Frequently Asked Questions
You can ask the staff and students at OTARC a question about Autism Spectrum Disorders (ASDs). Read past questions below or submit your own question through Ask a Researcher.
Are ASDs caused by gut bacteria as suggested by 'gut theory'?
This is one theory among many others put forward to explain the enigma that is autism.
Some children with an Autism Spectrum Disorder (ASD) appear susceptible to gastrointestinal (GI) conditions. Indeed, Autism Speaks, the US based organisation, funded the development of evidence-based guidelines for physicians to use to screen, assess, and treat GI conditions in children with ASD, recognising that their treatment can improve the quality of life for these children and their families.
However, this research is in the early stages, with the findings to date providing no evidence that gut bacteria and their by-products cause ASDs, even a subgroup of them, or that treating the gut can alleviate the specific symptoms of ASD.
Like the discredited MMR vaccine theory, the gut theory targets those cases of 'regressive' autism, where young children develop symptoms after a period of seemingly typical development. Regression most commonly occurs between 15 to 20 months of age, and these children tend to have more severe symptoms. Whether these are the children who are most vulnerable to GI problems remains to be determined.
Caution needs to be exercised in implementing treatments based on a theory with an insufficient evidence base. Unproven treatments can incur high costs to vulnerable families, often at the expense of securing effective behaviourally based intervention for which there is a solid evidence base.
Are sensory processing therapies effective for children with ASD?
Therapies to address sensory issues in ASD have been around for a while. But unfortunately there is no evidence that they work or add anything to standard behavioural treatments, such as ABA therapy. The research on non-standard therapies is either non-existent or poorly designed, so that conclusions about effectiveness can't be drawn.
There are a couple of websites that can provide further information. One is the Raising Children Network website (if you click on 's' you will find information specifically on sensory integration therapy).
Another website is from the Association for Science in Autism Treatment (ASAT) in the US. It provides information on Sensory Integration Therapy and more generally on sensory-motor therapies. One review article cited on this website is by Dawson, G., & Watling, R. (2000) [PDF 32KB] and a quote from their article says it all: "There exist so few studies that conclusions cannot be drawn" (p. 419).
As far as we know, not much has changed in this field since 2000, the year of the above publication.
Can I pass Aspergers on to my children?
Autism Spectrum Disorders (ASDs) run in some families and must therefore be caused, at least in part, by some genetic abnormality.
Even though there is a lot of research on which genes may be involved, we do not yet have a definitive answer. There is wide agreement that a multitude of genes is involved and that the genetic causes of ASDs are therefore complex.
We do know that about 1% of children in the Australia population and elsewhere have an ASD. This means that the chances of any family having a baby with an ASD are 1 in 100, even if there were nobody else in the family affected by the disorder. ASDs are approximately four to five times more common amongst boys than amongst girls, with boys having a 1 in 50, and girls a 1 in 250 chance of developing an ASD.
As far as we know, nobody has done any research to determine whether the chances of having a child with an ASD increases if there is a member in the extended family affected with the disorder. We do know that the risk of having a baby with an ASD increases to 1 in 5 (20%) if this baby has an older sibling with the condition. If this baby were a boy, he would have a 26% chance (1 in 4), for a girl the chance would be 9% (1 in 11). This risk increases further if there is more than one older sibling or when there is an affected identical twin.
If you are concerned by this issue we advise you to consult a genetic counsellor who may help you identify some ways of decreasing risk, such as 'sorting' female and male embryos (as the risk of ASD is lower for females). Be aware that we do not necessarily recommend this intervention, and such approaches may be costly.
Professor David Amaral is one of the experts in this area and you can read a transcript of his interview on PBS News Hour for more information.
- Dr Elfriede Ihsen
Is there a link between Rubella and autism?
We are aware of just one study that has summarised the evidence for a causal link between prenatal maternal Rubella and Autism.
In this paper the authors conclude: "The best association to date has been made between congenital rubella and autism; however, members of the herpes virus family may also have a role in autism. Further research is needed to clarify ... the mechanisms whereby viral infection early in development may lead to autism."
It is well documented however, that prenatal maternal Rubella causes brain damage in the unborn child, especially when the mother contracts the Rubella virus in the third trimester. The extent of the brain damage and hence the impact on child's development varies substantially, but some children unfortunately are intellectually, visually and/or hearing impaired. As the paper listed above suggests, there may be some link with autism as well, but more research is needed before it can be categorically stated.
- Dr Elfriede Ihsen
Can the Measles, Mumps and Rubella (MMR) vaccine cause autism?
It has been shown that the evidence for the causal link between MMR vaccine and autism was weak at best, and incorrect at worst. Andrew Wakefield, who published this evidence has been exposed as fabricating his data. For a really quick overview and lots of extra reading on this go to his Wikipedia page.
Parental doubt and confusion is caused by the fact that first symptoms (if not diagnosis) are often observed at the time of, or shortly after, the vaccination, so there is a temporal link but not a causal link between vaccination and observation of first symptoms. Current research indicates some brain differences as early as six months in children who are not yet showing signs of autism but go on to do so in the second year of life.
- Dr Elfriede Ihsen
What is the best evidence based treatment for children with ASD in relation to communication skills?
A very good starting point for comparing different interventions is the Raising Children Network's 'Parent Guide to Therapies' which provides a description of the most commonly used interventions in Australia, as well as a rating for research evidence, time commitment required, and cost. Research Autism, based in the UK, provides a similar service and is also well worth a look.
Even when we consider only those interventions for which there is good research evidence, we find that there is currently no single best intervention which works equally well for all children with ASD. This is no doubt due in large part to the fact that the individual skills and needs of each child, and his or her family, are unique.
- Dr David Trembath
Is there any evidence for the use of ICT for young children with an ASD?
There are still very few studies examining the use of iPads in an attempt to support the learning of children with ASD.
What we do know is that there is a long history of research examining computer-assisted instruction (CAI). From this, we know that some children concentrate better, are more motivated to engage, and at times perform better when taught with the assistance of a computer compared to face-to-face didactic teaching. We also know that some children with complex communication needs benefit from the use of low-tech and high-tech communication aids, designed to support expressive and receptive communication.
It would be reasonable to say that using iPads in the classroom has both potential benefits (e.g., student engagement and learning) and risks (e.g., distraction, lack of social interaction, cost/breakage). As with all technology used in the classroom, it is therefore a matter of weighing up the benefits and risks on a case-by-case basis.
- Dr David Trembath
How do I help my teenage son with Autism to socialise?
Often with ASD, socialising for the sake of socialising seems pointless, and there needs to be a purpose for interaction with other people. So carrying out a task in the company of other people is one way of not becoming isolated. This might include a hobby club, a sporting activity, an environmental task in the community, learning a new skill, teaching or mentoring other students or getting a part-time job.
Having the company of people, and carrying out productive activities with them may be sufficient to prevent loneliness. If this is in a predictable, nonthreatening, non-judgemental environment, then trust will be built up, and companionship may extend to friendship with time.
If your son is standing off to one side, he may be observing and learning social skills, and may be working out whether any of his class mates are 'suitable' as potential friends. Alternatively, he may be watching people socialising and this may be emphasising their 'differences' to him and could be a bit demoralising.
Not all those with ASD need a lot of friends, and this may be a time in his life when the benefits of avoiding activities in the company of teenagers outweigh the stress involved with doing so. Teenagers can be pretty full-on, and he may find it easier to make friends when everyone calms down a bit with age.
- Naomi Bishop
Can a diagnosis of Aspergers in an adult have a positive effect on a relationship?
Individuals with Asperger's syndrome (AS) may have difficulty with social interaction that hinders them from successfully beginning, developing, and/or maintaining an intimate relationship with another person. To our knowledge, there has not been any published research conducted on the area of romantic relationships and adults with AS.
There are various challenges experienced by Neurotypical (NT) individuals who know someone close to them who has a diagnosis of AS. Examples of the challenges outlined in the literature vary from organising a holiday, planning a wedding, and maintaining a sexual relationship with a person diagnosed with AS.
Additionally, NTs may be in an intimate relationship with a partner with AS who has deficits in empathy and spontaneity. Therefore, there may be some personal costs associated with maintaining a relationship in terms of the mental effort exerted by the individual with AS to maintain the relationship and to their NT partner in having to change their expectations of the relationship.
While the literature does not explicitly address whether a formal diagnosis of AS will help couples in a relationship, a clearer understanding of the impact that AS is likely to have on a romantic relationship is likely to provide couples with an opportunity to explore strategies to resolve the unique issues that may arise within their relationship.
- Carmela Germano
Is a change in diet effective for children with ASDs?
Complementary and alternative treatments such as the gluten and casein-free diet (GFCF), while not recommended in national and international guidelines on autism intervention, are extremely popular among families of children with autism spectrum disorders (ASDs), with a reported use between 52% and 95%.
The GFCF diet has been promoted as a treatment for the core symptoms of autism as well as the gastrointestinal (GI) symptoms that might be present in children with ASDs. The unproven rationale for this treatment is that GI and behavioural symptoms of autism originate from an impaired ability to break down dietary proteins present in gluten and casein, which would results in the formation of chemicals that cross the intestinal membranes, enter the bloodstream, and damage the brain.
This hypothesis was recently tested in a number of rigorous studies, all failing to show that children with ASDs have "leaky guts". While anecdotal reports have reported improvement in ASD symptoms with the GFCF diet, controlled studies have been limited. Based on preliminary findings, available research data do not support the use of GFCF diet as an effective treatment for individuals with ASDs.
However, given the real hardships associated with implementation of a strict GFCF diet, additional studies are needed to assess risk factors and possible markers that identify individuals who might benefit from these diets. Families must consider the implications of further dietary restriction in a child who may already have a limited food repertoire. Because bone loss has been reported in children on the GFCF diet, consultation with a registered dietician is recommended before foods are eliminated from the child's diet. Proper nutrition is as important for people with ASDs as it is for anyone else.
- Dr Giacomo Vivanti
Commonly used acronyms
- AD: Autistic Disorder
- ADHD/ADD: Attention Deficit Hyperactivity Disorder/Attention Deficit Disorder
- ASD: Autism Spectrum Disorder
- ASELCC: Autism Specific Early Learning and Care Centre
- AspD: Asperger's Disorder
- DD: Developmental Delay
- DQ: Developmental Quotient
- DSM-IV / DSM-IV-TR / DSM-5: Diagnostic and Statistical Manual of Mental Disorders-4th edition / 4th edition – Text Revision / 5th edition
- ESDM: Early Start Denver Model
- HFA: High-functioning autism
- ID: Intellectual Disability
- IQ: Intelligence Quotient
- LD: Language Delay
- OTARC: Olga Tennison Autism Research Centre
- PDD-NOS: Pervasive Developmental Disorder – Not Otherwise Specified
- TD: Typical development/typically developing