Unique Difficulties of Children with ASD
The world through your ASD child's point of view
Suppose, you are parachuted in to a crowded market in Beijing. You are not Chinese, you do not understand Chinese but people are constantly asking you questions, giving you directions and yelling at you. You have absolutely no idea what's going on. To make things worse, you drop your eye-glasses and with out glasses you cannot see anything close. You are walking half blind through a crowded place. You are a vegetarian & the smell of strong Chinese food is piercing through your nose… Now imagine you are stuck in that market for a week.
1. How would you feel?
2. Would you try to maintain eye-contact and have a nice conversation with people?
As a human being your first instinct is to run away from that place. If that is not possible, you will show your discomfort and annoyance by yelling at people. When that also fails, you will find a corner for yourself and try to somehow manage your life in that corner.
Children with ASD may be understood to be in a similar situation. They hear, see, feel and smell things differently compared to neurotypical people. They are in a world which doesn't understand them and that they don't understand as well. Please read through the unique difficulties these children have. Some children face all these problems and others may a few.
Auditory (Hearing) Processing Problems
An ASD child can have mild to severe hearing issues. However their hearing issues are very different from a deaf child's hearing problems. Children with ASD can hear things but they process what they hear differently compared to neurotypical people. Sometimes, they hear when a pin is dropped (hypersensitivity) but sometime they don't hear when their name is called (hyposensitivity). Sometimes the softest sound can hurt their ears while other times they are oblivious to even cracker noise. They may even have a delay in processing what they hear. Which means they may not process what you are saying to them in real-time, so they take a long time to respond to your questions.
Visual (vision) Processing Problems
An ASD child can have mild to severe visual issues, yet their visual problems are very different from a blind child. Children with ASD see things differently. Imagine you are wearing your grandfather's high power glass. Your vision will alter significantly and if you try to climb down stairs with that glass, you may even fall. ASD children see their environment in such distorted / altered manner. As a parent or therapist, we may never know how they are seeing things. In the same manner, the child may never realize that we are seeing things differently. They may be seeing things in pieces and may not know how to put them all together; at times they see things only partially. Certain lights like fluorescent lights or flickering lights may be very disturbing to them as well.
Touch and Smell Processing Problems
Just like the auditory and visual processing issues, children with ASD may also experience problems with touch and smell. They may be hypo or hypersensitive to touch and smell. Many ASD children hate gentle touch while they love deep pressure touch. Deep pressure touch is relaxing and may calm some children (but not all). Some children hate swings while others love it. While certain touch and smell evoke tantrums in them, for others it can have a therapeutic effect. Their sensitivity to touch is one of the reason why children with ASD are picky eaters. They may not like certain food textures like rice.
Even though most children with ASD do not show problems in walking, running or climbing, they may exhibit problems in imitating actions, tying shoe laces, buttoning, picking up small things, writing, speaking etc. Unlike walking and running, these skills need planning, working memory, impulse control, inhibition, initiation and monitoring of action. Among professionals, it is called motor executive dysfunction. This dysfunction also results in a condition called Apraxia. Apraxia is the inability to produce a learnt motor movement in response to a command or demand. For instance, you know your child can pick up a plate or say his name but when you ask him to pick up the plate, he can't do it or when you ask him to say his name, he can't say it.
Communication involves two aspects -- Comprehension (understanding) and Speaking. If the child has auditory (hearing) processing issues, naturally it will affect his/her comprehension and speaking. If the child has normal auditory processing but has oral motor issues or Apraxia, then even though the child may understand what you are saying, he/she may not be able to speak. In certain conditions the child may be able to repeat what you are saying but not understand what it means. This type of blind repetition of words and sentences is called echolalia. So in effect, the communication problems of an ASD child is because of the other underlying neurological issues.
Considering all the sensory, motor and communication issues that a child with ASD faces, it is quite natural that they are not social, do not maintain eye-contact and throw temper tantrums. Understand your child's unique difficulties, be patient and perseverant with him/her.