What is the TEA?
According to the World Health Organization (WHO), 1 in 160 children have autism.
The ASD autism spectrum disorder, is a neurodevelopmental disorder that is present in childhood and accompanies the person throughout life, as its name indicates, being a spectrum, it is varied and broad, so it cannot be generalized, Since we are not going to find two identical people, and with the same characteristics, each one from their particularity will have a way of being, communicating, thinking and acting, where the information process can occur in a different way.
In the TEA we will find people who may have an associated intellectual disability and others who may not. In the same way, a large group of people with the condition may present a specific sensory profile, which affects their own way of processing the different stimuli in the environment (Bogdashina, 2016).
It is important to highlight that the ASD condition cannot be limited to a clinical vision of a disorder or an abnormal form of development, but rather, on the contrary, as an expression of human diversity; in which the person travels a different route in the socio-cultural construction process.
People with ASD present difficulties in 3 aspects:
Communication. Verbal language is not always the best form of communication for people with this condition, they can have different linguistic levels. A high percentage may present difficulties when communicating and manifest it in various ways:
Comprehensive language:
- Understanding the messages orally.
- Difficulty understanding non-verbal communication (gestures, directions, emotional expressions).
- Although they understand words separately, it is difficult for them to integrate them into a sentence and understand the full meaning.
- They have difficulty understanding jokes, jokes, metaphors, or sarcasm.
expressive language:
- They may have difficulty expressing what they feel or what they think
- They may find it difficult to end a conversation when it is a topic of interest to them.
- They may use excessively formal language.
- Sometimes they may use language that does not fit the context.
- Some use intonation that is unusual.
Social interaction.
- They may have difficulty adapting their behavior to different contexts.
- Holding a conversation can sometimes be difficult.
- In some cases there may be difficulty in non-verbal communicative behaviors, such as gestures, facial expression or maintaining eye contact.
- They can be very social, but sometimes they don't have clarity on how to interact with others.
Repetitive and restricted interests.
- Your interest in topics and/or objects can take up an important part of your time and sometimes this will interfere with your activities.
- These behaviors can be verbal or non-verbal.
- They may have repetitive behaviors. (always follow the same routes or always greet and say goodbye with the same words, dress in the same way, always go to the same cafeteria, etc.).
- Their way of thinking tends to be inflexible and concrete, so they do very well in activities that require attention to detail and repetition of patterns.
Warning signs during the first 3 years of life:
Some signs that may occur in the development of language and communication:
- Delayed language development: absence of speech, or limited use of words and/or short phrases.
- Perception that the child's vocalizations are not directed at people, or only appear in moments of frustration or need.
- If speech exists, a particular intonation or timbre of voice may be perceived.
- The child's language seems very repetitive or inflexible (signs of echolalia, or repetition of the words and phrases heard).
- In times of need, may communicate by holding hands and leading adult to desired object, sometimes without making eye contact.
- Limited use of signage to communicate their social intentions.
- Limited use of gestures to communicate.
Some signs that may occur in social interaction skills:
- Limited use of eye contact
- Decreased or absent social smile, the person does not usually smile at friendly smiles generated by adults or only smiles if they are tickled.
- Little use of facial expressions to communicate.
- Shows little shared pleasure in different social activities, with peers or adults.
- Limitation or absence of response to the call by name.
- Does not give out conspicuous objects or toys to other people in order to share their interest, or only give out when they need help.
- Does not show conspicuous objects or events to other people, or does so very sporadically.
- Does not seem to follow the direction of the adult's gaze or pointing to locate an object.
- Few social approaches of the child towards other people, or they only appear in situations where they need help.
Warning signs during the first 3 years of life:
Some signs that can appear in the game:
- Plays with toys in a particular way, either repetitively or apparently not functional (example: does not use the car to roll it around the house, but to flip it over and spin its wheels).
- Only plays with construction games such as legos or puzzles, without showing signs of pretend play (eg, feeding a baby or acting out actions with toys).
- Limitation in imitation skills, does not usually imitate frequently or only imitates very striking or particular actions.
Some signs that may appear in their behavior:
- Particular sensory responses to different stimuli (example: covering the ears to specific noises, marked selectivity towards different types of food, difficulties with the use of shoes, stockings or certain textures of clothing, sidelong glances, among others)
- Repetitive movements of your hands, fingers, or other mannerisms (flapping, particular finger postures, whole body jerking).
- Presence of self-injurious behaviors (eg, head banging, slapping, biting, or hair pulling).
- Very marked, repetitive or inflexible interests.
- Difficulty with changes and transitions between activities.
Support levels:
Currently, the DSM V refers to 3 levels of support that require
people with ASD, both for the area of communication and social interaction and for repetitive and restricted interests.
People who are on the autism spectrum will need support throughout their lives whose intensity can vary, this will depend on the needs and difficulties that the person presents in communication and social interaction and on repetitive and restricted interests. Here it is important to highlight that support can be low at one moment, but at another it can be high or vice versa. This is related to the abilities that the person has and to the demands that the environment requires at certain times, where in a space or at an age of development, the support may vary. These levels of support are described in a general way below:
Very substantial support (high)
Social comunication:
Marked commitment to verbal and non-verbal communication skills. (example, no speech)
Initiates no or very few interactions (only to satisfy basic needs)
He does not usually respond to social approaches, or only does so before those who are very direct.
Restricted Interests and Repetitive Behavior:
The inflexibility of behavior, the extreme difficulty coping with changes or other behaviors restricted/repetitive, interfere markedly in operation in all spheres.
Substantial support (medium)
Social comunication:
The person has developed some kind of language, but only communicates with simple phrases.
Initiates interactions mainly related to their main interests.
Responds in a particular or reduced way to the approaches of others.
Restricted Interests and Repetitive Behavior:
The inflexibility of behavior and thought is observable in different contexts and people, however its level of interference is lower than in the level of very substantial support.
Requires support (low)
Social comunication:
The person has developed skills in constructing complete sentences and engaging in communication, however they may still fail to flow back and forth in conversation.
You may have difficulty establishing friendships or responding to certain social overtures from other people.
Restricted Interests and Repetitive Behavior:
The inflexibility of behavior and thought can interfere in one or some specific contexts (example: study, work, family life). Or the person may have difficulty planning, organizing their time, or completing their tasks.
What to do in case of suspected ASD:
Faced with warning signs for suspected developmental disorders, it is necessary for the family to attend a growth and development appointment. It is recommended to follow the route established in the clinical protocol for diagnosis, treatment and comprehensive care route for children with autism spectrum disorder. https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/DE/CA/Protocolo-TEA-final.pdf
Early detection. There are several tools used for the diagnosis of ASD, one of them is the M-CHAT R (Modified Checklist for Autism in Toddlers), which seeks to detect children between 16 and 30 months.
Application of specific tests for the diagnosis of ASD. There must be a team of trained professionals, who can observe and interact with the person, based on the application of observation tests that allow the collection of information, as well as a behavior analysis. Among others, there are tests such as the ADIR (Interview for the diagnosis of autism), ADOS (Observation scale for the diagnosis of Autism), to determine according to the criteria of the DSM V, if the person may have the condition of Tea.
Intervention. Once the ASD condition is confirmed, this person must enter an intervention with professionals, who will be facilitators and will generate strategies that help in the process of the child, adolescent and adult, for this the strengths and weaknesses must be known, and from they set out clear objectives, in the short, medium and long term.
Early and timely intervention plays a vital role in the process of the person and their family. It is essential to consolidate a personal plan in which social interaction skills, play, management of possible challenging behaviors, autonomy skills, grooming, personal development, among others, are stimulated.
Said stimulation must be comprehensive and intensive, taking advantage of different programs that currently have extensive scientific evidence, for example the Denver Model of early attention.
In the same way, it is essential to consider that there are three areas of special influence on the quality of life of the person with ASD and their family: communication, behavior and leisure (Simarro, 2015). In this sense, any comprehensive program must set objectives and concrete actions that favor the development of skills, provision of supports and the adaptation of necessary environments in these areas and the other dimensions of quality of life of the human being (personal development, physical well-being, emotional well-being, rights, personal development, interpersonal relationships, social inclusion and material well-being. )
Participation spaces. Participation in natural and everyday spaces is essential, where there is an opportunity to teach skills, share and learn. These spaces refer to the places that the child, adolescent and/or adult attends, where they can interact with people their age, and enjoy spaces such as parks, shopping centers, school, restaurants, university, work, among others.
For the success of the processes described above, it is necessary to take into account:
Trained professionals, who have knowledge about ASD, who provide strategies and tools to the person and their family. The training of both professionals and families is necessary to generate intervention and support programs based on scientific evidence, likewise it helps to break down myths and stigma that is generally held about ASDs.
2. Know and identify the person as a being with strengths, weaknesses, dreams and goals.
3. Remember and keep in mind the person's life course.