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TVTranscript
00:06Most people expect young children to play, interact with each other and grow up normally.
00:12This, however, is not always the case.
00:28Aaron's violent temper tantrums can last for hours.
00:34Emanuel has stripped his bedroom of wallpaper to satisfy his obsession with strips of paper.
00:42Paul has an obsession with embryos.
00:45Its legs are starting to grow in arms and its head pops out another way.
00:54The head's still there but it's really tiny.
01:00Tanya could spend most of the day walking on her toes in this way.
01:05These children have one thing in common.
01:07They've all been diagnosed as having autism.
01:12What is autism?
01:16Since the condition was first described in 1943, autism has baffled parents, professionals and medical scientists alike.
01:24Many questions still remain.
01:26What are the causes, the best methods of treatment and the long term outlook for these children?
01:33In the past, many thought that autistic behaviour was due to some sort of emotional problem.
01:37But this is not true.
01:39The autistic person has a severe developmental disorder.
01:44The severity of the disorder varies considerably between individuals.
01:48All, however, show the same pattern of disability.
01:52This pattern of disability can be divided into three groups.
01:58Most people associate autism with the presence of rituals and routines such as flicking and insisting that things remain the
02:05same.
02:09These children also have severe communication problems.
02:26In addition, social development is impaired.
02:30Autistic children isolate themselves and show very little interest in playing normally with others.
02:37Autism is a disorder of early infancy.
02:40Most parents will notice that their child is different within three years of birth.
02:45It's extremely rare for a child over three years who has developed normally to become autistic.
02:54Many children with autism look the same as any other child.
02:58This is a major problem for parents when interacting with others in the community,
03:02as their child's behaviour is definitely not normal.
03:13Concern about behaviour and development leads parents to seek professional advice.
03:17Often the first thing they do is visit their family doctor.
03:28In many cases, the child is then referred to a paediatrician or children's hospital for investigation.
03:41If autism is suspected, a further referral is made to a specialist diagnostic centre,
03:46where a series of investigations are undertaken over a few days.
03:53Often the first stage is a formal assessment which takes place in a playroom setting.
03:58Various activities are used to highlight the child's reactions and responses to a range of stimuli.
04:20The parents are observing the assessment, a detailed early developmental history is taken.
04:34The formal assessment is also videotaped for later analysis.
04:43The assessment process also includes observations of the child's behaviour in the home
04:48and the educational setting when that's appropriate.
05:02Having obtained a developmental history and completed the observations of the child,
05:07members of the diagnostic team review the evidence and rate the child's responses.
05:12A number of diagnostic tools are currently available.
05:16This diagnostic team is using the Childhood Autism Rating Scale,
05:20known as the CARS, which was developed in the USA.
05:24As a result of the total assessment, Emmanuel was diagnosed as having autism.
05:29He showed impairment in social development, delayed communication skills
05:33and obsessional and repetitive behaviours.
05:37These behaviours were evident before the age of three years.
05:42Autism is a rare condition.
05:44Some studies suggest an incidence as high as one in every one thousand people.
05:49This incidence can increase if there's already autism in the family.
05:53More boys are affected than girls, the ratio being four to one.
05:57The three diagnostic criteria will now be examined in detail, beginning with social impairment.
06:07These two children show a typical lack of awareness of each other.
06:11Patrick is using Tanya's hair in a self-stimulating way.
06:15Tanya is totally unaware of this.
06:18Both children have no interest in anything else in the room
06:20and show no interaction with the group.
06:26Children with autism are frequently described as being in a world of their own.
06:38Attempts to break into this world can provoke violent temper tantrums, which last for hours.
06:43The child may also deliberately injure himself.
06:46Aaron, this is mine.
06:52Not for Aaron.
06:58Unusual behaviour can be most embarrassing for parents.
07:02Because the child looks normal, it's easy for others to assume that the child's behaviour is the result of bad
07:08parenting.
07:09Lucy, Jonathan's mother, talks about how embarrassing this can be.
07:14The last time we took Jonathan to the Pizza Hut, he had a tantrum.
07:20He was a bit frightened because it was very crowded, as they always are.
07:25And he had a heck of a tantrum in the middle of the floor and he was kicking and screaming.
07:30We were just so embarrassed and we got so tense and upset ourselves that we just had to leave.
07:37We didn't eat, we'd ordered, we didn't eat, we just got up and left.
07:41Because we couldn't take the pressure of all eyes being focused on us.
07:47Often a major concern of parents is the lack of spontaneous affection shown by their child.
07:51Quite often autistic children will resist any form of physical affection and will only respond on their own terms.
07:58This is extremely distressing for parents, especially if the child is upset or in pain.
08:07Due to the efforts of his mother, support teacher and kindergarten staff, Aaron's temper tantrums are now less frequent.
08:13He's not so resistant to intervention at home and at kindergarten.
08:18Each child's potential to develop play and social skills varies.
08:22Aaron is very keen to participate and is learning to enjoy the kindergarten experience.
08:26Social development is an ongoing process for people with autism.
08:30Young children, such as Aaron, will need support throughout their lives to obtain some degree of social normality.
08:39Outings can provide an excellent opportunity for autistic children to practice social skills.
08:45During this outing, these children are learning social norms while interacting with others.
08:51The older child who has a degree of social awareness should be offered the opportunity to develop and practice social
08:57skills in a secure, non-threatening environment.
09:02This group of adolescents meets weekly to learn a variety of social skills.
09:09Games, activities, outings and role play are used to teach awareness of each other, how to interact with members of
09:16the group and how these skills are used in everyday situations.
09:20The group provides an opportunity to practice and to learn social skills informally.
09:25For the young adult, special social clubs can provide an opportunity to meet others and to socialise.
09:31Mark, who is the secretary of such a club, has recently moved out of his parents' home and is living
09:37independently.
09:37A bit lonely sometimes, but, um, and I tend to let the place go a bit.
09:46What about, um, shopping for food?
09:50Yes.
09:52Is that difficult? Do you find that difficult, making your money last?
09:57Mark has also had brief periods of employment.
10:02Well, I've also had work experience in the past in the library for a week.
10:08Um, except Wednesdays, they're not open on Wednesdays.
10:12Which is bloody difficult.
10:14Did you meet many people when you were working in the post office, or?
10:19No, not really.
10:21No, there's not a lot of people you can meet in the post office.
10:25What about your girlfriend?
10:26Had none.
10:28Would you like a girlfriend?
10:30What do you reckon?
10:32I'm asking you.
10:35Would you like a girlfriend?
10:37Yes.
10:39Whereabouts do you think you could go to meet a girl?
10:41I wouldn't have a clue.
10:42A lack of awareness of the existence of others,
10:45abnormal reactions to love and attention,
10:48and the lack of ability to make friendships is typical of the autistic person.
10:52Although Mark is able to function reasonably well,
10:55his level of social interaction and competence is not typical for most autistic people.
11:00The majority have major, lifelong problems with social interactions.
11:05A wide range of communication skills are affected in autism.
11:10Many people with autism do not develop speech,
11:13and are also severely limited in their understanding of language.
11:25The child is given alternative methods of communication, such as signing,
11:30the use of symbols, and picture communication.
11:34Simple words and phrases are used to increase the level of understanding.
11:41Some children can use language, but in most cases, it's deviant.
11:45Paul is talking about his work with his teacher.
11:48My throat is dark and cold.
11:50Venice is very hot.
11:52Saturday has rings.
11:55It has ten moons.
11:57Earth has one moon.
11:59Paul shows a lack of eye contact and normal interaction with his teacher.
12:03This is very common in autism.
12:05Language is sometimes used to reinforce obsessions and current interests.
12:10Remembering unimportant facts and figures, such as the number of pages in a book, is typical.
12:16It's got 23 moons.
12:19How do you know that?
12:21Yeah.
12:23How do you know that Saturn's got rings?
12:25Because it's a planet.
12:27But how do you know that?
12:28Where did you find that out from?
12:30The book.
12:31Which book?
12:34Space Traveller's Handbook.
12:36Have you read that?
12:38Yeah.
12:39Is that a big book or a small book?
12:40Big one.
12:41Big, thick one.
12:43How many pages has it got in it?
12:45I don't know.
12:46162.
12:48Andrew, in contrast, has a very limited use of language.
12:52This type of communication is more typical of the autistic person.
12:56The words he uses are a mixture of what is called ecolalia and jargon.
13:03How are you today, Andrew?
13:05Hey.
13:08Are you feeling happy?
13:10Happy?
13:10Happy?
13:11Are you feeling happy today?
13:13I don't know what am I laughing.
13:14I like tea.
13:17Are you at school?
13:20Lack of meaningful communication can lead to frustration and tantrums.
13:26It's a drink of milk.
13:28No, no, no.
13:30No, no, no.
13:31No, no, no.
13:31Come on, no, no.
13:34Catherine's speech and language skills are severely impaired.
13:37The words she uses are not related to what's happening.
13:41Apple, apple.
13:42Look.
13:44What's that?
13:46Sousasies.
13:49Rituals, routines and general resistance to change are perhaps the most obvious behaviours in an autistic person.
13:57Jonathan is seen here flicking a piece of plastic.
14:00The ritual involves wetting the plastic in his mouth before flicking it in front of his eyes and dancing on
14:05the spot.
14:07This ritual can last for hours.
14:09It's just one example of repetitive behaviours commonly seen in autism.
14:14He'll go to great lengths to satisfy this obsession.
14:17For example, he'd cross a busy road without any regard for himself or anything else to get a flicker, if
14:23allowed.
14:33During home instruction with his young brother, Aaron is keen and attentive.
14:37He does, however, lapse into ritualistic and repetitive behaviours.
14:42Holding his fork at an odd angle is a form of visual stimulation, which is often seen in repetitive behaviours.
14:51Patrick is using this block in a similar manner.
14:55A child may use a variety of objects to satisfy his need for stimulation in this way.
15:04Even when Patrick is given an alternative way to use the block, he returns to the same repetitive behaviour.
15:21Stereotyped body movements such as head weaving, rocking, spinning, head banging and so on, are used in a self-stimulating
15:28way.
15:29Each child has his own repertoire of behaviours to switch between.
15:33Five. Five, we've done so far.
15:37Five, we've done so far.
15:37Five, four, three, two.
15:40Even the child that appears to be functioning well may also show repetitive behaviours and restricted interests.
15:46Paul becomes obsessed with one topic which consumes every aspect of his day.
15:52He will amass facts and figures about the subject.
15:55He talks endlessly about it and at every opportunity and without regard for anyone else.
16:02Mark also has restricted interests and remembers trivial facts.
16:07What sort of things do you like doing in your fair time?
16:11Do you really want to know?
16:14What are your interests with?
16:17You know.
16:18But I want you to tell me.
16:22Um, yeah, reading to hear books. A lot of them.
16:27128 of them.
16:30I read a lot.
16:32I write a lot.
16:34Autistic children don't play in a normal, imaginative way.
16:37They play by themselves in a world of their own.
16:41Objects and toys are not used as intended.
16:44Aaron is using these discs in a ritualistic and self-stimulating manner.
17:00He's also resistant to change.
17:03When his teacher interrupts and attempts to redirect the ritual, a tantrum is the response.
17:22Quite often these children resist changes to any aspect of their daily routine.
17:27For example, food.
17:29At eight years of age, Stefan has a very limited range of foods that he'll accept.
17:34When offered a sandwich, he refuses to eat.
17:39Come on.
17:41Steffi, have a try.
17:43The only thing Stefan eats is strained baby foods.
17:46He has resisted changes to his diet for years.
17:50As well as food, these children also have a marked resistance to trivial changes in their daily routine.
17:56For example, if the order in which things are normally done is altered,
17:59or if well-travelled routes have changed,
18:01or the child is required to change from winter to summer clothing,
18:04prolonged temper tantrums can result.
18:09It's important to remember that repetitive routines, rituals and self-stimulating activities
18:14are part of the normal developmental process.
18:17At times, all babies will show these behaviours.
18:21Unlike the autistic child, Nellie's flapping and rocking can be easily stopped by socially interacting with her mother.
18:28Even at a very young age, the normal child is able to communicate and interact socially with others.
18:33This is the difference.
18:41No one knows the cause of autism.
18:44Links have been found with other genetic, biochemical and neurological disorders,
18:47but no one area of brain damage, or any specific biochemical abnormality,
18:52has yet been identified and directly linked to autism.
18:57Autism affects children of all intellectual levels.
19:00Popular belief is that autistic children have above-average intellect.
19:04This is not true.
19:05About three-quarters of those diagnosed with autism have a mild to severe intellectual disability.
19:21Over the years, a variety of treatments have been used, including behaviour modification,
19:26education, therapeutic techniques and drug treatments.
19:30Today, the aim is to work together with parents to achieve the best possible outcomes for their child.
19:35Having parents involved in the planning of their child's total programme ensures a consistent approach.
19:45Biscuit. Biscuit.
19:48Biscuit.
19:48You say, ta.
19:51No.
19:52Ta.
19:54Ta.
19:56Good boy.
19:58Two.
20:00It's commonly agreed that these children respond well to a structured educational environment,
20:05and the earlier this can be commenced, the better.
20:08This involves each child in an individually planned programme
20:12that incorporates the use of structured teaching methods and specific behaviour management techniques.
20:19Individual programmes should include training in communication, social interaction, self-help,
20:25independent living schools, recreation and methods to help control their own behaviour.
20:33With support, some children can be integrated into the regular educational system, where the normal skills of reading and writing
20:40can be learnt.
20:41In the long term, Paul can be expected to function reasonably well.
20:46He may, however, still experience problems in social situations.
20:52Most children will not be able to lead completely independent lives.
20:57Scott has required special education and support from an early age.
21:02As an adult, he is attending a sheltered workshop, and still requires considerable support, not only at work, but in
21:09all aspects of his life.
21:11Scott's situation is more typical of people with autism.
21:18And so the puzzle remains, a challenge for parents and those who work and live with autism.
21:24Increasing numbers of children are being referred earlier for diagnosis and for treatment.
21:29In an environment of care and professional support, there is hope.
21:35Hope that each child will reach his full potential and be able to live in our society with dignity and
21:41with understanding.
21:46Oh my goodness.
21:49I'll be theæ².
22:01It's a great deal.
22:03It's notazol.
22:04It's a great deal.
22:04I try to get a child's news when I'm in on the evening.
22:04I try to get the child's lives and I try to meet a child.
22:04I'm a mother who's a child.
22:05I try and enjoy this summer.
22:06I try and enjoy it.
22:07It's a great deal.
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