Children with autism can experience intense frustration, discomfort, even fear and self-injury when they are unable to communicate basic needs and concerns according to Bissel and Peng 2001. They can also be very impulsive and lack an awareness of dangerous situations. Play lacks typical curiosity and creativity and is sometimes riddled with conflict and aggression (Smith, 2001).

"Autism disorder (autism) is a disorder of childhood which is classified as a pervasive development disorder," says Cardwell  (2003). Pervasive means that it affects the child in every area of development. The main areas are language and communication, social, behavioural and academic. In some cases, children who are diagnosed with a pervasive development disorder (PDD) appear to develop normally for some months and then either regress in their behaviour or develop abnormal behavioural or physical symptoms. In other cases children with these disorders appear to be abnormal in some respects from birth or very early in life.

Children who have pervasive development disorders lack the skills needed for ordinary social interactions and their ability to communicate with others is either severely impaired or absent. In addition, children affected by these disorders are likely to behave in stereotyped ways, and are not able to adapt their behaviour to different situations. All in all, their social and cognitive behaviours are clearly different from those of most children of the same age.

(Olansky and Jacques (2003) found that "the permanent, day-to-day dependence of the child, the interminable frustrations resulting from the child's relative changelessness, the unaesthetic quality of mental defectiveness, the deep symbolism buried in the process of giving birth to a defective child, all these join together to produce the parent's chronic sorrow. The birth of a child with a disability is sometimes seen as a situation without hope of resolution or adaptation".

While we don't have any available statistics for Barbados, internet research indicates that:

• Autism affects as many as 1 in 150 children in developed countries;
• Autism is the fastest-growing serious developmental disability in the world;
• More children will be diagnosed with autism this year than with diabetes, cancer, and AIDS combined;
• Boys are four times more likely than girls to have autism;
• There is no medical detection or cure for autism, but early diagnosis and intervention improve outcomes;
• Autism does not discriminate by geography, class, or ethnicity.

Autism spectrum disorder is described as pervasive to the child, but this can be applied to the family living with autism. Every area of family life is affected. If coping processes and skills are ineffective and the family does not learn to adapt, find solutions and remain in control, then the only choice to be made would be that of institutionalization for the disabled member.

In Barbados, the psychiatric hospital is the only available institution and this is highly unsuitable.