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What is Autism?
Autism spectrum disorders (ASD) are characterized by difficulties in social-interaction, communication challenges and a tendency to engage in obsessive, or repetitive behaviours, interests and activities (DSM-V-TR; American Psychiatric Association, 2013). However, symptoms and their severity can vary widely across these three core areas. Taken together, combinations of these symptoms affect each child differently. Some children may only be mildly challenged by such symptoms, forming the high functioning end of the autism spectrum. On the other hand, symptoms for others may be more severe, where the lack of spoken language and repetitive behaviors can interfere with daily life and learning in school.
The main areas of difficulty that children on the autism spectrum have are as follows:
Social-interaction difficulties
Most children who develop autism have difficulty engaging in the give-and-take of everyday human interactions. By 8 to 10 months of age, these infants present symptoms such as a failure to respond to their names, reduced interest in people, and delayed babbling. By toddlerhood, these children have difficulty playing social games, don’t imitate the actions of others and prefer to play alone.
Children with autism also have trouble with theory of mind. They tend to find interpreting what others are thinking and feeling challenging, and have difficulty seeing things from another person’s perspective.
Children with autism are not as able to read and interpret facial expressions. Subtle, non-verbal, social cues such as a smile, grimace or wave may convey little meaning to them. Without the ability to interpret facial expressions and gestures, the social world can seem bewildering.
Lastly it is common, though not universal, for children with autism to have difficulty regulating emotions. This can take the form of seemingly “immature” behaviour such as having outbursts and crying, or may lead to disruptive and physically aggressive behaviour.
Communication challenges
Young children with autism tend to be delayed in babbling, speaking and using non-verbal gestures. When language develops, an individual with autism may use speech in unusual ways. Some have difficulty combining words into meaningful sentences and may speak only single words or repeat the same phrase over and over. Some may also go through a stage known as echolalia, where they repeat what they hear verbatim.
Another common difficulty is the inability to understand body language, tone of voice and facial expressions that are not meant to be taken literally, such as in the case of sarcasm. Conversely, someone affected by autism may not exhibit typical body language, where their expressions, movements or gestures may not match what they are saying, and tone of voice may fail to reflect their feelings. This can make it difficult to communicate what they want and need to others, which may, in turn, lead to frustration and inappropriate behaviour (such as screaming or grabbing) by the child with autism. Fortunately, there are proven methods for helping persons with autism learn better ways to express their needs, and with more effective communication skills, challenging behaviours often subside.
Repetitive behaviours
Unusual repetitive behaviours and/or a tendency to engage in a restricted range of activities are another core symptom of autism. Common repetitive behaviours include hand-flapping, jumping and twirling, arranging and rearranging objects, and repeating words, sounds, or phrases. The repetitive behaviour may also be self-stimulating, such as wiggling their fingers in front of their eyes. Additionally, the tendency to perform a restricted range of activities can take the form of intense preoccupations, or obsessions.
Promoting effective learning in children with ASD
Picture Exchange Communication Systems & Picture Activity Schedules
Visual supports can be extremely useful for children with ASD. Such children are more likely to think in pictures, and have difficulty extracting the big picture, and organising and planning their movement and routine. Having a visual support makes such information clear and easily interpretable to them. These visual cues serve as a scaffold in the demonstration of communication skills, social skills, academic skills and adaptive behaviour.
Visual supports take the form of tools that are represented visually, helping an individual move through the day. These include, but are not limited to, photographs, icons, written words & objects, or the use of a concrete cue (picture of object/drawing) paired with a word or verbal cue to provide information about an expectation or routine action.
Have a sense of visual clarity in the way the classroom is set up
Doing so allows the child to have a clear understanding of what behaviors are appropriate in which spaces. Make sure the environment is clutter free – ensuring that the child is not over stimulated, or distracted by the items around him/her. Having clearly defined boundaries, such as where to keep his hands when they work, where are the areas to play, and where are the areas to study, and where are the areas to eat, help a child organize and understand their environment and behave appropriately to what is expected. You can do this by something as simple as tape markings on desks and on the floor.
How can intervention help my child?
Occupational Therapy
The main purpose of Occupational Therapy (OT) is to develop and maintain a person’s capacity throughout their life and empower them with the ability to perform day-to-day tasks and roles. Occupational therapy addresses a holistic combination of cognitive, socio-emotional, physical and motor skills. This aims to help a child gain age-appropriate independence, and enhance their engagement and performance in daily living, play learning and social activities (Watling, Tomchek & LaVesser, 2005).
The therapist determines goals for each individual and selects strategies for enhancing these skills. For instance, goals may include independent dressing, feeding, grooming and use of the toilet, along with improved social, fine motor and visual perceptual skills (Autism Speak, n.d.). Therapy activities may thus include:
- Physical activities, such as stringing beads or doing puzzles, to help a child develop coordination and body awareness
- Play activities to help with interaction and communication
- Fine motor skills required for holding objects while handwriting or cutting with scissors
- Gross motor skills used for walking, climbing stairs, or riding a bike
- Play, coping, self-help, problem solving, communication, and social skills, among other skills
Speech Therapy
Speech therapy involves the management and treatment of conditions which affect a person’s ability to speak and communicate. It is designed to coordinate the mechanics of speech with the meaning and social use of language. Ultimately, the main objective is to help the child with autism communicate in more useful and functional ways.
A variety of augmentative and alternative communicative (AAC) devices and methods can be incorporated to benefit children who are nonverbal. For one, the Picture Exchange Communication System (PECS) is among the most commonly used devices for children and adults with little to no verbal ability. Through PECS, pictures are employed by therapists, teachers and parents to help the child build a vocabulary and articulate their feelings, desires and observations. With instruction, the child learns to distinguish pictures and symbols and to use both to form sentences. Although PECS employs visual tools, the program aims to emphasise and reinforce overall communication, both verbal and nonverbal (Autism Speaks, n.d.).
Child Psychology
Psychologists conduct assessments to formally diagnose a child with ASD. They typically perform a comprehensive evaluation which provides a roadmap to identify each child’s unique strengths and areas of need to help guide treatment and make recommendations through the assessment of the individual’s cognitive, behavioural, emotional and academic needs.
Psychologists then help tackle specific challenges that arise for children with autism and their families. For example:
- Honing social skills to help children with autism improve their conversational skills, nonverbal communication and play.
- Treatments to help individuals with autism manage anxiety or mood disorders such as depression.
- Treatments to help manage sleeping and feeding problems that often coincide with ASD.
- For persons with more severe cognitive impairments, interventions to decrease aggressive behaviours and self-injury, and improve compliance (American Psychological Association, 2017).
- These classes can also be tailored for children with other developmental concerns such as anger management and emotional regulation.
Ultimately, the goal of therapy may not be to completely cure ASD, but to help people with autism function at their best and cope with challenges.
Read to learn about learning interventions for children with:
Acknowledgement:
Ms. Tricia Tam, Psychologist at MindChamps Allied Care, who has contributed to this article.
References:
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th edn. Arlington, VA: American Psychiatric Publishing.
American Psychiatric Association. (2017, January). Diagnosing and managing autism spectrum disorder (ASD). Retrieved from http://www.apa.org/helpcenter/autism.aspx
Autism speaks. (n.d.). How Is Autism Treated? Retrieved from https://www.autismspeaks.org/what-autism/treatment
Autism speaks. (n.d.). What are the symptoms of Autism? Retrieved from https://www.autismspeaks.org/what-autism
Autism speaks. (n.d.). What Treatments are Available for Speech, Language and Motor Issues? Retrieved from https://www.autismspeaks.org/what-autism/treatment/what-treatments-are-available-speech-language-and-motor-impairments
Watling, R., Tomchek, S. & LaVesser, P. (2005). The scope of occupational therapy services for individuals with autism spectrum disorders across the lifespan. American Journal of Occupational Therapy, 59, 680–683.
World Health Organisation. (2017, April 4). Autism spectrum disorders. Retrieved from http://www.who.int/en/news-room/fact-sheets/detail/autism-spectrum-disorders
Bryan, L., & Gast, D. (2000). Teaching On-Task and On-Schedule Behaviors to High-Functioning Children with Autism Via Picture Activity Schedules. Journal Of Autism And Developmental Disorders, 30(6). doi: 0162-3257/00/1200-0553$18.00/0
Dettmer, S., Simpson, R., Myles, B., & Ganz, J. (2000). The Use of Visual Supports to Facilitate Transitions of Students with Autism. Focus On Autism And Other Developmental Disabilities, 15(3), 163-169. doi: 10.1177/108835760001500307
Hume, K. (2011). Structured Teaching Strategies: A Series Article 4: Visual Structure in the School Setting [Ebook] (pp. 1-7). Indiana: Indiana Resource Center for Autism. Retrieved from https://www.iidc.indiana.edu/styles/iidc/defiles/IRCA/Structured%20Teaching%20Strategies%20Article%204.pdf
Hume, K., & Odom, S. (2011). Best Practice, Policy, and Future Directions: Behavioral and Psychosocial Interventions. Autism Spectrum Disorders, 1295-1308. doi: 10.1093/med/9780195371826.003.0084
Tarbox, J., Dixon, D., Sturmey, P., & Matson, J. (2014). Handbook of Early Intervention for Autism Spectrum Disorders (pp. 229-315). New York: Springer.
Teaching Students With Disabilities. (2012). AUTISM. [online] Available at: https://sites.google.com/a/ucdavis.edu/teaching-students-with-disabilities/home/idea-disabilities/autism [Accessed 25 Oct. 2017].
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by Joanne Lee
Multipotentialite. Loves creating and seeing ideas come alive. View all articles by Joanne Lee.
