Autistic Spectrum Disorder (ASD)
Autistic spectrum disorder is the diagnosis given to people who have a very different way of relating to other people and their environment in comparison to ‘neurotypical’ people. People with autism have a different way of processing and interpreting the world round them.
This leads to people with autism having differences/ difficulties in the areas of:
- Communication, social interaction and relationships
- Flexibility of thought
- Sensory processing
Communication, social interaction and relationships
Individuals with autism have a different way of understanding:
Verbal and non-verbal communication
This could be not understanding the meaning of spoken words, or only understanding the last word spoken to them, or not understanding non verbal cues (such as gesture or facial expression). Approximately 30% of individuals with autism are non-verbal and therefore they do not use spoken language to communicate. Each individual with autism will communicate differently.
Nature of a conversation.
Individuals with autism can have difficulty understanding the two–way process of a conversation and therefore may not respond if a person asks them a question, or it could be that they talk at someone for long periods of time without pausing for the other person to talk.
Jokes and sarcasm
Individuals with autism can have a very literal understanding of what has been said. Alongside misinterpreting non verbal communication, the use of intonation, facial expression and body language can be misunderstood in jokes, sarcasm and idioms. For example, someone saying “you can say that again” in a sarcastic way, may be misinterpreted to the literal meaning and the individual may therefore literally, say it again.
Emotions and feelings
It can be very difficult for an individual with autism to understand their own emotions and consequently,what to do when they feel a certain way. For example, it could be difficult for a person to understand how to manage their behaviour in a way that is viewed as ‘appropriate’ when they feel angry or upset. Understanding other people’s emotions is therefore particularly difficult. It can also be challenging to understand that other people have different feelings to themselves. Emotions and feelings and responses need to be taught explicitly.
Unwritten social rules that can often be naturally understood and noticed by ‘neurotypical’ people but it can be difficult for individuals with autism to identify or acknowledge. Social skills and social rules will therefore need to be specifically taught in order to be understood.
Flexibility of Thought
Individuals with autism can have differences in:
Guessing what other people are thinking
Individuals with autism can find it difficult to understand that other people have different thoughts and feelings other than their own. This is often referred to as the ‘ theory of mind’. This can lead to anxiety from being unable to predict the intentions of others.
Predicting what will or could happen next and changes outside of routine
Being able to think ahead, predict what will happen next and anticipate consequences of actions can be very challenging. Many individuals with autism therefore like routine as it enables them to know what will happen next. Deviating from this routine can cause a lot of anxiety for people with autism. Organisation and preparation in advance using resources that can be understood (i.e. photos, pictures, stories, objects) can support a person to understand the change or what they are about to do/ where they are going to go.
Understanding abstract concepts
Abstract concepts can be difficult to understand as they are not visible and cannot be experienced by our senses. Abstract concepts (e.g. time and danger) will need to be taught in a concrete way with visuals, repetition and practical activities.
Engaging in imaginative play
It can be common for children with autism to enjoy playing with familiar or the same toy, possibly in a repetitive manner or in a way that the toy is not intended for (e.g. lining up trains or completing a puzzle in the same way each time). It may be difficult for someone to engage in imaginative play. A child once got very upset during a lesson when I put on a hat and gave her a ticket because I was a ‘bus driver’. The child shouted “you are not a bus driver!” and ran off crying. She was right, I am not a bus driver.
Every person with autism is very different. One person may be above-average intelligence and will take part in conversation and may seem to some as ‘anti-sociable’. Another person may not engage in any verbal communication and may display very repetitive or ‘inappropriate’ behaviour.
Three case studies of children with autism:
Zachery is 8 years old. He is verbal and can name many items and will say familiar peoples names when asked. Zachery communicates by using single words and pointing. In familiar, contexts, he can say sentences of up to 3 words. If you ask Zachery a question he is not familiar with, he will not respond.
Zachery can read and write but doesn’t choose to do so if given the choice. He much prefers to spin items on a table or the floor. He also likes playing on a spaceship game on the computer where he enjoys watching the same scene over and over again.
Zachery is fascinated by electrical equipment and likes to turn things on and off such as lights, fans and hand dryers and will do so if he sees one. Zachery is hypersensitive to sound and will at times put his fingers in his ears.
Sean is 11 years old. He is non-verbal and communicates through vocalisations, single signs, photos and leading an adult to what he wants. Sean can sort colours and complete puzzles with 2 or 3 pieces. He really likes looking at photos and bouncing on a gym ball. Sean finds verbal language confusing and he gets very anxious if an adult speaks to him using a lot of words. When this happens, Sean may hit the closest person to him. It is best to communicate with Sean with single words, gesture and sign only. Sean also feels very anxious if he doesn’t know what he is doing next or if he goes somewhere unfamiliar.
Sean is hyposensitive to touch and often seeks pressure around his body. He therefore pulls tables very close to him when sitting in a chair and he loves hugs.
Shania is 13 years old. She has an average IQ and her favourite subject is Egypt. Shania can talk for hours about Egypt. Someone can start a conversation with Shania and very quickly, she will start talking about Egypt. At school play times, Shania can often be seen walking up and down the playground by herself or talking to an adult.
Shania really likes routine. She writes her daily timetable down as a list and crosses each one off as she completes it. If Shania’s routine is suddenly changed, she can get very upset. In these circumstances, her behaviour can become very challenging and she will need a lot of time and space to calm down. At times, lying under a weighted blanket can help her calm down. Shania will only use the downstairs toilet at school. Her diet consists of mainly dry foods and she eats with the same knife and fork only.
Individuals with autism process the world very differently and various strategies can be put in place in order for children with autism to be independent in their environment, no matter what their ability.
Research suggests that many autistic children are visual learners and therefore we must ensure that when we want a child to know or learn something, we must model what we want them to do first and not just say it, but also show visuals, pictures or objects to enhance meaning.