[Hong Kong Parents' Guide] Autism Social Training Full Strategy

1.Why is “social” at the core of ASD?

The overall prevalence of Autism Spectrum Disorder (ASD) in Hong Kong is approximately 1:54, or 1 in 54 children is diagnosed. Difficulties in social communication are one of the two core symptoms of ASD, and a lack of training can affect academic, employment and mental health in the long run.

2.ASD Causes: Congenital-dominated, acquired combined

Heredity: Studies show heritability can reach 80%, with a sibling reoccurrence rate of about 18.7%.

Environment: Older fathers, infections during pregnancy, and premature birth are high risk factors, but vaccines and upbringing are not causes.

Brain structure: fMRI revealed abnormal function of the amygdala and frontal lobe in children with ASD, resulting in difficulty in interpreting the emotions of others.

3. Common symptoms (noticable before age 2)

According to the two core diagnostic criteria of the DSM-5:

A. Difficulties in social communication

‧Zero gaze: Eyes wandering when talking to others, even using the other person "as a tool".

‧No sharing: Rarely shows toys, points to objects or says "Mom see!"

‧ Language monster: intonation flat, echo-style answering (echolalia), difficult to maintain back and forth conversation.

B. Repetitive behavior and narrow interests

‧ Insist on taking the fixed route to school. The bell will break out as soon as the change of class bell is changed.

‧ Addicted to wheels, MTR route maps, can recite bus numbers throughout Hong Kong and Kowloon.

‧ Sensory abnormalities: Covering the ears and screaming when hearing the sound of a hair dryer, or constantly smelling the smell of glue rubbing.

4.Golden Assessment Process for Ages0-6

Step 1 Initial screening

‧The Maternal and Child Health Center will use the M-CHAT questionnaire at 18 and 24 months. If high risk is indicated, refer to:

Step 2 Specialist Assessment

‧ Public: Child and Adolescent Psychiatry, Margaret Hospital, Neurological Development, Prince of Wales Hospital;

‧ Private: University of Hong Kong, CUHK, Autism Partnership, etc., 2-4 weeks to report.

Step 3 Interprofessional meeting

The ASD Diagnosis with Recommendation is issued by a clinical psychologist, speech therapist, and educational psychologist to facilitate applications for preschool special education services (SEN EETC) and kindergarten/primary one support.

5. Social training methods: 5 empirical strategies

ABA Behavior Analysis (most common in Hong Kong)

‧Intensive: 15-25 hours a week, teaching eye contact, waiting, and greeting in the form of “breakdown goals → demonstration → rewards”.

‧Subsidy: The Department of Social Security’s Preschool Rehabilitation Services (OPRS) can be funded by $13,000/month.

DIR floor time

‧Parents follow their children’s interests and interact on the floor, emphasizing emotional connection. For example, if a child is pushing a cart wildly, parents can pretend to be passengers and guide them to say "I want to take the XX bus".

PEERS Youth Social Skills Course

‧ Suitable for ages 7-16, group format teaches “how to join a group and respond to bullying”. Psychiatry at the Chinese University of Hong Kong offers annual classes for $2,800 for 8 sessions.

Theory of Mind Training

‧Use picture cards and situational short videos to teach "others think differently than me" and reduce the situation of "not being ashamed to say the wrong thing".

Technology Assisted

‧ Free App "Pictello": Make your own social story to remind you to say "thank you" at your birthday party.

‧VR glasses: simulate restaurant ordering, subway seat giving, reduce practical anxiety.