DSM 5 Shorthand Description of Diagnoses:
Autism Spectrum Disorder: a developmentally inappropriate and persistent pattern of predominant impairments in social relatedness and restricted interests and behaviors.
Intellectual Disability: Deficits in intellectual functions confirmed by standardized intelligence testing; deficits in adaptive functioning.
-Common Child Disorders DSM-5 Criteria
Autism Spectrum Disorder (ASD) and Intellectual Disability (ID) will be discussed together to emphasize the need for long-term care that extends beyond childhood. The concerned is about the importance of focusing on stability and long-term goals when treating this population. Most children grow into independence, but this may not be the case for those with ASD or special needs. It’s also important for providers to make sure the family’s wishes are known in case of emergencies. In extreme cases, people have harmed the person out of despair, therefore, you want to build the support and resources while considering the long-term plans.
Considerations for Treatment
- Sensitivity: People with ASD and ID can be hypersensitive to stimuli like sound or textures, which can trigger anxiety or irritability. Patience and reassurance are essential. Medications may also have atypical effects, making genetic testing a valuable tool for tailoring treatment.
- Core vs. Extra Behaviors: Medications typically treat meltdowns and other difficult behaviors but are not designed to address the core traits of ASD, like the non-verbal communication. Clinicians should clarify this with families to set realistic expectations for treatment.
- Nutrition and Health: Proper nutrition should be emphasized, especially given picky eating habits in this population. Alternative forms of medication (like patches or liquids) may be necessary, and regular monitoring of growth and bathroom habits is crucial to reduce metabolic effects.
- Simplicity in Treatment: Treatments should be as simple as possible, avoiding complex medication regimens to make it easier on the family and patient. Medication choices may depend on family circumstances (e.g., a stable home environment, transportation, financial issues). Thus, I would avoid lithium, clozapine, etc. in certain situations.
- Focus on Life Skills: Long-term treatment should prioritize life skills/activities of daily living (ADLS), and independence, not just academic performance or behavior control. Parents should understand that treatment is often lifelong and should focus on stability and future goals. Additional ASD help.
Helpful Links about Autism & Communication
Learning and treating ASD and ID is a lifelong process, especially for the general population. Some people have made assumptions that being nonverbal indicated a lack of intelligence or brain issues, which can be untrue and hurtful. Communication challenges for nonverbal individuals persist despite intensive therapy, therefore, here are some helpful resources on the topic:
- About Nonspeaking and Nonverbal: a firsthand account about a person with ASD who covers this issue.
- A Japanese author describes what it’s like to be a person with nonverbal autism…and published more than 20 books! – Time Magazine
- I Have Nonverbal Autism. Here’s What I Want You to Know: Here’s another firsthand account from a nonverbal person (and who still is) name Philip, who has his own blog: Faith Hope and Love Autism. His blog also has a list of bloggers about non-speakers and some articles about the subject. He started to communicate using the Rapid Prompting Method (RPM) that was developed by Soma Mukhopadhyay that helped her son Tito who is now a published writer and poet, in spite of his severe autism. Philip also has a list of other resources r/t RPM.
- The Art of Autism: a cool little interview from a non-speaking boy who wrote a bestseller book at the age of 9! don’t forget sometimes people with autism and mental disorders have superpowers and become prodigies.
- A story and some videos about a person who was once non-verbal and now write books for autistic children and I just love underdog stories like these –Scoop
⚠️⚠️Extra ⚠️⚠️
Warnings About Water
Children with ASD are at a particularly high risk for drowning incidents. This article shares a story about a mother’s son who ran into a pool and was unaware of the risks. Thankfully, a man intervened and saved the child, who recovered. It’s also concerning that many residential areas lack general supervision. The mother explained:
…Anything could happen in a matter of minutes, and she has since learned autistic children are especially drawn to bodies of water. ‘A lot of autistic kids, love large bodies of water, pools, lakes, and like the ocean. I didn’t know until I was in the hospital, they [the staff] let me know a lot of information about autistic kids,’ she said.
Public health data suggest that individuals with autism spectrum disorder (ASD) are at a disproportionate risk of water-related accidents, including drowning. The current study evaluated the effectiveness of a behavioral intervention package consisting of verbal instructions, modeling, physical guidance, feedback, and differential reinforcement to teach three distinct in-water safety skills to three boys with ASD. The targeted skills were (a) moving toward a fixed point of safety, (b) rolling from front to back, and (c) floating on the back and yelling for help. –NDPA
