Autistic Spectrum Disorders in the Early Years

Lynn Plimley, Maggie Bowen, Hugh Morgan

• Publisher: SAGE Publications Ltd
• Year: 2007
• Print ISBN: 9781412923156, 9781412923149
• eBook ISBN: 9781446223192
• Edition: 1
• Topic: Medicine
• Subtopic: Medical Theory, Practice & Reference

?An extremely helpful, compact guide for anyone working in early years education... provides clear information for all professionals who work with children from birth to five with autistic spectrum disorders... A short, accessible and reader-friendly book that addresses the key issues? - Nursery Education

Looking at the early years of a child?s life, this book provides information on the services that are available for those from birth to five years, and addresses issues related to identification, assessment, teaching and learning and family support.

It is illustrated with case studies provided by parents and practitioners.

The following areas are discussed:

o the Code of Practice for SEN & the SEN and Disability Discrimination Act

o identification and assessment

o good practice examples of multi-agency collaboration and provision

o partnership with parents

o social skills and behaviour

o alternative intervention and home-based programmes

o the transition from pre-school to school.

Professionals in Health, Social Services and Education, pre-school playgroups, nursery staff, parents and carers will all find this book useful.

Conference Information

The Good Autism Practice (GAP) conference is based on the successful foundations of the Good Autism Practice (GAP) journal, which provides a platform for acknowledging and sharing good practice in autism.

1

A guide to gaining a basic understanding of people on the autistic spectrum

This chapter looks at the history behind the diagnosis of autistic spectrum disorders and some of the typical characteristics manifest in individuals with the diagnosis.

The condition of autistic spectrum disorders has had a relatively short diagnostic lifespan, compared with other disabilities (e.g. Down’s syndrome, cerebral palsy) and it continues to have a range of different names (most with the term ‘autism’ mentioned somewhere). The main conditions of autism and Asperger syndrome were researched and outlined in the mid-1940s by two separate Austrian medical practitioners, Leo Kanner, a child psychiatrist, and Hans Asperger, a paediatrician. The condition of autism, or Kanner’s autism as it is sometimes called, was published in English in 1943. The condition of Asperger (hard ‘g’) syndrome was published in German and reached English-speaking countries only in the 1980s when it was translated. A fuller historical picture can be gained from reading Wing (1996), Frith (1989) and Jordan (1999). It is possible that autism or its characteristics have existed through time (Frith, 1989; Waltz, 2005).

There is currently a range of professional views on giving a diagnosis of autism/Asperger syndrome/ASD. Look at what professionals and others have used to describe ASDs. These are all taken from literature and medical or educational notes.

What’s in a name?

Kanner’s autism
Classical autism
Childhood schizophrenia
Asperger syndrome
Autistic features
Childhood psychosis
Lack of theory of mind
Pathological demand avoidance
Idiot savant
Pervasive developmental disorder
Pervasive developmental disorder – NOS (not otherwise specified) Central coherence difficulties
Semantic pragmatic disorder
Executive function deficit

The current terminology is ‘autistic (or autism) spectrum disorder/s’ (Wing, 1996).

Whatever the overarching label for the condition, there is a series of characteristics that are common to all – the triad of impairments (Wing, 1988) – three main areas of development where people with ASD manifest differences. These are:

• social interaction
• communication
• rigidity of behaviour and thought.

Social interaction

• Preference for individual activities
• Apparent aloofness
• Indifference towards others
• More adult-oriented than peer-oriented
• Likely to exhibit different spontaneous responses
• Passive acceptance of contact
• Lack of empathy
• Failure to appreciate significant others
• Poor understanding of social rules and conventions
• Inability to seek comfort at times of distress.

Wing and Gould (1979) believe that there is also a subgroup of three distinct character/behaviour types in social interaction.

Aloof

Describes those people with ASD who behave as if you are not there, do not respond to your interactions and lead you to the place or activity that they want rather than requesting it.

Passive

Those who are completely passive in their interactions with others, will accept interaction and become a willing ‘participant’.

Active but odd

Those who wish to have social contact but lack a means of initiating it in a socially appropriate way, so they may hold a gaze too long, sit too close or respond in an unpredictable way.

Communication

• Little desire to communicate socially
• Lack of understanding of non-verbal gestures of others
• Not appreciative of need to communicate information
• Idiosyncratic use of words and phrases
• Prescribed content of speech
• May talk at rather than to
• Poor grasp of abstract concepts and feelings
• Literal understanding of words and phrases
• Does not ‘get’ subtle jokes
• Will develop expression before understanding.

Rigidity of behaviour and thought

• May have stereotyped activities
• Can become attached to repetition of movement or certain objects or routines
• Complex order of activity
• Cannot deviate from one way of doing things
• May be tolerant of situations and then overreact to something minor
• May develop rituals that have to be completed
• Can have extreme physical rituals – e.g. spinning, rocking
• Can develop extreme behaviours to avoid certain stimuli.

These areas of difference in development have to be noted by the age of 3 years. Although there has been a greater willingness to diagnose young children in the last decade, many are not diagnosed until they are much older. A diagnostician will ask questions of parents/carers about their child’s development before the age of 3. Professional reluctance to diagnose early may frustrate the needs of parents who are already suspicious about their child’s development. However, the diagnosis is for a condition for which there is no known cure, so practitioners have to be absolutely sure that their assessment is accurate. Some of the characteristics of ASD could be the result of some other developmental delay. Chapter 2 deals with issues around diagnosis in more detail.

REFLECTIVE OASIS

Have you come across these characteristics in a child known to you?

How do these areas of impairment influence the way they relate to you?

Have you known a child who has not been diagnosed despite referral to a consultant?

What were their reasons for not diagnosing ASD?

Here are some common characteristics of people with ASD:

Social interaction

Limited tolerance of others

Inability to share or take turns

Inappropriate social behaviours

No desire to investigate or explore, unless it’s an interest

Lack of empathy for others

Inability to know what others are thinking or feeling

Socially aloof or awkward

Restricted interests

Simple social actions are often a complicated process (organising themselves, personal space, dialogue)

May know some social conventions and apply them rigidly

Communication

Understands some basic instructions

Expresses own needs

Lack of desire to communicate

Lack of understanding of the attempts of others

No shared enjoyment of social situations

No use of gesture, intonation, non-verbal expression and inability to understand use of these by others

Cannot respond spontaneously

Appears not to ‘hear’ what has been said

Limited conversation repertoire

Talks incessantly on topic of interest and can manipulate conversations round to this topic

Rigidity of thought and behaviour

Finds it hard to separate fact from fiction
Difficulty in social situations that require a spontaneous response
Repetitive quality to interactions and routines
Will copy but not necessarily understand
Inability to see cause-and-effect of their own behaviour
Holds black-and-white views
Doesn’t understand subtlety/sarcasm/jokes/irony
Cannot create spontaneously without a model or intensive input
May not transfer skills and concepts learned in one situation to other settings/people/topics

There is a general consensus of opinion that, in behavioural terms, there is no singular ‘autistic’ way of responding. These characteristics exist within all of us. The difference is that we ‘neurotypicals’ (NTs) ...

Table of contents

• Cover Page
• Title
• Copyright
• Contents
• Acknowledgements
• How to use this book
• 1 A guide to gaining a basic understanding of people on the autism spectrum
• 2 Identification and assessment
• 3 Family relationships
• 4 Partnership with parents
• 5 Multi-agency collaboration and service provision in the early years
• 6 Using a statutory framework to enhance service provision in the early years
• 7 Social skills training – self-help skills
• 8 Managing behaviour
• 9 Community involvement – helping young children to cope in the outside world
• 10 Alternative intervention and home-based programmes
• 11 Transition planning
• References
• Useful Websites
• Sources of information
• Glossary
• Index