This month is autism month. The birth of a child into a family is an event viewed by most expectant parents as a joyful experience.

Plans are made for the new arrival and the whole family is thrilled to welcome the new addition. When the baby arrives, all anxiously await the appearance of the developmental milestones.

Joy begins to turn into concern when communication difficulties, demanding and peculiar behaviours and problems in emotional expression are noted.

Autism spectrum disorders (ASD) or, simply, autism is a range of complex neurodevelopment disorders characterised by social impairments, communication difficulties and restricted, repetitive and stereotyped patterns of behaviour.

Its degree and symptoms may vary from one individual to another. Its onset appears in infancy and early childhood and can be seen in delays in basic areas of development, such as early words, playing and interaction with others.

No matter the degree of severity, every autistic individual will have difficulties such as social communication and social interaction across multiple contexts, relating to others and the world around them and thinking and behaving flexibly. Although each individual with autism is unique, Mesibov et al., (2005) have identified a significant number of common characteristics and have described them as neuropsychological deficits and strengths such as:

Early signs of autism may be misinterpreted as having a ‘good and quiet baby’

• A strength and preference in the processing of visual information in comparison to the difficulties with language and auditory processing;

• Marked variation of levels of attention, where individuals may be highly distracted at times and at others may be so intensely focused that they may have difficulty in shifting their attention;

• Difficulties in communication which include impairments in the social use of language;

• Difficulty with the concept of time such as recognising the beginning or end of an activity, how long it will last and when it’s over;

• Attachment to routines and particular settings, hampering the transfer or generalisation of skills from the original learning environment;

• Special interests and intense engagement in preferred activities, resulting in great difficulty to focus interest elsewhere; and

• Sensory processing difficulties which may be displayed as strong preferences or aversions.

The number of possible combinations and varying degrees of how an individual with autism is affected by these factors clearly shows that there is no set pattern of how each may learn. Thereby, any approach implemented must be personalised.

There has recently been a steady increase in the demand for specialised services for children with autism. This is mirrored in the increasing number of referrals Inspire’s autism specialised programmes are receiving. The reported rise in the number of children being diagnosed and referred to services may be attributed to increased awareness, the broadening of the diagnostic criteria used or an actual increase in the incidence of autism.

In collaboration with the parents, the providers of services in the areas of health, social care and education must be in a position to respond and provide for the needs of autistic children, who make up one per cent of the child population (Baird et al., 2006).

Early detection can make a big difference. The best person to spot the earliest warning signs of autism is the parent or guardian with whom the child lives. Professionals are valuable partners, but the importance of the parents’ observation and experience must never be underestimated.

The earliest signs of autism are evident through the absence of typical behaviours rather than the presence of abnormal ones. Early signs of autism may be misinterpreted as having a ‘good and quiet baby’.

Any loss of previously gained skills such as early words (mummy, up, bye bye), babbling, gesturing or social play (peek-a-boo, clapping hands, waving) should be taken seriously. Early detection of autism will reap benefits. Firstly, parents can finally get answers to their questions, thereby allowing them to understand what autism is and how this will affect their child.

Once presented with a diagnosis, the family can focus on positive planning. As soon as the difficulty is identified, specialised intervention should start straight away.

In young toddlers, a straightforward diagnosis may not necessarily be made at a very early age. The child would be closely monitored and reassessed at a later age, as it may be the case that the suspected difficulties initially displayed are not a result of being autistic.

It is not necessary to have a diagnostic label to start to get help. Recommendations to address concerns can be made to target any potential difficulties from very early days, as it is never too early to start introducing strategies that tackle communication, social and sensory difficulties.

Parent training should also be initiated to enable and empower them to facilitate their child’s learning process. If there’s a concern about the child’s development, rather than worrying and hoping they will grow out of it, precious time is passing by.

For more information, call Doreen Mercieca on 2092 8112 or e-mail her at doreen.mercieca@inspire.org.mt.

Doreen Mercieca is an autism spectrum disorder adviser and forms part of Inspire’s expert panel.