The triad is usually accompanied by repetitive patterns of behaviour and interests, and often by challenging behaviour. Around 75% of children with autistic spectrum disorders have general learning difficulties that fall in the moderate (IQ 35-50) range. The children usually have an uneven pattern of cognitive strengths and weaknesses, with reading decoding skills often being way ahead of comprehension - a condition known as hyperlexia. Around 10% of the children have a special skill in such areas as music, art or computational skills.
Children with Asperger Syndrome are amongst the most able of those within the autistic spectrum and will often be educated in mainstream schools. Diagnosis is sometimes difficult for these pupils, as they do not have such an obvious learning disability, but may have been considered 'odd' by their teachers and classmates. Obsessions are associated with special interests rather than behaviours. It is less usual for motor mannerisms or preoccupation with parts of objects to occur. Language skills may appear good, but they may fail to make adjustments to fit different social contexts or the status of different listeners. Non verbal aspects are impaired, such as tone of voice, facial expression, gesture, gaze and posture. Motor development may have been delayed with clumsiness or awkwardness evident later.
Children with Asperger Syndrome have a higher degree of self-awareness and interest in others. They are often more aware of the impediments to normal social relationships that they experience and this can lead to a painful degree of distress or anger towards others. Some young children with an early diagnosis of autism may later 'evolve' into a pattern more consistent with Asperger Syndrome.
Epidemiological studies suggest that 2-5 children in every 10,000 fall within the autistic spectrum.
The following section enlarges upon the triad of impairments that characterises autistic spectrum disorders, and is reprinted with the kind permission of the UK National Autistic Society from their booklet Could this be Autism? The address for NAS publications, together with the NAS weblink, is given below (see Resources).
The Triad of Impairments
Autism is a pattern of abnormal development that unfolds over time. In most cases, the triad of impairments emerges in the first 2-3 years of life. Sometimes indications are there even earlier. In infancy one of the most important indications that autism could be present is the absence, or very delayed development, of drawing the attention of parents and others to objects or events. In normal childhood development, by the time a child is 12-18 months, they are usually pointing at things and trying to engage the interest of the person they are with so as to invite them to look too. They also gain attention by bringing toys and make eye contact when doing this. If this behaviour does not occur, or begins very late and is limited to the child's own interests, an autistic disorder should be suspected.
Because autism is a complex condition it is easy to miss important clues. The triad can be shown in many different ways:
Impairment of Social Interaction
A child with autism will:
Impairment of Social Communication
A child with autism will:
Impairments of Imagination
Alongside the triad of impairments, the child will usually show repetitive activity of behaviour. At a simple level, this might involve repeatedly flicking their fingers or an object like a piece of string. More complex signs might include an insistence on following an identical route to certain places, a lengthy bedtime ritual or the repetition of a sequence of odd bodily movements.
The child may also form an intense attachment to particular objects for no apparent purpose, arrange objects in lines or patterns, or collect things like pebbles or plastic bottles without apparent regard to their intended purpose. They may become fascinated by certain topics, such as electricity, astronomy, birds or train timetables, or even specific people, asking the same series of questions and demanding standard answers. While some of these patterns of behaviour are recognisable features of normal development, it is the intensity and frequency, combined with a disregard for the normal use of purpose of activities, that suggests they are part of a pervasive developmental disorder.
The child may also demonstrate challenging behaviour such as running away, screaming, biting or kicking other people, grabbing things off counters in shops, socially unacceptable habits or making naive and embarrassing remarks.
About 10% of children with autistic spectrum disorders have some special skill at a much higher level than the rest of their abilities, for example music, art, numerical calculations or jigsaw puzzles. Some have a remarkable memory for dates and things that particularly interest them.
The following extract is reprinted with the kind permission of East Sussex County Council (UK), and is taken from their booklet Understanding Autism and Asperger Syndrome. Details of how to obtain this publication are given below (see Resources).
For a teacher or teaching assistant approaching the education of pupil with autism, there are three basic rules to follow:
Poor Attention and Distractibility
Problems with Recall of Instructions
Difficulty Organising and Sequencing Tasks
Difficulty Following Group Instructions
Difficulty Knowing How to Ask for Help
Problems Selecting Relevant from Irrelevant Information
Resistance to Change in Activity and Routine
The main area for careful differentiation concerns 'understanding' in the widest sense. Pupils with autism may have reasonable and even excellent technical skills (e.g. reading, computation), but true understanding of the meaning and purpose underlying the curriculum is likely to be substantially impaired.
The following books are available from IPS Publications; prices are shown in £ sterling; an approximate exchange rate for US$ is £1 = US$1-50. Postage is £1 per book for UK domestic orders, and £2 per book for overseas surface postage. A secure publication ordering system is available at IPS OnLine Store; any queries on publications should be addressed by e-mail to: email@example.com
Asperger Syndrome - Cumine, Leach and Stevenson £14
Autism and Learning - Powell and Jordan £14
Autism: From Theoretical Understanding to Educational Intervention - Peeters £19-50
Children with Autism and Asperger's Syndrome, A Guide for Practitioners and Carers - Howlin £17
Diagnostic and Statistical Manual of Mental Disorders - DSM IV (4th edition) £35
Handbook of Autism and Pervasive Developmental Disorders - Cohen and Volkmar (2nd Edition) £80
Teaching Children with Autism to Mindread, A Practical Guide - Baron-Cohen, Hadwin, Swettenham and Howlin £17
Teaching Pupils with Autism and Asperger Syndrome: Guidelines for Schools East Sussex County Council
Understanding and Teaching Children with Autism - Jordan £20
The UK National Autistic Society has a wide range of publications including information leaflets and books. In addition, NAS can provide details of courses and conferences, support groups, consultancy services and university courses, applicable to the UK.
National Autistic Society, 393 City Road, London, England EC1V 1NG
Telephone: +44 (0)20 7833 2299
Facsimile: +44 (0)20 7833 2299
The National Autistic Society:www.oneworld.org/autism_uk/asd.html
Updated 26Dec00 2210gmt rl