What is Autism?
Diagnosis
According to the Diagnostic and Statistical Manual of Mental Disorders V (DSM 5), the term Autism Spectrum Disorders (ASD) is a single umbrella term that encompasses the following subtypes: Autism, Asperger's Syndrome (ASP), Childhood Disintegrative Disorder(CDD), and Pervasive Developmental Disorder-Not otherwise specified (PDD-NOS). It also emphasizes that individuals with ASD must possess symptoms from early childhood even though they may not become apparent until later in life.
Encouraging Communication
Each autistic child has a right to communicate, and it is our responsibility to provide them this opportunity. In order to allow an autistic child to appropriately communicate their needs, offer them a personalized functional communication system based on their individual needs and abilities. As each autistic child is unique not only in their level of severity, their physical abilities, their interests, and their level of functioning, the communication system needs to be tailored to each individual. For example, if a severely autistic child responds positively to music, then you may want to come up with impromptu songs to help that child communicate.
Early Childhood Intervention (ECI)
Early Childhood Intervention is a program offered by the Department of Assistive and Rehabilitative Services (DARS) in Texas for families of children with disabilities and developmental delays. It is for birth through three years. Its eligibility is determined through evaluations and assessments at no cost to families.
Autism Myths
Myth: An environmental or psychological factor such as child rearing practices or early childhood trauma causes autism. Fact: There is no single cause of autism; however, research links it to a neurological factor.
Developing Social Skills
"Children with autism often have to be taught in considerable detail all of the complexities of social interactions such as how to play a game with another child, how to express affection, to wait one's turn, to console another child who is crying, or to initiate a play interaction" (S.L. Harris, 1995b, p.312). The ease with which an autistic child learns to socialize depends greatly on his or her communication skills. Parents, teachers, siblings as well as peers play a very important role in fostering life skills required for developing social skills. Teaching social skills one-on-one may not be very effective unless interactions are linked with normal peers. Thus, a natural learning environment plays a pivotal role in nurturing social development in children with autism. At school, they should be encouraged to interact with other students mostly during recess, lunch time, or during special activities such as sports, arts, or drama/music. At home, parents and siblings can work together to provide an autistic child with opportunities for positive social interactions.
These diagnostic labels are based on the commonalities and the distinctiveness of the symptoms in each type of ASD. The defining symptom of ASD is substantial deficit in the area of social relations and communication.
-Asperger's Syndrome is mostly considered to be a mild form of ASD, and it's considered to be at the high functioning end of the spectrum. -PDD-NOS is commonly used for those individuals that do not fully meet the criteria for ASD or Asperger's Syndrome. -CDD differs from autism in its occurrence as it develops in children with normal development that later start regressing.
A. Social Relations
-Babies/Toddlers may not respond to cuddling or being picked up -Preoccupation or fixation with objects -Lack of interest in other children, may prefer to play alone -Limited or lack of attachment with parents and peers -Restrictive eye contact -Difficulty taking turns in play or conversation -May or may not smile -Face problems in making and maintaining friendships
B. Communication
-Delayed speech or lack of speech -Restrictive functional language -Unlikely to ascertain emotions, intentions or facial expressions -Unable to understand jokes, riddles, puns, or idioms -May lack facial expressions in communicating their feelings -Use echolalia (repeat exact words of others) thus speech may sound like a robot or parrot -Reverse pronunciations (confusing the listener) -Unusual tone (monotone, high pitched, or programmed) -Less likely to initiate conversations, share experiences, or bid for attention (watch me) -Rigid use of words and may have difficulty accepting the concept that an object may have more than one name -May not follow directions or respond consistently
Practical tips for fostering communication in an ASD child:
-Paraphrasing and using simple language that is clear and unambiguous -Repeating directions and checking for understanding -Using short sentences when giving instructions -Focusing on important words only and not complete sentences -Labeling areas in room with words and pictures -Using sequence cards to teach order of events -Explicitly teaching reciprocal communication (for example, How should one respond if someone says "I'm hungry"?)
Practical tips to help alleviate stereotypical behaviors in an ASD child:
-Provide consistency and set a routine schedule. -Create a structured environment which is predictable so they know what comes next. -Vary the activities within a daily schedule in order to avoid rigidity and inflexibility over a set routine. -Warn or prepare them in advance for transitions or of any change in routine. -Reinforce desirable behaviors as an alternative to undesirable behaviors. -Understand their sensitivity toward loud noises, bright lights, excessive touching. -Create a calming area or sensory area which can include stress release activities such as drawing, brushing, squeeze toys, weighted blankets, or music through which they can escape for short periods when they are upset. -Watch for signs of anxiety such as hands over ears or repetitive behaviors such as rocking or stimming (a repetitive body movement). -Minimize verbal demands when the child is disturbed. -Be aware that they may behave in a confusing way in public places and large assemblies.
Use the following practical tips for enhancing social skills of an autistic child:
-Teach explicitly the social rules and rationales behind interactions such as sharing, taking turns, listening, initiating interactions, and respecting the personal boundary and space of others -Help them label their emotions -Use stories, comics, cartoons and other creative ways to teach social responses -Teach and rehearse appropriate responses to bullying -Show them the distinction between public and private behaviors -Provide natural environments to share their hopes, fears, and interests -Build social interactions around their interest areas -Immediately reinforce the appropriate social behaviors
Stereotyped/Ritualistic/Repetitive Behavior
-Unusual fixation to an object, toy, TV show, or a movie and thus repetitively plays with the same toy or watches the same movie over and over -Difficulty transitioning or accepting change and strictly follows daily routine or schedules -Repetitive body movement such as rocking, spinning, or finger flicking -Extreme sensitivity to certain sensory stimulation and thus may react abnormally to certain textures, tastes, smells, visual or auditory stimuli and may resist certain foods, textures, or gaze with one eye at an object -May be obsessed about lining, piling, or stacking things, sometimes in a color-coded way -May display tantrums atypical in duration, frequency, and intensity -May display aggression directed towards others or cause self-injury through head banging, hand biting, or skin picking
Functional Communication Systems could be in various forms:
-Verbal Interaction based on the child's vocabulary -Non-verbal gestures/pointing at things -Sign language ( parents also need to learn simple signs; these can be learned online) -Picture Exchange Communication Systems designed to teach functional language to an autistic child. It could be as simple as pointing at pictures (e.g. a child points at 1 of 4 pictures like cookie, cereal, chips, or juice to express his need; whereas, an advanced level person may be taught to respond to questions or comments) -Assistive Technology (includes assistive, adaptive, or rehabilitative devices such as a voice output device or other tools that would aid people with disabilities) -I-Pads, keyboards, computers, and smartphones with various apps or software designed to meet the specific needs of an individual with ASD
Individual and Disabilities Education Act (IDEA)
According to Individual and Disabilities Education Act (IDEA), all children in the USA are entitled to Free Appropriate Public Education (FAPE) in the Least Restrictive Environment (LRE). It means every effort should be made to include students with disabilities in the same classroom with non-disabled students to the maximum extent possible. They are also eligible for appropriate services and adaptations to maximize their participation in the classroom. These services are provided to individuals between the ages of 3 to 21 years.
Applied Behavior Analysis (ABA)
Applied Behavior Analysis is developed on scientific principles of learning and behavior. It is a set of techniques and principles that fosters positive change in behavior. One of the basic principles of ABA is positive reinforcement. Thus positive behaviors are rewarded in order to increase its occurrence and conversely minimizing negative or undesirable behaviors. Its techniques may be applied in varied settings by diverse groups of people to individuals with distinct needs. It is not a quick one-size-fits-all approach, but in fact it is a plan customized by a trained ABA therapist keeping in mind an individual's skill level, interests, needs, and family background. It is also a gradual ongoing process requiring intensive step by step instruction. It needs to be consistently applied and monitored in order to be able to notice any meaningful progress or change in behavior. Today ABA is widely recognized, and research studies have indicated its effectiveness in improving communication, social skills, as well as life skills.
What is Autism?
Autism is a developmental disability typically affecting communication and social interaction. Its symptoms are usually apparent in the first three years of life. Autism is considered a "spectrum disorder." This means its symptoms vary from person to person and ranges from mild to severe.
Dealing with Stereotyped/Ritualistic/Repetitive Behavior
Autistic children may use self- stimulating, self-injurious, or aggressive behavior directed toward themselves or others as a way to communicate their needs, get attention, or escape demands. Self-stimulating behavior can be in the form of hand flapping, rocking, staring in space, or any repetitive movement. Self-injurious or aggressive behavior may be in the form of head banging, biting, scratching, and pulling their own hair or the hair of others. It does not mean that all children with autism are always aggressive or that their actions are intended to hurt others or themselves.
Individualized Education Plan (IEP)
Early intervention plays a key role in facilitating progress in an autistic child. In order to accommodate diverse needs of an individual with ASD, the public schools in the United States are mandated by the Individuals with Disabilities Education Act (IDEA) to provide an Individual Education Plan (IEP) for all students identified as having a disability. An IEP consists of goals and objectives for a student to work on throughout the year. These goals are identified based on individualized evaluation and thus are tailored to accommodate each individual's strengths and weaknesses. It is a detailed description of an autistic child's educational plan developed by a team of professionals. It also outlines the services that a student might need in order to accomplish the IEP's goals.
Functional Behavioral Assessment (FBA)
Functional Behavior Assessment is a methodical strategy to determine the underlying function or root cause of the behavior leading to an effective intervention plan. It consists of data describing the problem behavior, the cause or the antecedents that lead to that particular behavior, and the consequent events that control the behavior. In other words Functional Behavior Assessments or Behavior Intervention Plans (BIP) can be created by examining a student's specific problem behavior, identifying antecedents, understanding consequences that maintain the behavior, and developing strategies to reduce the inappropriate behavior and increase desirable behavior.
Common Characteristics of ASD
Normally, the symptoms of autism fall in three main categories which include deficits in the areas of: social relations, communication, and behavior. These symptoms range in severity from mild to severe, and its manifestations vary from person to person. Therefore, symptoms of ASD fall on a continuum or a spectrum and thus the term 'Autism Spectrum Disorder.'
EDUCATORS
Special Education and Related Services for ASD
Can autism be treated?
hough no medications have been approved by the U.S. Food and Drug Administration specifically for the treatment of autism, certain psychotropic medications can treat some of the symptoms associated with autism such as anxiety, hyperactivity or other such challenging behaviors. On the other hand, problem behaviors associated with autism can be approached through behavioral intervention. It not only focuses on reducing challenging behavior but also emphasizes coaching of appropriate behavior. Certain professionals can provide services to students with autism. Speech-language therapists can help students improve their ability to communicate and interact with others. Occupational therapists can help students with motor skills and find ways to modify tasks. Physical therapists can provide activities and exercise for students that help with motor control and improve posture and balance.
