Because Autism exists on a spectrum, it affects each individual in different ways. While the condition is diagnosed based on difficulties in the areas of communication, social skills, and repetitive and restricted behaviours, there are a number of other challenges that commonly occur among individuals on the spectrum. These include:
- Difficulties applying learning across multiple settings and people (generalisation of skills)
- Poor motor planning and motor skills
- Difficulties with impulsivity and hyperactivity
- Obsessive compulsive traits or anxiety
- Learning difficulties
- Sleep problems
- Behaviour challenges
These are not considered core deficits of autism, but are recognized as common or associated characteristics. Sometimes these challenges are beyond what we could expect for a person with autism, warranting an additional or secondary diagnosis. Some of these conditions frequently diagnosed in addition to autism are:
- Attention Deficit Hyperactivity Disorder (ADHD)
- Developmental Coordination Disorder
- Intellectual Impairment
- Sensory Processing Disorder
- Verbal Dyspraxia
- Gastrointestinal (GI) Issues
Anxiety disorders form a category of mental health diagnoses characterised by excessive nervousness, fear, apprehension, and worry. Individuals who struggle with anxiety may be avoid particular objects or environments, display extreme behavioural rigidity or repetitive behaviours, have sleep difficulties, and/or experience various physical symptoms such increased heart-rate, sweating, and/or stomach and headaches.
It can be difficult at times to recognise anxiety in those who are unable to verbalise their fears or worries, so it is very important to discuss any concerns with a psychologist or psychiatrist who understands both anxiety and Autism.
Although it can be difficult to assess anxiety in Autism, and estimates of the rate of anxiety in autism vary greatly, it is widely accepted that anxiety is extremely prevalent, and can be quite debilitating for those with Autism.
Learn more about anxiety and Autism from the National Autistic Society
Attention Deficit Hyperactivity Disorder (ADHD)
Individuals with ADHD have difficulty paying attention, following through on tasks, are impulsive, and may talk, fidget or move excessively. Many children with autism would display these characteristics, and thus many professionals would refrain from providing the additional diagnosis. However, there may be instances where it is appropriate to pursue additional assessment. If you have concerns about your child’s ability to pay attention, activity level, or impulsivity, speak with your child’s GP to discuss whether a referral for assessment may be warranted.
Learn more at the HADD Ireland website.
Dyslexia is a learning disability that makes it difficult for children to learn to read, write, and spell, not reflective of overall learning ability. There may be early signs such as delays in language or difficulty learning new words and mixing up sounds, but it wouldn’t become apparent or be diagnosed until the school-aged years when reading ability can be assessed. Dyslexia is typically diagnosed by and Educational Psychologist.
Learn more from Dyslexia Ireland.
Developmental Coordination Disorder (Dyspraxia)
Developmental Coordination Disorder, frequently referred to as Dyspraxia here in Ireland, is characterized by significant difficulties with fine or gross motor skills, as compared to overall intelligence or ability otherwise and not accounted for by any other medical condition. Children with DCD will appear clumsy and may frequently fall, run into others, drop things, and/or have difficulty with self-care routines such as tying shoe and buttoning. The various individuals who may be involved in the assessment of DCD include the Pediatrician, Occupational Therapist, Clinical or Educational Psychologist, Physiotherapist, or Neurologist.
Get more information on the Dyspraxia DCD Ireland website.
Intellectual Disability or Impairment is defined by significant limitations in intellectual functioning (ability to reason, learn, and problem-solve), adaptive behaviours and daily living skills.
It is diagnosed through clinical assessment and use of standardized tests of intelligence (IQ tests), and scales of adaptive behaviours. Levels of intellectual impairment are often described as mild, moderate, severe, or profound. Many support services to individuals with Autism in Ireland are delivered based on the presence or absence of intellectual impairment.
However, it should be noted that the credibility of such tests to measure intelligence has been questioned due to the potential impact of inherent language and communication difficulties, attentional issues, behavioural or motivational factors, and sensory processing difficulties.
Sensory Processing Disorder
Sensory Processing Disorder is a condition in which the brain has trouble receiving and responding to information coming in through the senses.
Individuals may be overly sensitive to certain stimuli and have intense reactions to seemingly minor experiences (e.g. touch, sounds). Or individuals may seem under sensitive; they may be unresponsive to pain or extreme cold. Individuals with SPD may also seem uncoordinated and have poor body awareness. Concerns about sensory processing should be assessed by an Occupational Therapist with experience in Sensory Processing and Sensory integration.
You’ll find more information on the Sensory Process Disorder Parent Support website.
Verbal dyspraxia, also referred to as apraxia of speech, is a speech disorder that can start to show when a child is learning to speak. A child with verbal dyspraxia has difficulty planning and coordinating their movement of muscles used (e.g. tongue, lips, jaw, palate) to produce the right speech sounds or words, and delays in speech development. A Speech Language Therapist can diagnose and help treat the condition.
Epilepsy is a brain disorder that leads to a person having repeated seizures. During seizures, there is abnormal excessive electrical activity in the brain, and this causes the person to convulse (their muscles jerk), fall, or behave strangely (e.g. stare into space, not respond when spoken to). If you suspect that you or your child may have epilepsy, seek evaluation from a neurologist. Evaluation typically involves an electroencephalogram (EEG) to check for seizure-related brain activity.
Learn more about epilepsy and Autism on the Epilepsy Ireland website.
Gastrointestinal (GI) Issues
According to research children with ASD are four times more likely than those without ASD to suffer from gastrointestinal problems. This might include constipation, chronic diarrhea, stomach pains, food allergies, and other GI symptoms. You should discuss any concerns with your child’s GP.
Source: McElhanon B, McCracken C, Karpen S, Sharp W. Gastrointestinal Symptoms in Autism Spectrum Disorder: A Meta-analysis. Pediatrics. 2014. Retrieved from http://pediatrics.aappublications.org/content/133/5/872