Autism Spectrum Disorder in Cambodia

In recent years Autism Spectrum Disorder (ASD) has gained in awareness and acceptance in Cambodia.While statistics of incidence and prevalence are imprecise, it is well understood that children with Autism and intellectual disabilities face an uphill struggle for services and education in Cambodia. The kingdom has a shortage of early childhood and adolescent mental health professionals and educators and finding treatment for those who have been diagnosed with the disorder is often difficult except for the affluent.  Autism is not a physical disability so people on the spectrum look no different from their peers and this may make it difficult for some people to understand why an autistic person might be behaving or reacting in a particular way.

ASD affects how people communicate and interact with others and it impacts how they make sense of the world.  Autism is typically a life-long condition though with therapy progress can be made in improving communication, social interaction, and other typical behaviors associated with ASD. Furthermore, it is important to understand that the term “spectrum” is used to emphasize that ASD manifests differently in every single person.  Thus, people with autism have a range of challenges as well as abilities.

ASD - not to be confused with low intelligence

Children with autism have trouble communicating and difficulty understanding what other people think or feel.  This makes it hard for them to express themselves with words, gestures, or non-verbal communication.  However, it is important to recognize that even though children with autism may have problems in certain areas such as relating to others, they may also test higher in some areas such as drawing, math problems, or memorizing facts.  Thus, it is not unusual for an autistic child to test average or above average on non-verbal intelligence tests.

Slow to speak?

Language delays are also common with ASD.  Often parents with a child that is slow to speak will visit health professional fearing that it may be ASD only to learn that language delays can occur with many other diagnoses. 

What causes autism?

Because autism runs in families most researchers think that certain combinations of genes may predispose a child to autism.  Nevertheless, in addition to the theoretical genetic link there are other factors such as the advanced age of the mother or father(over 35) that increase the risk or incidence of autism.  Nevertheless, it is important to understand that that the causes of ASD are not completely understood.

Autism Assessment:

In most instances a diagnosis is possible before or around a child’s second birthday.  By this time the parents and caregivers have noticed differences in the child when compared to his peers, meaning that he or she has not met developmental milestones seen in other children of the same age.  And early, accurate diagnosis will help families to establish a framework so that the child's difficulties can be better understood.  And any diagnosis from a young age will be periodically reviewed as categories and conclusions may change as the child develops.

It is important to understand that mild cases of autism are often difficult to diagnose, particularly at two years of age.  The mild cases may be diagnosed later, when the child starts school or even in adulthood.

Treatments for Autism:

The type of treatment your child receives for ASD depends on his needs as autism is a spectrum disorder, meaning each child and case is unique, so there are a variety of treatments.  It is also advised that parents, family members, and caregivers receive training so that they can support the learning and skills development throughout the day.

There are several different kinds of therapies designed to improve speech and behavior, sometimes accompanied by medication should the condition warrant it.

Brief Mention of the therapies:

Applied Behavior Analysis: Often used in schools and clinics. The goal is to help the child learn positive behaviors and reduce negative ones. This approach can be used to improve a wide range of skills.  Please see the ABA link below.

TEACCH:  Treatment and Education of Autistic and Related Communication-handicapped Children.

This treatment uses visual clues such as picture cards to help the child learn every day skills like getting dressing.  Information is broken down into small steps so he can learn more easily.

Sensory Integration Therapy: If your child is easily upset by sounds, lights, sand on the floor, fear of being touched, etc, then this therapy can help him to learn to deal with this type of sensory information.

Occupational Therapy:  Usually administered by a trained Occupational Therapist.  This kind of treatment helps the child learn life skills like feeding and dressing himself, bathing, and understanding how to relate to himself.  This type of professional is in short supply in Cambodia and at present there are few training programs. These skills are sorely needed.

References and Resources:

Diagnosis and Assessments in Cambodia:

Dr. Kao Sambath, MD  

Dr.  Okawada, MD,  at Sunrise Hospital  This email address is being protected from spambots. You need JavaScript enabled to view it.

Dr. Todd Jungkuntz, PhD 

Understanding Autism

Autism  

ABA Link

Scale and severity:

From 1994-2013, when the Diagnostic Statistical Manual (DSM) was revised, autism was divided into three diagnoses: autistic disorder, Asperger’s disorder and pervasive development disorder not otherwise specified (PDD-NOS). Now under the DSM-5, there is a single ‘umbrella’ diagnosis of autism spectrum disorder (ASD), with three severity categories (level 1, level 2 and level 3, in increasing order of severity).


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