Autistic Spectrum Disorder - Essay Example

? Possibilities of including children with Autism in mainstream school How can children with Autism be placed in a mainstream setting Introduction Autistic spectrum disorder refers to a range of disorders that would be grouped into the category of autism. The severity of the disorder in a given child is on a continuum. On one end of the continuum is the child who cannot speak and lives completely in his or her own world (Durig, 1996, p. 98). On the other end is the child with Asperger’s syndrome, who is perfectly fluent with speech, but has trouble with social conventions (Klin et al., 2000, p. 25). . Nevertheless, all of the children who are diagnosed with a form of Autistic Spectrum Disorder have commonalities, and this paper explores what they are. Further, there are intervention strategies that can be successful in helping the autistic child negotiate the areas where he or she is most weak, and these are explained as well. What is Autistic Spectrum Disorder? Autistic spectrum disorder encompasses a wide range of the disorder, and there are different diagnostic categories for the syndrome, and these are Asperger’s syndrome, Kanner’s autism (classic autism), and “atypical” autism (Jordan, 1999, p. 1). The DSM-IV-TR states that the autistic spectrum includes autistic disorder, Asperger disorder, Rett disorder, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified (Ozonoff et al. 2003, p. 4). For purposes of expediency, the autistic spectrum will simply be known as “autism,” although Asperger’s will also be delineated as such later in this paper Autism is a continuum, in that there are individuals with pure autism, which means that the symptoms described below are severe, to high-functioning, in which the symptoms are mild (Durig, 1996, p. 98). For instance, with repetitive behaviors, individuals with a higher level of the disorder will display more of these behaviors than an individual with a lower level of the disorder (Kleinhans, 2005, p. 9). Autism is usually diagnosed in, and remains present throughout, one’s life span, and affects development “in virtually all domains of functioning” (Burack et al., 2001, p. 5). The signs of autism are that there are major speech problems, as well as major problems in the comprehension of human mime and gesture (Coleman, 1985, p. 19). One of the forms of autism is known as Asperger’s syndrome. Asperger’s syndrome is marked by social deficits, such as those seen in autistic individuals, yet language and cognitive abilities, at least early in life, are preserved (Klin et al., 2000, p. 25). While individuals with Asperger’s syndrome may not have impaired language, they will speak differently, such as children speaking like “little adults” by using a large vocabulary in a pedantic way (Mesibov et al., 2001, p. 12). Individuals with Asperger’s social deficits are less pronounced then autistic individuals, but they still have social difficulties. One reason is because individuals with Aspberger’s are generally unable to have a conversation, because they lack the ability to reciprocate. They will talk, but they will not listen. Because of this, they will have a difficulty making friends, and will often be teased (Atwood, 2007, p. 13). Individuals with Asperger’s also have difficulties with social conventions (Frith, 1991, p. 152), where an individual with Asperger’s has a desire to engage with others, unlike those with autism, but their capacity to engage with others is impaired by their social deficits (Rhode & Klauber, 2004, p. 33). As with autistic individuals, individuals with Asperger’s also have obsessive interests in different things, such as collecting facts and objects. They also tend to be hypersensitive to criticism (Schopler & Mesibov, 1998, pp. 12-13), and have a low tolerance level which leads o frustration easily (Dubin, 2009, p. 44). Not surprisingly, because individual’s with Asperger’s tend to be socially isolated and frustrated, therefore teens with Asperger’s run a “significantly higher risk of depressive symptoms and full-blown depressive disorders” (Bromfield, 2010, p. 113). Dilemma on Inclusion or Exclusion Educating students in the general classroom is not the best way for autistic students to be educated. The reason for this is because autistic students thrive upon routine, and anything that upsets the routine is upsetting for the student with autism (Burack et al., 2001, p. 5). In a general classroom, there will be a number of different distractions that an autistic child might find difficult to take, because students who do not have autism do not have the same sensitivities. Therefore, a teacher in a regular classroom may be spontaneous with the students, in an effort to liven up the classroom. For instance, maybe the teacher will want to teach her class outside one day, to take advantage of nice weather. This would not be possible with an autistic child in the classroom (Barnbaum, 2008, pp. 27-29). Or maybe the teacher would want to have a day when the kids play educational games, or a free day. Again, the autistic child may not be able to handle these changes (Brock et al. 2006, pp. 75-76). Therefore, it is best that the child be in a autism friendly classroom, with structured routines that the child knows, and there should not be any deviation from the routines. This is best accomplished in a special class that contains other autistic children. Moreover, it is best to keep autistic children in a special class with other autistic children because they have special needs that cannot be addressed in a general classroom. The teacher in a general classroom typically has a large number of children to whom the teacher must attend (Simpson et al., 2003, p. 118). That teacher may not have the time to attend to the autistic child who may throw fits, or not be able to use the bathroom alone, or might become obsessed with different aspects of the classroom or other children (Powers, 1989, p. 3). In addition the teacher in a general classroom will probably not be an expert in handling children with autism. Perhaps the teacher has had some training with this, or maybe has taken several classes on the exceptional child, but autism is a disorder that is so complex, and every child is affected so differently, that only a teacher who has had extensive training and extensive education about the disorder will be able to properly handle the child (Simpson, et al., 2003, p. 127). And, it is important that an autistic child be handled properly, because, otherwise, the child will suffer and will not be able to get a good education; and the other kids in the class will suffer because the teacher is spending an inordinate amount of time attempting to care for the autistic child, which means less time for the other students. As for children with Asperger’s, the analysis is a bit different. Children with Asperger’s do not have same problems as an autistic child. They can speak fluently. They do not have the same obsessive desire for sameness as do children with autism preserved (Klin et al., 2000, p. 25). All of their symptoms are much less pronounced than that of an autistic child (Atwood, 2007, p. 13). Therefore, mainstreaming a child with Asperger’s would not present the same challenges as mainstreaming a child with autism. That said, there are a number of challenges that a teacher should address, and the main one is that a child with Asperger’s will have problems socializing (Frith, 1991, p. 152). Therefore, the child probably will be teased, because these children are socially awkward and do not have the same grasp of social cues as do other children (Rhode & Klauber, 2004, p. 33z0. The teacher needs to be sensitive to whether the Asperger child is being bullied by the other children, and put a stop to it, zero tolerance. Moreover, the teacher should institute a number of games that have socializing as their purpose, especially with younger children. Peer modeling is another strategy that the teacher should use, to show the child the proper way to communicate in a group, address the teacher in class, etc. (Brock et al., 2006, pp. 93-94). Also, before the child comes to class for the first time, the teacher should brief the class about the disorder, and explain how children are affected by the disorder, and solicit any questions from the class about the disorder. That way, perhaps the kids will not merely think that the Asperger child is “weird,” but understand that the child has a disorder, so they might be more sympathetic. Gym teachers should not have “team captains” who choose teams, because these kids are bound to be picked last every time, which will make them feel even more left out. In short, teachers need to really be aware that these kids have special challenges with socializing, and make sure that the child is protected from other kids’ bullying, and made to feel included at every turn. Strategies to Educate Students with Autistic Spectrum Disorder in Mainstream Schools As for educating individuals with autistic spectrum disorder, there are many variables that need to be considered. According to Koegel et al. (1982), behavioral assessment is the first step in this process. This begins with screening; then goes on to problem definition, in which specific problems that the child has are identified; from there, intervention programs can be designed that will address the specific problems of the specific child; monitoring the treatment progress is the next step, and if the child reaches a target behavior, then the child may progress to attempting to meet new target behaviors; evaluation of treatment intervention is the final step, and this is when the effects of the treatment are measured (Koegel et al., 1982, pp. 5-6). Brock et al. (2006) state that there are specific strategies that teachers may use for children with autism. Preparing and accommodating the child for tests and examinations represents the first cluster of strategies. The teacher should prepare the child for tests by familiarizing the child with the examiner, exam room and exam experience. Further, because autistic children tend to get very distressed when their routine is not followed the child needs to know, well in advance, when the test or exam will take place. Distractions during exams need to be minimized, because of the visual and auditory sensitivities in the autistic child leads to distractions such as pencil sharpening, and phones ringing, which can be very distressing. External rewards should be given the child, and the teacher needs to tell the child in advance that, when the child finishes the exam that he or she will receive the reward. This is necessary because autistic children tend to be unmotivated. Another strategy regarding exams is that the teacher should alternate easy tasks with difficult ones, which increase’s the student’s motivation as well (Brock et al. 2006, pp. 75-76). Egel (2008) provides further suggestions for teaching autistic children. One of these suggestions is that teachers may use a technique known as joint attention and communication. This is where the child alternates his or her attention between an object and a communication partner (Egel, 2008, p. 129). This is an important skill to learn, because, children learn better to receptive and expressive language when they are able to master joint attention skills (Dawson et al., 2004, p. 272). Egel echoes Brock, wherein he suggests the use of peer-mediated interventions and social stories in reinforcing appropriate social behavior in autistic children. For motivational techniques, Egel suggests that the teacher should manipulate “the manner in which antecedent or consequent stimuli are presented” (Egel, 2008, p. 134). Further, Brock et al. has suggested a range of specific educational interventions that will help the child with target skills, such as language function, social skills and behavior problems. For language function, Brock et al. suggests using picture symbols and printed word cards, so that the nonverbal child can initiate a picture request (Brock et al., 2006, pp. 92-93). This is helpful, for autistic children might think in terms of pictures – such as picturing an eagle for the concept of America (Grandin, 1995, p. 34). For social skills, the suggestion is that the teacher needs to intervene in groups, and teach the child to make “appropriate eye contact, body language, emotion recognition and response, perspective taking, and conversational skills” (Brock et al., 2006, p. 93). Another suggestion to help a child with his or her social skills is the use of stories to demonstrate appropriate social rules and behaviors. Peer driven therapy, in which trained and untrained peers model appropriate behavior is another strategy (Schopler et al., 1986, p. 28). Brock et al., also suggests that there should be intensive intervention with behavior problems, which would include assessing the particular behavioral problem and reinforcing target behaviors (Brock et al., 2006, pp. 93-94). One of the ways that autistic children can be served in schools is by mainstreaming them, which means putting them into general classrooms. Simpson et al. (2003) state that mainstreaming autistic students can work if the teacher modifies the classroom environment, as well as modifying the curriculum for the autistic child. The teacher also must have social support, a coordinated team, home-school collaboration and recurrently evaluate the inclusion procedures (Simpson et al., 2003, p. 118). Koegel et al. also states that the goal is to mainstream the autistic child into the least restrictive environments such as the child’s home, school, community and vocational environments. The best way to do this, according to Koegel et al. would be to delineate the natural environments that the autistic child may find him or herself, along with the sub-environments; determine what activities occur in these environments and sub-environments; determine what skills are necessary to negotiate these environments and sub-environments; and design programs that will aid the autistic child in negotiating these environments and sub-environments by teaching the child the skills that will be necessary to be successful in these environments and sub-environments (Koegel et al., 1982, p. 12). In this way, the child can be prepared for the general classroom, which is the least restrictive environment that he or she can be in. Further, the teacher must have a team of professionals who are able to implement the special programs in the classroom and give support services. The teacher must also have extensive training on teaching the autistic child (Koegel et al., 1977, p. 197). Teacher assistants, who are in the classroom to assist the teacher, also must be available in the classroom (Groom & Rose, 2005, p. 20). It is important to have limited number of children in classroom hence reducing the class size, due to the fact that the teacher must spend a lot of time engaging the student and controlling the behavior of the student. As for the recurrent evaluation of the inclusion practices, the teacher must evaluate her aides and services; how much benefit the child is getting from the class; and how appropriately the child participates. The home-school collaboration has several different elements, which include “development and maintenance of a collaborative home-school environment, application of collaboratively oriented administrative arrangement, and a willingness on the part of professionals to train parents and family members to participate as a member of a school team (Simpson et al., 2003, p. 129). According to Simpson et al. this type of arrangement may be beneficial to the autistic child, who is given the opportunity to interact with his or her peers. Further, there should be some kind of coordination between the special education teachers who teach autistic children and the teachers who specialize in teaching the gifted and the talented, if the school has such teachers. The reason for this is because of the number of autistic savants who have a special talent that should be nurtured, as well as a great number of children with Asperger’s who show special talent and intellect (Hewetson, 2002, p. 11). Perhaps the child has a special talent in facts and figures, or art, or music, or chess. Whatever the special talent the child has should be nurtured, and the best way to nurture this talent is to consult with a teacher of gifted and talented children, and coordinate the educational programs with that teacher or teachers. As for teaching strategies, probably the best teaching strategy would be the strategy where the autistic children are encouraged to think in terms of pictures, by using pictures to help the child with their verbal skills. The reason why this might be so is because of what Temple Grandin indicated about her thinking processes. She expressed that she had to train herself to think in pictures, and this is the way that she grasped concepts. Included in the concepts that Grandin mastered by thinking in pictures was the concept of give and take, which is crucial in negotiating social relationships. She was able to use pictures in her mind, including pictures of doors and windows, to help her understand this concept. Perhaps this is the key to teaching autistic children abstract concepts. If the child is encouraged to use pictures that are associated with abstract concepts, they can make these concepts concrete, and this would be extremely helpful for the student (Grandin, 1995, p. 34). Conclusions Children with autistic spectrum disorders have a range of difficulties, and the degree of difficulty each child has is dependent upon how severity of autism the child has. General difficulties that autistic children experience are speech difficulties, difficulties in perception, social difficulties, and difficulties understanding the world. Severely autistic children may not have any kind of speech, or may be ecolalic, in that they state one word over and over again. Still others may have speech, but only in the sense that a parrot has speech – they speak, but do not understand what they are saying. Individuals with Asperger’s, which is a form of high-functioning autism, may have no difficulty speaking at all. However, as with other forms of autism, the Asperger individual will have social difficulties for a variety of reasons. One of these reasons is the fact that they are not able to understand social conventions, such as when to speak. That said, there are a variety of interventions that can be used to make sure that Autistic and Asperger’s children can have the best chance at success. The first step is to evaluate the individual child, and the individual behaviors that are of concern. Then, a plan can be implemented to assist the child in reaching targeted behaviors. Such specific intervention strategies as using peer and teacher driven interventions in social behaviors, in which the peer and/or the teacher models appropriate behavior, has shown promise in helping with the social aspects of the disorder. Such strategies as using picture cards and alternating the child between an object and the conversationalist have helped children with cognitive difficulties. Furthermore, teachers should prepare the autistic child for testing situations, as these tend to be stressful for children who thrive on routine. Such things as minimizing distractions, giving the child a reward and ensuring that the child knows about the testing are all good strategies for preparing the child for optimal testing success. References: Atwood, Tony (2007) The Complete Guide to Asperger’s Syndrome. London: Jessica Kingsley Publishers. Barnbaum, Deborah (2008) The Ethics of Autism. Bloomington, IN: Indiana University Press. Bogdashina, Olga (2003) Sensory Perceptual Issues in Autism and Asperger’s Syndrome. London: Jessica Kingsley Publishers. Boyd, Brenda (2009) Appreciating Asperger’s Syndrome. London: Jessica Kingsley Publishers. Bromfield, Richard (2010) Doing Therapy with Children and Adolescents with Asperger Syndrome. Hoboken: John Wiley & Sons. Brock, Stephen, Shane Jimerson & Robin Hansen (2006) Identifying, Assessing and Treating Autism at School. New York: Springer. Burack, Jacob, Tony Charman, Nurit Yirmiya & Philip Zelazo (2001) The Development of Autism. Mahwah,NJ: Lawrence Erlbaum Associates Publishers. Coleman, Mary & Christopher Gillberg. (1985) Biology of the Autistic Sydromes. New York: Praeger Publishers. Dawson, Geraldine, Karen Toth, Robert Abbott, Julie Osterling, Jeff Munson, Annette Estes & Julie Liaw (2004) “Early Social Impairment in Autism.” Developmental Psychology 40.2: 271-283. Dubin, Nick (2009) Asperger Syndrome and Anxiety. London: Jessica Kingsley Publishers. Durig, Alexander (1996) Autism and the Crisis of Meaning. Albany: State University of New York Press. Egel, Andrew (2008) “Classroom-Based Interventions for Children with Autistic Spectrum Disorders,” in Shapiro, Bruce & Pasquale Accardo (2008) Autism Frontiers. London: Paul H. Brookes Publishing Co. Frith, Uta & Elisabeth Hill (2003) Autism: Mind and Brain. Oxford: Oxford University Press. Frith, Uta (1991) Autism and Asperger Syndrome. Cambridge: Cambridge University Press. Grandin, Temple (1995) Thinking in Pictures. New York: Doubleday. Groom, Barry & Richard Rose (2005) “Supporting the Inclusion of Pupils with Social, Emotional and Behavioural Difficulties in the Primary School: The Role of Teaching Assistants” Journal of Research in Special Education Needs 5.1: 20-30. Happe, Francesca (1994) Autism and Introduction to Psychological Theory. London: University College of London Press. Hermelin, Beate (2001) Bright Splinters of the Mind. London: Jessica Kingsley Publishers, Ltd. Hewetson, Ann (2002) The Stolen Child. London: Bergin & Garvey. Houston, Rab & Uta Frith (2000) Autism in History. Oxford: Blackwell Publishers, Ltd. Howlin, Patricia (1997) Autism and Asperger’s Syndrome. Second Ed. London: Routledge. Jordan, Rita (1999) Autistic Spectrum Disorders. London: David Fulton Publishers, Ltd. Kleinhans, Natalia (2005) Cognitive Heterogeneity in Autism Spectrum Disorders. San Diego: San Diego State University. Klin, Ami, Fred Volkmar & Sara Sparrow (2000) Asperger’s Syndrome. New York: The Guilford Press. Koegel, Robert, Arnold Rincover & Andrew Egel (1982) Educating and Understanding Autistic Children. San Diego: College-Hill Press, Inc. Koegel, Robert, Dennis Russo & Arnold Rincover (1977) “Assessing and Training Teachers in the Generalized Use of Behavior Modification in Autistic Children.” Journal of Applied Behavior Analysis 10.2: 197-205. Mesibov, Gary, Victoria Shea & Lynn Adams (2001) Understanding Asperger’s Syndrome and High- Functioning Autism. New York: Kluwer Academic. Osteen, Mark (2008) Autism and Representation. New York: Routledge. Ozonoff, Sally, Sally Rogers & Robert Hendren (2003) Autism Spectrum Disorders. London: American Psychiatric Publishing, Inc. Powers, Michael (1989) Children with Autism. New York: Woodbine House. Rhode, Maria (2004) The Many Faces of Asperger’s Syndrome. London: H. Karnac Ltd. Schopler, Eric & Gary Mesibov (1998) Asperger Syndrome or High-Functioning Autism? New York: Plenum Press. Schopler, Eric & Gary Mesibov (1984) Social Behavior in Autism New York: Plenum Press. Simpson, Richard, Sonja de Boer-Ott & Brenda Smith-Myles (2003) “Inclusion of Learners with Autism Spectrum Disorders in General Education Settings.” Topics in Language Development 23.2: 116-133. Read More