Autism

Autism

What is Autism? Autism is a developmental disability that typically appears during the first three years of life. The result of a neurological disorder that affects functioning of the brain, autism and its associated behaviors occur in approximately 15 of every 10,000 individuals.

Autism is four times more prevalent in boys than girls and knows no racial, ethnic or social boundaries. Family income, lifestyle and educational levels do not affect the chance of autism’s occurrence.

Autism interferes with the normal development of the brain in the areas of reasoning, social interaction and communication skills. Children and adults with autism typically have deficiencies in verbal and non-verbal communication, social interactions and leisure or play activities. The disorder makes it hard for them to communicate with others and relate to the outside world. They may exhibit repeated body movements (hand flapping, rocking), unusual responses to people or attachments to objects and resist any changes in routines. In some cases, aggressive and/or self-injurious behavior may be present.

Here is a beautiful story of a family that raised an autistic boy – the grace, the pain, the challenges, and the blessing. Is there a place for professionals, and how important is love in the equation? This homeschooling family found blessing as they consistently followed the leading of God’s Word. Every child is a special child, and this program will help every parent raise that special child. (more) It is conservatively estimated that nearly 400,000 people in the U.S. today have some form of autism. It’s prevalence rate now places it as the third most common developmental disability – more common than Down’s syndrome. Yet the majority of the public, including many professionals in the medical, educational, and vocational fields are still unaware of how autism affects people and how to effectively work with individuals with autism.

Is there More than One Type of Autism? Autism is often referred to as a spectrum disorder, meaning that the symptoms and characteristics of autism can present themselves in a wide variety of combinations, from mild to severe. Although autism is defined by a certain set of behaviors, children and adults can exhibit any combination of the behaviors in any degree of severity. Two children, both with a diagnosis of autism, can act very differently from one another.

Professionals utilize a diagnostic handbook, the Diagnostic and Statistical Manual now in its fourth edition (DSM-IV). Several autism-related disorders are grouped under the broad heading “Pervasive Developmental Disorder” or PDD: Autism, PDD-NOS (pervasive developmental disorder, not otherwise specified), Asperger’s syndrome and Rett’s syndrome. These four diagnoses are used differently by professionals to describe individuals who manifest some, but not all, of the autism characteristics.

The diagnosis of autism is made when a specified number of characteristics listed in the DSM-IV are present, in ranges inappropriate for the child’s age. In contrast, a diagnosis of PDD-NOS may be made when a child exhibits fewer symptoms than in autism, although those symptoms may be exactly the same as a child with an autism diagnosis. Asperger’s and Rett’s syndrome display the most marked differences from autism.

Therefore, most professionals will agree that there is no standard “type” or “typical” person with autism. Parents may hear more than one label applied to the same child: autistic-like, learning disabled with autistic tendencies, high functioning or low functioning autism. These labels don’t describe differences between the children as much as they indicate differences between the professionals’ training, vocabulary, and exposure to autism.

The differences in children’s behaviors are often very subtle. Each diagnosis relies on observation of the child and whether or not the professional is well educated on autism will certainly affect which label is used. Many professionals believe that the distinction between autism and PDD-NOS is not significant. Some believe they are “sparing” the parents by giving a diagnosis of PDD-NOS rather than autism. Many professionals still argue whether or not Asperger’s is really a form of autism. What is most important to understand is that whatever the autism diagnosis, children are likely to benefit from similar approaches to education and treatment.

What Causes Autism? Medical researchers are exploring different explanations for the various forms of autism. Although one specific cause of autism is not known, current research links autism to biological or neurological differences in the brain. MRI (Magnetic Resonance Imaging) and PET (Positron Emission Tomography) scans show abnormalities in the structure of the brain, with significant differences within the cerebellum, including the size and number of Purkinje cells. In some families there appears to be a pattern of autism or related disabilities, which suggests there may be a genetic basis to the disorder, although at this time no one gene has been directly linked to autism.

Several older theories about the cause of autism have been now proven false. Autism is not a mental illness. Children with autism are not unruly kids, who choose not to behave. Autism is not caused by bad parenting. Furthermore, no known psychological factors in the development of the child have been shown to cause autism.

How is Autism Diagnosed? There are no medical tests for diagnosing autism. An accurate diagnosis must be based on observations of the child’s communication, behavior and developmental levels. However, because many of the behaviors associated with autism are shared by other disorders, a doctor may complete various medical tests to rule out other possible causes.

Diagnosis is difficult for a practitioner with limited training or exposure to autism, since the characteristics of the disorder vary so much. Locating a medical specialist or a diagnostician who has experience with autism is most important. Ideally a child should be evaluated by a multidisciplinary team which may include a neurologist, psychologist, developmental pediatrician, speech/language therapist, learning consultant or other professionals knowledgeable about autism. Several diagnostic tools have been developed over the past few years to help professionals make an accurate autism diagnosis:

Behavior Rating Instrument for Autistic and other Atypical Children

A brief observation in a single setting cannot present a true picture of an individual’s abilities and behaviors. At first glance, the person with autism may appear to have mental retardation, a behavior disorder, or even problems with hearing. However, it is important also to distinguish autism from other conditions, since an accurate diagnosis can provide the basis for building an appropriate and effective educational and treatment program.

What are the Symptoms? What are People with Autism Like? Children with autism often appear relatively normal in their development until the age of 24-30 months, when parents may notice delays in language, play or social interaction.

The following areas are among those which may be affected by autism:

Communication:

language develops slowly or not at all;

use of words without attaching the usual meaning to them;

communicates with gestures instead of words;

short attention spans.

Social Interaction:

spends time alone rather than with others; shows little interest in making friends; less responsible to social cues such as eye contact or smiles

Sensory Impairment: unusual reactions to physical sensations such as being overly sensitive to touch or under-responsive to pain; sight, hearing, touch, pain, smell, taste may be affected to a lesser or greater degree

Play: lack of spontaneous or imaginative play; does not imitate others actions; doesn’t initiate pretend games

Behaviors: may be overactive or very passive; throw frequent tantrums for no apparent reason; may perseverate on a single item, idea or person; apparent lack of common sense; may show aggressive or violent behavior or injure self.

There are great differences among people with autism. Some individuals mildly affected may exhibit only slight delays in language and greater challenges with social interactions. They may have average or above average verbal, memory or spatial skills but find it difficult to be imaginative or join in a game of softball with their friends. Others more severely affected may need greater assistance in handling day to day activities like crossing the street or making a purchase.

Contrary to popular understanding, many children and adults with autism make eye contact, show affection, smile and laugh, and show a variety of other emotions, but in varying degrees. Like other children, they respond to their environment in positive and negative ways. The autism may affect their range of responses and make it more difficult to control how their body and mind react. They live normal life spans and the behaviors associated with autism may change or disappear over time.

While no one can predict the future, we do know that some adults with autism live and work independently in the community, while others depend on the support of family and professionals.

Adults with autism can benefit from vocational training to provide them with the skills needed for obtaining jobs, in addition to social and recreational programs. Adults with autism may live in a variety of residential settings, ranging from independent home or apartments to group homes, supervised apartment settings, living with other family members to more structured residential care.

Individuals with autism may have other disorders which affect the functioning of the brain, such as epilepsy, mental retardation, or genetic disorders, such as Fragile X Syndrome. About two-thirds of those diagnosed with autism will test in the range of mental retardation. Approximately 25-30% may develop a seizure pattern at some period during life.

Is there a Cure for Autism? Our understanding of autism has grown tremendously since it was first described in 1943. Some of the earlier searches for “cures” now seem unrealistic in terms of today’s understanding of brain-based disorders. To cure means “to restore to health, soundness, or normality.” In the medical sense, there is no cure for the differences in the brain which result in autism.

However, we’re finding better ways to understand the disorder and help people cope with the various symptoms of the disability. Some of these symptoms may lessen as the child ages; others may disappear altogether. With appropriate intervention, many of the autism behaviors can be positively changed, even to the point that the child or adult may appear to the untrained person to no longer have autism. The majority of children and adults will, however, continue to exhibit some symptoms of autism to some degree throughout their entire lives.

What are the Most Effective Approaches to Autism? Because of the spectrum nature of autism and the many behavior combinations which can occur, no one approach is effective in alleviating symptoms of autism in all cases. Various types of therapies are available, including behavior modification, speech/language therapy, sensory integration, vision therapy, music therapy, auditory training, medications and dietary interventions, among others.

Experience has shown that individuals with autism respond well to a highly structured, specialized education and behavior modification program, tailored to the individual needs of the person. A well designed intervention approach will include some level of communication therapy, social skill development, sensory impairment therapy and behavior modification at a minimum, delivered by autism trained professionals in a consistent, comprehensive and coordinated manner. The more severe challenges of some children with autism may be best addressed by a structured education and behavior program which contains a 1:1 teacher to student ratio or small group environment.

Students with autism should have training in vocational skills and community living skills at the earliest possible age. Learning to cross a street safely, to make a simple purchase or to ask assistance when needed are critical skills, and may be difficult, even for those with average intelligence levels. Tasks that enhance the person’s independence, give more opportunity for personal choice or allow more freedom in the community are important.

To be effective, any approach should be flexible in nature, rely on positive reinforcement, be re-evaluated on a regular basis and provide a smooth transition from home to school to community environments. A good program will also incorporate training and support systems for the caregivers as well. Rarely can a family, classroom teacher or other caregiver provide effective habilitation for a person with autism unless offered consultation or in-service training by a specialist knowledgeable about the disability.

A generation ago, 90% of the people with autism were eventually placed in institutions. Today, as a result of appropriate and individualized services and programs, even the more severely disabled can be taught skills to allow them to develop to their fullest potential.

Autism Society of America,

Home based Programs for all ages

7910 Woodmont Ave, Suite 650,

Bethesda, MD 20814-3015 Tel: (800)-3AUTISM

(301)-657-0881 Fax: (301)-657-0869

Essential Learning Institute

(800) 285-9089

 

Autism Traits

What is Autism?

Autism Continued, traits and more

Learning Styles of Students with Autism

Request our free Autism info pack

Individuals with autism usually exhibit at least half of the traits listed below.

These symptoms can range from mild to severe and vary in intensity from symptom to symptom. In addition, the behavior usually occurs across many different situations and is consistently inappropriate for their age.

Difficulty in mixing with other children

Insistence on sameness;

resists changes in routine

Inappropriate laughing and giggling

No real fear of dangers

Little or no eye contact

Sustained odd play

Apparent insensitivity to pain

Echolalia (repeating words or phrases in place of normal language)

Prefers to be alone

Aloof manner

May not want cuddling or act cuddly

Spins objects

Not responsive to verbal cues;

Acts as deaf

Inappropriate attachment to objects

Difficulty in expressing needs;

Uses gestures or pointing instead of words

Noticeable physical overactivity or extreme underactivity

Tantrums – displays extreme distress for no apparent reason

Unresponsive to normal teaching methods

Uneven gross/fine motor skills. (May not want to kick ball but can stack blocks.)

Adapted from the original by Professor Rendle-Short, Brisbane Children’s Hospital, University of Queensland, Australia.

Conference Notes: by Lisa Ruble

How do you teach someone with autism? It is probably no surprise that this is usually the first question new teachers ask when they have a student with autism in their classroom. In her ASA presentation Methods to Enhance Learning in Students with Autism, Kathleen Quill addressed this issue. She said that the first thing needed is to try to understand how people with autism “think.” Using this as the guide, educators can then begin to understand how to teach. Dr. Quill began her presentation with a discussion of the cognitive and social thinking in autism. Then she described methods to enhance learning through the use of routine and visual aids.

Cognitive Thinking and Socialization

An understanding of cognitive thinking of individuals with autism can be gleaned from the work of people like Temple Grandin, Donna Williams and others. We can conclude that individuals with autism are likely to:

think in pictures, not words

play a video in their mind that takes time to retrieve

have difficulty with long sequences or strings of verbal information

be unable to hold one piece of information in their mind while manipulating another

use or attend to only one sensory channel at a time

have difficulty with generalizing, experience inconsistencies in perceptions.

Information that is known about the socialization of these individuals tells us that they are likely to

have difficulty understanding the motives and perceptions of others,

experience sensory overload, and

use intellect instead of emotion to guide social interaction.

Therefore, based on the assumption that students with autism acquire information differently, a match between learning styles and the presentation of materials must be made. Teachers need to work from the strengths of the student with autism. Dr. Quill emphasized that in order to create a helpful learning environment, educators must implement structure in their teaching.

Structure

Structure is vital in teaching students with autism.

Activities are structured with

organized materials

clear instructions

a hierarchical system of prompts

Structure is enhanced by routines and visual aids which are not language oriented. Routines allow for the anticipation of events leading to self control and independence.

A sequence of tasks

provides consistency and predictability

establishes patterns

provides stability and simplicity

enables the individual to anticipate

increases independence.

There are three types of routines.

First, spatial routines associate specific locations with specific activities. These can take the form of a visual chart that can be used as a daily schedule.

Secondly, temporal routines associate time with an activity and make the beginning and ending of an activity visually evident.

Finally, instructional routines associate specific social and communicative behaviors.

Visual aids add structure to teaching because they are fixed in space and time and can represent many types of materials such as printed materials, concrete objects, and photographs. Often we assume that printed words are more difficult. Dr. Quill points out that this is an erroneous assumption.

Visual aids

assist the child to attend to information

provide organization and structure

clarify expectations and information

assist the child with making choices

decrease reliance on adults

increase independence.

Visual tasks such as puzzles, the alphabet, books, print, writing, and computers have a clear beginning and end which promotes clarity and purpose.

Principles of Interaction

When teaching social interaction, use

a predictable sequence of interactions,

a planned set of conversational scripts,

messages mixed with ongoing activity,

messages linked to what the child is doing,

a high degree of repetition,

complexity of messages which match the child’s level of comprehension,

simultaneous use of speech and visual cues,

a pause technique,

exaggeration.

In summary, Dr. Quill explained that it is necessary to match teaching methods to the cognitive and social learning styles of people with autism. Using structure in the form of routines and visual aids enhances teaching. Dr. Kathleen Quill has completed a book with a chapter written by Nancy Dalrymple to be published this year.

Reprinted from the Wabash Valley ASA Update, November 1993

Autism Society of America,

7910 Woodmont Ave, Suite 650,

Bethesda, MD 20814-3015 Tel: (800)-3AUTISM

(301)-657-0881 Fax: (301)-657-0869

Essential Learning Institute

Home-based programs for all ages

(800) 285-9089

Autism Learning Styles

What is Autism?

Autism Continued, traits and more

Learning Styles of Students with Autism

Request our free info pack

Learning Styles of Students with Autism

by Gary B. Mesibov, Ph.D.,

Co-Director Division TEACCH,

University of North Carolina

Parents and professionals are well aware of the difficulties children with autism have in many educational settings. In response they have developed alternative programs and intervention strategies. Although some of these have been useful, most emphasize remediating behavioral difficulties to improve educational functioning. Another aspect of the problem, however, has received less attention: the specific learning needs of this unique population.

This article will identify some unique learning characteristics of students with autism and their implications of these educational practices. Needs addressed will include organizational difficulties, distractibility, sequencing problems, inability to generalize, and uneven patterns of strengths and weaknesses. Although none of these applies to the entire population of students with autism, these learning problems are seen in a large percentage of these students to a significant degree.

Organization is difficult for each of us and especially for students with autism. It requires an understanding of what one wants to do and a plan for implementation. These requirements are sufficiently complex, interrelated, and abstract to present formidable obstacles for students with autism. When faced with complex organizational demands, they are frequently immobilized and sometimes never even able to begin their required tasks.

Developing systematic habits and work routines have been effective strategies for minimizing these organizational difficulties. Students with established left to right and top to bottom work routines do not stop working in order to plan where to begin and how to proceed. Organizational difficulties are also minimized through checklists, visual schedules, and visual instructions concretely showing autistic students what has been completed, what remains to be done, and how to proceed.

Distractibility is another common problem of students with autism. It takes many forms in the classroom: reacting to outside car noises, visually following movements in the classroom, or studying the teacher’s pencil on the desk instead of completing the required work Although most autistic students are distracted by something, the specific distractions differ considerably from child to child.

Identifying what is distracting to each student is the first step in helping them. For some it might be visual stimuli, while for others it might be auditory. Distractions can be responding to extraneous noises or visual movements as well as not focusing on central aspects of required tasks. Careful assessments of individual distractions is crucial. Following these assessments environmental modifications can be made, which might involve the physical make-up of a student’s work area, the presentation of work-related tasks, or many other possibilities.

Sequencing is another area of difficulty. These students often cannot remember the precise order of tasks because they focus concretely on specific details and do not always see relationships between them. Because sequences involve these relationships, they are often disregarded.

Consistent work routines and visual instructions compensate for these difficulties. Visual instructions can highlight sequences of events and remind autistic students of the proper order to follow. The visual picture remains present and concrete, helping the student to follow the desired sequence. The establishment of systematic work habits is also helpful; a student who always works from left to right can have work presented in the correct sequence.

Difficulties with generalization are well-known in autism and have important implications for educational practices. Students with autism frequently cannot apply what they have learned in one situation to similar settings. Appropriate generalization requires an understanding of the central principles in learned sequences and the subtle ways in which they are applicable to other situations. Focusing on specific details, students with autism frequently miss these central principles and their applications.

Parent-professional collaboration and community based instruction are important ways to improve generalization in students with autism. The more coordinated between the home and the school teaching efforts can be, the more likely it is that the students will apply what they learn to different settings. Using similar approaches and emphasizing similar skills are ways in which parents and professionals can collaborate to improve the generalization skills of their students.

Community-based teaching is also important for improving generalization skills. Because our ultimate goal is successful community-based training, activities must be available throughout educational programs. These should include regular field trips of increasing frequency as the students grow older, community-based work opportunities in ‘real’ job settings, and community-based leisure activities.

Uneven profiles of skills and deficits are well-documented characteristics of students with autism. They are also among the most difficult to program for. An autistic student can have the extraordinary ability to see spatial relationships or understand numerical concepts but be unable to use these strengths because of organizational and communicative limitations. Skilled teachers with experience teaching to these unique strengths and weaknesses are a necessity!

Teaching students with these wide ranges of abilities requires thorough assessments of all aspects of their functioning. These cannot be restricted to academic skills but must also include learning styles, distractibility, functioning in group situations, independent skills, and everything else that might impact the learning situation. Learning styles are especially important for the assessment process because they are keys to releasing learning potential.

How does each child with autism process information and what are the best teaching strategies given unique strengths, interests, and potential skills? A skilled teacher can open the door to many learning opportunities. Adults with autism working in libraries, with computers, in food service establishments, and many other settings are evidence that they can be productive adults if given appropriate instruction. Too many education programs, however, do not recognize the unique strengths and deficits of this puzzling group of learners. A greater appreciation of their uniqueness and more training for professionals to help them understand these learning styles are the main possibilities for continued progress.