Communicating with Children with Autism - Essay Example

COMMUNICATING WITH CHILDREN WHO HAVE AUTISM INTRODUCTION AUTISM AND CHILDREN Autism is a brain disorder which is one of the most common among the group called as Pervasive developmental disorder which involves delays in many areas of childhood development. Autism affects the crucial areas of development of a child including the verbal and nonverbal communication, social interaction and creative play. Autism is one of the disease conditions in children, which cause problems in interacting with the society, and the children develop certain repetitive behaviours. The normal milestones of development of a child include: the social smile, the ability of the child to follow the objects past in the midline of their face, the child producing ooo or aah sounds etc. If the child is having these kind of developmental milestone probably the child is not having autism. It is not uncommon for the child to develop epilepsy in adulthood. The repetitive behaviors such as hand flapping or spinning may be seen in children. The children may develop excessive fear or temper tantrums or aggression. There are even eating disorders. The individual usually have a normal life span but they require life long supervision. Autistic children have repetitive and stereotyped patterns of behavior like abnormally preoccupied with some interest, sticking to certain habits, self-stimulating behaviors etc. "Also, many autistic children are mentally retarded 94% have an IQ of less than 68". (Keepkidshealthy.com. n.d.) CAUSES OF AUTISM "Leo Kanner first identified autism in 1943 when he described 11 self-absorbed children who had autistic disturbances of affect contact" (NIDCD. 2008.) Autism was once thought of an attachment disorder occurring as a result of poor parenting. But, this has been proved to be a myth. Nowadays, the specialists were of opinion that autism is a brain disorder which makes a person to process and respond to the world. Autism seems to have a genetic origin as in some cases, it seem to run in families. Autism is two to three times common in boys than girls. Autism affects people of all levels of intelligence. Autism affects people of all races, ethnic groups and of all socio economic background. Identification of Autism The early signs and symptoms that parents and Pediatricians look for to alert them that a child needs further evaluation for autism include: not smiling by six months of age not babbling, pointing or using other gestures by 12 months not using single words by age 16 months not using two word phrases by 24 months Having a regression in development, with any loss of language or social skills the children with autism avoid eye contact with the people as they are unaware of the people around them. The symptoms of autism are generally identified about the age of 3 but in some cases the symptoms could be identified even about six months of age. NORMAL DEVELOPMENT OF LANGUAGE Normal development of speech and language occurs during the first three years of life, which is the period when the brain is developing and maturing. These skills are apt to develop best in a world that is enriched with sounds, sights and constant exposure to speech and language. At this developmental stage, there occurs intense desire to communicate with the external world. SPEECH, LANGUAGE AND COMMUNICATION PROBLEM IN AUTISM Even though, the exact cause of speech and language problems in autism is not known, many specialists that believe that these may be due to a variety of conditions which occur before, during or after birth which affects brain development. Some scientists are of opinion that the communication problem to be a theory of mind where there is impaired ability to think about thoughts or imagine another individual's state of mind combined with an impaired ability to symbolize. The common communication problem in autism differs depending on the intellectual and social development of the child. Some may have a problem in speaking; others may have a good vocabulary and can talk about their topics of interest in great depth. In spite of this variation, the majority of the autistic children have little or no problem with pronunciation. Most of them have difficulty in using language. An autistic child who speaks often says matters which have no content of information. Some may repeatedly say words. Others have echolalia, a repetition of which he had been heard previously, or have immediate echolalia, in which he repeats the question. In another form, called delayed echolalia, he may repeat the old words whenever he hears a question. Most of the autistic children have poor attention duration and do not make eye contact. They are unable to use gestures either for a primary level of communication or for helping verbal communication like pointing towards an object they want. Some speak in high pitched voice or robot like speech. They remain as unresponsive to the speech of others. Autistic children have difficulty in using pronouns. In some, the development of speech and language is uneven, and for example, in some vocabulary development in areas of interest may be accelerated. Some may have advanced ability or savant skills in specific areas such as calendar calculation, musical ability or maths. For communication purpose, it is not just, what people say, but the way that is said. For actual communication, the words are important, but the body language and the tone are the social aspects which help people to understand a great deal more about what the words mean. Asperger syndrome is one of the main issues with Autism which are difficulties in communication which can occur on all three of these levels. Autistic children have the social part of communication more difficult as they become older, so that if they are not understood, they better try to avoid communication all together. For autistic people who are unable to produce words, there are therapies or treatments like music therapy or the controversial facilitated communication so that they can communicate through a different medium. Other autistic children can use words but they lack the body language and tone. Their body language can be awkward or uncomfortable, with eye gaze and lack of engagement. GOVERNMENT POLICIES FOR AUTISTIC CHILDREN "Autism is a disability under the Disability Discrimination Act. According to this legislation, organisations must make reasonable adjustments to include autistic individuals; under the Disability Equality Duty all public bodies must promote the equality of autistic individuals. As autism affects social communication and interaction social inclusion, for instance in leisure activities, is a particular challenge." (POST.2008) "A central theme in Government autism initiatives is the promotion of user or consumer participation, not just in the delivery but also in determining the priorities of public services." (DfES. 2006) According to UN Convention on the Rights of the Child 1989, all children should enjoy freedom to seek, receive and impart information and ideas of all kinds. Children should be supported to communicate spontaneously according to their wishes and feelings, needs and wants so that they can enjoy this right. Also, children have the right to learn how to communicate spontaneously. Many of the professionals like teachers, speech and language therapists are of strong opinion that autistic children, who have little or no speech can and do communicate with others. Unfortunately, common misconceptions about autistic children about their communication and interaction abilities and little or no speech can mean that these children do not receive the professional support they are in need of how to learn and to initiate communication. Most of the autistic children used the non-conventional ways of communicating, like physical manipulation e.g. taking his mother's hand over to a desired object and re-enactment e.g. repeating one activity to continue it. Few children are taught about the conventional ways of communicating such as pointing and multi-pointing even though these helped autistic children for effective communication of complex messages. Minimal and no speech like conventional ways of communicating should be introduced to autistic children as early as possible to reach their maximum effective communication. THE COMMUNICATION ENVIRONMENT Communication environment is an effective way of considering all the factors that influence one's ability to communicate, like adult way of interacting and talking, a communication system, opportunities to communicate, adult attitudes, expectations and the physical environment. "This study found strong evidence that the rate and quality of children's spontaneous communication were directly related to the nature of their communication environments, not to their degree of autism or other impairments per se. Some children communicated much more often than others and for more social purposes. Those children who communicated most were not less autistic, nor did they differ in age from the other children, while their degree of learning difficulty and everyday living skills were similar. The significant factor that differentiated them was the quality of their communication environments, and how far these helped or hindered spontaneous communication." (Joseph Rowntree Foundation, 2001) CREATING A COMMUNICATION-ENABLING ENVIRONMENT A wide range of communication-enabling strategies and approaches are used by professionals to increase the level and quality of spontaneous communication in children. One of the most successful ways of doing this is to adopt a minimal speech approach - to reduce the amount of spoken language. Autistic children just tune out from speech and voices. When others try to talk to them, they withdrew from the social interaction by turning away, protesting or switching off. The minimal speech procedure is a therapy in which the adults will consistently use only one or two relevant concrete words while communicating with children who understands little speech. The minimal speech approach is very effective that using limited words for communication, children often become more socially interactive and communicate more often. Proximal communication is a variety of communication in which adult's uses a set of non-verbal strategies to encourage children to initiate communication. Examples include imitation of the child, use of bursts of activity contrasted with frequent pauses, along with the use of minimal speech approach. CREATING OPPORTUNITIES FOR COMMUNICATION Autistic children often react and communicate when they were provided frequent high quality opportunities for communication throughout the day. "High quality communication opportunities were: embedded in everyday activities throughout the day, not only in specially designated communication sessions; conducted using a minimal speech approach; very motivating for individual children; well structured, making it clear to children in non-verbal ways, when it was their turn to communicate and what there was to communicate about; characterized by the adult's use of long pauses at critical points in the interaction to give children time and opportunity to communicate." (Joseph Rowntree Foundation, 2001) Autistic children must be given adequate time to notice themselves that there is something to communicate about in their immediate surroundings. Often these children are not given opportunities to do this as adults verbally compel them to communicate using questions, for example. If pauses are given instead of spoken prompts in a range of situations, children are found to respond to what was happening in their environment and begins to communicate. TREATMENT OF COMMUNICATION PROBLEMS IN AUTISM No single method of treatment has been found successful in improving communication in autistic children. The best treatment should be started during the preschool period, target should be both behaviour and communication and as well as involves parents or primary care takers. Speech- language pathologists are the best to give treatment to an autistic child. There are well planned behaviour modification programs, in-home therapies, music therapies and sensory integration therapies to help autistic children. Medications help to improve an autistic child's attention span or decrease unwanted behaviours like hand-flapping, but due to their side effects, they are not recommended fro long term use. No medicine is specifically found to improve the communication problem in autistic children. The most important problem in treating children with autism is the constant motivation they needed as they met with lot of failures in life. The failures in life cause the child to respond less or not at all with the environment. The children may even become aggressive and disruptive. How to Motivate Autistic Children: Technique of motivation: The important components in the motivation of autistic children include reinforcements and task variation. The motivation can be enhanced by appropriate stimulus which the child chooses instead of which is selected by the clinician. LANGUAGE USAGE: Language characteristics: the important language characteristics include verbal, nonverbal, delayed verbal and echolalia. The verbal type gives a very elaborate description on a single topic. With early detection of children with autism the incidence of children in nonverbal type has come down significantly. The common communication pattern of children is by requesting objects, or by protesting. They have many problems in phonology and syntax. The autistic children usually involve in limited social interactions due to limited number of utterance they emit. The autistic children use the language more to meet their need instead of socializing with others. The echolalia is manifested as they repeat all or part of the words just heard. INTERVENTION TECHNIQUES: Functional analysis: this technique consists of assessment of the primary motivation of a behavior. In fact the disruptive behavior is used by the autistic children to express the frustration or anger of children. Stimulus over selectivity is seen in certain autistic children. That is, they respond to very restrictive portion soc complex stimuli. They identify or recognize some person by a small and extraneous cue, but fail to recognize if that single cue is missing. Intervention techniques help to respond to multiple cues and thus help to respond to complex stimuli. SELF MANAGEMENT Self management helps autistic children to reduce parental stress and dependency which in turn helps to reduce the disruptive behavior of the autistic child. "Recent data indicates that autistic children who are completely nonverbal are capable of learning at least some expressive language if naturalistic procedures are begun before age five. Utilizing naturalistic procedures is referred to as milieu teaching and this form of teaching more closely resembles the manner in which developing children naturally learn language." (Madrona, L. M. n.d.) Milieu teaching involves varying the stimulus items to the one present in the natural environment, employing natural reinforces, by giving rewards for communication attempts by the child, and by practicing natural interactions. For delayed verbal children, physicians are now implementing a series of self-initiated strategies to expand their communicative abilities. For example, they introduce a series of question pattern to help to initiate communication in autistic children. Examples for this are: What's that Where is it Whose is it Etc. CONCLUSION Autistic children with minimal speech forms one of the most communicatively disempowered groups in our society. To enable them to communicate spontaneously should be accepted as a key educational goal. Integrating children with developmental delays in an environment with similarly aged typical peers is a very beneficial method. Autistic children who have severe socialization problems learn to socialize better when they are exposed to a significant number of opportunities. "The research involved 18 children, 16 boys and 2 girls, who had an average age of 4.5 years. All had a medical diagnosis of autism, and minimal or no speech, and were based in autism specialist classes within 5 special schools in England. Extensive information about the children's spontaneous communication was collected through both observing and videotaping them in a range of everyday school activities. This study supports the view that the key to achieving this is the creation of communication enabling environments within school and other settings, using strategies and approaches that are designed to enhance children's own role as spontaneous communicators using systems such as pointing/multi-pointing." (Joseph Rowntree Foundation, 2001) Thus, it is high time to look how environments could be developed and attitudes and curricula could be enhanced which help to enable better communication in autistic children. Read More