Autism

Definition

Autism is a neurodevelopmental disability that can have a significant impact on a student’s communication skills, social interactions, and behaviors. Those more severely impacted exhibit autistic characteristics at a relatively young age with unusual behaviors such as repetitive behaviors, self stimulating movements, resistance to change, and atypical reactions to sensory input.

A number of disorders are included within the umbrella category of Autism Spectrum Disorder. These include not only the most severe form known as autism, but also pervasive developmental disorder/not otherwise specified (PDD-NOS), Asperger’s Syndrome, Childhood Disintegrative Disorder, and Rett’s Disorder.

  • Pervasive developmental disorder/not otherwise specified is diagnosed when the individual displays some of the characteristic symptoms of autism but does not meet the 6 out of 12 criteria defined in the Diagnostic Standards Manual IV necessary for a diagnosis of autism.
  • Asperger’s Syndrome is generally (and incorrectly) considered a milder form of autism. While individuals with this diagnosis have more spoken language, they can exhibit significant delays in the pragmatic aspects of social interaction that prevent them from being able to hold a job or live independently. Individuals in this category of autism are considered to be in the “high functioning range” of the disorder because they can speak and often test to have very high IQs. However, social impairments can prove to require a lifetime of support.
  • Rett’s Disorder is historically not considered truly autism, but it shares many of the same common symptoms along with some notable differences. Unlike autism, Rett’s Disorder is progressively degenerative. And while autism affects a far greater number of males than females, nearly all cases of Rett’s Disorder have been present in females.
  • The most essential feature of Childhood Disintegrative Disorder is a marked regression in multiple areas of functioning following a period of at least 2 years of apparently typical development and before age 10 years.

Prevalence

The most accepted prevalence rate for autism is 10 per 10,000, a rate derived from analysis of 32 separate prevalence surveys conducted between 1966 and 2001. This rate is highly contested however, with some autism advocates and professionals who work with this population, claiming an incidence rate of approximately 1 in 150. Without question, the prevalence rate has been steadily rising in the past decade, but whether this is due to improved diagnostic procedures or an actual increase in incidence is unclear.

Characteristics

The characteristics of autism can vary widely from individual to individual dependent on both developmental age and etiology. However, there are key characteristics that are apparent in some form in this population across all of the spectrum disorders. Individuals with autism will always have developmental differences in communicative function, social interaction skills, and behavioral characteristics that will be present to varying degrees.

Communicative functioning in individuals with autism is often delayed, both in verbal and in nonverbal communication abilities. Language development is slow and atypical, and currently about 50% of individuals never progress to spoken or symbolic communication. When language does develop, the individual may be unable to sustain conversation unless it involves something of personal interest to them, and abstract topics, such as emotions, may be rarely expressed. Nonverbal abilities are also impacted in autism, and social skills, such as maintaining eye contact and appropriate personal space, can be particularly difficult for these individuals. These deficits in communication can negatively impact the ability of these individuals to successfully navigate the social world of friendship, academia and work.

Socially, individuals with ASD can be as diverse as their typical peers - seeking constant attention at one end of the spectrum, all the way to avoiding all contact at the other end of the spectrum. Their inability to express their desire for social contact in socially acceptable ways (i.e. they may not make any eye contact and may look away while standing very close) often gives the impression that a person with ASD wishes to be isolated from their peers. Students with ASD may lack the pragmatic, language, observation and imitation skills to participate in a majority of social situations. Additionally, people with ASD may also have difficulty with personal hygiene, conforming to dress codes, and auditory processing. Students with ASD may experience difficulty responding to new and/or unique situations. They may have restricted interests and self-stimulating behavior which can negatively impact their ability to socialize easily or effectively. If 90% of communication is non-verbal, individuals with ASD are often unaware of this 90% of communication.

Unusual, negative and/or aggressive behavior issues are often present in individuals with autism, some of which can pose a danger to the individual. Some children can display self-injurious behavior such as biting, scratching, pinching, or hitting their own faces or bodies. These extreme behaviors often seem to have an underlying communicative function, such as expressing pain or hunger. Individuals with autism can also be drawn to ingest nonedible items, a condition called pica, which they share with a number of other disability categories. These individuals can often be alternately extremely sensitive or nonreactive to both sounds and touch.

Impact on Learning

There are several key characteristics of autism that must be taken into consideration when planning an instructional program for a student with autism. One primary issue with students with autism is the communication deficit that is inherent to this condition. A student with autism generally may not be able to communicate effectively with either peers or adults and will sometimes give the impression of understanding an instruction when such comprehension is not actually taking place. Verbal instruction should be short, simple and direct and supplemented with a visual cue if it is a new or unique instruction. Visual processing is quite good in most children with autism, and thus, they are highly motivated by visual information. An effective instructional program for a student with autism combines auditory instruction with some type of visual support.

Personnel who work with individuals with autism will need to be careful and pay attention to training about the types of prompts used with this population as the students frequently become prompt dependent. Some children with autism will wait for an adult-directed verbal or physical prompt even when they know what is expected of them. Once this dependency on cues develops, this habit is very difficult to break.

An effective instructional program for individuals on the autism spectrum needs to also address the difficulties with generalization of topics and information learned and experienced by these students. Students with autism will sometimes focus on irrelevant aspects of an activity rather than the important points, making the design of instructional programs very challenging for teachers. Instruction works best when the teacher isolates or highlights key points of what is being taught in order to insure that students are focusing on and learning the intended lesson objectives.

Students with autism also typically respond poorly to changes in routine, sometimes resulting in problem behaviors or self injurious behaviors. These problem behaviors can impact the teacher-student, peer-student, or the parent-child relationship, and that perhaps is the greatest challenge facing an effective instructional program for students with autism. Children with autism can prove very challenging to teach, and they often need far more instruction than other students in order to grasp concepts. In the face of problem behavior and no emotional connection with the student, the teacher may find it particularly challenging to continue working towards social and instructional interactions that may require intensive repetition and practice.

Managing Student Behavior

For decades, behavior management has been guided by two basic tenets. One, behavior can be analyzed and understood, and two, behavior is determined and caused by the environment in which it takes place. Determining the function of a student’s challenging behavior is absolutely essential in developing an appropriate intervention to eliminate or replace inappropriate behaviors.

Each behavior serves some specific purpose for the student displaying the behavior. Typically, this type of maladaptive behavior in students with autism is communicative, as the individual has not yet developed a more effective way of communicating to others. It often is the only way the child has learned to ask for preferred objects or activities or alternately escape painful or unwanted tasks or environments. When the student receives the desired result, this maladaptive behavior is, of course, reinforced in the perspective of that student and is likely to be used again. Particular attention must be paid by a third party observer to specific details of the environment in which the challenging behavior takes place. A third party can often better observe the environment and resulting behaviors more objectively than individuals involved in the situation.

The particular behavior may serve different functions in different environments; for example, the same act of aggression may be used either to receive attention from a preferred caregiver or to escape an unwanted task or sensory stimuli. If the specific purpose of the behavior is not determined, any intervention employed will meet with little success and may even compound or escalate the behavior. Once the teacher can determine what the behavior is communicating, a more appropriate method of communication can be introduced and taught to the student. Building on the pre-existing skills of the student, teachers can devise an effective communication strategy that will lead to better outcomes for both the student and those around him. The general education teacher should be able to rely on the student’s Individualized Education Program (IEP) team for assistance in developing strategies for the student with autism. This team should include special education professionals who are familiar with the student and the disorder who can partner with the student’s family members, general education teachers, and other school personnel to develop appropriate communication strategies for the student.

Teaching Strategies

Children with autism pose a challenge because their unique set of strengths and challenges requires individualized interventions that are not typically a part of teacher preparation programs unless teachers are trained in applied behavior analysis or positive behavior supports. Teachers of students with autism must be aware of the characteristics of autism in order to develop an effective instructional program that best serves the needs of this unique population. The classroom setting and all instructional materials must be organized to best reflect the learning styles of these students, and the delivery of instruction must also follow suit. However, making these accommodations in setting and style is not difficult for teachers who follow established best practices for all students. In fact, when teachers adapt instructional organization and delivery for students with autism, the likely result will be a higher degree of learning for the entire class.

First, the teacher must design the classroom and all instructional materials to contain visual supports and cues. Students with autism typically have far better visual processing skills than auditory processing skills and respond well to picture symbols and other visual information. Picture symbols can be used to create a personal visual schedule for the student and can be instrumental in minimizing many problem behaviors. Being able to anticipate transitions and changes in routine ahead of time can be a powerful emotional support for these students. Picture symbol cues may be posted in readable areas. The classroom environment itself should have clearly marked delineations between work and leisure areas.

Second, the teacher should use instructional goals in the daily routines of the student. This allows for multiple opportunities to practice newly acquired skills throughout the day. This is a technique that is often used in general education, especially with reading instruction. Often targeted goals can be infused in a variety of lessons by using thematic teaching, a teaching style that utilizes extended teaching units based on one central idea or theme. Some additional classroom planning may need to take place, but most effective teachers probably are using some form of integrated curriculum in their classroom even before they have a student with autism in their class.

Third, forming strong connections with the parents of children with autism can be a very effective instructional support. Good parent-teacher relations are important for any student’s progress; however, it can be critical for students with autism in order for any meaningful generalization to transfer to the home and community environments. These students typically need a great deal of extra practice to master many academic and social skills, and the parents can be very useful as tutors in the home setting. The teacher should collaborate with the parents at every step, and the parents should be instrumental in choosing the goals and skills they would like to work on with their child. Support systems and activities should be as simple as possible to ensure their ready application.

Assistive Technology

Due to the inherent difficulties with communication experienced by individuals with autism, an alternate communicative support system can be designed to help support productive social interaction. Individuals with autism typically respond best to visual information that is support to written or verbal labels. A communication system is an object and/or technique that can be utilized to supplement and support communication between individuals. A communication system can incorporate items as simple as specific short verbal phrases, written notes, or any number of augmentative communication devices. This visual information can be presented in the form of simple line drawings or in photographs of actual people and objects. Once the student has learned the significance of these pictures (i.e., that a picture of a ball represents a real ball in the classroom), then these symbols can be presented in a sequential format to represent daily routines, steps in a particular activity, or specific requests of the student.

While communication systems can be helpful for many children in general, for children with autism, these augmentative communication techniques are absolutely essential. For many of these children, this is the only way that they are able to communicate their own needs and desires. Communication systems for children with autism can include sign language, picture symbols, electronic communication devices, and even computer programs and video modeling. Using these strategies can enable the child to hold conversations with others, request items, escape from undesirable situations, and make choices for himself. This can increase the child’s sense of self-determination and help eliminate many inappropriate behaviors that result from a failure to communicate effectively.

Assessment to determine the best medium to use must be performed prior to the introduction of the new communication system, and an extensive training period may be necessary before the student learns to use the system appropriately. However, once the system is in place, it should be employed as consistently as possible between settings and can be utilized to bolster communication in every aspect of the child’s daily routines.

Organizations

There are a number of excellent organizations that can help support classroom instruction for students with autism spectrum disorder (ASD). The information presented in this module is intended as just a very brief description of ASD and its impact on learning. Much more in-depth information and instructional strategies can be accessed through the following organizations:

Autism Society of America

ASA exists to improve the lives of all affected by autism. They do this by increasing public awareness about the day-to-day issues faced by people on the spectrum, advocating for appropriate services for individuals across the lifespan, and providing the latest information regarding treatment, education, research and advocacy.

7910 Woodmont Avenue, Suite 300
Bethesda, Maryland 20814-3067

Web: www.autism-society.org/site/PageServer

Autism Speaks

Autism Speaks is dedicated to funding global biomedical research into the causes, prevention, treatments, and cure for autism; to raising public awareness about autism and its effects on individuals, families, and society; and to bringing hope to all who deal with the hardships of this disorder. They are also committed to raising the funds necessary to support these goals.

2 Park Avenue, 11th Floor
New York, NY 10016

Web: www.autismspeaks.org/about_us.php

Burkhart Center for Autism Education and Research

The Burkhart Center is housed in the Texas Tech University College of Education. It provides a variety of resources in the areas of adult transitions, technical assistance in implementing evidence-based interventions for children, and community outreach services. The Center also supports Master’s and Doctoral Students with scholarships, graduate assistantships, and opportunities to work with individuals on the spectrum.

P.O. Box 41071
Lubbock, TX 79409-1071

phone: (806) 742-1998, ext. 458
e-mail: Burkhart.educ@ttu.edu Web: www.educ.ttu.edu/edsp/burkhartproject

Center for Disability and Development

Dept. of Educational Psychology
4225 Texas A&M University
College Station, TX 77843-4225

Email: cdd@tamu.edu
Web: cdd.tamu.edu

Ladders (Learning and Developmental Disabilities Evaluation and Rehabilitation Services)

LADDERS is a highly successful program designed to evaluate and treat children and adults having a wide variety of developmental and handicapping conditions. Our mission is to provide the highest quality clinical, social and support services to those diagnosed with autism, pervasive developmental disorders and other developmental disabilities.

65 Walnut Street
Wellesley, MA 02481

Email: info@ladders.org
Web: www.ladders.org

National Autism Association

The mission of the National Autism Association is to educate and empower families affected by autism and other neurological disorders, while advocating on behalf of those who cannot fight for their own rights. We will educate society that autism is not a lifelong incurable genetic disorder but one that is biomedically definable and treatable. We will raise public and professional awareness of environmental toxins as causative factors in neurological damage that often results in an autism or related diagnosis. We will encourage those in the autism community to never give up in their search to help their loved ones reach their full potential, funding efforts toward this end through appropriate research for finding a cure for the neurological damage from which so many affected by autism suffer.

1330 W. Schatz Lane
Nixa, MO 65714

Email: naa@nationalautism.org
Web: www.nationalautismassociation.org

Families for Early Autism Treatment

FEAT is a non-profit organization of parents, family members, and treatment professional dedicated to providing best outcome education, advocacy, and support for individuals with autism.

P. O. Box 255722
Sacramento, CA 95865-5722

Email: feat@feat.org
Web: www.feat.org

National Autism Association

1330 W. Schatz Lane
Nixa, MO 65714

Email: naa@nationalautism.org
Web: www.nationalautismassociation.org

The PDA Center: Professional Development in Autism

Phone: (206) 543-4011
Email: pdacent@u.washington.edu
Web: depts.washington.edu/pdacent/courses/autism101.html

South Plains Autism Network

Texas Tech University Health Sciences Center
Speech-Language-Hearing Clinic
Room 2A300
Lubbock, Texas 79409

Web: www.educ.ttu.edu/EDSP/burkhartproject/span.php

Spot University

Web: www.spotuniversity.com

Texas Autism Advocacy

Web: www.texasautismadvocacy.org

Texas Education Agency State Conference on Autism

autism.esc2.net

Texas Statewide Leadership for Autism

Texas Education Agency authorized clearinghouse
www.txautism.net

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