Autism was first identified in the mid-twentieth century, and affects an estimated 1 in 500 children. There are five different types of pervasive development disorders (PDD) that are more often referred to as autism spectrum disorders (ASD). Asperger's syndrome is the mildest form of the disorder. All the disorders are characterized by varying degrees of impairment in communication skills, social interactions, and restricted, repetitive and stereotyped patterns of behavior. Another definition makes similar points:
A disorder that is present from birth or very early in development that affects essential human behaviors such as social interaction, the ability to communicate ideas and feelings, imagination, and the establishment of relationships with others. The spectrum of conditions that make up autism often lead to great family disruption and to unfulfilled lives for many children, so any teaching methods that may alleviate the effect of the condition are very important. The independent variable are the characteristics of autistic children and the dependent variable is the degree to which they can be taught with those characteristics.
The education of autistic children is a vital part of the overall education system. Since first being identified in the 1930's, autism has been increasing out of proportion with the general rise in population. As of 2002 the government estimated that nearly 120,000 autistic children were being treated under the auspices of the Individual with Disabilities Act. This was a staggering 500% increase over the previous decade. Within the whole US population, about 1.5 million people live with one form or another of autistic conditions. These figures make autism one of the most prevalent mental disabilities, and its prevalence is only met by the difficulty of treating and educating those with the condition.
In some ways a daunting task awaits anyone seeking to educate an autistic child. The main task initially is, understanding what causes these problem behaviors to emerge during early childhood and preschool years, what maintains them, and what evokes their moment-to-moment expression. A lot of medical research is being done into such matters, but those at the level of educating autistic children (and education and treatment are often synonymous with this syndrome) are at the forefront of attempts to understand and alleviate the condition.
Before teaching can occur autism should be detected as at young an age as possible. It is nearly always identified by the end of three, and at times can be seen at the age of eighteen months. Many studies have shown that early intervention has a dramatic impact on reducing symptoms and increasing a child's ability to grow and learn new skills. If autism is not discovered early enough then a dire situation may occur in which one moderate to severe problem behaviors become part of the child's repertoire . . . an autistic child usually does not outgrow them.
Early intervention relies upon a highly structured and specialized teaching environment. Applied Behavioral Analysis (ABA) has become the cornerstone for early autism intervention, with the Surgeon-General stating that thirty years of research demonstrated the efficacy of applied behavioral methods in reducing inappropriate behavior and in increasing communication and appropriate social behavior. The basis of ABA is intensive, one-on-one child-teacher reaction for 40 hours a week. The idea of this approach is to reinforce desirable behavior and reduce undesirable actions.
What are the details of this treatment/teaching program? It builds upon the child's natural interests, offering a very predictable schedule that teaches tasks as a series of simple steps. In the pre-school stage, most of the program will occur at home, with the parent(s) taking an active role in the development and implementation of the program. Research has shown that parental involvement is actually key to success. In the early stages of teaching, ABA targets specific deficits in learning, language, imitation, attention, motivation, compliance and initiative of interaction. Communicative, occupational and physical therapy combines with behavioral methods that concentrate on social play interventions.
The day for the pre-school autistic child often starts with a physical activity that helps to develop co-ordination and body awareness. Thus painting, piecing puzzles together and stringing beads may be tackled. Motor skill activities are concentrated upon as, once mastered, these seem to lead (in some children at least) to improved social interaction, The exact process at work here is unknown (as is the exact cause of all autistic conditions), but the improvements have been noted by many different studies.
At snack time (often in the middle of the morning) the teacher will encourage social interaction and communication skills through modeling how to ask for more juice and treats. Again, the repetitive nature of this activity, every day, is what appears to break through some of the "wall" that often surrounds the perceptions of autistic children. This process is called discrete trial instruction (DTI). The technique involves breaking skills down into as small tasks as possible that can be taught individually. Discrete (separate) trials can be used to teach eye contact, imitation, fine motor skills, self-help, language and instruction.
For example, if a therapist wants to teach an autistic child imitation he will say "do this", tapping the table. The child is expected to tap the table in turn and, if successful, will receive positive reinforcement, such as a piece of candy, a toy or general praise. If the child does not do the task (does not tap the table) the therapist says "no" and then repeats the original command and action after a pause. 'Prompts' are also used, involving helping the autistic child tap the table when they have failed. The process will be repeated over and over again until the child starts to complete the task most of the time. Great patience on the part of the teacher is needed.
The latest development in ABA is a technique called Applied Verbal Behavior. This was created as a response to BF Skinner's 1957 analysis of verbal behavior and stresses the fact that the child will start to realize that language will get her what she wants.
A very recent study produced the Treatment and Education of Autistic and Related Communication Handicapped Children (TEACCH) at the University of North Carolina. This technique of teaching autistic children involves less intensive work on ABA during the preschool years. The TEACCH classroom is usually very structured, with separate, defined areas for each task, such as individual work, group activities and play.
TEACCH relies on one of the strengths that many autistic children possess: visual learning. The children use strict schedules for their day that enable them to move from one activity to another and potentially bring about a sense of pattern that may enable them to communicate better with other individuals. Those in the program may sit at a play station and be required to finish activities, such as making a picture or matching images. The finished assignments are placed in a container and then closed. The children then move to the next station.
This method may help with the difficulty that many autistic children have with transitioning from one activity/place to another. However, TEACCH has been criticized because it does not stress socialization and communication. In this sense the method accentuates the idea of accommodating the child's autistic traits rather than attempting to overcome them.
TEACCH also seems to enter the territory of the extremely rare, but fascinating autistic that some patients present in which some abilities (often mathematical or memory associated) are developed to an almost unbelievable degree while others are completely lacking. These so-called autistic savant s often display abilities that seem almost supernatural in origin, and which appear to be visually-based.
Thus the so-called calendar savant can tell you what day of the week Christmas will be 267 years hence, but may not be able to tie their shoes. These savants essentially 'see' a calendar within their minds and then read their answer to the question. Other savants have the ability to precisely 'estimate' distance to a particular object to within a few feet, even when it is several miles away. Joseph Pearce has graphically described this odd, but vital situation:. . . so far as can be observed, the savant has not acquired, could not acquire, and is quite incapable of acquiring, the information that he so liberally
dispenses.
The idea that the autistic child should be essentially taught a series of rote exercises is countered by such individuals. They suggest that teaching techniques that stress that the world of the autistic is both relevant and valuable may be the route to helping the great majority of autistic individuals that do not exhibit the remarkable abilities outlined above. While the truly exceptional autistic savants are rare indeed, about 10% of autistic individuals show at least some savant skills.
How can these individuals be taught to make the most of their abilities?
Philips asked the important question regarding education of the savant, the problem of treatment comes next . . . is it better to eliminate the defects or train the talent. It seems that if the educator tries to train the talent and some of the problems seem to subside. Savant talents seem to be a 'conduit' towards at least some degree of normalization: socialization, language acquisition and independence. A Savant Skill Curriculum has been developed that combines strategies employed for the gifted and talented child such as enrichment, acceleration and mentorship, together with those from autism education such as visual support and socialization. The apparent 'opposites' of gifted and talented and autism may in fact coalesce quite well.
Recently, some educational institutions have developed programs specifically aimed at developing these remarkable individuals. The "Soundscape center" in London, England is an educational facility that is solely dedicated to the needs and potentials of people with sight loss, special musical abilities and autistic conditions. This Center is described thus:
"Soundscape is a place where disability is viewed from a different perspective, where self-expression and communication through music will lead to a world of freedom, independence and hope for the future. The professional staff at Soundscape know that music can transform the lives of people with sight loss. They are creating a center where the talents of performers can be nurtured and where the students can train for employment. Soundscape will become the international center of excellence for music and the performing arts for people with serious sight problems and other disabilities."
A teaching technique for the wider autistic population (the majority who are not savants), that seems to stem from this contrasting philosophical outlook upon the wider implications of the movements, energy and potential of the autistic child "Floor Time" has been developed by Stanley Greenspan. In floor time the child's movements are assumed to be purposeful and the teacher/parent's role is to follow the child's lead and help them to develop interaction and communication through the frame of reference that the child is creating through their movements. So if a child repeatedly bangs a toy against a table then the teacher will do the same or, in a perhaps more intuitively educational action, place his car in front of the child's, thus stopping the child's action. The child will 'react' to the new situation and thus a form of communication/interaction has been established. As can be seen, floor time is essentially a reversal of the roles from the previously discussed methods, although it relies upon imitation.
Floor time suggests that there is a discipline and pattern within the often randomly repetitive movements of an autistic child. The route to communication is to empathize with the child's world on their own terms. While some school systems incorporate floor time into their teaching strategies, it is not often the primary means to trying to help autistic children. Often it is used in conjunction with some ABA techniques a sensible combination of various techniques may enable the autistic child to make sense of the conventional world around him while the parent/teacher makes sense of the world inhabited by the autistic child. Communication in that way become two-way, and may lead to enriched experience for the child.
The basis for Greenspan's work is that children with autistic patterns have attachments and emotional experiences but demonstrate them in their own idiosyncratic manner. This observation was based on the fact that only 5% of the children he treated were extremely self-absorbed, evidencing almost no affective engagement or pleasure, reciprocal interaction or symbolic elaboration, implying that the vast majority (95%) did. This is particularly the case with less severe versions of autism such as Asperger's syndrome.
The contrasting autistic disabilities that various children display mean that very careful evaluation needs to be done as to which type of education they should be placed in. Wherever possible a part-home schooling, part institution program is perhaps the best, but as this is often not feasible a carefully chosen educational program designed for the needs of the individual child is needed. While the autistic savants are a minority within the autistic population, their profound and often awe-inspiring abilities may point the way towards seeing autism as a state of being that can be nurtured and perhaps even valorized rather than merely being 'treated' as totally malignant. This is not to suggest that autism, in any of its forms, is anything other than tragic, but rather to point the way towards a practical reaction to a condition that seems, because of our lack of the most understanding of what causes it, here to stay.
This article if for information only and is not meant to present any form of treatment or type of autism. It is recommended that professional help be sought for more information. Click here for information.
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