Autistic Disorder is a social situation impairment noted by a failure
to exchange nonverbal behaviors such as eye contact, facial expression, body
posture, and gestures. The onset is prior to three years old. The symptoms of
autism can usually be observed by 18 months of age. Some may have a delay in
one or more areas of development, while many other autistic individuals may be
more typical of other ASDs. 7 The main signs and symptoms of autism involve
problems in the following areas: social interaction, communication, age
appropriate play, and reasoning. These impairments are evidenced by lack of
appropriate exchange and understanding of emotional, verbal, or body language.
Autistic people have issues in developing age appropriate activities and
relationships. Routine behaviors are present as they may repeat actions or
words in an obsessive manner. Examples include echoing others’ sounds,
finger/hand flapping, twisting, and sudden or slow complex whole-body movements.
Dangerous or fantasy play inappropriate to developmental level may be
displayed. An autistic child may be persistently preoccupied with certain
objects such as a hot coffee cup or poisonous chemicals. This person has a
level of impaired development of communication and may or may not present an
attempt to use other forms of expressing themselves to share feelings of pain,
illness, joy, or sadness. Some individuals may present adequate speech at
normal or odd moment, and may or may not have the ability to talk with others.
Asperger’s Syndrome and High Functioning Autism (HFA)
These conditions are considered by many scholars and health care
professionals to have overlapping signs and symptoms of each other. The
behaviors may include more or less common aspects of each other. Asperger’s
Syndrome is the impaired ability to utilize social cues such as body language,
abstract reasoning, appropriate eye contact, and socialization skills. They
tend to have odd behaviors such as being extremely sensitive in responding to
stimuli, also exhibiting unusual or repetitive movements. They can be seen as
autistic people who talk well. Experts argue that although verbal speech is
intact, other 8 communication problems may exist. Asperger’s can use verbal
communication whereas autism usually has limited or no speech. A person with
Asperger’s is also described as one who shows no interest in developing human
bonds. The degree to which Asperger’s kids actually are aware of their trouble
making bonds with others, is often misunderstood. Asperger’s and Autism
together share the issue of recognizing the existence and intentions of others.
Children with Asperger’s Syndrome, generally have a normal to advanced
intelligence level. They may exhibit a satisfactory understanding of vocabulary
and grammar subjects with a decreased ability to concentrate and or understand
Pervasive Developmental Disorders (PDD)
The term Pervasive Developmental
Disorders is a diagnostic category used to describe many neurological disorders
that involve impaired social skills and repetitive behaviors. They include
Autism, Asperger’s Syndrome, Pervasive Developmental Disorder not Otherwise
Specified (PDD-NOS), Childhood Disintegrative Disorder (CDD)*, and Rett’s
Syndrome*. (Rett’s Syndrome and CDD will not be included as they differ and
have a more progressive course where loss of skills and abilities occur over
time.) The PDDs are characterized by their developmental delays in functional
and communication skills. Traditionally children with autism were said to have
a PDD, implying that a child demonstrates disorganized development. They are
pervasive, meaning the disease affects many areas. Learning ability is affected
but may improve to other levels. The condition is something that happened
during early development, and not from an accident or injury. They are medical
disorders that are not caused by parenting errors, 9 toxins, poor care, etc.
Some cases may be genetic. There is a wide spectrum of impairments associated
with PDD and ASD, which can range from mild to severe. One cannot outgrow PDD
and to date there is no cure. The condition is expected to be present for the
entire life span.
Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS) and
The characteristics of PDD-NOS are presented as they have overlapping
symptoms with Atypical Autism. Atypical Autism is the primary diagnosis given
to children who have some form of autistic symptoms but do not have all of the
particular traits to form a diagnosis of autism. These types of cases, mainly
the milder forms, are usually discovered later in life than prior to age three,
as general autism. People who are closely related to the affected individuals
have a higher than expected incidence of these disorders. The cause may
possibly have a genetic basis, but there are no facts to support that notion.
The symptoms and severity of Atypical Autism can vary from person to person.
Some traits of people with Atypical Autism may be that they have a difficulty
with language skills, whereas they display limited or no verbal ability and
possess a smaller vocabulary than other children in the same age
group.Individuals with PDD-NOS usually experience an area of impairment however
10 their overall living skills are more advanced than people with autism. They
often do not know how to react in an appropriate manner to other people’s
emotions. People with this disorder often have difficulty understanding
non-verbal cues or language that is not meant to be taken literally. These
factors often lead to uncomfortable social interactions, therefore re-enforcing
the tendency of people with atypical autism to prefer solitude.
There is no single best treatment for all children with ASDs, because
no two individuals are alike. What may work for one may not work for another. A
well structured treatment plan designed to teach specific skills is ideal and
very important. Before a family chooses a treatment regime, it is important to
talk with the child’s health care team to understand all the risks and benefits
that are involved. Routine medical, dental, physical, and mental exams should
be a part of the treatment plan. It may be hard to tell if a child’s behavior
is related to an ASD or caused by another underlying condition. For example, a
head banging child could have an ASD, or they could simply just be having
headaches. In some cases a thorough physical exam is needed. Many different
types of treatment options exist such as auditory training, discrete trial
training, vitamin therapy, anti-yeast or anti-allergy therapy, music therapy,
occupational therapy, physical therapy, and sensory integration. The different
types of treatments fall into the following four categories: Complementary and
Alternative, Medicine, Behavior and Communication Approaches, Dietary
Approaches, and Medication.
Causes and Cures
Parents should be reassured that
at the present time, there is no scientific evidence to support claims that MMR
vaccine or any combination of vaccines cause ASD. No one really knows what
causes autism. Autism is not caused by one’s income, parent’s educational
level, race, ethnic, or social background. Autism can be present in any new
born, any where in the entire world. Some use to think that autism had a direct
connection with people who were poor. This is not the case because there are
many people that are wealthy that have conceived children with autism. Bad
parenting was even considered as a cause, at one point in time, in the early
years of the disorder. We do know that according to the Centers for Disease
Control, the incidence rate for autism spectrum disorders is now as high as 1
in 110, including 1 in 70 boys. It is now known to be a heterogeneous disorder,
with milder forms being more common than the classic form. Autism is the
fastest growing developmental disorder in the U.S., representing a 600 percent
increase in the past 20 years. No one can explain why the disorder is growing
Suspecting ASD and Seeking Support Immediately (SASSI)
An initial suspicion of any ASD means that you should seek professional
medical attention immediately. Many options are available to help families
provide the best treatments available. Supportive services and testing
procedures will help families cope with fears and issues. A good acronym to
remember is SASSI.
Seek Support Services
Any child with a suspected delay or symptoms of ASD should be given the
opportunity to enroll in an age-appropriate early intervention program
immediately, even before a definitive diagnosis is available. (Pediatric
Neurology 39.1 (2008)) Children are entitled to many federally mandated
programs and services for children with developmental delays or deviations.
Although criteria may vary slightly among states, eligibility for these
programs is based on the presence of a delay, not on a categorical diagnosis.
Conduct Lead Screening
In some cases a child may show developmental delays and behavioral
problems that can be a sign of lead poisoning. Children at young ages have a
tendency to put many objects in their mouth. These objects could be from a wide
range of household items such as crayon, toys, or even tools. With the range of
risks involved, lead screenings are performed routinely when a child shows
signs of a developmental delay or disorder. If elevated lead levels suspected,
refer the child to a local emergency center.
Perform Formal Auditory Assessments
In some cases, a child that may appear to have a developmental delay
could actually be hearing impaired. There is a strong relationship between the
child’s hearing, and his communication ability. If a child’s hearing impairment
goes undiagnosed, he may experience delays in development and communication
issues. A child with a communication or developmental disorder may also have
related issues with sensitivity to sound. If a physician is concerned after the
screening there should be additional testing done. One the previous issues are
ruled out, it may be necessary to seek additional help from an ASD specialist.
Conduct Autism Screening
If the developmental screening raises concern it is highly recommended
that parents follows up with an autism screening and diagnosis specialist, (Da
Capo Press, 2009). Most autism screening tools are designed to detect autism
spectrum disorders, concentrating on social and communication impairments in
children and focusing on the Diagnostic and Statistical Manual of Mental
Disorders of the American Psychiatric Association (DSM-IV) criteria for autism.
Some professionals use the 17 International Classification of Disease (ICD-10),
which is a diagnostic manual developed by the World Health Organization.
Although all autism screening tools have limitations, most notably by the lack
of well-validated screening tools available for children 18 months of age and
younger. It is vital that your child receive the proper screenings necessary to
determine that he or she has autism.
Solutions for Cognitive Problems
Teachers can visually deliver instruction in the
Use multisensory delivery.
Dramatic presentations, comics, PowerPoint presentations, overheads,
movies, and online resources involve both auditory and visual processing.
Color-coded notebooks or colored markers and pens can help students
differentiate subjects. Color can also be used to highlight directions.
Use visual cues.
Schedules, calendars, timetables, and lists of items to complete can be
placed on students’ desks. These can take a variety of forms: written,
pictures or symbols, and photos. Alphabet and number lines or mnemonic
devices also provide visual cues for students. Bulletin boards, banners,
posters, and flashcards reinforce content area knowledge.
other handouts to help students stay focused during verbal instruction.
When information must be presented verbally,
teachers can support students with ASD when they:
out instructions; use hand signals.
the first examples with students.
instructions after allowing 10 seconds for processing time; speak slowly
and clearly, modify tone and pace.
instructions in the same place always.
analyze tasks and break them into small steps.
extra time and resources.
students in presentations.
Students with ASD might also need a variety of
adapted materials, including:
books, audio and video tapes,
and alternative communication) devices and voice output devices,
software designed for struggling learners or children with ASD,
types of paper – textured, graph, lined papers (raised lines, colored
lines and mid-lines),
variety of writing utensils: golf pencils, magic markers, highlighters,
chalk holders, pencil grips, and stamps and stamp pads,
writing boards, recipe stands,
Many students with ASD are not “fond” of writing,
whether they are engaged in the mechanical process itself or the slow process
of translating oral language into the written word. Because so much of the
curriculum output expected from students includes written work, it is
imperative to have alternatives for students with ASD to demonstrate their
knowledge of what has been presented in a lesson.
The following are some alternative ideas for
students with ASD to demonstrate their knowledge:
Solutions for social problems
In some cases, parents
can minimize unpleasant sensory stimulation. For example, parents can avoid
certain clothing fabrics that their child finds intolerable. Others may buy secondhand
clothing, or wash new items repeatedly, to minimize the unpleasant rub of new
fabrics. It can be very difficult for parents to find these causes of distress
especially when the child is very young or does not communicate well. There may
be some detective work and experimenting needed to find the sources.
Where are source of
distress cannot be realistically avoided, there are behavioral techniques to
allow a child to gradually accept the unpleasant sensory sensation. With time
and patience, Desensitization can
be a powerful technique. For example, a child may scream uncontrollably in
supermarkets. The parent will explain to the child that they will stand outside
the supermarket for 30 seconds then go home. The next time, it may be explained
that they will go in for 30 seconds then go home. Time spent in the supermarket
is gradually lengthened until the child has adapted to this environment. For
more information, see the Behavior Management Strategies fact
There are other
interventions available that help autistic children to integrate their senses
and have more pleasurable interactions with people and their environment. See
the Sensory Integration Therapies fact
sheet for treatment options.
Temple Grandin’s ‘hug machine’ is
an interesting option for some children with sensory problems.
This treatment is based
on the theory that behavior rewarded is more likely to be repeated than
behavior ignored. It focuses on giving the child short simple tasks that are
rewarded when successfully completed. Children usually work for 30 to 40 hours
a week one-on-one with a trained professional. Some practitioners feel this
method is too emotionally draining and demanding for a child with autism.
Yet, years of practice has shown that ABA techniques result in new skills and
improved behaviors in some children with autism.
TEACCH (Treatment and
Education of Autistic and Related Communication Handicapped Children)
This is a structured
teaching approach based on the idea that the environment should be adapted to
the child with autism, not the child to the environment. Teaching strategies
are designed to improve communication, social, and coping skills. Like ABA,
TEACCH also requires intensive one-on-one training.
Solutions for social
Children with Autism have
persistent problems and difficulties with social interactions and
communication. They may not properly understand the social rules and etiquettes
which makes socializing difficult for them.
Their abilities are
completely different than those of their fellow peers . This in turn makes them
conscious and secluded which as a results put autistic children at a much
higher risk of being bullied by other children at school.
Children with Autism
learn differently than other kids. They need more attention and a distinctive
teaching approach. These children could suffer due to ineffective teaching
methods. As educators, teachers have a responsibility to ensure that the
quality of education their students receive is customized to their learning
capabilities. The best way to help an autistic child learn to their best
potential is to understand what problems they face at school.
Recommendations for disabled students
Autism is characterized as a unique set of neurological disorders that
affects the individual’s communication abilities, reasoning, learning, and
physiological response. Children with autism demonstrate behaviors and skills
that can range from mild abnormalities to severe developmental challenges.
Although clinical patterns vary depending on severity, all children with ASDs
lack the normal ability to fully engage in mutual social interaction,
communication, movements, behaviors, interests, and activities. One has to
remember there are no two people with autism that are alike. Interventions must
be individualized and catered to accordingly, the person’s specific autism
traits. Although autism may not be curable, it is manageable through treatment,
support systems, resources, and awareness. Sharing knowledge and awareness prevents
discrimination, neglect, and dispels myths. It is vital for parents, employers,
the general public, and counselors to know the significance of the autism
spectrum so that society can be aware of the warning signs, interventions, and
breakthrough technologies that allow the person early treatment. Most
importantly, if we do not act to detect the early developmental abnormalities,
we will 39 delay the individualized care to the autistic population, and
ultimately decrease their quality of life.