'What is autism?' - An overview for teachers.
This piece was written as part of a 'Inclusion and Diversity' module whilst studying for the Professional Masters in Education.
What is autism?
Autism is a neurological, developmental disorder which affects how a person engages and makes sense of the world. It is defined by two main areas of impairments, called the Dyad of Impairments. The dyad comprises of impairments in social communication skills and the presence of restrictive and repetitive patterns of behaviour. It is used to describe the main areas of difficulty that all people with autism experience, to varying degrees. However, while people with autism share some difficulties in common, it is a spectrum disorder that affects every individual in a unique way.
In this post I will be providing an overview of autism, with a particular focus on social interaction, rigid and repetitive routine, and sensory processing.
Impairment in social communication and interaction
Impairment in social communication is a diagnostic criteria for autism (American Psychiatric Association, 2013) and can present in a spectrum of ways. One such way is a difficulty in recognising and understanding social cues. As people on the autism spectrum often struggle with reading social cues, they do not instinctively learn to adjust their behaviour to suit different social contexts. These difficulties can affect the ability of people with autism to interact with others, as they often do not know what to say or do in social situations (Hull et al., 2017). Those with high-functioning autism may have extensive vocabularies and possess an ability to talk about specific subjects in great detail. However, they can find it challenging to read other important tools of communication such as body language, facial expressions and tone of voice (Rubin and Lennon, 2004).
Impairment in social communication can also present as non-verbal communication. While most people with autism eventually begin to speak, there are some who remain non-verbal (Seltzer et al., 2004). Not being able to communicate their difficulties can lead to anxiety and frustration, which can manifest in an outburst of challenging behaviour. This behaviour can be self-injurious or physically challenging. As such, they require other methods of communication to be established. There are many forms of purposeful communication that non-verbal people with autism engage in, such as echolalia, gestures or augmentative and alternative communication systems, such as visual systems (Roberts, 2014).
Restrictive and repetitive patterns of behaviour
The world can present as an unpredictable place to people with autism. Repetitive behaviour, obsessions and routines can be a method of coping with the anxiety this creates. However, they can also limit a persons’ involvement in activities and interfere with learning and social situations. Higher-order repetitive behaviours include routines, rituals and intense and highly-focused interests. A person with autism can experience anxiety when faced with things that they have not experienced before. This can push a person them further into familiar territories, such as a fixed interest. These fixed interests may present as a focus on a particular topic or object.
As people with autism face difficulties with executive function, it can be challenging for them to think ahead. Creating a routine and using visual supports can be very beneficial. However, many people with autism view things as being ‘rigid’ (D’Cruz et al., 2013). They can find it difficult to consider alternatives or to accept when things are not as they expected. As a result, variations from the normal routine can cause distress and may lead to meltdowns.
Many people with autism experience sensory processing challenges. For these people the brain may be more sensitive to sensory inputs, slower to respond to sensory inputs or require additional sensory inputs. This varies greatly amongst people as every person with autism has a unique sensory profile. Those who are slower to process proprioceptive sensory input have poor coordination and awareness of their body. They can find slow movements more difficult, which can cause them to seek out more movement by fidgeting. Proprioceptive difficulties among children with autism have been shown contribute to decreased motor planning and postural control and disruptive behaviours that negatively affect their participation in daily tasks (Blanche et al, 2012).
Stimming (self-stimulatory behaviour)
To gain or reduce sensory input, self-stimulating behaviour can be comforting for people with autism. It helps them cope with challenges in their sensory processing in their daily lives by providing an outlet to self-regulate through (AsIAm, 2018). If a person with autism does not get an opportunity to self-stimulate and meet their sensory needs, they may withdraw or experience a meltdown. Certain types of self-stimulation can be self-harming. As it is often an involuntary response, it can be harder for them to control their behaviour. In addition to being a response to sensory input, this behaviour can be an expression of medical problem such as migraines. A person with autism may struggle to verbalise their discomfort and may engage in self-stimulation as a means of easing physical pain and internal anxiety, as well as expressing their emotions.
Autism is a lifelong developmental disorder, however there is a positive trajectory. About 1.55 in 100 students in Ireland have an autism spectrum disorder (NCSE, 2015), so it is vital teachers understand best practice in working with such students. By being able to identify how the Dyad of Impairments presents in a child, appropriate strategies can be formed to support their unique needs. By facilitating this in a classroom setting, the classroom becomes a safe space for the child. A space where they feel included and are enabled to develop.
For further reading, I recommend the 'School Handbook for Teachers' which was created by AsIAm.ie
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders : DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association.
AsIAm (2018). Stimming. [online] Available at: https://asiam.ie/stimming/ [Accessed 06 August. 2020].
Blanche, E.I., Reinoso, G., Chang, M.C. and Bodison, S. (2012). Proprioceptive Processing Difficulties Among Children With Autism Spectrum Disorders and Developmental Disabilities. American Journal of Occupational Therapy, 66(5), pp.621–624.
D’Cruz, A.-M., Ragozzino, M.E., Mosconi, M.W., Shrestha, S., Cook, E.H. and Sweeney, J.A. (2013). Reduced behavioral flexibility in autism spectrum disorders. Neuropsychology, 27(2), pp.152–160.
Hull, L., Petrides, K.V., Allison, C., Smith, P., Baron-Cohen, S., Lai, M.-C. and Mandy, W. (2017). “Putting on My Best Normal”: Social Camouflaging in Adults with Autism Spectrum Conditions. Journal of Autism and Developmental Disorders, 47(8), pp.2519–2534.
NCSE, 2015. Supporting Students with Autism Spectrum Disorder in Schools. NCSE Policy Advice Paper No. 5. Meath
Roberts, Jacqueline. “Chapter 3. Echolalia and Language Development in Children with Autism.” Communication in Autism, by Joanne Arciuli and Jon Brock, Amsterdam ; Philadelphia, John Benjamins Publishing Company, 2014, pp. 53–74.
Rubin, E. and Lennon, L. (2004). Challenges in Social Communication in Asperger Syndrome and High-Functioning Autism. Topics in Language Disorders, 24(4), pp.271–285.
Seltzer, M.M., Shattuck, P., Abbeduto, L. and Greenberg, J.S. (2004). Trajectory of development in adolescents and adults with autism. Mental retardation and developmental disabilities research reviews, [online] 10(4), pp.234–47. Available at: https://www.ncbi.nlm.nih.gov/pubmed/15666341 [Accessed 20 Aug. 2019].