Autism
with Malcolm Reeve
Objectives
1. To feel more informed about both the
historical and modern researchers which attempt to define what Autism is.
2. To look at the most appropriate ways in which we should communicate with a person who has Autism and make it
applicable into our day to day practice.
What is Autism?
Basic Facts
• Autism is a life long developmental disorder.
• Autism is a neurological disorder.
• Latest estimates from The National Autistic Society suggest that there are as many as
500,000 people who have an Autistic Spectrum Disorder in the UK.
• At Columbus there are 52 pupils who either have an Autistic Spectrum Disorder or who are described as having Autistic tendencies.
Dr Hans Asperger Dr Leo Kanner
Dr Leo Kanner
“He seems to be self-
satisfied. He has no apparent affection when petted. He
does not observe the fact that anyone comes or goes, and never seems glad to see father or mother or any
playmate. He seems almost to draw into his shell and live within himself.”
Kanner, 1943, ‘Autistic Disturbances of Affective Contact”
Dr Hans Asperger
In 1943 he carried out a study of 200
families with children who were similar to the children Kanner was observing except that they appeared
not to have the severe language delays
Autistic Spectrum Disorder
Severely Autistic Moderate Autistic Mild Autism
Dr Leo Kanner Dr Hans Asperger
Related Conditions
• Attention Deficit Hyperactivity Disorder
• Dyslexia
• Epilepsy
• Developmental Delay
• Sensory sensitivities
• Dyspraxia
• Pathological Demand Avoidance Syndrome.
• Rett Syndrome
Autistic Spectrum Disorder
Severe Moderate Light
Shore, 2006
The Triad of Impairment
Language and Communication
Imagination or flexibility of
thought Social
Interaction
Wing & Gould, 1979
Social
Interaction
Social Interaction:
The unwritten rules of communicating
A neurotypical person should;
• take turns, passing the
conversation back and forth,
• Wait, look and listen in
anticipation for a response,
• stand a distance apart from one another appropriate to the content of the conversation,
• you choose appropriate
content determined by where you are and who you’re with.
Social Interaction:
The unwritten rules of communicating
A person with Autism;
• may not take turns, continually fires
information at you and interrupt,
• may stand too close or too far away talk too loud or too soft,
• may start inappropriate conversations.
Social Interaction
Unwritten social rules are all the things your rarely explicitly taught but often
the ones that will get you in the most trouble if you get them wrong.
Imagination
Imagination
People with Autism may have difficulties with;
• understanding and interpreting other people's thoughts, feelings and actions,
• predicting what will happen next, or what could happen next,
• understanding the concept of danger, for
example that running on to a busy road poses a threat to them,
• engaging in imaginative play and activities:
children with autism may enjoy some
imaginative play but prefer to act out the same scenes each time,
• preparing for changes to routines and plans.
Language and
Communication
Communication – Things that a person with Autism may find difficult:
Facial Expressions
Facial muscles pull the skin and tissues, temporarily distorting the shape of the eyes, brows, and lips, and the appearance
of folds, furrows and bulges in different patches of skin. The changes in facial muscular activity typically are brief, lasting a few seconds; rarely do they endure more
than five seconds or less than 250 ms
Hager & Ekman, 2008
Communication – Things that a person with Autism may find difficult:
Paralanguage
The "how" something is said is referred to as paralanguage, which includes intonation,
emphasis, word and syllable stress, pitch and volume. These are non-verbal (but tied to the voice) characteristics. They strongly affect how something is extracted by the other person, and how we interpret the words. They provide an
additional context, and a very important one.
Paralanguage
“Yes, I really want to talk to you about that”
• Desired outcome of the literal delivery is for the other person to come and talk to you about a
particular topic.
• Desired outcome of the sarcastic delivery is to make the person aware that you really don’t
want to talk to them about a particular topic.
• Desired outcome of an aggressive delivery is for the other person to come and talk to you
about a particular topic and to be aware that you aren’t happy with them.
Figures of Speech
Communication – Things that a person with
Autism may find difficult:
V
Analysis
Verbal Communication
“Now come on Wizzy you’re being a silly girl.
I’ll turn that computer off for good, you’ve still got to come and finish your work. Look, turn it
off now. Look your being a really silly girl now
Izzy come and finish your work”.
Analysis of Communication
Non Verbal Communication
Hands on hips as an attempt to signify authority and added intent in the delivery.
Poke on the shoulder as an attempt to make her pay attention.
Paralanguage
Substantial use of paralanguage to add authority and intent on the demand.
Analysis
Verbal Communication
Izzy, computer has finished, its time to sit and do your work.
Nonverbal communication
• Signed ‘I’ for Isobel and ‘finished’ to provide additional opportunities for Isobel to understand and process the request..
• Used gestures to show Isobel where it was she wanted her to complete her work
Paralanguage
• Minimal use of intonation, emphasis, word and syllable stress, pitch and volume.
Sensory
Sensitivities
Smell (Olfactory) System
• Processed through chemical receptors in the nose, this tells us about smells in our immediate
environment.
Smell (Olfactory) System
Hypo
• some individuals have no sense of smell and fail to notice extreme odours
• some people may lick things.
Strategies -
• use strong-smelling products as rewards and to distract them from possibly inappropriate strong-smelling stimuli (faeces).
Hyper
• smells can be intensified and overpowering
• toileting problems
• dislike of individuals with distinctive perfumes, shampoos, etc.
Strategies –
• use unscented detergents or shampoos, refrain from wearing perfumes, make environment as fragrance free as possible.
Sight (Visual) System
• Situated in the retina of the eye and
activated by light, our sight helps us to
define objects, people, colours, contrast and spatial boundaries.
Sight (Visual) System
Hypo
• may see things darker, lose features, lines
• for some they may concentrate on peripheral vision because their central vision is blurred; others say that a main object is magnified and things on the periphery become blurred
• poor depth perception - problems with throwing and catching, clumsiness.
Strategies
• increase the use of visual cues.
Hyper
• distorted vision occurs and objects and bright lights can jump around
• fragmentation of images, as a consequence of too many sources
• focusing on particular detail (sand grains) more pleasurable than looking at something as a whole.
Strategies
• reduce fluorescent lighting by using deep-coloured light bulbs instead sunglasses
• create a work station in the classroom: a space or desk with high walls or divides on both sides to block out visual distractions from the front and sides
• use blackout curtains.
Touch (Tactile) System
• Situated on the skin, the largest organ of the body, it relates to touch, type of pressure, level of pain and helps us distinguish temperature (hot and cold).Touch is a
significant component in social development. It helps us to assess the environment we are in and enables us to react accordingly.
Touch (Tactile) System
Hypo
• has high pain threshold - temperature/pain self-harming
• enjoys heavy objects on top of them.
Strategies
•weighted blanket/jackets
• sleeping bags.
• massage Hyper
• touch can be painful and uncomfortable and they will often withdraw from aspects of touch.
• dislike of having anything on hands or feet
• difficulties in brushing and washing hair
• only likes certain types of clothing or textures.
Strategies
• warn the child if you are about to touch him or her; always approach him or her from the front
• gradually introduce different textures - have a box of materials available
• allow the individual to complete the activities themselves, enabling them to regulate their sensitivity (eg, hair brushing and washing).
Hearing (Auditory) System
• Situated in the inner ear, this informs us about sounds in the environment. It is the most commonly
recognised aspect of sensory impairment.
Hearing (Auditory) System
Hypo
• sounds may only be heard with one ear, the other ear either only having partial hearing or none at all
• the person may not acknowledge particular sounds
• enjoys crowded noisy places, kitchens, bangs doors and objects.
Strategies
• use visual cues to back up verbal information.
Hyper
• volume of noise can be magnified and surrounding sounds distorted and muddled
• inability to cut out particular sounds - difficulties concentrating
• they may have a lower hearing threshold, which makes them particularly
sensitive to auditory stimuli, for example hearing conversations in the distance.
Strategies
• shut doors and windows - to reduce the external sounds they have to deal with prepare them before they go to a noisy place or crowded situations
• ear plugs
• Walkman
• create a work station.
Taste (Gustatory) System
• Processed through chemical receptors in the tongue tells us
about different tastes - sweet, sour, bitter, salty and spicy.
Taste (Gustatory) System
Hypo
• likes very spicy foods
• eats everything - soil, grass, materials.
Hyper
• some flavours and foods are too strong and overpowering for them
• certain textures also cause discomfort; some children will only eat smooth foods such as mashed potatoes or ice-cream.
Body Awareness (Proprioception)
• Situated in the
muscles and joints, our body awareness system tells us where our bodies are. It also informs us where our body parts are and how they are moving.
Body Awareness (Proprioception)
Hypo
• proximity - standing too close to others/not understanding personal body space navigating rooms - avoiding obstructions
• bumping into people.
Strategies -
• position furniture around the edge of the room to make navigation easier
• put coloured tape on the floor to indicate boundaries
• use the arm's-length rule
Hyper
• difficulties with fine motor skills, manipulating small objects (buttons, tying shoe laces)
• moves whole body to look at something.
Strategies –
• threading activities
• lace boards
Balance (Vestibular) System
• Situated in the inner ear, this provides
information on where our body is in space and its speed,
direction and
movement, all in
relation to the pull of gravity.
Balance (Vestibular) System
Hypo
• the need for rocking, swinging, spinning.
Strategies –
• encourage activities which help them develop their vestibular system - rocking horse, swing, roundabout and see-saws.
Hyper
• difficulties in activities which include movement, such as sport
• difficulties in stopping quickly or during an activity
• car sickness
• difficulties with activities where the head is not in an upright position, or where feet are off the ground.
Strategies –
• break down activities into small steps, use visual cues such as a finish line or prompts.
Objectives
1. To feel more informed about both the historical and modern researchers which attempt to
define what Autism is.
2. To look at the most appropriate ways in which we should communicate with a person who
has Autism and make it applicable into our day to day practice.
