Characteristics and Issues of Autism Spectrum Disorders

Transcription

1 Please note the following Characteristic and function on a continuum. For ease in finding information, I have sub-grouped information into Low- Functioning and then Asperger s/high Functioning. and of Autism Spectrum Disorders Language and Communication Low Functioning - No verbal speech, may have vocalizations, appears to have no communication intent. Lack of eye contact. If verbal speech is present, it may be echolalic. Asperger s/high Functioning Verbal speech, may have pronoun reversals, dropping of prepositions, concrete vocabulary, unusual prosody and tone of voice. Social communication skills can be inappropriate in any or all of the following: eye contact, appropriate topic selection and maintaining the topic of conversation, turn-taking, interpreting body language and tone of voice; and understanding abstract language such as idioms, metaphors and multiple meaning words. Low Functioning They benefit from visual-spatial augmentative communication system and visual environments. The children who fall into this level would most likely be involved at an early age. It is important to remember that behaviors are communication!! When looking at behaviors, one must always look to the antecedent events of the behaviors. The most common function of language is to make a request. Difficulty shifting attention from a toy or object to an adult or from person to person is common. Note: To compare the major approaches, see the handouts provided in this packet: Autism Treatments-Behavioral and Educational Treatments for Autism

2 Spectrum Disorders and Autism Treatments- Current Interventions in Autism- A Brief Analysis from the Advocate, Nov-Dec Asperger s/high Functioning Their understanding of social communication really impairs normal interaction. Untrained personnel may attribute these inappropriate interactions as behavior issues and approach them accordingly. We must always consider the antecedent events of these behaviors to consider what really is being communicated. They usually are rigid and have a need for routine. Language concepts and vocabulary may be based on their experiences only. They may have no or an unusual sense of humor. Conversations may appear to be more like a monologue or narrative that are usually about their favorite topics. Asking questions to maintain a conversation is very difficult. Sensory Processing/Motor Low Functioning -The senses are not experienced normally. They can be hypoor hyper-sensitive. The senses can overlap. Motor planning such as starting, maintaining, switching or finishing can be difficult. Asperger s/high Functioning -They have the same issues as above, but usually to a lesser extent. Low-Functioning Use of a sensory diet usually is a vitial part of their day. Schools may have to design rooms or areas to meet the sensory needs. Common items are swings, mats for deep pressure, trampolines for jumping, treadmills, pushing or carrying heavy items, and a variety weighted blankets, vests or bags. A calming room or area would provide such things as soft lighting, soothing music, beanbag chairs, weighted items, headphones and a variety of fidgits. Asperger s/high Functioning - Because these children can be in regular education classes, it is important to be proactive rather that reactive to their sensory issues. They usually will be able to tell you what their specific sensory issues are and a sensory diet can be developed to meet those needs. Depending upon the extent of the sensory needs and the type of sensory diet that is needed, you may need to have a sensory diet built into the daily schedule OR provide a pass for the student to go to the sensory area or calming room when it is determined that the student has a need for activities that can meet the needs.

3 Note: Please refer to the handout provided in this packet: Impact of Sensory Input on Student Behavior and Performance: adapted from Barbara Hanft, OTR, FAOTA (1994). Behavior Low Functioning Look at behaviors as having communication intent. When inappropriate behaviors occurs, we should be looking at what happened prior to the inappropriate behaviors and then alter that event. Many inappropriate behaviors are due to sensory issues. Also consider co-morbid disorders and appropriate treatment plans. A close relationship between the family, the school and the medical doctors is extremely important as many behaviors have a medical origin. If a disorder is identified and treated with medication, many times the inappropriate behavior is no longer an issue. Asperger s/high Functioning Most inappropriate behaviors seem to be a function of eother avoiding or seeking certain situations that deal with sensory needs. Co-morbid disorders many create inappropriate behaviors. The need for routine and following the rules and being rigid create problems. Low Functioning The people working with children who have extreme behaviors really should be trained in behavioral analysis as that is usually the most effective way to understand why the behavior is occurring. Having access to qualified medical intervention (child psychiatrist) to address co-morbid disorders can be time consuming and frustrating. Care should be taken when considering academic settings, as some behavior management techniques that look only at the behavior can be very inappropriate. Use of social stories can be effective. Using a picture schedule to indicate a change in the schedule works well. Asperger s/high Functioning Because of the need for routine and rigidity, any change in schedule should be explained ahead of time if possible. Many will avoid situations they consider too difficult to handle because of sensory issues (large groups, noisy events, hallways, etc.). Making accommodations for these types of things should be written into the IEP so that all personnel working with the child are aware of and accommodating to these needs as stated in the IEP. If

4 the child should have a co-morbid disorder, getting the appropriate treatment should be pursued. Many adolescents have issues with depression and anxiety. Social Low Functioning Being social will have to be taught. It may be extremely difficult for them to be social as it is not natural or comfortable. Asperger s/high Functioning Many of these children may appear to be social because they are verbal, some very verbal, as they just love to talk about their favorite interest. If they can find someone who shares the same interest they can be social with that while they sharing their interest. Looking at true social behavior, one needs to be aware of and accommodating to others needs. As discussed under Communication, there are usually deficits in social communication. Low Functioning Getting children into programs at a young age is vital. These social behaviors will have to be taught and the intense programming at the earliest ages are showing great promise. Communication is vital in being social so programming using augmentative communication systems especially visual systems can be very effective. Asperger s/high Functioning Remembering that these children are ruledriven helps to understand why they have so many problems in this area. They need to follow the rules and are usually quite distressed when others are not following the rules. They will report to the authorities (parents or teachers) that a child has broken a rule and will expect the proper reaction from the authority figure. This type of behavior creates the perfect environment to be teased. Functional Daily Living

5 Low Functioning This can be a major component in programming. Sensory processing and motor difficulties need to be addressed. Many have no or little self-help skills while some have splinter skills. Asperger s/high Functioning For the most part, this is not a major area of concern. Some may have a total lack of self that becomes apparent in their lack grooming practices. Some sensory processing and motor difficulties may cause limitations. Some of the older teenagers are working so hard to handle the academics that they feel they can wait until they are ready to leave home to work on their specific areas of weaknesses. Low Functioning Having qualified personnel do a functional assessment is most appropriate. This would require an understanding of the scope and sequence of skills. Parents are vital in all aspects including providing accurate information for the assessments and cooperation at home. Many issues occur regarding toileting and eating. Asperger s/high Functioning Lack of organizational skills is the big area that affects daily living. The area of grooming can be an issue here, too. Academics (Regular Education) Low Functioning Not many of these children are in classes to learn academics as their regular education peers. Asperger s/low Functioning These children are in regular education classes with varying degrees of expectations. The IEP should generate a plan on how a child is expected to function in academics. Low Functioning By law a child should be in the least restricted environment when educated. Be sure to understand that does not mean a regular education classroom. It means where they learn most effectively. This can change as the child becomes more independent. Asperger s/high Functioning Some of these children are gifted or talented. Providing in-services to teachers and staff is important so they know how to teach to the students strengths.

6 Created by Ginger Slota, M.S., CCC/SLP Speech and Language Pathologist October, 2004