are able to assist by teaching the child appropriate social skills.

My child is missing some of his milestones, but I don't know what's the problem. What should I do?

Every child grows and develops at different pace and speeds. Milestone checklists are a helpful baseline, but not every child will hit each stage according to its projections. ​ However, some missed milestones can be red flags that point to larger complications. By 12 months: No babbling or gestures such as pointing, waving, or showing By 16 months: No words By 24 months: No two-word meaningful phrases It is best to seek professional advice as early as possible. Book an appointment with a doctor or a consultation with us to help you with your next steps.

I have not heard of ABA therapy. How can ABA therapy help my child?

ABA (Applied Behavioural Analysis) therapy can improve various aspects of your child's developmental areas including,

• behaviour,
• speech and communication,
• attention,
• school readiness skills,
• social skills and more.

Is my child too young to start therapy?​

We have worked with little ones as young as 18 months! Expect nothing but fun-filled and engaging sessions where your child will learn through play as we work on various skills such as joint attention, imitation, pointing to share interest, and receptive language. ​ Early intervention is key.