The Autism Umbrella

When people are diagnosed with Autism Spectrum Disorder, they often receive multiple diagnoses that fall under the Autism Spectrum umbrella. Autism Spectrum Disorder on its own generally shows challenges in social/emotional awareness and behaviour challenges. When our children are diagnosed with ASD, often, there are other coexisting conditions in cognitive, emotional, and behavioural disorders.

Any two people with Autism Spectrum Disorder are (never the same) different, which can make it difficult to gain an accurate diagnosis. Some conditions coexist with ASD that can cause misdiagnosis, leading to ASD often being underdiagnosed. However, due to added awareness, correct diagnosis is becoming more common. The misdiagnosis of ASD often adds to complexities in treatment options for effective intervention.

Coexisting conditions in people with Autism Spectrum Disorder
Most children and adults with Autism experience other coexisting conditions or disorders. ADHD, Sensory Processing Disorder, learning disabilities, disruptive behaviour disorders, mood disorders, anxiety, tics, and Tourette’s Syndrome are some of the more common conditions that may co-occur.

The lives of teens and adults may also be complicated by overlapping signs or symptoms. It is not uncommon to see signs of Anxiety, Depression, Post Traumatic Stress Disorder, or Eating Disorders amongst teens and adults with Autism Spectrum Disorder.

Sensory Challenges
Many people with ASD either overreact or underreact to stimuli in their environment that involve their senses. This is known as Sensory Processing Disorder. For example, some may:
  • Dislike or show discomfort from a light touch or the feel of clothing on their skin.
  • Experience pain from sounds like a vacuum cleaner, a telephone, or a sudden storm which may cause them to cover their ears and scream.
  • Have little to no reaction to intense cold, heat, or pain.
  • Have difficulty eating, dressing, and toilet training.
  • Crave sensory stimulation or constant movement.
Sleep Challenges
Autistic children tend to have challenges not only falling asleep but staying asleep. This can make it difficult for them to focus or pay attention and will reduce their ability to function and learn. This, in turn, can lead to behaviour problems and increased stress with poorer general health. Sleep challenges can continue through the teenage and adult years.

Fortunately, sleep challenges can often be treated with changes in sleep schedules or creating new routines for your child. Some children do use melatonin which is a hormone that naturally occurs in the human body, to regulate the sleep-wake cycle, with generally little or no side effects.

When their sleep pattern becomes regulated, you will notice changes in your child’s ability to function and learn, which will help with behaviour and health issues. Melatonin is a product that you need to consult with your physician about, to see if it’s right for your child. Even though our bodies naturally make it, it’s not a sleep solution for every child.

Learning challenges
Many children with ASD have some level of learning challenges. When tested, some children may have abilities that are within the normal range while others, especially in the areas of thinking and language skills, may be relatively weak. Children with a form of ASD, like Asperger Syndrome, may even have above-average intelligence, and cognitive and language skills.

One in four children with ASD has a seizure disorder because the brain is on constant overload from the sensory system. It’s like their brain can’t process all the information they are receiving, so it misfires. This abnormal electrical activity in the brain can result in short-term loss of consciousness, convulsions, or staring spells. Seizures can be brought on by a lack of sleep or a high fever. After being treated medically, some children with ASD ‘grow out’ of their seizures while others can have lifelong challenges with seizure disorders.

Fragile X Syndrome
Fragile X Syndrome is a genetic disorder and is the most common form of inherited intellectual disability causing symptoms similar to those of ASD. Fragile X refers to one part of the X chromosome that has a defective piece that appears pinched and fragile under a microscope. Fragile X Syndrome is found only in a single gene. This mutation will then turn off that specific gene. Symptoms range from none to severe, with around one-third of children with Fragile X Syndrome also meeting the diagnostic criteria for ASD, and about 1 in 25 children diagnosed with ASD having the mutation that causes Fragile X.

Co-Occurring mental disorders
People with ASD can developmental or mood disorders such as anxiety, eating disorders, Attention Deficit Hyperactivity Disorder (ADHD), or depression. Research has shown that people with ASD are at higher risk of developing these disorders. Managing these conditions with medication and behavioural therapy that teaches appropriate coping mechanisms, can reduce a child’s ASD symptoms.

Angelman Syndrome
Angelman Syndrome is a genetic disorder that causes developmental disabilities, neurological problems, and sometimes, seizures. People with Angelman Syndrome smile and laugh frequently and have happy excitable personalities.

Landau-Kleffner Syndrome
LKS is a rare childhood disorder characterized by the loss of language comprehension (auditory verbal agnosia) and oral expression (aphasia) in association with severely abnormal EEG findings (electrical activity of the brain) during sleep and clinical seizures in most patients.

Prader-Willi Syndrome
Prader-Willi Syndrome (PWS) is a genetic disorder due to the loss of function of specific genes. In newborns, symptoms include weak muscles, poor feeding, and slow development. Beginning in childhood, people with PWS can continuously become hungry which often leads to obesity and type 2 diabetes.

Rett Syndrome
Rett Syndrome is a rare genetic neurological and developmental disorder that affects the way the brain develops causing a progressive inability to use muscles for eye and body movements, and speech. It occurs almost exclusively in girls.

Tardive Dyskinesia
Tardive Dyskinesia is a side effect of antipsychotic medications used to treat schizophrenia and other mental health disorders. TD causes stiff, jerky movements of their face and body that they can’t control.

Williams Syndrome
Williams Syndrome is a developmental disorder that affects many parts of the body. This condition is characterized by mild to moderate intellectual challenges or learning problems, unique personality characteristics, distinctive facial features, and cardiovascular problems.

Global Developmental Delay
GDD is the general term used to describe a condition that occurs during the developmental period of a child between birth and 18 years of age. It is usually defined by the child being diagnosed with having lower intellectual functioning than would be perceived as normal.

Hyperlexia is a syndrome that is characterized by a child’s precocious ability to read far above what would be expected for their age, significant difficulty in understanding and using verbal language, and significant challenges during social interactions.

Apraxia of speech is now found to affect up to 65% of children with Autism Spectrum Disorder. Apraxia of speech is an acquired oral motor speech disorder affecting an individual’s ability to translate conscious speech plans into motor plans, which results in limited and difficult speech ability.

Dyspraxia is a brain-based developmental disorder that makes it hard to plan and coordinate physical movement. Children with Dyspraxia often struggle with balance and posture and may appear to be clumsy or out of sync with their environment.

Palilalia is a language disorder characterized by the involuntary repetition of syllables, words, or phrases. It has features that resemble complex tics but is based upon contextually correct speech.

Although these are not the only conditions or disorders that can coexist with Autism Spectrum Disorder, it’s an excellent start to understanding some of the verbiage you may see on an assessment, or hear your physician or therapists speaking about.

All of these conditions are treatable with hard work and early intervention. If any of the coexisting disorders are diagnosed with Autism Spectrum Disorder, your physician will give you the best therapy options with professionals that can help your child and your family learn to thrive, even with the challenges you may be facing.

Autism Spectrum Disorder can seem daunting and confusing especially when newly diagnosed, or with multiple diagnoses. Take your time to learn as much as you can about treatment options and available resources. As overwhelming as it all may seem, it does get better. You and your child will learn together, and you will find that your child will be your greatest teacher.