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Head Office: Miranda (Sydney)  (02) 9541 1177

The Autism Spectrum Clinic

Autism spectrum disorder (ASD) is a neuro-developmental disorder, which is characterised by difficulties in social communication (verbal/non verbal) which impacts social interactions, routines and repetitive behaviours, circumscribed interests, and/or sensory sensitivities.

All children diagnosed with ASD have a wide range of difficulties and abilities. Some kids and teens with ASD have very impressive skills and strengths. One child with ASD might be gifted, highly verbal and have a very good memory. Another child might be an excellent artist or a gifted visual learner or have excellent computational skills. Despite their strengths, kids and teens with ASD struggle in their social and emotional development and require ongoing intervention and support.

In Australia, Autism Spectrum Australia (Aspect) has revised its autism prevalence rates from 1 in 100 to an estimated 1 in 70 people in Australia on the autism spectrum. ASDs affect almost four times as many boys than girls. However, many girls do have ASD, but learn to mask their challenges through imitation and practice.

ACPC Psychology receives a high number of referrals for the assessment, diagnosis and treatment of Autism Spectrum Disorders and other related developmental conditions from various sources including Paediatricians, General Practitioners, Allied Health Professionals (Speech & Occupational Therapists) as well as schools and preschools.
 

Autism Spectrum Disorder (ASD)

ACPC Psychology focuses on the assessment, diagnosis and treatment of individuals with an Autism Spectrum Disorder (including Asperger's Syndrome). Our clinicians have extensive experience and training in providing services for preschoolers, school aged children, adolescents and adults with autism spectrum disorders. Our clinic ensures that we are up to date on the research and evidence based therapies within this area. Our psychologists tend to share a special interest in Autism Spectrum Disorders, and aim to deliver services reflective of their extensive experience and knowledge of ASD.

The clinic is supervised by ACPC Psychology Director & Principal Psychologist Azza Brown, who holds extensive experience in working with young children, children and adolscents and adults with an Autism Spectrum Disorder.

Similar to all referrals to our clinic, a comprehensive assessment is conducted with famiilies for the purpose of creafing an intervention plan specific to the individual needs of your child, adolescent and family. The assessment and treatment process at the Autism Specialist Clinic also includes:

  • Standardised assessment and screening measures that assesses social, emotional, and behavioural developmental issues associated with Autism Spectrum Disorder
  • Gold standard therapeutic interventions derived from evidence based research specific to ASD
  • Pre and post outcome measures to enhance treatment outcomes.

At ACPC Psychology, clinicians working with children and adolescents, adopt several innovative and creative strategies to increase their client's attention and engagement during sessions whether it may be via online or face to face sessions. Not only are our clinicians competent in delivering suitable interventions that will keep our clients engaged throughout sessions, whilst keeping the treatment goals in mind, but our clinicians are also well informed of the many special interests that kids and teens with ASD may have! Thus, we develop effective rapport building with our ASD kids and teens, whilst implementing evidence based therapies which leads to maximising outcomes during our therapy sessions...

Girls on the Autism Spectrum

Research shows that the average age of being diagnosed with ASD Level 1 for boys worldwide is approximately 8 years of age, in contrast, for girls the age is approximately 13 years of age. In recent years however, professionals working with children and adolescents are increasingly receiving referrals for diagnostic assessments of girls due to more awareness that girls on the spectrum may present very differently than males. 

The most common reason why girls receive a late diagnosis is mainly due to their ability to successfully camouflage their autism. Girls and women on the spectrum are often missed on standardised measures for autism and in clinical settings due to their camouflaging ability which allows them to hide some of the characteristics of autism. Instead, they would rely on observing people in their social world including peers, by analysing and mimicking the observed social rules and conventions. In this way, they can acquire social and interpersonal abilities successfully. 

Whilst camouflaging may assist in 'bending in' with peers and the social world, it has also been shown to be associated with poorer mental health and wellbeing outcomes including; anxiety, depression and low self esteem. In addition, camouflaging often delays the diagnosis of autism and thus accessing appropriate support and intervention that is individually tailored to ASD individuals.

Pathways to diagnosis for girls and women with ASD may include; an initial diagnosis of social anxiety, ADD/ ADHD, selective mutism, depression or bipolar disorder, gender dysphoria, OCD or even anorexia nervosa. Another common pathway for girls is searching on the internet and discovering that they resonate with a description of Asperger's Syndrome. Another common pathway for women in particular is reflection following a diagnosis in one of their children or another family member. 

Regardless of when or how diagnosis is sought, at ACPC we believes that the main underlying reason for diagnosis is for the individual to further their strengths and difficulties when it comes to abilities including intellectual, language, learning, social and emotional development, which in turn can contribute to increased self identity and promote self acceptance to be able to live fulfilling lives!

For further reading, please see links below:

https://attwoodandgarnettevents.com/2019/12/12/understanding-girls-on-the-spectrum-by-prof-tony-attwood-and-dr-michelle-garnett/

https://attwoodandgarnettevents.com/2019/12/04/camouflaging-girls-and-women-with-autism-by-prof-tony-attwood-and-dr-michelle-garnett/

Catering for ASD Across the Lifespan

The following lists a summary of services offered for families on the Autism Spectrum:

EARLY CHILDHOOD (16 months to 5 years old)

  • Child screening
  • Diagnostic Assessment
  • Early Intervention
  • Behavioural intervention
  • Clinical preschool/ Child care observations
  • Parent training
  • Assisting in challenging behaviours
  • Assisting in toilet training
  • Support for preschool/ child care staff

SCHOOL AGED CHILDREN (6 years to 12 years old)

  • Assessment & Diagnosis
  • Assessment of IQ and Learning
  • Behavioural management
  • Emotional training
  • Anxiety treatment
  • Anger management
  • Social skills training
  • Dealing with bullying
  • Teaching problem solving
  • Support for educators
  • Parent training
  • Social skills groups
  • Friendship management


ADOLESCENTS (13 years to 17 years old) 

  • Assessment & diagnosis
  • Assessing learning difficulties
  • Individualised therapies
  • Anxiety treatment
  • Anger management training
  • Educational coaching
  • Career guidance
  • Friendship groups


YOUND ADULTS & ADULTS (18 years to 25 years old)

  • Assessment & Diagnosis
  • Assisting with relationship issues
  • Assisting in work related matters
  • Anxiety treatment 
  • Emotional & Social Training

Managing Challenging Behaviours

At ACPC Psychology,  we are passionate about working with children with neurodevelopment conditions (incl. autism spectrum disorders) and their families using Functional Behavioural Analysis (FBA) principles and Positive Behaviour Support (PBS), alongside others evidence based therapies. Our treatment plans are individually tailored to assist your child's and family's needs. Our role as professionally trained therapists, is to help improve the quality of life for children with developmental delays and their families to empower them with new ways of understanding, managing and thus reducing challenging behaviour.

Children will engage in challenging behaviour for various reasons. There is always a 'function' underlying their behaviour. Generally speaking, it may be as a way to get something good whether it be a tangible thing or a feeling, or they might do it to get away from something that they don't like or that makes them uncomfortable.

The team at ACPC Psychology is committed to examining underlying reasons for challenging behaviour displayed by any child. Our therapists are trained through their qualifications on how to assess the function of a particular behaviour. Once the function of the behaviour is determined, then we look for ways to help our kids fulfil that need in a way that keeps them safe and is functional. In behavioural therapy, this is referred to as a replacement behaviour. Whatever our clinicians decide to teach it would be something that we determine based on the child's strengths and preferences whilst also working with parents or guardians of the child since they know their child the best!

When it comes to managing challenging behaviours, ACPC team takes into consideration the following important factors:

1. Individual differences

The initial stage of investigated the underlying reasons behind the challenging behaviours is to determine whether changing such behaviour needs to be addressed in the first place. In doing so, we work collaboratively with the individual and their families to examine the nature of the behaviours and prioritising which behaviour seems to be having a significant impact on the child and family's quality of life.

The second stage is to meet with the child and learn as much as we are able to about the child in terms of their overall development (i.e. language level, play skills, temper regulation), their strengths and interests, what types of things are they really good at it and what motivates them, things that they may dislike and the types of skills that would benefit from further development and training. Such information is vital when developing the individualised treatment plan for the child and their family.

2. Reasons underlying the challenging behaviour

It can be difficult for a parent or guardian, being emotionally attached to their child, to determine underlying reasons to challenging behaviours displayed by their children. As trained professionals in behavioural analysis, we work on analysing particular behaviours to help the individual to learn a new way to meet their needs, and assist families in understanding and managing displayed behaviours. It is important to involve trained professionals because there are tools that they have learned about that can help identify why it is happening.

3. Teaching a new behaviour / skill

Behavioural therapy principles works on empowering the child by teaching more effective skills to get their needs met in a more functional manner. In doing so, it is necessary to obtain observations of child's developmental level, functioning ability (i.e. interaction with parents, peers etc.) and analyse their progress in both their home and educational setting.This would involve working with parents/ carers and liaising with educators and other therapists including speech pathologists and occupational therapists.

4. Taking into account that the "student is always right"

Behavioural therapy works in the framework of "If the person we are trying to teach is not learning what we are trying to teach then we need to change how we are teaching". Reasons as to why a child may not be learning could include the possibility of selecting the wrong thing to teach; or that the skill is too hard and we need to teach the basics first prior to jumping to what the child is 'expected to know'. We therefore aim on breaking down each skill to the child's developmental level (i.e. level of understanding, readiness, temper regulation, attention/regulation etc.).

Summary Adapted from: Sarah Kupferschmidt, Autism Daily News http://www.autismdailynewscast.com/applied-behaviour-analysis-aba-challenging-behaviour/28818/guest/

Assessment of Typical vs. Atypical Eating

Picky eating and problem feeding is common in children with Neurodevelopmental conditions including (but not limited to): Autism Spectrum Disorders, Sensory Processing Disorder, ADHD and in cases of elevated anxiety levels. 

Assessing the underlying reasoning behind "picky" or "selective" eating can be tricky when doing so independently. It is an area of significant stress for families and the information available can be very broad which in turn causes confusion and further stress.

Trained psychologists at ACPC are able to assess underlying reasons, provide psychoeducation and further support, intervention and direction as needed.

In the mean time, the following provides a helpful summary organised by Amanda Kenyon, psychologist at ACPC, outlining the the complexity of feeding and eating issues in young and school aged children:

What is typical eating?

There is significant variance in the development of eating habits, amount of food consumed and the types of food consumed that would fall within 'typical' eating habits of children. Children's eating habits are also very different to adults therefore we cannot use the same criteria to compare. Typical children's eating habits include the following:

  • They may eat one food item at each meal rather than a mixture
  • They may eat far less or far more than 'recommended' but still be healthy and developing appropriately
  • They prefer carbohydrates such as bread, pasta (which is needed for fueling growth and activity.)
  • Intake varies significantly depending on energy and activity such as during growth spurts or at times of illness
  • There is a normal decrease in intake when leaving the growth spurt phase of infancy
  • Children will refuse previously eaten foods and come back to them naturally on their own months later
  •  Learning to eat solids is a process that takes 2-3 years starting from approximately 6 months old (adjusted for prem babies)
  • Children with developmental delays will take longer to learn to eat.

As a child develops they pass through a few developmental food milestones as described below:

  1. Infants (6mo to 15 mo) – This stage is characterised by the transition to solids and self-feeding.
  2. Toddlers (15m to 4 years) – This stage is characterised by 'Caution and control', it is a stage of developmentally appropriate picky eating. Children are learning that they are individuals and have some control over what they do (and eat).
  3. Preschoolers and older (3-10 years) – This stage is characterised by 'Competence and Relationship'. At this stage children are motivated to please their parents, learn and try new things and feel competent.

How do I differentiate typical eating from feeding and eating disorders?

In order to differentiate typical eating from being something more, we can ask ourselves the following.

Are there emotional signs of distress around food??? – does the child cry or become upset around food, do they feel bad about eating.

Are there physical signs of nutritional deficiencies???- are they falling off their growth curve, do they have low energy or frequent meltdowns when hungry.

Are their social experiences impacted???- are they unable to go to or participate in social gatherings, sleep overs, restaurants, are they teased by their peers or getting excessive attention from family or teachers.

If you answered yes to any of these questions it may be worth further exploring your child's eating.

Why do feeding and eating disorders start in children?

Feeding and eating disorders can begin for a range of reasons as summarised below:

1. Medical – allergies, reflux, eosinophilic esophagitis (allergy related to erosion of esophagus), severe constipation, cardiorespiratory or muscular conditions effecting breathing (congenital heart defects, chronic lung disease, muscular dystrophy). All these conditions will make eating more difficult for a child.

2. Oral motor impairments – any issue that makes it difficult to get food into the mouth, chew, breathe, swallow or sit up can be a reason to avoid food or food groups. For eg: cleft palate, malformation of the trachea/oesophagus, dental issues, enlarged adenoids or tonsils or tongue tie. Also any jaw malfunction which impacts coordinated movements of the tongue and cheek, Poor chewing technique (biting and chewing with front teeth only) or limited movement of tongue (especially if unable to move side to side). 

3. Sensory processing disorder – Means that sensory input is experienced in a more intense or dulled way. Children may crave certain sensory experiences (spice, sourness, crunch) or be unaware of the sensation of food in their mouth. Some children with SPD will only eat uniform textures (all smooth or all crunchy).

Examples of sensory presentations:

  • Taste/Smell – only eating bland or strong flavours, same few flavours preferred, turned off by strong smells.
  • Tactile – wants hands wiped of any mess, or unaware of food all over face, not mixing textures, preference for crunchy, distracted by feet dangling at meal times, prefers food at certain temperatures.
  • Visual – only eats certain brands, finds patterns distracting, doesn't like bright lights.
  • Auditory – reacts to noise more than peers, prefers steady background noise, stressed long after after unexpected noise ends.
  • Sensory seeking – crave intense sensory input particularly seeking out strong and intense flavours, can be unaware of foul tasting foods, often bite tongue, drool or eat with mouth open.

4. Temperament/Mood – Children with feeding or eating disorders are often highly verbal and intelligent. They tend to be independent natured and want to do things 'on my terms, in my own way'. This can lead to them becoming increasingly frustrated when things don't work. They often feel and express intense emotions. They also tend to be sensitive to their parents agenda and pressure leading to increased risk of experiencing anxiety. Food refusal also links to shyness, emotionality and irritability. (Children with this independent temperament also often have toilet training issues and constipation for similar reasons).

5. Negative Experiences – If in the past eating or feeling hungry has resulted in an uncomfortable or scary experience, such as choking, food poisoning, vomiting, forced feeding or illness, appetite can decrease.

By: Amanda Kenyon, Psychologist at ACPC, Adapted from resource: Helping your Child with Extreme Picky Eating. By Katja Rowell.

Please Contact our clinic for a Consultation!
Call: +61 2 9541 1177

Our goal is to ensure your advocacy needs are met through the process of continuous engagement and genuine understanding of your needs