**Author details**

As can be seen throughout this chapter, people with visual impairments show many behav‐ iours that are similar to ASD, such as the lack of understanding of social situations, ego-cen‐ teredness, and lack of understanding gestures and facial expressions. But, according to Gense and Gense [20], these behaviours may still be taught. Teaching appropriate behav‐ iours is especially important, because inappropriate behaviours may interfere with regular social interactions [18], depriving disabled children of these otherwise valuable experiences. And whereas for non-autistic people without visual impairments these behaviours are im‐ plicitly learned, in non-autistic visually impaired people, they need to be explicitly taught. With the right type of education, visually impaired people may still learn to interpret social situations, read and understand gestures and facial expressions and learn to play with oth‐ ers [20]. This was also found for two severely mentally disabled deafblind young men, of whom the social interaction became significantly better after tailored training sessions [58]. Although this was only a small study with two participants, it does indicate what a special‐ ized training can mean for children that are not restrained by ASD. The same applies to lan‐ guage. When a delay in language is caused by a lack of seeing things to talk about, parents need to offer more tactile or auditory stimuli [18]. Basically, it is important to take into ac‐ count everything that singular or multiple disabled people lack. When sensory and intellec‐ tual impairments are involved, one needs to try and substitute the missing modality for

Many characteristics of ASD seem to overlap with characteristics that are naturally present in people with sensory disabilities, intellectual impairments or a combination of disabilities. The characteristics appear the same whether ASD is present or not, which makes it difficult to make a valid diagnosis of ASD in this group. All of the criteria that are used in DSM-IV-TR to define ASD are, to some extent, also present in people with one or more of these disa‐ bilities. However, if one would look closer to these criteria, and the way they are expressed within people with sensory and intellectual impairments, slight and subtle differences can be found. There are differences in the way the symptoms express themselves, the severity of the symptoms and the underlying causes for the behaviours. Problems also occur in meth‐ odology. Paradigms that are used to assess problems that are related to ASD, such as ToM tasks, fail to be successful in differentiating people with sensory or multiple impairments. This overlap and these problems in methodology make it a major challenge to diagnose

The slight differences in the way symptoms are expressed show that a distinction between au‐ tistic behaviours and non-autistic behaviours can be made. Making this distinction is very im‐ portant to do, because the needs of people with ASD differ very much from people without ASD. To make sure the needs of every individual are met, people should be diagnosed in the right way. This is especially important for those groups with problems in communicating their wants and needs. In order to do this, subtle differences need to be taken into account. Up until this day, no instrument is suited to diagnose ASD or assess autistic behaviours within multiply

others as much as possible.

**6. Summary and Conclusion**

494 Recent Advances in Autism Spectrum Disorders - Volume I

ASD within people with sensory and intellectual disabilities.

Gitta De Vaan1\*, Mathijs P.J. Vervloed1 , Harry Knoors1,2 and Ludo Verhoeven1

\*Address all correspondence to: g.devaan@pwo.ru.nl

1 Behavioural Science Institute, Radboud University Nijmegen, NijmegenThe Netherlands,

2 Royal Kentalis, Sint-Michielsgestel, The Netherlands

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**Section 6**

**Aetiological Factors - Parents and Families**


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60-9.

**Chapter 22**

**Empowering Families in the Treatment of Autism**

It is well known that autism is a complex, currently incurable disorder with an unclear etiol‐ ogy, and that individuals with autism typically have normal life expectancies which require parents, and later siblings, to provide varying levels of lifelong care. Because of the complex‐ ity of the disease, it is critically important to help families understand the disorder, manage stress, and sift through information that frequently includes erroneous media views and un‐ substantiated claims of treatment efficacy. This chapter will help families and advising pro‐ fessionals by providing them with an overview of several topics: first, the common reactions and beliefs about autism and individuals with autism that are held by family members; sec‐ ond, the family-centered as well as complementary and alternative treatment approaches that are currently available; and finally, the best recommendations for helping families adapt to an autism diagnosis and maintain healthy functioning as caregivers—all while

Families are faced with enormous challenges in caring for children with autism over a life‐ time. The first challenge is obtaining the initial diagnosis, which can be difficult despite the fact that autism is better understood today than it was in the past. Indeed, it is common for families to consult a variety of professionals such as pediatricians and primary health care providers before receiving a conclusive diagnosis. Once the diagnosis is made, however, pa‐ rents face a second, far greater challenge: mourning the loss of their "perfect child"—which can be a long and arduous process that involves coming to terms with the fact that their child, whose physical appearance is normal or even unusually attractive, has a complex, in‐ curable, and frequently debilitating condition. After the family advances through stages of

> © 2013 Elder; licensee InTech. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

© 2013 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution,

distribution, and reproduction in any medium, provided the original work is properly cited.

and reproduction in any medium, provided the original work is properly cited.

planning for, and addressing the lifelong needs of, individuals with autism.

**2. Common reactions and beliefs held by family members**

Additional information is available at the end of the chapter

Jennifer Elder

**1. Introduction**

http://dx.doi.org/10.5772/54303
