1. What causes ASD?

ASD is thought to have a genetic component which results in atypical neurological development and functioning. A lot of research is being done to try and find the cause of autism, but as yet there are no definite answers.

  • There is agreement however that autism is no-one’s fault. It is not a parent’s fault that their child has been born with autism.
  • It is NOT a psychological or emotional disorder.
  • It is NOT the result of bad parenting and children with ASD do NOT choose to misbehave. Misbehaviour are often reactions to the environment and are expressions of the difficulties people with ASD experience.

3. What is ASD? (Autistic Spectrum Disorder)

Autism spectrum disorder (ASD) and autism are both general terms for a group of complex disorders of brain development.
ASD is a developmental disability and people with ASD may communicate, interact, behave, and learn in ways that are different from most other people.
The learning, thinking, and problem-solving abilities of people with ASD can range from gifted to severely impaired.
Some people with ASD need high support (a lot of help and intensive intervention) while others need low support (less help and less intensive intervention).

Autism spectrum disorder (ASD) are chararacterized, in varying degrees, by

  • difficulties in social interaction,
  • verbal and nonverbal communication,
  • repetitive behaviours and
  • differences in sensory perception.

5. Facts about ASD

  • Developmental disabilities such as ASD are brain-based, neurological conditions that have more to do with biology than with psychology
  • Not one person with ASD is affected in the same way
  • ASD is usually diagnosed by the time a child is 3 years old
  • ASD is found in every country, every ethnic group, and very socio-economic class
  • Autism is diagnosed four times as often in boys than in girls
  • Children who are diagnosed with ASD need early intervention as soon as possible

7. ASD includes all Autism Disorders

Recent diagnostic changes
With the May 2013 publication of the DSM-5 diagnostic manual, all autism disorders were merged into one umbrella diagnosis of ASD.

A diagnosis of ASD now includes several conditions that used to be diagnosed separately:

  • Autistic disorder
  • Pervasive development disorder (PDD-NOS)
  • Asperger Syndrome

9. Possible Signs of Autism

Call Autism South Africa if you notice 3 or more of the signs for ASD
0114849909 info@autismsouthafrica.org www.aut2know.co.za

  • Little awareness of others.
  • Self-injurious behaviour, e.g. head banging, scratching or biting.
  • Imaginative play may be poor. E.g. cannot play with a wooden block as if it is a car.
  • Unusual habits such as rocking, hand flapping, spinning of objects etc.
  • The development of speech and language may be atypical, absent or delayed.
  • Indifference to, or dislike of being touched, held or cuddled.
  • Minimal reaction to verbal input and sometimes acts as though he/she is deaf.
  • Sense of touch, taste, sight, hearing and/or smell may be heightened or lowered.
  • Changes in routine or the environment may cause distress.
  • Sudden laughing or crying for no apparent reason
  • Pursues activities repetitively and cannot be influenced by suggestions of change.
  • Uneven gross/fine motor skills.
  • Inappropriate attachment to objects.
  • Abnormal sleeping patterns.
  • Displays extreme distress and/or tantrums for no apparent reason
  • Prefers to play alone.
  • Difficulty in interacting with others and little or no eye contact.
  • No real fear of dangers.

Possible Signs (taken from Autism Ontario – Durham Region)

  • No babbling by 11 months of age
  • No simple gestures by 12 months (e.g., waving bye-bye)
  • No single words by 16 months
  • No 2-word phrases by 24 months (noun + verb – e.g., “baby sleeping”)
  • No response when name is called, causing concern about hearing
  • Loss of any language or social skills at any age
  • Rarely makes eye contact when interacting with people
  • Does not play peek-a-boo
  • Doesn’t point to show things he/she is interested in
  • Rarely smiles socially
  • More interested in looking at objects than at people’s faces
  • Prefers to play alone
  • Doesn’t make attempts to get parent’s attention; doesn’t follow/look when someone is pointing at something
  • Seems to be “in his/her own world”
  • Odd or repetitive ways of moving fingers or hands
  • Oversensitive to certain textures, sounds or lights
  • Lack of interest in toys, or plays with them in an unusual way (e.g. lining up, spinning, opening/closing parts rather than using the toy as a whole)
  • Compulsions or rituals (has to perform activities in a special way or certain sequence; is prone to tantrums if rituals are interrupted)
  • Preoccupations with unusual interests, such as light switches, doors, fans, wheels

11. Screening and Assessment

Autism South Africa assists families in accessing assessment and diagnostic services by qualified professionals.
If you would like to be assisted in getting a diagnosis for yourself or your child, please download and complete the assessment application form below.
Please send it to director@autismsouthafrica.org or deliver it to your nearest Autism SA office.
Download ASD_Assessment_Questionnaire

You will then be contacted with the next step.
Please note, the more information the diagnosing team has the better. All school, doctors or other relevant reports must be provided.

13. Autism Specific Government Schools

Schools that may assist learners with Autism Spectrum Disorder

(See also Regional Autism Organizations)

ASD Specific Government Schools

UNICA School – Pretoria
Tel: 012 460 6539
Email: info@unicaschool.co.za
Web: www.unicaschool.co.za

JHS4Autism – Johannesburg
Tel: 011 643 3050 / 011 484 2429
Email: ronel@jhs4autism.co.za
Web: http://www.johannesburghospitalschool.co.za

Vera School – Cape Town
Tel: 021 696 2844
Email: info@vera.co.za
Web: www.vera.co.za

Alpha School – Cape Town
Tel: 021 447 1212/3
Email: info@alphaschool.co.za
Web: www.alphaschool.co.za

Quest School – Port Elizabeth
Tel: 041 581 0964
Email: admin@questschool.co.za
15. Regional Autism Organizations

Regional Services that may be helpful

Action in Autism – KwaZulu-Natal
Tel: 031 261 1154
Email: info@actioninautism.org.za

Autism Eastern Cape – Port Elizabeth
Tel : (041) 581-0650
Email : info@autismec.co.za
Web: www.autismec.com
www.facebook.com/AutismEC

Autism Free State
Tel: 082 856 6618
Email: info@autismfs.org
Web: www.autismfs.org

Autism Western Cape
Tel: 021 557 3573
Email: support@autismwesterncape.org.za
Web: www.autismwesterncape.org.za

Autism & Asperger – Namibia
Tel: 00 6461 22 4561/2
Email: petrad@iway.na

Regional Services – PDF Downloads:

Services-Northern-Cape
Services-Western-Cape
Services-Mpumalanga
Services-North-West
Services-Limpopo
Services-KwaZuluNatal
Services-Free-State
Services-Gauteng
Services-Eastern-Cape

2. Growing Up downloads

Finished_at_School_guide
I am growing up
Working with an Asperger Pupil in Secondary School
I have a brother with autism

4. Adults Matter downloads

Autism-guide-for-criminal-justice-professionals-2011
Reasonable_Accommodation_in_the_Workplace

6. Disability Community downloads

Constitution of SA
UN Convention of the Rights of People with Disabilities
SASSA Document
KNOW_YOUR_RIGHTS
Parent Brochure
Code of Good Practice on Key Aspects on the Employment of People with Disabilities
Technical Assistance Guidelines on the employment of people with disabilities
The_Preferential_Procurement_Policy_Framework
MTSF 2014-2019
Outcome 1 Education MTSF Chapter
Outcome 2 Health MTSF Chapter
Outcome 3 Safety MTSF Chapter
Outcome 4 Economy MTSF Chapter
Outcome 5 Skills MTSF Chapter
Outcome 6 Infrastructure MTSF Chapter
Outcome 7 Rural MTSF Chapter
Outcome 8 Human Settlements MTSF Chapter
Outcome 9 Local Government MTSF Chapter
Outcome 10 Environment MTSF Chapter
Outcome 11 International MTSF Chapter
Outcome 12 Public Service MTSF Chapter
Outcome 13 Social Protection MTSF Chapter
Outcome 14 Nation Building MTSF Chapter

8. Information downloads and links for Parents

The Super Useful Guide To Managing Meltdowns
ASA ZFolder
Low support needs ASD
100 Day Kit for Newly Diagnosed Families
Why does Chris do that?
Bullying and how to deal with it
Classroom and Playground Support
Dietary Intervention
Asperger Sibling Brochure
10 Tips for Parents
Developmental Milestones Chart

10. Info downloads for professionals and family members

Classroom
Autism Preparation Kit For Teachers
20 ways to include a student with AS
Teacher’s Brochure
Understanding difficulties
Education SA article
Classroom and Playground Support Part 1
Classroom and Playground Support Part 2
Classroom Poster – Love goes a long way
Classroom Poster – Just because I cannot talk
Environment
Environment and surroundings
Fidget Toys ideas
Sensory Issues
The Sensory World
Medical
Going to the doctor
Doctor’s Brochure
Patients with an Autism Spectrum Disorder
Siblings
I have a brother with autism
Sibling Brochure
General
Early Years and Autism Spectrum Disorders
Going to the shops
Sexuality
Sexuality Article USA
Sexuality with your Special Needs Child

12. Autism – Practical Aspects in 7 local languages

Autism – Practical Aspects Sepedi
Autism – Practical Aspects isiZulu
Autism – Practical Aspects Tswana
Autism – Practical Aspects Sesotho
Autism – Practical Aspects English
Autism – Practical Aspects Afrikaans
Autism – Practical Aspects Xhosa

14. aut;talk publications by Autism South Africa

aut;talk Issue 01
aut;talk Issue 02
aut;talk Issue 03
aut;talk Issue 04
aut;talk Issue 05
aut;talk Issue 06
aut;talk Issue 07/08
aut;talk Issue 09
aut;talk Issue 10
aut;talk Issue 11
aut;talk Issue 12
aut;talk Issue 13
aut;talk Issue 14
aut;talk Issue 15
aut;talk Issue 16 Part-1
aut;talk Issue 16 Part-2
aut;talk Issue 17
aut;talk Issue 18
aut;talk Issue 19
aut;talk Issue 20
aut;talk Issue 21 Part_1
aut;talk Issue 21 Part_2
aut;talk Issue 21 Part_3

16. Autism-Specific Adult Services

Autism Eastern Cape (AEC) Adult Care Centre
Tel: 041 581 0650/083 267 2973
Email: info@autismec.org.za
Web: www.autismec.com

Pretoria – Lethabo le Khutso and Abrina Houses
Tel: 012 329 3627 / 7065
Email: manager@autismadults.co.za

Cape Town – Hurdy Gurdy House
Tel: 021 902 0953/056
Email: info@hurdygurdyhouse.org.za
Web: www.hurdygurdyhouse.org.za

Craighall – Adult programme for people with Autism
Tel: 082 499 7012
Web: http://appautism.org/

Cape TownThe Academy for Adults with Autism
Tel: 021 788 7652
Web: www.adultswithautism.org.za

Western CapeDe Grendel Home
Tel: 021 838 1139
Web: www.autisticadults.org.za

17. Understanding Autism – clinical description

Autism is a lifelong, complex condition that occurs as a result of disordered brain growth, structure and development. Autism is believed to stem from a genetic predisposition triggered by environmental factors and affects 4-5 times more boys than girls. There are a vast number of ways that a person can manifest their autism and as a result this condition is now more often referred to as “Autism Spectrum Disorders” (ASD).
Autism Spectrum Disorder is a lifelong, extremely complex condition that appears to result from a genetic predisposition that is triggered by environmental factors.

Autism Spectrum Disorder is a new DSM-5 name that reflects a scientific consensus that four previously separate disorders are actually a single condition with different levels of symptom severity in two core domains. ASD now encompasses the previous DSM-IV autistic disorder (autism), Asperger’s disorder, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified.
ASD is characterized by 1) deficits in social communication and social interaction and 2) restricted repetitive behaviours, interests, and activities (RRBs).
Because both components are required for diagnosis of ASD, social communication disorder is diagnosed if no RRBs are present.

Quadrant of Impairments

Regardless of the manifestation of Autism Spectrum Disorder, ALL people on this spectrum, are affected in different degrees, by the “Quadrant of Impairments” that causes a disturbance in quality of development in the following areas:-
Language and Communication. 40% of people with “Kanner/Classic autism” never speak nor understand verbal communication. Even those across the full spectrum who do have speech, often still have severe problems understanding the normal process of reciprocal communication;

Social Interaction.

People with autism, due to the altered chemistry and functioning within the brain, literally cannot fully understand other people s emotions, reactions and the complexity of social relationships (Mindblind). This can result in people with autism reacting inappropriately by our “normal” standards, thus being shunned by society, which sadly can then result in these people becoming confused and isolated from those around them;
Imagination and Creative Play. A person with autism usually becomes trapped by rigid thought patterns and behaviours, a limited range of imaginative activities, as well as a poor understanding of day-to-day concepts, jargon and the abstract.

Sensory Disturbances.

All people with ASD will have either heightened or lowered sensory perception; this may affect one or more senses.

Red Flags for possible Autism

Warning Signs of Autism in Early Childhood

Parents should ask their child’s family doctor for referral to a developmental pediatrician for assessment if there are concerns with any of the following:

Communication Red Flags

  • No babbling by 11 months of age
  • No simple gestures by 12 months (e.g., waving bye-bye)
  • No single words by 16 months
  • No 2-word phrases by 24 months (noun + verb – e.g., “baby sleeping”)
  • No response when name is called, causing concern about hearing
  • Loss of any language or social skills at any age

Behaviour Red Flags

  • Odd or repetitive ways of moving fingers or hands
  • Oversensitive to certain textures, sounds or lights
  • Lack of interest in toys, or plays with them in an unusual way (e.g., lining up, spinning, opening/closing parts rather than using the toy as a whole)
  • Compulsions or rituals (has to perform activities in a special way or certain sequence; is prone to tantrums if rituals are interrupted)
  • Preoccupations with unusual interests, such as light switches, doors, fans, wheels
  • Unusual fears

Social Red Flags

  • Rarely makes eye contact when interacting with people
  • Does not play peek-a-boo
  • Doesn’t point to show things he/she is interested in
  • Rarely smiles socially. Asperger’s Disorder is characterized by severe and sustained impairment in social interaction combined with restricted, repetitive and stereotyped patterns of behaviour, interests and activities (DSM-IV, 1994).

This disorder differs from autism in that “few clinically significant delays in language or cognitive development are apparent, and self-help and adaptive behaviours often appear normal.” (Rapoport & Ismond, 1996).

Rett’s Disorder is the only subtype of PDD which occurs exclusively in females. In this disorder, development seems normal through the first five months of life, followed by deceleration of head growth, loss of previously acquired purposeful hand skills with subsequent development of stereotyped hand movements, loss of social engagement, appearance of poorly coordinated gait or trunk movements, and severely impaired expressive and receptive language, (DSM-IV, 1994).

Childhood Disintegrative Disorder is characterized by development that appears normal through the first two years of life. Following this, abnormalities develop in at least two of the following areas: social interaction, communication, and restricted, repetitive, stereotyped patterns of behaviour, interests, and activities. In addition, there is clinically significant loss of previously acquired skills (before age 10), in at least two of the following areas: expressive or receptive language, social skills or adaptive behaviour, bowel or bladder control, play, and motor skills. (DSM-IV, 1994).

The category of PDD-NOS is used when there is severe and pervasive impairment in the development of reciprocal social interaction and verbal and nonverbal communication skills, or when stereotyped behaviour, interests and activities are present, but symptoms do not meet the criteria for other disorders. (DSM-IV, 1994).

Typically, Pervasive Developmental Disorders are extremely incapacitating, and their symptoms are chronic and lifelong (although this is less the case for Asperger’s Disorder). “Factors considered most important for determining prognosis are IQ levels and development of social and language skills” (Rapoport & Ismond, 1996). Identification of variables that predict outcomes reliably continue to undergo intense study within the scientific community. Given the chronic nature of PDD, however, long-term treatment is typically required.

Intellectual Disability (Intellectual Developmental Disorder)

Diagnostic criteria for intellectual disability (intellectual developmental disorder) emphasize the need for an assessment of both cognitive capacity (IQ) and adaptive functioning. Severity is determined by adaptive functioning rather than IQ score. The term mental retardation was used in DSM-IV. However, intellectual disability is the term that has come into common use over the past two decades among medical, educational, and other professionals, and by the lay public and advocacy groups.

Communication Disorders

The DSM-5 communication disorders include language disorder (which combines DSM-IV expressive and mixed receptive-expressive language disorders), speech sound disorder (a new name for phonological disorder), and childhood-onset fluency disorder (a new name for stuttering). Also included is social (pragmatic) communication disorder, a new condition for persistent difficulties in the social uses of verbal and nonverbal communication. Because social communication deficits are one component of autism spectrum disorder (ASD), it is important to note that social (pragmatic) communication disorder cannot be diagnosed in the presence of restricted repetitive behaviours, interests, and activities (the other component of ASD). The symptoms of some patients diagnosed with DSM-IV pervasive developmental disorder not otherwise specified may meet the DSM-5 criteria for social communication disorder.

References/Definition of Autism

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
Autism Society of Maine. (No date). Autism. [Brochure]. Gardiner, ME: Author.
Klinger, L. & Dawson, G. (1996). Autistic disorder. In Marsh, E. & Barkley, R. (eds.), Child Psychopathy (pp 311 – 339). New York: Gilford Press.”