The Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) [American Psychiatric Publishing (APA), 2013], is a handbook that is used by professionals around the world to diagnose mental disorders. The DSM–5 describes Autism Spectrum Disorder (ASD) as a type of neurodevelopmental disorder, which means there is atypical growth and development of the brain or central nervous system resulting in their abnormal functioning (APA, 2013).
ASD is characterised by difficulties in two domains: (1) social communication and social interaction; and (2) restricted, repetitive patterns of behaviour, interests or activities. The onset of symptoms in the two domains must be present from infancy or early childhood, but deficits may not fully manifest until social demands exceed capacities, and may be masked by learnt strategies in later life. It is important to stress that ASD itself does not cause challenging behaviours, rather, challenging behaviours are a common reaction of individuals with ASD when faced with demands that outweigh their skills.
The symptoms cause significant impairment in social, academic or occupational or other important areas of functioning (APA, 2013).
Causes of Autism Spectrum Disorder
The exact cause of ASD is currently unknown, rather the interaction between the risk factors may contribute to its development. They include:
Genetic factors – Certain genes inherited from the parent can make the child vulnerable to developing ASD.
Neurobiological factors – Abnormalities in the genetic code may result in changes in the way the brain develops and works.
Environmental factors – Parental health (e.g. infections and diseases the mother might have had during pregnancy); low birth weight, childhood illness, food intolerance and reaction of pollutants may contribute to the child developing ASD.
Emotional and behavioural difficulties associated with symptoms of Autism Spectrum Disorder
Autism is a Spectrum Disorder, meaning that the severity of each of the symptoms described below will vary from individual to individual. How each of the symptoms are exhibited, the degree to which they affect the individual’s functioning and the level of support needed will be unique to each individual with ASD.
Symptoms of restricted, repetitive patterns of behaviour, interests or activities as described in DSM – 5 (APA, 2013) that can cause challenging emotional and behavioural difficulties
- Stereotyped or repetitive body movements (e.g. tip toe walking, hand flapping), use of objects (e.g. repeatedly spinning wheels of a car, lining up objects) or speech (e.g. repeating phrases or words); moving constantly.
- Insistence on sameness, rigid routines for daily activities, or ritualised patterns of verbal or non-verbal behaviour (e.g. turning the light on and off three times before entering the classroom).
- Difficulties with dealing with changes to routines (e.g. a change in teacher, change in subject) or environment (e.g. furniture moved around, change in classrooms).
- Difficulties with transitioning from one activity to another (e.g. going from the playground to the classroom).
- Highly restricted and persistent preoccupation on an interest and obsession that is abnormal in intensity or focus (e.g. learning all about vacuum cleaners, bus schedules).
- Under sensitivity (hypo-reactivity) or oversensitivity (hyper-reactivity) to sensory input or unusual interest in sensory aspects of the environment (e.g. apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights
Symptoms of social communication and social interaction impairment as described in DSM – 5 (APA, 2013) that can cause challenging emotional and behavioural difficulties
- Difficulties with processing language.
- Difficulties with understanding language especially abstract or complex language.
- Literal interpretation of language.
- Difficulties with understanding and using appropriate eye gaze, voice, facial expressions and body language.
- Difficulties with understanding the intentions of others.
- Difficulties with taking account of what other people don’t know.
- Difficulties or failure to initiate or respond to social interactions.
- Difficulties or failure in forming, sustaining and understanding friendships.
- Difficulty understanding and discussing feelings
- Lack of interest in other people and difficulty in sharing interests, activities, and achievements with others.
- Delayed language and speech development.
- Difficulties with expressing needs or desires.
- Difficulties initiating, sustaining and ending conversations appropriately
Behaviour Zen: A transformative journey
Supporting individuals with ASD who exhibit challenging emotional and behavioural difficulties is an ever changing journey that brings new challenges and demands at different times. There are no quick fixes or magical solutions that will permanently change things overnight. Hence, the Behaviour Zen journey is an ongoing and continuous cycle of three stages: Assess – Manage – Prevent.
To learn more information please refer to: Bhargava, D. (2016). Behaviour Zen and Autism Spectrum Disorder: A Transformative Journey. Perth, WA: Behaviour Zen Company please click here
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th Ed.). Arlington, VA: American Psychiatric Publishing.