Prevalence of Autism Spectrum Disorder (ASD) 

In Singapore, 1% of the population is diagnosed with Autism Spectrum Disorder (ASD), and these numbers have seen a rising trend since 2016. This trend is also attributed to the advancement of techniques in observing the presence and severity of the disorder, especially in females and increased awareness of ASD in the general public.

What is ASD? 

ASD is a term used for a group of various neurodevelopmental disorders such as Autism, Asperger’s Syndrome, Childhood Disintegrative Disorder and Pervasive Developmental Disorder, etc. Individuals suffering from ASD display symptoms in varying degrees where some are completely unable to function cognitively and some are functioning perfectly well. The cause of ASD is still widely researched on but thus far, links to defects in genes or problems during stages of neurodevelopment have been found.

Gender Differences in ASD

In the past, the diagnostic criteria for ASD were exclusively based on the male experience, resulting in women and girls being easily misdiagnosed. Now, since females have been part of the increasing body of research, it is possible to differentiate ASD manifestation in males and females.

✽ Sociability

From birth, girls tend to be more intrigued by human faces and can seem more prosocial than boys. Even though females with autism may experience problems related to making friends and maintaining friendships, they are more inclined to be sociable. This is one of the main reasons why females get misdiagnosed or underdiagnosed. As these girls mature, with practice, they can become so skilled at socializing that others fail to realise the difficulties they experience.

✽ Interests

One of the diagnostic criteria for ASD is a “restricted, repetitive pattern of behaviour, interest or activities.” Boys have a tendency be very fixated on collecting items and learning about specific topics. However, girls of the same age tend to show the same level of fixation on things that girls their age are typically assumed to be interested in. As their behaviour appears to be in line with that of a neurotypical child of their age, their excessive interest could go unnoticed by parents.

Assessment Using ADOS-2

The Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) can be considered a reliable assessment for diagnosing ASD in children and adults. It is a semi-structured, standardised assessment of communication, social interaction, play and restricted and repetitive behaviours. These activities help elicit behaviours directly related to ASD diagnosis.

There are five modules, each requiring roughly 40-60 minutes. Each individual only has to go through one module depending on their level of language and chronological age.

Toddler Module: For children between 12 and 30 months of age who do not consistently use phrase speech
Module 1: For children 31 months and older who do not consistently use phrase speech
Module 2: For children of any age who use phrase speech but are not verbally fluent
Module 3: For verbally fluent children and young adolescents
Module 4: For verbally fluent older adolescents and adults

Signs and Symptoms

✽   Delayed or Abnormal Expressive Language/ Feelings

✽   Difficulties Understanding Simple Commands

✽   Inability to Sustain a Conversation

✽   Troubles Maintaining Eye Contact

✽   Inability to Interpret Body Language, Facial Expressions or Tones of Voice

✽   Increase/Decrease in Sensory Inputs

✽   Struggles Maintaining Friendships

✽   Exhibit Antisocial/Disruptive Behaviour

✽   Behavioural Differences (Repetitive Behaviour/Echolalia/Hand Flapping)

Is it Important to Get Assessed?

The symptoms of ASD can be difficult to manage and live with, especially if one is unaware of their diagnosis. As we’ve mentioned, ASD has the potential to inhibit a person’s daily functioning and social relationships. Going through an assessment can give people a better understanding of the difficulties they’ve been experiencing, even if a diagnosis of ASD is ultimately not received. This can also give them access to resources and skills to manage the difficulties they face.

At Psychology Blossom, we provide screening for ASD in both children and adults. If you think this could benefit you or someone you know, please feel free to contact us at +65 8800 0554.

Treatment for ASD

ASD cannot be cured, but medication is available to reduce anxiety, hyperactivity or aggressiveness that individuals with ASD may display. Therapies is also available to improve and reduce digression of skills such as:

• Motor Skills (e.g. Art Therapy, Physiotherapy)
• Cognitive Skills (e.g. Counting Money, Doing Puzzles)
• Speech and Language (e.g. Phonics Lessons, Speech Therapy)
• Psychosocial Skills (e.g. Involvement in Support Groups and Clubs)

There are many programmes and organisations introduced in Singapore (e.g. Autism Resource Centre, Autism Association) that provide structured teaching programmes (e.g. TEACCH, Floortime, Applied Behavioural Analysis) to support individuals with ASD and increase their quality of life. Some therapists may use music (iLs program) and sensory items (Sensory integration therapy) to help children improve social interaction and speaking.

Special Schools for ASD

Such schools have teachers and curriculum that are specialised and catered to students who may have needs that are not met in mainstream education.

✽   Pathlight School

✽   AWWA

✽   Rainbow Centre

✽   Eden School

✽   St. Andrew’s Autism Centre

“If a child can’t learn the way we teach, maybe we should teach the way they learn.” – Ignacio Estrada.