About Autism -THE NATURE OF THE PROBLEM:
Autism defines children at a behavioural level but is associated with multiple aetiologies. However, all have deficits in social cognition and communication.
About Autism – Social Impairment:
The hallmark of ASD is disturbance of social development. As Wing (1981) noted, it is the underlying social difficulties, which impacts the interpersonal relationships, communication and contributes to inflexibility of behaviour and thinking. The resulting social impairment leads to socially inept behaviour in the child with ASD.
At the superficial level this implies seemingly odd or irrational behaviours. At a more profound level, social difficulties encompass the individual’s understanding of how the world functions. This is caused by the fact that many of the children are unable to be part of social units like mother-child, family, friends and community. This inability reduces opportunities for social transactions, which further affect social development. Hence a relatively small social disability has a pervasive effect on the later social development, which gradually becomes profound.
About Autism – How does this effect my child?
The social impairment impacts almost every aspect of the child’s functioning, whatever his or her intellectual ability (Howlin 1998). It can lead to inappropriate and unacceptable behaviours in various social situations, causing the child to be ostracised. It can also lead to deficits in socialisation with difficulty in interacting with people and making friends.
In normal development social responsiveness is seen as early as 2 – 3 months when a baby smiles at its caregiver. It responds to its own name by 7 – 10 months and waves goodbye by 9 – 12 months. The perceptual ability enables children to learn how to respond socially. At 18 – 24 months they perceive when they are hurting others and either repeats the act to check on the response or comfort them by kissing, stroking or appeals for help. They start to perceive social rules and who transgresses them. They also become aware of others feelings and attempt to comfort others in distress. Around this age they start using humans as social tools – appealing for help, using their perception as a reference point and draw their attention to others breaking rules. Toddlers also develop a pro – social act of sharing.
The whole gamut of social responses appears to be disrupted in ASD, even when they maybe functioning well in other areas of life like self-help skills or academic tasks.
About Autism – Social Awareness, Importance
Understanding others is an important mechanism by which humans blend together in groups, families and communities. It allows learning of self-control co-operation and collaboration. Individuals with ASD have difficulties understanding others from a very young age.
As early as one year children are aware of anger in others and show distress whilst 18 month olds rarely ignore disputes in others and by 3 years children draw attention of adults to transgressions of peers. Two year olds can recognise and empathise distress in others whilst three year olds are also aware of what situations gave rise to that distress. (Jordan, R. Unit 2, Social & Emotional Needs, 2000) Children with ASD do not distinguish well between objects and people and also behaviour between people and people. They do not perceive people’s feelings and appear to lack empathy.
About Autism – What will happen?
They fail to develop a sense of oneself or personal agency (Russell 1996). In the same way they do not develop the concept of others and their ‘selves’ as described by Frith (1989) in the concept of ‘Theory of mind’.
Theory of Mind or Mentalising ability is a complex social skill. (Jordan, R. Unit 2, Social & Emotional Needs, 2000) It differs from superficial social competence, which includes behaviours like gaze contact, imitation and turn taking. Theory of mind is awareness a child develops that other people have a variety of mental states. These include attributing mental states such as ‘knowing’ and believing to other people and also to oneself. Individuals with ASD, not only do not understand what others are thinking and feeling, they do not even understand that they themselves or others are thinking or feeling at all (Baren-Cohen S., Leslie, A. and Frith, U., 1985)
About Autism – Communication problems:
Language and communication problems are one of the defining characteristics of autism (Coupe Okane Goldbart 1998). The range of language and communication skills varies tremendously across the continuum. It is clear that the fundamental problem lies with communication rather than language per se. Non-verbal forms of communication are affected and even when language is present, its use as a communication tool remains poor. In normal developmental pattern, communication precedes language and is the prime reason for learning it. This pattern is disrupted in autism leading to delay and deviant language development. It is not mere acquisition of language structure, which may be well developed, but rather its use and meaning, which is affected (Coupe Okane Goldbart 1998).
Early communicative consists of shared attention, imitation, turn taking, social organisation, mutual gaze, communication intention and communication comprehension. These behaviours are deviant or delayed in autism.
About Autism – How does this effect my child?
Shared attention is seen very early. Around 9 – 14 months infants show clear signs of wanting to share other people’s attention, indicating joining points of reference (such as the light or fan). Not only do they indicate the objects but also at the same time look at people as if to check whether they too are interested and perhaps looking at the same thing (Mundy and Sigman 1989), something that children with autism cannot do.
The process of imitation is crucial in developing an understanding of others (Bremner 1988). Imitation is the earliest form of social interaction. True imitation occurs when the child can decide which action or sound is to be copied. It is at this level of imitation that the child understands the concept of others at a cognitive level. Imitation is almost always active and creative. It is never a perfect copy. Imitation is also fundamental to the development of the representation of language (Piaget 1951). Individuals with ASD may have a ‘parasitic’ quality to their imitation i.e. they exactly copy the perceptual features of the behaviour.
Robson (1967) noted that mutual gaze was a fundamental form of human communicative behaviour and lent a framework to other modalities of communication. The child and adult spend periods of intense eye-to-eye and face-to-face communication (Brazelton 1979). The reflexive gaze is modified into gaze coupling which is a turn taking interaction that resembles later gaze patterns seen in mature conversation (Jaffe et al 1973). Individuals with ASD, whatever the intellectual level, show disruption of mutual gaze in early development. Gaze avoidance or excessive/inappropriate use of gaze are part of the clinical picture of ASD.
About Autism – Social Communication
A variety of social organisational strategies are used for communication (Coupe Okane Goldbart 1998). These are needed for initiating, maintaining or terminating a communication like calling out, question/answer, breaking off conversation or repairing misunderstandings. Skills acquired through infancy through interpersonal interactions underpin the skills needed for these conversational and discourse management (Coupe & Jolliffe 1988). Individuals with ASD lack strategies to organise communication. It is probably more evident in high functioning verbal individuals who are capable of conversation.
The turn taking that is seen in a social interaction or dialogue starts with the adult leaving space for children to fill their turn with sounds or actions. Individuals with ASD have difficulty with turn taking at a very early age, both in vocal interactions but also in physical tasks.
Communication intention is the reason or goal of communication in the mind of the speaker i.e. the why one communicates. Children initially use situational cues and gestures to assist comprehension. The comprehension gradually depends more and more on linguistic input. Some examples of communicative intentions are drawing someone’s attention to an object or making a request or giving information (Okane & Goldbart 1998). Others include gaining attention for communication like a tap on the shoulder, drawing attention to something to another person like saying ‘oh look’, and intention to regulate social contact. With impairment in perception and mentalising ability, individuals with ASD lack communication intentions, which adds to their social impairment.
Comprehension in context starts in the first 6 months of life where infants start to ‘read’ the signals and expressions of other people’s behaviour. It gradually develops into a highly developed area of expertise, which allows individuals to abstract meaning from the adult’s intonation patterns, voice quality and facial expressions.
The individuals with ASD will have difficulty in all the areas of early communicative behaviours affecting their language development, socialisation and their ability to express themselves.
About Autism – Language problems:
Though it is communication rather than language, which is impaired in autistic spectrum disorders, language is affected in most individuals with ASD. Lord and Rutter (1994) estimated that around half of all children fail to develop functional speech. Spoken language ability in autism can range from muteness to an apparent facility. Even with good expressive vocabulary there is a persistent and pervasive impairment in the communicative use of language, and in understanding complex or abstract concepts (Lord and Rutter 1994). The typical speech in autism tends to be non-productive, echolalic, pedantic and uttered in a monotone. Its use to share experiences, express feelings or emotions, or to converse is restricted to high functioning asd or Asperger Syndrome and that to in a limited way.
About Autism – Cognitive impairments:
The ability to plan, to arrange events in order and to postpone the need for gratification is referred to as ‘executive abilities’ or Executive Function. They are necessary for the development of time concepts; motivation and ‘common sense’ (Ozonoff et al 1991) Happe (1994) pointed out that executive functions are deficient in Autistic Spectrum Disorders. This resulted in typical behaviour in individuals with ASD, which was rigid, inflexible and perseverative. They found it difficult to apply their large store of knowledge meaningfully, often were impulsive and narrowly focused on detail (Cumin, L., Leach, J., Stevenson, G., 1998).
All humans, from a very young age demonstrate an inherent drive to seek out meaning, pattern and coherence from details presented to them – Central Coherence (Frith 1989, Happe 1994). In autism, individuals failed to see the picture as a whole and tended to fragmentary processing. The failure to draw together diverse information to construct higher-level meanings in context led to specific problems (Frith 1989). These included the insistence on sameness, attention to detail rather than whole, insistence on routine, obsessional preoccupations and existence of special skills.
About Autism – Memory:
Memory processing differs qualitatively in individuals with autism. Impairment in the ‘Theory of Mind’ leads to an inability to reflect on their own thinking. Hence, remembering facts related to personal events pose a problem but other memory remains unimpaired and maybe exceptional. People with autism find it difficult to remember episodes where there is a personal element included and when there is no external cueing. They find it difficult to remember him or herself performing actions, participating in events and possessing knowledge and strategies (Jordan and Powell 1995). The experiencing self in normal development is able to search their memory and does not need specific cues. This peculiar memory-processing problem is impaired personal episodic memory.
About Autism – Problem Solving:
Jordan and Powell (1995) noted, that problem solving was difficult for these children because their poor self-awareness that prevented them from reflecting on their own abilities to solve problems. They also said that the highly attention specific style of thinking of autistic children affected their problem solving ability. It led to inflexible attention, which could not be readily harnessed or moulded to the need of the situation. Their oversensitive and idiosyncratic perception faculties also aggravate the problem solving impairment. Over reaction to situations cause panic attacks and difficulty in problem solving.
About Autism - Emotional Problems
Individuals with ASD fail to understand others’ mental and emotional states, which results in other people appearing confusing. This leads to children with ASD withdrawing and failing to engage with people. Hobson (1993) believes that due to a biological deficit, they failed to perceive emotions in others and thus could not empathise or relate to them. The ability to recognise, interpret and express emotions is rooted in early perceptions and social development. Children with ASD have emotions and feel but have difficulty expressing them and communicating them. The inability to relate to others affects development of friendships. Moreover, emotional immaturity results in uninhibited expression of emotions, especially negative ones. This results in an inability to control emotional outbursts, which can be disruptive. High functioning ASDs are more likely to suffer from its consequences as their emotional development is far below their intellectual and academic ability making it more unacceptable (Jordan and Powell, 1995).
Emotional immaturity also affects learning, as children with ASD are unable to motivate themselves to learn. They do not see the need to please teachers or parents so will not learn a task just to please them, a feature seen to aid learning in non-autistic children. The stress of new tasks may lead to emotional outbursts and withdrawal instead of stimulating learning.
Thus impairment in emotional development affects socialisation, behaviour and learning in children with ASD.
For more information on Autism, please refer to the Information on Disorders page.
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