Autism

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Autism is a developmental disability that affects an individual’s ability to communicate and socialize. Individuals with autism also have repetitive behaviors and may have poor sensory integration. Autism affects one in 150 kids according to the Centers for Disease Control (Kalb 2008). According to statistics from the U.S. Department of Education and other governmental agencies (ASA, 2006), autism is growing at a startling rate of 10-17 percent per year. At this rate, ASA estimates that the prevalence of autism could reach 4 million Americans in the next decade.


Autism falls under the umbrella of Autistic Spectrum Disorder (ASD) synonymous with Pervasive Developmental Disorders (PDD). Other disorders categorized under ASD or PDD are Asperger’s Syndrome, Childhood Disintegrative Disorder (CDD), Rett's Disorder and Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS).

Autism is a spectrum disorder because no two people with autism are alike. The symptoms and characteristics of individual’s with autism can occur in any combination and vary widely from mild to severe (Autism Society of America, 2005).

Contents

Characteristics of Individuals with Autism

(adapted from NIMH, 2005)

Social Interaction

  • Lack of eye contact
  • Prefers to be alone
  • Has trouble making friends
  • Has trouble interpreting facial cues or body language
  • Difficulty seeing the perspective of others
  • Difficulty regulating emotions
  • Does not engage in appropriate social play with others


Communication

  • Delayed or no speech development
  • Unusual speech patterns (e.g. speaking only in single words, repeating the same phrase over and over and echoing what they heard (echolalia))
  • Difficulty sustaining a conversation
  • Have large vocabularies and speak like a little adult
  • Facial gestures, movements and body language do not match what they are saying
  • Unusual voice pitch (e.g. always high-pitched and sing song or monotone and robot like)
  • Unable to understand sarcasm

Repetitive Behaviors

  • Odd repetitive motions such as flapping hands
  • Does not engage in pretend play (e.g. with blocks does not build a tower but focuses on arranging the blocks in a certain way)
  • Likes routine
  • Persistent, intense preoccupation (e.g. being obsessed with and learning all about ancient Egypt).

Sensory Integration

  • Overly sensitive to certain sensor stimuli (e.g. covering ears and screaming when they hear thunder)
  • Seemingly oblivious to some sensory input (e.g. does not notice if they are too hot or too cold)
  • Poor fine and gross-motor skills.

Not all individuals diagnosed with autism will display each characteristic. Additionally, the severity of each characteristic will vary from individual to individual The characteristics for diagnosis of autism are found in the Diagnostic & Statistical Manual for Mental Disorder (DSM –IV).


Causes of Autism

It was once held that autism was a psychological disorder caused by traumatic experiences that forced a child to retreat into a world of fantasy (Encarta, 2005). They believed it was an emotional illness caused by "refrigerator mothers" or emotionally unattached parents. This belief is credited to Bruno Bethleheim (Dyches, et. al., 2001). In 1964, Bernard Rimland, a psychologist and father of a son with autism, wrote the book Infantile Autism: The Syndrome and Its Implication for a Neural Theory of Behavior. In the book he made the case that autism is not an emotional illness but a biological disorder. The book is credited with changing the way autism was perceived (Cure Autism Now, 2005). Today it is widely believed that autism is the result of "abnormalities in brain structure or function" (Autism Society of America, 2005). Researchers may have narrowed this down to the amygdala - a part of the brain involved in emotional control.[[1]] What is not know is the underlying cause(s) of the abnormalities. There are several theories regarding the causes from genetics to environmental factors such as exposure to certain chemicals. Research in the area of genetics, developmental neurobiology, neuropsychology and brain imaging are investigating the causes as well as the development of individuals with autism and much is still being learned about the disorder (NIMH, 2005).

Another theory is that the cause of autism is related to a mercury compound used as a preservative in some childhood vaccines. Some people refuse to believe the vaccines have anything to do with the increased rate of autism. Thimersal has now been banned by most states. If it was a cause we should start to see a decline in the number of cases.

Application in classrooms and similar settings

Children with autism fall under the mandates of Individuals with Disabilities Education Act (IDEA), which stipulates public schools must provide children a free, appropriate education to children with disabilities. The education must also meet their unique needs. It further requires that children with disabilities be placed in the “least restrictive environment‿ meaning that children with disabilities be placed in the regular classroom setting to the extent that it is possible. This impact of IDEA is that schools must provide instruction and curriculum suited to the special communicative, social, sensory and behavior needs of students with autism. This will most likely require a coordination of services among several individuals for example a special education teacher, speech and language therapist, social worker or school counselor, occupational and/or physical therapist and regular classroom teacher.

Strategies used to teach children with autism

Many therapies and teaching strategies have been designed to meet the unique learning needs of children with autism. Most of the strategies described below have been research. However, the research is sometimes limited to a few studies and the number of children in each study is fairly small, usually less than 10 children. Additionally, because autism varies from child to child, a strategy that works for some children with autism might not work for all children with autism. Researchers also recommend considering several factors before implementing any strategy (Terpstra, et al., 2002, p. 3).

  1. Developmental level of the child
  2. Language abilities of the child
  3. Motivational techniques
  4. The type of setting
  5. The skills to be taught

Pictorial or textual cues- These have been used to help children with autism communicate but also to keep children on a schedule, to provide instructions on how to complete an activity and to prompt appropriate behaviors. For example a picture cue with the text quiet voice may prompt a child to work quietly. In most instances picture cues are taught and reinforced (Bakken & Brock, 2001).

Augmented and Alternative Communication - This is a communication system for individuals who have little or not speech. Speech is replaced or augmented with such methods as sign language, gestures and body language, electronic voice output machine (VOCA), photographs or picture books (PECS), line drawings on a communication board, handwriting or miniature objects that denotes the real object (Mirenda, 2001).

Computer assisted instruction (CAI) - A skill is reinforced or taught with a computer program (Coleman-Martin, et al., 2005).

Social Stories- This technique was developed by Carol Gray and involves creating a story that describes the “individual steps of a social situation‿ in order to teach the appropriate social skills and behaviors. For example, a social story may describe how to walk in a line in the hallway (The Gray Center, 2005).

Applied Behavior Analysis (ABA) - “Applied Behavior Analysis is the use of behavioral methods to measure behavior, teach functional skills, and evaluate progress‿ (Autistic Spectrum Therapies, 2005).

Pivotal Response Training (PRT) - This is technique incorporates principles of ABA. It targets motivation because it seems to be pivotal and lots of behaviors can be modified at a time. The intervention is also used in a natural setting . (Autistic Spectrum Therapies, 2005).


Critics and their rationale

The medical definition of autism is a deficit model because autism is diagnosed as an impairment in social skills and communication. Also there is a notion that the symptoms of autism need to be cured. However, there is an alternative view that autism is not disorder but merely a different way of experiencing the world. Jane Meyerding, an individual with Asperger’s, describes it as being “different brained‿ (Meyerding, 2005) It has been noted that individuals with autism have various strengths such as good rote memory skills, remembers information for a long time, good at rule governed abstract thought (such as math, engineering and computer science), visual thinkers, take in chunks of information quickly, and concentrate on narrow topics of interest (Autism Association of NSW, 2005). Individuals with autism advocate “autistic people have characteristically autistic styles of relating to others, which should be respected and appreciated rather than modified to make them "fit in‿ (Autism Network International, 2005).


Diversity considerations

When Leo Kanner first described autism in 1943 he originally believed there might be a link between parental characteristics and children with autism. He had observed that all the parents were intelligent, professionals with high levels of education. Today it is commonly held that autism occurs across racial, ethnic, economic and social boundaries (Dyches, et al., 2001). Though some researchers challenge this notion and have reported “low incidence of autism in many Latin American countries and in several developing countries such as Kenya, India, and Hungary (Dyches, et al, 2001, p. 154).

There is very little research on multicultural issues and autism. It is important though that teachers consider multicultural issues when teaching students with autism for several reasons

  • Possibility of misclassification because cultural behaviors are misinterpreted
  • Cultural differences in the appraisal of autism (e.g. a Native American family may focus on what the child with autism is able to do rather than what the child is unable to do)
  • Being able to honor the child’s culture while teaching the child how to function in the dominant culture (Dyches, et al, 2001).


Signed "life experiences", testimonies and stories

I work at a school for students that have a primary disability of Mental Retardation but many of them also have secondary disability of autism. I feel that some of my students truly have autism which in turn brings their IQ score into the level of mental retardation because of their inability to express themselves or recall information needed to test their IQ. Many of my students, given different means of communication and allowed to use different strategies are able to function closer to their age equivalent peers. My goal is to use my graduate program based in technology to help me obtain the best from my students with disabilities, especially autism. -J. Melhouse (December 2008)

This fall will be my first true experience with teaching students with autism. As of right now, I have two incoming Kindergarteners with autism. Though I am nervous and hope that I will serve their needs and teach them in a manner that is sensitive to those needs, I am quite excited about having them in my class. Most exciting is the fact that having these two students in my class is allowing me for summer writing and professional development opportunities with which I would not normally have been privilege. Right now, I am in the process of meeting with the special education teacher who also serves as their IEP case manager. These meetings have been extremely helpful in allowing me to delve into the subject of autism and the types of instructional strategies that work best with these two children. I have been able to meet with past teachers to discuss learning and behavior goals and strategies; to review the progress that has been made in terms of their IEP goals and where to go next; as well as given literature and video on such topics as using visual schedules and PECS to condition behaviors and learning. What is quite sad is that I would not have had these learning opportunities and collaboration meetings had I not been assigned these two students. I feel that all teachers would benefit from these learning opportunities and wonder why all classroom teachers are not given the opportunity to participate. -D. Jacob (June 2006).

I have taught quite a few students with autism or some sort of autistic spectrum disorder. Most of these students have been challenging, but very rewarding. Being a music teacher, I get to see them in ways that not all teachers get to experience. Most autistic children love music and you can get them to interact in ways that traditional class room tactics can not. They also love to discuss specific topics and can become obsessive if not watched. The best way to handle this is to have a code word that only you two know what it means. One boy that I had was obsessed with 80's rock bands and so I would give him the opportunity to "lecture" the class on a specific band, but when he would start to go over board, I would quietly say "nice job" which was our code word for that is enough. It was our way of helping him to understand boundaries, which are not very evident to people with autism. A. Dorough


I have taught a student with autism and try to keep the class as predictable as possible. I know that the student really doesn’t like change so I keep everything a routine as possible. When he gets over stressed, he like to flip through pages of a book and I let him to that when he needs to get himself calmed down. P Graham

I teach a student with Asperger’s syndrome (which from what I understand is a form of Autism). At any rate, many of the items you say here I can totally sympathize with. This young man scared all of the teachers when he came to be with us. He would have run roughshod over us if we had used traditional methods of discipline with him. However, using some alternative strategies and having a great deal of patience, we had a very successful year with him. The thing I found most helpful was that the other students were aware of his condition and were helpful in our dealing with him. As opposed to what we thought going into the year, they (the other students) did not question our discipline methods when he (the student with Asperger’s) was given extra latitude that they were not privy to. Nick Chatterton

As stated above, autistic students have difficulty interpreting facial cues or body language. This can be especially difficult when viewing a film in class, during which a student with autism may be unable to determine significant character development or emotional reactions, whereas he/she may have picked up on these cues if reading these in text. Giving a written summary of the scenes to these students may help them to properly interpret the movie. Daniel Kuglich

I have had two experiences with students who have either had autism or Asperger's. These experiences have taught me that these children need consistency and predictability in the classroom routines. When the routines change without warning, it can possibly present great amounts of stress for the child. For example, one of my students would get very anxious and worried about fire and tornado drills. One of the things that frightened this child was the alarms that went off. Even though I would warn the child when we might have a drill, the sudden noise would cause him great distress. Prior to the drill and after it, we would talk about what we would do/did and how everything ended up to be fine. However, it was the suddenness of the situation and the quick response that he could not emotionally deal with. -Tricia Pearl

This past school year I had the privilege of teaching a student who was labeled high functioning autistic. Now I was not informed of this until a couple of days before the school year started. His parents brought him in to meet me while I was decorating bulleting boards, and he made quite an impression on me in the first five minutes. I was often frustrated with my inability to read this students supposedly obvious autistic cues throughout the year, but his sense of humor kept all of us going and hoping to understand him more. The interesting thing about this student is that he could go through the entire list of behaviors in one afternoon, so there was no doubt that the diagnosis fit. I have learned quite a bit about inclusion and autism this school year and I hope to continue learning more. -Candace Hatchett

I haven't had much experience with students with autism, but I've noticed so far, that all 3 have turned out to be brass players. When recruiting beginning band students, every student gets an opportunity to explore and play 3 instruments: one brass, one woodwind, and another of their choosing. Each student has had no interest in percussion and have not liked reed instruments due to texture. This was quite interesting to me, and I wonder if other students with autism will have a tendency towards brass...or if this was merely coincidental. -S.Scott

This year I have had the oppotunity to work with an autistic student in my physical education class. I am always amazed at how stressed the child gets regarding change. He is very concerned about the color gymsuit he gets to wear and the team he is playing on. When he is forced to changed something about his routine, he asks many questions and repeats over and over the new directions he is given. I have been lucky tha the has adapted to the change so well. I have really enjoyed working with him this year. - Amy Neighbors

As a principal of a catholic school, I have a parent who has 2 children in my school and her third child is autistic and wants to come to school with his brothers. I have spent a great deal of time with this family working on ways to get him to be able to come to my school. The biggest hurdle we have now is trying to the school district to fund a part time aide for him. He is a very smart child and he can hold conversations and he is very advanced on the computer and the computer programs we have he can understand and work on. I know in the next year or two I will have him at my school and between now and then I am going to continue my research on how to best prepare the teachers,students, and parents in the best way to work with this young man. Sue Whisson

This year I have had the opportunity to have a student with autism in my class. This student enjoys his daily routines and can be upset when the class deviates from that routine. When he is in his routine he produces quality work and participates in class. His peers enjoy his company and when he is absent(which doesn't happen frequently)they are concerned about him. -R. Folkens

I am teaching an 8th grade autism student who I have had for three years now. I started working with him in 6th grade. He has always been very quiet, but he has always been an extreme pleasure to work with in class. He is extremely bright and intelligent. I have watched him grow so much through these three years. In 6th grade, he would barely talk to anyone and you would never see him make any physical contact with anyone. When he came out on the playground, he would immediately go over to the wall of the school and be by himself. I had a hard time with this because he was such a great kid. I wanted everyone to experience the kindness from this boy, but I let him do as he pleased. I would always go and talk to him. He knew that I cared. During his seventh grade year, he didn't change much other than his height. He still stayed to himself and didn't talk to many people. However, this year there has been a total change in this young man. I see him playing on the playground with other students. He seems to really enjoy himself with other students now. Another great change is that he now comes up to me to give me a hug, give me a handshake, or tell me a joke. I just love it because he just doesn't seem to close himself off as much as he used to. His parents have told me for three years that I have been a major positive influence in his life. I truly hope this young man will someday come back to keep me up to date on what is going on in his life. Thanks to this young man for making a difference in my life. (R. Hayes, 2008)

References and other links of interest

[Asperger Disorder Homepage] A guide to a form of Autism that often goes undiagnosed.

"Autism," Microsoft® Encarta® Online Encyclopedia 2005 http://encarta.msn.com © 1997-2005 Microsoft Corporation. All Rights Reserved.

Autism Association of NSW, Thinking and Learning in Autism retrieved on July 28, 2005 http://www.aspect.org.au/publications/Thinking%20and%20Learning%20in%20Autism.pdf

Autism Network International, Introducing ANI retrieved on July 26, 2005 from http://ani.autistics.org/intro.html

Autism Society of America (ASA), Causes for Autism retrieved on July 28, 2005 from http://www.autism-society.org/site/PageServer?pagename=autismcauses

Autistic Spectrum Therapies What is ABA? retrieved July 28, 2005 from http://autismtherapies.com/aba.htm

Bakken, J., Brock, S. (2001). Developing Appropriate Curriculum for Students with Autism Spectrum Disorders in Wahlberg, T., et al. (Eds) Advances in Special Education Volume 14 - Autistic Spectrum Disorders, Educational and Clinical Interventions Advances. Kidlingotn, Oxford, UK: Elsevier Science.

Coleman-Martin M., et al., (2005). Using Computer Assisted Instruction and the Nonverbal Reading Approach to teach word identification. Focus on Autism and Other Developmental Disabilities. 20 (1) 80-91.

Cure Autism Now, A brief history of Autism retrieved July 28, 2005 from http://www.cureautismnow.org/kb/subcat/3207.jsp

Dahle, K. (2003). Services to Include Young Children with Autism in the General Classroom. Early Childhood Special Education. 31(1) 65-70.

Dyches, T., et al., (2001). Autism – Multicultural perspectives in Wahlberg, T., et al. (Eds) Advances in Special Education Volume 14 - Autistic Spectrum Disorders, Educational and Clinical Interventions Advances. Kidlingotn, Oxford, UK: Elsevier Science.

Gladwell, Malcolm (2005). Blink: The Power of Thinking Without Thinking, Boston: Little, Brown.

The Gray Center for Social Learning and Understanding, Social Stories retrieved July 28, 2005 from http://www.thegraycenter.org/Social_Stories.htm

Kalb, C. (2008, March 24). Mysteries and Complications. Newsweek, pp. 64-65.

Meyerding, J. Thoughts on finding myself differently brained retrieved July 28, 2005 from http://ani.autistics.org/jane.html

Mirenda, P. (2001). Autism, Augmented Communication, and Assistive Technology – What do we really know? Focus on Autism and Other Developmental Disabilities. 16(3) 141-162.

NIHM (National Institute of Health) Autism Spectrum Disorders retrieved on July 27, 2005 from http://www.nimh.nih.gov/publicat/autism.cfm

NINDS http://www.ninds.nih.gov/disorders/autism/detail_autism.htm

Sissexporn, K. (2005) "The Autism Source Book; Everything You Need to Know About Diagnosis, Treatment, Coping and Healing". Harper Collins Publishers.

Terpstra, et al., (2002). Can I play? Clasroom-based interventions for teaching playskills to children with autism. Focus on Autism and Other Developmental Disabilities. 17(2) 119-128. http://www.semissourian.com/story/160265.html

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