What is it?

Autism spectrum disorder (ASD) refers to a group of neurodevelopmental disorders that affect how people communicate, learn, behave, and socially interact.

What are common signs of ASD?

Children and youth with ASD usually experience two types of symptoms:

1.  Social impairment and communication difficulties

• Avoids or does not keep eye contact
• Does not respond to name 
• Does not show facial expressions like happy, sad, angry, and surprised 
• Does not play simple interactive games 
• Uses few or no gestures (e.g. does not point at what you point to or wave goodbye)
• Does not share interests with others 
• Does not notice when others are hurt or sad 
• Does not pretend in play 
• Shows little interest in peers
• Has trouble understanding other people’s feelings or talking about own feelings 
• Does not play games with turn-taking 

2. Repetitive or restricted behaviours

• Lines up toys or other objects and gets upset when order is changed
• Repeats the same words or phrases over and over 
• Plays with toys the same way every time
• Is focused on parts of objects 
• Has obsessive interests
• Must follow certain routines and gets upset by minor changes
• Flaps hands or rocks body in circles
• Has unusual reactions to the way things sound, smell, taste, look or feel
• More sensitive or less sensitive than others to sensory experiences (pain, temperature, texture, smell, taste, or sound)

Other signs: 

• Delayed language skills
• Delayed movement skills
• Delayed cognitive or learning skills
• Hyperactive, impulsive, and/or inattentive behaviour
• Epilepsy or seizure disorder
• Unusual eating and sleeping habits
• Gastrointestinal issues 
• Unusual mood or emotional reactions
• Anxiety
• Lack of fear or more fear than expected
•  Self-harm

When is it time to seek professional help? 

ASD symptoms can vary greatly from child to child depending on the severity of the disorder. Children should be screened for developmental delays during periodic checkups.

You may also want to consider these tools:

First Signs®

Autism Navigator®

Modified Checklist for Autism in Toddlers (M-CHAT)

What makes ASD difficult to diagnose in children?

• Symptoms of one disorder can look like another disorder. 
• Symptoms of one disorder can hide symptoms of another disorder.
• Symptoms can vary greatly from child to child. 
• There are only a few guidelines and tests that help to diagnose other mental challenges in children with ASD.

What can be done?

Educational/behavioural interventions

Early behavioural/educational interventions have been very successful in many children with ASD. In these interventions, highly structured and intensive skill-oriented training sessions are used to help children develop social and language skills. 

Applied Behavioural Analysis (ABA) is a type of therapy that can improve social, communication, and learning skills through reinforcement strategies.

Modified Cognitive Behavioural Therapy (CBT) is an example of behavioural intervention. Cognitive Behavioural Therapy (CBT) teaches people to examine and change the way they think (cognitive), act (behaviour) and feel (emotionally and physically). Cognitive Behavior Therapy (CBT) is beneficial to people with Autism Spectrum Disorder (ASD) but scientists suggest that the method needs to be modified in relation to the child’s cognitive profile. 

Medications

While there is no medication that can treat ASD itself or even its main symptoms, there are medications that can help with related symptoms such as anxiety, depression, schizophrenia and obsessive-compulsive disorder. Antipsychotic medications are used to treat severe behavioural problems. Seizures can be treated with one or more anticonvulsant drugs. Medication used to treat people with attention deficit disorder can be used effectively to help decrease impulsivity and hyperactivity in people with ASD.

What makes some children more vulnerable to ASD? 

Scientists believe that both genetics and environment likely play a role in ASD. ASD is a complex disorder that is the result of many interacting genes as well as the result of genes interacting with the environment.  

Autism is more common in children born prematurely. Studies suggest that ASD could be a result of disruptions in brain growth very early in the child’s brain development. These disruptions may be the result of weakness in genes that control brain development and regulate how brain cells communicate with each other.

Where can I access support? 

An early diagnosis is important so that the child can get the help they need. Talk to the child’s family doctor or pediatrician. The doctor can refer the child to the BC Autism Assessment Network (BCCAAN) for further assessment and diagnosis.

Contact Autism Information Services BC (AIS BC), a provincial information centre for autism and related disorders. AIS BC has information on assessment, diagnosis and treatment options, and you can reach them by phone, in person or via email.

Talk to the child’s guardianship worker to explore what options are available for assessment so their diagnosis and treatment plan can be included in their Care Plan. The guardianship worker will help make appropriate referrals for specialized supports and services.

What is it?

Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder. In some children, they’re noticeable as early as three years of age. Children who have ADHD have higher levels of inattention, impulsivity, and/or hyperactivity than their peers.

What are the symptoms of ADHD in children?

There are three types of ADHD.

1. Inattentive. Most symptoms fall under inattention, distraction and disorganization.

• Trouble paying attention to details
• A tendency to make careless mistakes in schoolwork or other activities
• Difficulty staying focused on tasks or play activities
• Apparent problems with listening
• Difficulty following instructions
• Problems with organizing tasks or activities
• Avoidance or dislike of tasks that require mental effort
• A tendency to lose things like toys, notebooks, or homework
• Easily distracted
• Forgetfulness in daily activities, such as forgetting to do chores

Because children with this form of ADHD are less likely to disrupt the classroom or other activities, their symptoms may not be noticed as quickly.

2. Hyperactive-impulsive. Most symptoms are related to hyperactivity and impulsiveness.

• Fidgeting or squirming
• Difficulty remaining seated
• Excessive running or climbing
• Difficulty playing quietly
• Always seeming to be “on the go”
• Excessive talking
• Blurting out answers, interrupting the questioner
• Difficulty waiting for a turn or in line
• Problems with interrupting or intruding on others’ conversations, games or activities

2. Combined. It is a mix of many inattentive symptoms and hyperactive-impulsive symptoms.

The physical signs of ADHD cannot be detected by a lab test. Typical ADHD symptoms may overlap with those of other physical and psychological disorders.

ADHD doesn’t cause other psychological or developmental problems. However, children with ADHD are more likely than others to also have conditions such as:

• Learning disabilities, including problems with reading, writing, and math skills 
• Anxiety disorders 
• Depression
• Disruptive mood dysregulation disorder: severe irritability, anger, and frequent, intense temper outbursts
• Oppositional defiant disorder (ODD) 
• Conduct disorder 
• Bipolar disorder
• Tourette syndrome  

When is it time to seek professional help?

Young children with ADHD are more likely to experience difficulties in daycare or school, including problems with peer relationships, learning, and a higher risk of injuries. An early diagnosis is important so that the child can get the support they need to minimize challenges. 

Since the early years is a critical time for brain development, it is important for children to learn positive behaviours and for caregivers to learn how to support their unique individual needs, even for young children who are showing some symptoms of ADHD but do not have ADHD. It’s best to address problematic behaviours sooner rather than later. 

What can be done?

ADHD is best managed with a combination of medications and counselling. Effective treatment of childhood ADHD involves behavioural skills training, behavioural school intervention and medication. Behavioural skills training can help parents and caregivers develop a positive relationship with the child and encourage positive behaviour. Behavioural skills training has been shown to work as well as medication for ADHD in young children. 

Any good treatment plan will include follow-up and monitoring. In some cases, the symptoms of ADHD become less severe or change as the child grows older, particularly if the child’s environment is conducive to their development and their self-regulation skills improve. 

What makes some children more vulnerable to ADHD?

Many genetic studies indicate that ADHD runs in families. However, it is important to understand that ADHD is a complex disorder that is the result of many interacting genes as well as the result of genes interacting with the environment. Other risk factors for ADHD include exposure to environmental toxins (e.g. lead or pesticides) during pregnancy or childhood, premature birth or low birth weight or brain injury. 

Where can I access support? 

An early diagnosis is important so that the child can get the help that they need. Talk to the child’s family doctor or pediatrician. The child may be referred to specialists (e.g. psychologist, behavioural specialists, psychiatrist, neurologist, or developmental pediatrician). 

Talk to the child’s guardianship worker to explore what options are available for assessment so their diagnosis and treatment plan can be included in their Care Plan. The guardianship worker will help make appropriate referrals for specialized supports and services. 

Your local Child and Youth Mental Health team may be able to provide an assessment or refer the child to specialized resources in your community. Your local CYMH office offers a range of free and voluntary mental health services and supports for children from 0-18 years of age and their families. These services include assessments, therapy and treatment, education and referrals to specialized programs and resources. There are 100 intake clinics for children, youth and their families at convenient locations throughout BC. Please note that not all local Child and Youth Mental Health teams provide assessments and support for ADHD. Call your local Child and Youth Mental Health office first to ask if they provide this service.

What is it?

Anxiety is a general term used to describe a feeling of extreme worry or unease. When a child feels anxiety that lasts a long time and prevents them from doing things like going to school or playing with their friends, then it becomes an anxiety disorder.

Anxiety is normal and a part of life. When a child is threatened or in actual danger, their body has an alarm system that prepares the body to defend them from harm. Symptoms of anxiety are accompanied by a “fight, flight or freeze” reaction, which is triggered by real or imagined threats.

What types of anxiety are common in children?

Generalized anxiety disorder: Children with generalized anxiety disorder tend to have worries that span multiple topics. It causes children to worry almost every day — and over lots of things.

Panic disorder: Children with panic disorder have frequent, sudden anxiety attacks that can cause overwhelming physical symptoms.

Separation anxiety: Children who experience separation anxiety get very anxious and upset when separated from parents and caregivers. They worry that bad things will happen to them or loved ones while separated.

Social anxiety: Children with social anxiety have an intense fear of social situations and become self-conscious around others.

Specific phobia: While it’s normal for children to have fears, some children can experience a more intense and longer-lasting irrational fear of certain things (e.g. fear of enclosed spaces, insects, needles, thunder).

What are the symptoms of anxiety disorders?

Anxiety has many symptoms and can look different from child to child.

Physical symptoms include:

• Crying
• Rapid heart rate
• Quick breathing or difficulty catching one’s breath
• Muscle aches (especially stomach and headaches)
• Quick irritability and being out of control during outbursts
• Feeling tense and fidgety
• Using the toilet often
• Shaking, dizziness, tingling
• Sweating
• Fatigue

Emotional symptoms include:

• Ongoing worries about friends, school, or activities
• Worrying about things before they happen
• A need for everything to be “perfect”
• Constant thoughts and fears about their safety (or of others, such as parents and siblings)
• Reluctance or refusal to go to school
• “Clingy” behaviour
• Inability to concentrate
• Irritability
• Trouble sleeping
• Inability to relax

When is it time to seek professional help?

1. When it is not getting better or is getting worse, and efforts to tackle it yourself have not worked

2. When it’s slowing down their development or having a significant effect on their schooling or relationships

3. When it happens very frequently

What can be done?

A severe anxiety disorder can delay or derail child development. Research shows that there are two main treatments that often help children or youth with an anxiety disorder.
1. Cognitive Behavioural Therapy (CBT) is an evidence-based and structured type of therapy that focuses on teaching children and families how to:

• identify and challenge anxious thoughts
• practice facing feared situations in a stepwise way
• helping parents and caregivers to promote courageousness in children and change patterns of reassurance

2. Medications are sometimes a useful component of treating children with anxiety.

What makes some children more vulnerable to anxiety?

• Biological factors such as genes and brain chemistry
• Psychological factors such as temperament and coping strategies
• Environmental factors such as anxious parenting, trauma, adverse childhood experiences and toxic stress

Where can I access support?

Talk to the child’s family doctor or pediatrician if anxiety causes the child to limit participation in activities or worry often.

Talk to the child’s guardianship worker to explore what options are available for assessment so their diagnosis and treatment plan can be included in their Care Plan. The guardianship worker will help make appropriate referrals for specialized supports and services.

Get help from a mental health professional by getting an assessment through your local Child and Youth Mental Health team. Your local CYMH office offers a range of free and voluntary mental health services and supports for children from 0-18 years of age and their families. These services include assessments, therapy and treatment, education and referrals to specialized programs and resources. There are 100 intake clinics for children, youth and their families at convenient locations throughout BC.

You can also contact a private psychologist or counsellor through the BC Association of Clinical Counsellors or the BC Psychological Association. You can use website filters to search for a counsellor in your community that specializes in certain mental health challenges.