About 1 in 44 children has been identified with Autism Spectrum Disorder (ASD), the latest figure according to the Centres for Disease Control and Prevention (CDC) announced in December 2021. Signs of ASD usually begin during early childhood and typically last throughout a person’s life. We are honoured to have the opportunity to interview Dr. Angel Au to learn more about the signs and symptoms of ASD and her professional advice for parents who are in doubts.
Q1. What are the ‘red flags’ i.e. early signs, indicating a child who could be at risk of ASD?
Parents should keep in mind that there are differences between ASD and other disorders with certain overlapping symptoms. For example, Speech Delay: children with speech delay usually show good attempts to communicate their wide variety of intents and will interact with others socially using a variety of non-verbal language: e.g. various flexible gestures (e.g. nodding their heads to indicate “yes”, tapping the person to seek their attention, holding their hand with the palm up to ask for an object); whilst pre-verbal children with ASD usually show fewer “social” desires and adopt only a few basic gestures to communicate their needs (e.g. pulling other’s hands, reaching for the item directly or holding their hands out to be carried). Another example is children that are socially anxious. Whilst social anxiety is not uncommon in children with ASD, children who are only socially anxious present clear social connectedness and communicate their thoughts and feelings adequately in more familiar settings with people they feel comfortable with. As such, a formal evaluation is crucial.
Q2. Why do some parents delay the diagnosis and the opportunity for early intervention?
1. Inadequate Understanding About Early Childhood Development
3. Special Interests and Strengths
Q3. What are the risk factors for a child to develop ASD?
Q4. Please share some advice with our parents.
Parents should familiarize themselves more with early childhood development, including not only motor and language development but also the milestones of play and social development. I highly recommend the website of Centres for Disease Control and Prevention （www.cdc.gov/ncbddd/autism）which provides comprehensive information including checklists, videos, and a lot of other useful resources to professionals and parents about early developmental milestones and symptoms of ASD in young children.
If you suspect your child could have ASD or other developmental problems, contact a General Practitioner for referral to a specialist who is trained to perform in-depth diagnostic assessment for childhood disorders as soon as possible. The Hong Kong Department of Health also provides developmental surveillance for young children.
Information provided by:
Dr. Angel Au is a Registered Clinical Psychologist of Hong Kong Psychological Society and has undergone doctoral training in Clinical Psychology. She has received extensive training and on-going supervision from Dr. B. J. Freeman, a world-renowned diagnostician in Autism Spectrum Disorder. After completing the Clinical Training of Autism Diagnostic and Observation Schedule (ADOS) in 2003, which is a well-regarded as gold standard in diagnosing ASD, Dr. Au has also completed the ADOS Advanced Research training, from the University of Michigan Autism and Communication Disorders Centre in 2011. Her doctoral thesis was on early identification of the more able children with ASD in mainstream preschool settings.
She specializes in assessing individuals on the milder end of the spectrum and has more than 14 years of experience in diagnosing individuals from toddlerhood to middle-age adults. Other than ASD, Dr. Au also assesses a wide array of individuals with different diagnosis, including Attention Deficit / Hyperactive Disorders, Global Developmental Delay and individuals with various behavioral challenges.
Under the direct supervision and training of Dr. Ronald Leaf and Dr. Mitch Taubman, Dr. Au started providing Applied Behavior Analysis therapy for individuals with ASD since 1996. Other than seeing cases locally, she has also provided overseas consultations in China, India, Japan, Malaysia and Singapore. Applying her many years of experience in helping children with ASD, Dr. Au also specializes in providing psychotherapy and social skills training for adolescents and adults with ASD and other behaviorally challenged conditions.