AUTISM SPECTRUM DISORDER
This is a disorder not well understood in Zimbabwe, so there are not many statistics for it. In fact in Africa in general, not much published research has been done on the disorder.
Autism Spectrum Disorder is a neurodevelopmental disorder, which occurs in about 1 in every 68 people in America. Not much is known about the causes of ASD, but some contributing factors are thought to be
• Advanced Paternal Age at time of conception
• Exposure to certain agents during pregnancy when the foetal brain is developing, such as certain epilepsy drugs and other medications, or infective agents
• Genetic Factors.
Genetics plays a much larger role in the propensity of ASD than in, say, cancer, heart disease or diabetics. This does not necessarily mean that it runs in families. It is often caused by gene changes or mutations in an individual during vital developmental stages. Possibly one gene is affected, or a combination of genes. Research has shown that as many as 200 – 400 different genes can be involved in the onset of ASD during the developmental stages of brain formation. This accounts for the many different symptoms of ASD, and the name Autism SPECTRUM Disorder. There are so many different symptoms of the disorder that these symptoms form a spectrum on which people can be diagnosed. These genetic changes or mutations can occur during the formation of the sperm or egg cells, or at any other stage of the foetal brain development.
Early diagnosis of ASD is key to the management of the disorder, as there are several things you can do to impact on the life of the individual in a positive way. To this effect there are several tests you can have carried out on an infant to determine the likelihood of them being on the Autism Spectrum. One of these is an eye tracking exercise done in babies. While a person sings within eye contact of the baby, if the baby looks directly at the singer’s eye, this baby will not be on the ASD scale; if the baby does not look at the singer’s eyes at all, but focuses on their mouth, chin, nose, in fact all over, but not on the eyes, this baby has more chance of being diagnosed on the Autism Spectrum Scale.
As mentioned before, there are several different genes involved in the development of ASD, and therefore many different symptoms of the disorder. Each of these symptoms can exhibit with different ranges and each person will have a different combination of characteristics which each require different levels of support. There is no one cultural or socio economic group affected more than any other, it occurs in all groups, but it is 4 times more prevalent in males as in females.
Red Flags: How do you know if your child has Autism Spectrum Disorder?
A red flag is not an indication that your child has Autism Spectrum Disorder, but rather, is a reason to take them to your GP or paediatrician to have them checked.
Check with your doctor if your baby is not:
• Smiling or responding to you with joy by 6 months
• Sharing and interacting with you with sounds and facial expressions by 9 months
• Babbling by 12 months
• Gesturing pointing and waving, reaching out, by 12 months
• Using words by 16 months
• Using 2 word sentences by 24 months
• Has a loss of speech or social skills at any age
There are often associated diagnoses (comorbidities) alongside the diagnosis of Autism Spectrum Disorder:
• Sensory Processing Disorder
• Sensory Integration Disorder
• Anxiety Disorder
• Motor Disorders
• Sleep Disorders
• Seizure Disorders
• Immune Dysfunctions and Gastro Intestinal Tract Disorders
• Mood Disorders
• Speech Disorders
This does not mean that people with ASD will exhibit all these comorbidities, but they may exhibit some of them. It also does not mean that someone with these symptoms will be on the spectrum, but if some of these are shown together with the typical behavioural symptoms, they may be classed as comorbidities of ASD.
Signs of Autism Spectrum Disorder
A person with Autism Spectrum Disorder will have difficulty with communication and social interaction. Some will need support to manage any form of communication, while others may be able to understand complicated sentences, and talk in complicated sentences, but the people they are conversing with will notice that the conversation doesn’t flow back and forth. They often have trouble making eye contact.
Signs of ASD may be something a fully functioning person may see in themselves, but in the person with ASD these signs will limit or impair their everyday functioning ability, they will not be able to function in these areas without support, in any other person these signs will not exhibit to the degree that they need support in order to function.
The two main categories of characteristics shown by a person with ASD, are:
a. Social Communication Impairment : In this area of life a person with ASD will need support for the following:
i. Social Initiation and Response – on one end of the spectrum a person may not engage in polite or considerate conversation, at the other end of the spectrum, a person may not respond at all without support
ii. Non-verbal Communication – at one end of the spectrum, a person may be confused by facial expressions and may not respond to facial expressions without support, they need support to learn what facial expressions mean. At the other end, the person will not respond to facial expressions at all, this person will need support in order to use other forms of communication.
iii. Social awareness and social relationships – at one end of the spectrum the person may have some trouble maintaining friendships due to a difficulty in communication which may develop over time with support from others. At the other end of the spectrum a person may not be aware of the concept of friendship, this person may form new relationships with significant support from the people in their life.
b. Repetitive Behaviour and Restricted Interests
i. The person with ASD may show atypical speech or movement, using the same words repetitively, or flapping their hands.
ii. Someone with ASD may have specialised interests, and for these particular interests they exhibit a vast, in depth knowledge, but they don’t show much interest in anything else.
iii. A person with ASD may show atypical sensory behaviour, either requiring excess sensory stimulation, or moving away from any sensory stimulation. Those requiring excess stimulation will push against objects or people, on the other end of the spectrum, the person will be very careful not to make contact with other people or objects.
iv. A person with ASD will have certain rituals they have to undergo in order to find peace, or they may be very resistant to change.
v. A person with ASD may be under responsive to sensory input, in other words they may not respond to extreme temperatures, or changes in temperature, or they may be over responsive to sensory input, for example they may have a strong reaction to textures.
Consider a person with ASD’s reaction to sensory input. As seen above they are either over responsive or under responsive to sensory input. An over responsive person will react to sunlight, smells, sounds, dirt or textures, amongst other things. An under responsive person will seek out intense movement or sound, they will go barefoot, and they will even lick things to seek them out.
So how will this person react to these things which over or under stimulate them? They will engage in self stimulating behaviour, or stimming. This manifests in repetitive movement or sound, maybe as mild as a habit any person may have, tapping a pen, or maybe as severe as banging their head against an object. This self-stimulatory behaviour will block the undesirable sensory input within the environment, and may also be calming. They can also react to unwanted sensory input by becoming aggressive.
How do horses help with ASD?
ASD is very rarely ‘cured’. In some rare instances, with early detection, and people only requiring Level 1 Support, the improvement in the symptoms can be almost 100%. However, the quality of life for these people can be improved ten-fold if they are given the means by which to cope with social interactions and over and under responsiveness issues. There are many support systems available for people with ASD.
Horses are highly intuitive animals and are very sensitive to human emotions. They can be whoever you want them to be. Dealing with horses is full of repetitive, routine actions, which will soothe someone with ASD, but horses also have their own brain, and their own responses, and each one responds slightly differently to human emotions, enough to prepare someone with ASD for a slight deviation in their expected routine, whilst still maintaining the basic routine and feeling of accountability. In this way the participant is supported but also challenged to step out of their comfort zone within a safe environment.
Using the controlled and safe environment of a therapeutic riding session, people with ASD can be challenged and exposed to new experiences without being overloaded. They can encounter new situations and learn to cope with these situations under the watchful eye of the instructor and the horse. These skills learnt amongst the horses can be transferred to real life situations, and give the person with ASD the necessary tools to cope with change and sensory issues.
Choose your mount for your situation – for a person requiring increased sensory input you can use a forward going horse with a rougher stride, providing the extra stimulation needed by these under responsive people. This more energetic setting can jolt the participant into an awareness of life around them. At the other end of the spectrum, a person with over responsiveness to sensory input, can be mounted on a smooth moving, slower striding horse, to allow them time to process the situation and give the correct responses, rather than going into overload and self-stimulating.
The very stride of the horse is extremely repetitive, and so the people with ASD will be given this action they can rely on, which will soothe them and allow them to think of something else calmly and with more reason.
It is also much easier to make eye contact and interact with these non- judgemental animals than with a human, and as much as the person with ASD is unaware of socially acceptable behaviour, working with horses forces them to realise the consequences of their actions, the horse will respond positively or negatively to their actions, and so people realise that in your actions towards society, there are always consequences and reactions. This is a highly valuable life skill lesson.
A big aspect of therapeutic riding is the platform for independence in these people who require so much support in most of the areas of their life. They are able to get onto this huge animal and interact with it in such a way as to influence the direction, pace and manner in which these animals go. Imagine how that feels to someone who needs a great deal of support in their lives, imagine the confidence and self-worth instilled in them. Now, after a series of interactions of this sort these people can carry this confidence and self-worth through to the other areas of their life.
So, even though nothing much is known about either Autism Spectrum Disorder or Therapeutic Riding in Zimbabwe, we hope you have learnt a bit about both from this article, and that you will open your minds up to both, ASD is real, but it does not mean that the person on the spectrum has nothing to offer to the community. With understanding from the community, and a bit of help from the horses, people with Autism Spectrum Disorder can show that they have just as much to offer the community as you or I!
Healing with Horses offers Therapeutic Riding to people with Autism Spectrum Disorder.