AUTISM SPECTRUM DISORDERS

Autism Spectrum Disorders (ASD) are a group of neurobiological developmental disorders, which includes autism and Asperger syndrome. Autism spectrum disorders are characterized by impairments in communication and social interactions, and by repetitive and stereotypic behaviors. Other characteristics might include unusual responses to sensory experiences, difficulty with transitions, and resistance to change.

The term spectrum disorder means that the disorder can present with mild to severe characteristics. Individuals with autism can be:

• highly intelligent or cognitively delayed;
• highly verbal or functionally nonverbal;
• “oddly” sociable or have no social interactions whatsoever;
• singularly, almost obsessively, focused on one interest or appear to have no interest at all in their environment;
• either over- or under- reactive to sensory input.

Asperger syndrome is similar to autism, but a child with Asperger syndrome has no cognitive delays, developmentally has a typical interest in the world and his environment, and is usually very verbal.

Students with ASD can present some particular challenges for educators. No single individual with ASD appears characteristically just like another. In addition, social interactions and communication between students with ASD and their peers and teachers may be difficult.

Stanley I. Greenspan, a pediatric neuropsychiatrist who specializes in autism spectrum disorders, refers to autism simply as a “disorder of relating and communicating.”

COMMUNICATION CHALLENGES

Often students with ASD have a difficult time processing language auditorily, especially metaphors, innuendoes, and jokes. These students will struggle in a classroom environment in which much of the information is presented verbally. However, these same students sometimes have great visual memory, which can be used productively in the classroom. Students with ASD (as well as visual learners) will benefit from instruction delivered in picture icons or written sequentially.

Teachers can visually deliver instruction in the following ways:

• Use multisensory delivery. Dramatic presentations, comics, PowerPoint presentations, overheads, movies, and online resources involve both auditory and visual processing.
• Use color. Color-coded notebooks or colored markers and pens can help students differentiate subjects. Color can also be used to highlight directions.
• Use visual cues. Schedules, calendars, timetables, and lists of items to complete can be placed on students’ desks. These can take a variety of forms: written, pictures or symbols, and photos. Alphabet and number lines or mnemonic devices also provide visual cues for students. Bulletin boards, banners, posters, and flashcards reinforce content area knowledge.
• Use guided notes or other handouts to help students stay focused during verbal instruction.

When information must be presented verbally, teachers can support students with ASD when they:

• Demonstrate/model/act out instructions; use hand signals.
• Complete the first examples with students.
• Repeat instructions after allowing 10 seconds for processing time; speak slowly and clearly, modify tone and pace.
• Put instructions in the same place always.
• Simplify; analyze tasks and break them into small steps.
• Provide extra time and resources.
• Involve students in presentations.
• Team teach.

Students with ASD might also need a variety of adapted materials, including:

• low-vocabulary books, audio and video tapes,
• AAC (augmentative and alternative communication) devices and voice output devices,
• talking calculators,
• educational software designed for struggling learners or children with ASD,
• manipulatives,
• different types of paper – textured, graph, lined papers (raised lines, colored lines and mid-lines),
• sticky notes,
• a variety of writing utensils: golf pencils, magic markers, highlighters, chalk holders, pencil grips, and stamps and stamp pads,
• slant writing boards, recipe stands,
• desk organizers

Many students with ASD are not “fond” of writing, whether they are engaged in the mechanical process itself or the slow process of translating oral language into the written word. Because so much of the curriculum output expected from students includes written work, it is imperative to have alternatives for students with ASD to demonstrate their knowledge of what has been presented in a lesson.

The following are some alternative ideas for students with ASD to demonstrate their knowledge:

• oral tests
• PowerPoint presentations
• dramatic presentations
• dioramas
• graphs and diagrams
• comic strips
• storyboards
• flow charts
• sign language

Special education teachers, speech-language pathologists, and occupational therapists can be a source of ideas for other instructional methods to support students in demonstrating knowledge of specific curriculum and content standards.

SOCIAL SKILLS

Another area of concern for students with ASD is social skills – the challenge of relating to others in an acceptable manner. The social skills impairment of individuals with ASD significantly differentiates them from students with other disabilities. Instruction in these skills is imperative for students on the autism spectrum to communicate in class, build friendships, and participate in the community. Social skills impairments can be manifested in a number of ways, including:

• lack of reciprocity, or the give-and-take of conversation,
• inability to initiate conversation,
• lack of spontaneous sharing of interests and enjoyment,
• inability to take the perspective of others,
• lack of appropriate social pragmatics (i.e., proximity to others, body language, vocal tone, interruptions, and responses to facial and other physical gestures),
• inability to understand humor, sarcasm and innuendo,
• monologues on the individuals’ specific interests.

Social skills seem to “just come naturally” to typically developing children. But these skills need to be taught directly and practiced often by students with ASD.

There are several proven methods that can support social skills instruction. Often these skills are taught by speech-language therapists and intervention specialists. Some of these techniques and methods include:

• social stories,
• role-playing,
• video modeling,
• labeling and recognition of emotions in self and others,
• structured small-group instruction, including typical peers for review of learning objectives, often involving games, role-playing, and discussions (example: simple peer mediation role-playing),
• informal groups, such as “friends groups” or “lunch bunch,” where social skills can be applied in natural settings and spontaneously facilitated for reinforcement or correction,
• structured outdoor or indoor recess to apply social skills with or without facilitation and to measure for generalization of skills in a large setting.

Many of these skills can be taught for whole-class instruction. For example, as a special education consultant for a student with Asperger sydrome included in a general education fifth-grade classroom, I gave direct instruction in conflict management to that student and a couple of his classroom peers. I used scripted “conflicts” that the students role-played.

The students were given a simple sequential procedure for conflict management. After learning the procedure and acting out several scripts, they were given written prompts for which they had to come up with their own dialogue. Once the three students became proficient in the methods, we took the role-play, scripts, and prompts to the whole fifth-grade class, where all the students participated in learning the conflict management procedures. We used the same methods but in a shorter amount of time. All students, including the student with ASD, benefited from this method of instruction. This is an example of how social skills instruction can be taught, and generalized to a classroom setting.

This article has just touched on some ideas to use in the areas of communication and social skills for students with ASD. It is always necessary to read a student’s IEP (Individualized Education Program) to determine the best approaches to facilitate instruction for him or her in the classroom.

BOOKS

There is a wealth of information and resources on supporting students with ASD in the classroom. Some good titles for social skills instruction include:

Gajewski, Nancy, Polly Hirn, and Patty Mayo. Social Skills Strategies: A Social-Emotional Curriculum for Adolescents, Thinking Publications, 1998.

Gray, Carol. Comic Strip Conversations: Illustrated Interactions that Teach Conversation Skills to Students with Autism and Related Disorders. Future Horizons, 1994.

Gray, Carol. The New Social Story Book. Future Horizons, 2000.

Gray, Carol. Social Stories and Comic Strip Conversations: Unique Methods to Improve Social Understanding. Future Horizons, 1998.

Moyes, Rebecca A., Incorporating Social Goals in the Classroom: A Guide for Teachers and Parents of Children with High-functioning Autism and Asperger Syndrome. Jessica Kingsley Publishers, 2001.

McAfee, Jeanie. Navigating the Social World: A Curriculum for Individuals with Asperger’s Syndrome, High Functioning Autism and Related Disorders. Future Horizons Inc., 2000.

Winner, Michelle Garcia. Thinking About You Thinking About Me. Jessica Kingsley Publishers, 2003.

Online Resources

Here are some web sites that may help you understand more about autism spectrum disorders as well as sites directed at teachers.

Autism Spectrum Disorders (Pervasive Developmental Disorders)
A 41-page booklet, available online and downloadable, from the National Institute of Mental Health describes ASD, its prevalence, and its diagnosis in children. The readable text also covers adolescents and adults.

Facts About ASDs
This web page on the Centers for Disease Control and Prevention (CDC) site concisely covers types of ASDs, signs and symptoms, treatment, and diagnosis.

Life Journey Through Autism: An Educator’s Guide
This guide along with a guide to Asperger syndrome is published by the Organization for Autism Research. The guides provide teachers and other education professionals with a plan for teaching a child with autism or Asperger syndrome in the general classroom setting.

Strategies to Help Students with Autism
The many characteristics of children with autism spectrum disorder, the extreme diversity among these children, and strategies to work effectively with them are included in this article written for both special and general education teachers. This is one of several articles on autism available to nonmembers on the Council for Exceptional Children web site. See also Practical Suggestions for Teaching Autism.

Teaching Tips for Children and Adults with Autism
These 28 tips are drawn from the experiences of Temple Grandin, a Colorado State University professor of animal science, the author of several books, and a frequent speaker on growing up with autism. One of Grandin’s books is titled Thinking in Pictures and Other Reports from My Life with Autism.