Most people expect young children to play, interact with each other and go up normally.
This however is not always the case.
Aaron's violent temper tantrums can last for hours.
Emmanuel has stripped his bedroom of wallpaper to satisfy his obsession with strips of paper.
Paul has an obsession with embryos.
His legs are starting to grow and arms and his head pops out another week.
The head is still there but it's really tiny.
Tanya could spend most of the day walking on her toes in this way.
These children have one thing in common.
They've all been diagnosed as having autism.
What is autism?
Since the condition was first described in 1943, autism has baffled parents, professionals and medical scientists alike.
Many questions still remain.
What are the causes, the best methods of treatment and the long term outlook for these children?
In the past many thought that autistic behaviour was due to some sort of emotional problem.
But this is not true.
The autistic person has a severe developmental disorder.
The severity of the disorder varies considerably between individuals.
All however show the same pattern of disability.
This pattern of disability can be divided into three groups.
Most people associate autism with the presence of rituals and routines such as flicking and insisting that things remain the same.
These children also have severe communication problems.
In addition, social development is impaired.
Autistic children isolate themselves and show very little interest in playing normally with others.
Autism is a disorder of early infancy.
Most parents will notice that their child is different within three years of birth.
It's extremely rare for a child over three years who has developed normally to become autistic.
Many children with autism look the same as any other child.
This is a major problem for parents when interacting with others in the community as their child's behaviour is definitely not normal.
Concern about behaviour and development leads parents to seek professional advice.
Often the first thing they do is visit their family doctor.
In many cases the child is then referred to a paediatrician or children's hospital for investigation.
If autism is suspected, a further referral is made to a specialist diagnostic centre where a series of investigations are undertaken over a few days.
Often the first stage is a formal assessment which takes place in a playroom setting.
Various activities are used to highlight the child's reactions and responses to a range of stimuli.
Whilst the parents are observing the assessment, a detailed early developmental history is taken.
The formal assessment is also videotaped for later analysis.
The assessment process also includes observations of the child's behaviour in the home and the educational setting when that's appropriate.
Having obtained a developmental history and completed the observations of the child, members of the diagnostic team review the evidence and rate the child's responses.
A number of diagnostic tools are currently available.
This diagnostic team is using the Childhood Autism Rating Scale, known as the CAHS, which was developed in the USA.
As a result of the total assessment, Emmanuel was diagnosed as having autism.
He showed impairment in social development, delayed communication skills and obsessional and repetitive behaviours.
These behaviours were evident before the age of three years.
Autism is a rare condition.
Some studies suggest an incidence as high as one in every 1,000 people.
This incidence can increase if there's already autism in the family.
More boys are affected than girls, the ratio being four to one.
The three diagnostic criteria will now be examined in detail, beginning with social impairment.
These two children show a typical lack of awareness of each other.
Patrick is using Tanya's hair in a self-stimulating way.
Tanya is totally unaware of this.
Both children have no interest in anything else in the room and show no interaction with the group.
Children with autism are frequently described as being in a world of their own.
Attempts to break into the world can provoke violent temper tantrums which last for hours.
The child may also deliberately injure himself.
Unusual behaviour can be most embarrassing for parents.
Because the child looks normal, it's easy for others to assume that the child's behaviour is the result of bad parenting.
Lucy, Jonathan's mother, talks about how embarrassing this can be.
The last time we took Jonathan to the Pizza Hut, he had a tantrum.
He was a bit frightened because it was very crowded as they always are.
And he had a heck of a tantrum in the middle of the floor and he was kicking and screaming.
We were just so embarrassed and we got so tense and upset ourselves that we just had to leave.
We didn't eat, we'd ordered, didn't eat, we just got up and left.
Because we couldn't take the pressure of all eyes being focused on us.
Often a major concern of parents is the lack of spontaneous affection shown by their child.
Quite often autistic children will resist any form of physical affection and will only respond on their own terms.
This is extremely distressing for parents, especially if the child is upset or in pain.
Due to the efforts of his mother, support teacher and kindergarten staff, Aaron's temper tantrums are now less frequent.
He's not so resistant to intervention at home and at kindergarten.
Each child's potential to develop play and social skills varies.
Aaron is very keen to participate and is learning to enjoy the kindergarten experience.
Social development is an ongoing process for people with autism.
Young children such as Aaron will need support throughout their lives to obtain some degree of social normality.
Outings can provide an excellent opportunity for autistic children to practice social skills.
During this outing these children are learning social norms while interacting with others.
The older child who has a degree of social awareness should be offered the opportunity to develop
and practice social skills in a secure, non-threatening environment.
This group of adolescents meets weekly to learn a variety of social skills.
Games, activities, outings and role play are used to teach awareness of each other,
how to interact with members of the group and how these skills are used in everyday situations.
The group provides an opportunity to practice and to learn social skills informally.
For the young adult, special social clubs can provide an opportunity to meet others and to socialise.
Mark, who is the secretary of such a club, has recently moved out of his parents' home and is living independently.
It's a bit lousy sometimes but I tend to let the place go a bit.
What about shopping for food?
Yes.
Is that difficult? Do you find that difficult, making your money last?
Yes.
Mark has also had brief periods of employment.
Well I've also had work experience in the past in the library for a week,
except Wednesdays, they're not open on Wednesdays, which is bloody difficult.
Do you meet many people when you're working in the post office?
No, not really. There's not a lot of people you can meet in the post office.
What about girlfriends?
I've had none.
Would you like a girlfriend?
What do you reckon?
I'm asking you. Would you like a girlfriend?
Yes.
Whereabouts do you think it goes from me to girls?
Whatever clue.
A lack of awareness of the existence of others, abnormal reactions to love and attention,
the lack of ability to make friendships is typical of the autistic person.
Although Mark is able to function reasonably well,
his level of social interaction and competence is not typical for most autistic people.
The majority have major lifelong problems with social interactions.
A wide range of communication skills are affected in autism.
Many people with autism do not develop speech
and are also severely limited in their understanding of language.
Toilet.
You try it on.
Lovely.
Toilet.
Good girl.
The child is given alternative methods of communication,
such as signing, the use of symbols, and picture communication.
Simple words and phrases are used to increase the level of understanding.
Some children can use language, but in most cases it's deviant.
Paul is talking about his work with his teacher.
My child is dark and cold.
Venice is very hot.
Saturn has rings.
It has ten moons.
Earth has one moon.
Paul shows a lack of eye contact and normal interaction with his teacher.
This is very common in autism.
Language is sometimes used to reinforce obsessions and current interests.
Remembering unimportant facts and figures, such as the number of pages in a book, is typical.
It's got twenty-three rings.
How do you know that?
Yeah.
How do you know that Saturn's got rings?
Because it's a planet.
But how do you know that? Where did you find that out from?
The book.
Which book?
The bus driver's handbook.
Have you read that?
Yeah.
Is that a big book or a small book?
Big one. Big, thick one.
How many pages has it got in it?
I don't know. 162?
Andrew, in contrast, has a very limited use of language.
This type of communication is more typical of the autistic person.
The words he uses are a mixture of what is called echolalia and jargon.
How are you today, Andrew?
Good.
I'm fine.
Are you feeling happy?
Happy? Are you feeling happy today?
I'm happy.
I like tea.
Are you at school?
Yes.
Lack of meaningful communication can lead to frustration and tantrums.
No!
It's a drink of milk.
No, no, no, no, no, no.
No, no, no, no.
Catherine's speech and language skills are severely impaired.
The words she uses are not related to what's happening.
Apple, apple.
No.
What's that?
Sassages.
Rituals, routines and general resistance to change are perhaps the most obvious behaviours in an autistic person.
Jonathan is seen here flicking a piece of plastic.
The ritual involves wetting the plastic in his mouth before flicking it in front of his eyes and dancing on the spot.
This ritual can last for hours.
Just as one example of repetitive behaviours commonly seen in autism.
He'll get a great length to satisfy this obsession.
For example, he'll cross a busy road without any regard for himself or anything else to get a flicker, if allowed.
During home instruction with his young brother, Aaron is keen and attentive.
He does, however, lapse into ritualistic and repetitive behaviours.
Holding his fork at an odd angle is a form of visual stimulation, which is often seen in repetitive behaviours.
Patrick is using this block in a similar manner.
A child may use a variety of objects to satisfy his need for stimulation in this way.
Even when Patrick is given an alternative way to use the block, he returns to the same repetitive behaviour.
Stereotyped body movements such as head weaving, rocking, spinning, head banging and so on are used in a self-stimulating way.
Each child has his own repertoire of behaviours to switch between.
Even the child that appears to be functioning well, they also show repetitive behaviours and restricted interests.
Paul becomes obsessed with one topic which consumes every aspect of his day.
He will amass facts and figures about the subject.
He will be endlessly about it and at every opportunity and without regard for anyone else.
Mark also has restricted interests and remembers trivial facts.
What sort of things do you like doing in your spare time?
Do you really want to know?
What are your interests then?
You know.
But I want you to tell me.
Yeah, reading the hair books. A lot of them. 128 of them.
I read a lot. I write a lot.
Autistic children don't play in a normal imaginative way. They play by themselves in a world of their own.
Objects and toys are not used as intended.
Aaron is using these discs in a ritualistic and self-stimulating manner.
He's also resistant to change.
When his teacher interrupts and attempts to redirect the ritual, a tantrum is the response.
Quite often these children resist changes to any aspect of their daily routine.
For example, food.
At eight years of age, Stefan has a very limited range of foods that he'll accept.
When offered a sandwich, he refuses to eat.
The only thing Stefan eats is strained baby foods.
He has resisted changes to his diet for years.
As well as food, these children also have a marked resistance to trivial changes in their daily routine.
For example, if the order in which things are normally done is altered, or if well-traveled routes have changed,
or the child is required to change from winter to summer clothing, prolonged temper tantrums can result.
It's important to remember that repetitive routines, rituals and self-stimulating activities are part of the normal developmental process.
At times, all babies will show these behaviours.
Unlike the autistic child, Nellie's flapping and rocking can be easily stopped by socially interacting with her mother.
Even at a very young age, the normal child is able to communicate and interact socially with others.
This is the difference.
No one knows the cause of autism.
Links have been found with other genetic biochemical and neurological disorders,
but no one area of brain damage or any specific biochemical abnormality has yet been identified and directly linked to autism.
Autism affects children of all intellectual levels.
Popular belief is that autistic children have above average intellect.
This is not true.
About three-quarters of those diagnosed with autism have a mild to severe intellectual disability.
Over the years, a variety of treatments have been used, including behaviour modification, education, therapeutic techniques and drug treatments.
Today, the aim is to work together with parents to achieve the best possible outcomes for their child.
Having parents involved in the planning of their child's turtle program ensures a consistent approach.
It's commonly agreed that these children respond well to a structured educational environment, and the earlier this can be commenced, the better.
This involves each child in an individually planned program that incorporates the use of structured teaching methods and specific behaviour management techniques.
Individual programs should include training in communication, social interaction, self-help, independent living schools, recreation and methods to help control their own behaviour.
With support, some children can be integrated into the regular educational system, where the normal skills of reading and writing can be learned.
In the long term, Paul can be expected to function reasonably well.
He may, however, still experience problems in social situations.
Most children will not be able to lead completely independent lives.
Scott has required special education and support from an early age.
As an adult, he is attending a sheltered workshop and still requires considerable support, not only at work, but in all aspects of his life.
Scott's situation is more typical of people with autism.
And so the puzzle remains, a challenge for parents and those who work and live with autism.
Increasing numbers of children are being referred earlier for diagnosis and for treatment.
In an environment of care and professional support, there is hope.
Hope that each child will reach his full potential and be able to live in our society with dignity and with understanding.
Thank you for watching!