Walking through the hallways of a local elementary school, it is likely that you will hear a scream or two. You may look around, trying to figure out where it came from. If a teacher from the school is nearby and you ask where the screaming is coming from, you will most likely get something similar to the following response, “Oh, that’s just the autistic class. They do it all the time.” Even the first grade students that attend the elementary school know that the screaming comes from the autistic classroom. If you’re a person who is familiar with educational laws, you will realize that there are laws requiring many students with disabilities, including autism, to be included into the regular classroom. You may wonder how that can be possible with autistic children who may scream intermittently throughout the school day. Perhaps you are a teacher, and you just found out that you will have a student with autism in your class. What is going to happen? What do you need to know to be able to give this student as well as the twenty other students the best possible learning environment? Here is what may happen if you have a student with autism in your classroom.
First of all, there will have to be an Individualized Education Plan (IEP), which is created by educational professionals, including yourself, the principal and/or guidance counselor, the child psychiatrist, a speech therapist, an occupational therapist, and many other professionals who are involved with this child, as well as the student’s parents. There will be a meeting which sets certain goals that should be attained by the student at the end of the school year. This meeting has the possibility of lasting several hours due to all that must be accomplished. During this meeting, the professionals involved will determine what accommodations need to be made in order for the student to succeed in a general education classroom. The IEP is a guide for all individuals responsible for teaching the child. If the child receives occupational therapy, it is stated in the IEP what the goals are and how often the child should receive this therapy. Perhaps a keyboard is necessary for communication, or a special seating arrangement so the child is able to see, or even a Teacher Support Staff (TSS) needs to be present in the classroom at all times.
A TSS is the most common of all accommodations. This is an adult who will work with the child throughout the school day, keeping him/her on task. A TSS is usually a big help in the classroom, because he/she will save the regular classroom teacher from having to stop class in order to redirect the student with autism. However, a TSS can occasionally be a hindrance, because the child may not listen to or may argue with the TSS. This has a tendency to cause a disruption for the rest of the class.
Besides a TSS, there are not very many ways in which a general classroom teacher receives help in dealing with a student who has autism. There are a variety of strategies that are becoming available through research, but every child is different and there isn’t a one size fits all strategy. A strategy needs to be individualized for the student, using what works and throwing out what doesn’t. I feel that in order for a teacher to be able to understand his/her student with autism, then the teacher needs to know what it is that affects the student. How can a teacher help a student if the teacher doesn’t understand what the student is dealing with? The teacher should have a general knowledge about what autism is and how it may affect the individual student.
DEFINITIONS OF AUTISM
When you begin to research autism, you will find that there are many different definitions of autism that exist in both medical and educational resource books. These definitions will begin to give you a general idea as to what behaviors or characteristics may be displayed within the classroom. The American Psychiatric Association has classified autism as a Pervasive Developmental Disorder (PDD) (Zager, 1999). Present research has led psychiatrists to believe that PDDs are neurological disorders which are based in the brain (Batshaw, et al., 1997). There are five syndromes that are included under the title of Pervasive Developmental Disorder. They are: autistic disorder, Asperger disorder, pervasive developmental disorder-not otherwise specified, Rett syndrome, and childhood disintegrative disorder. Autism is considered to be the most severe of the PDDs; however, individual cases can vary greatly in severity (Batshaw, et al., 1997). PDDs contain three common features that appear in the early years of life: impaired reciprocal social interaction; impaired communication skills; and restricted, repetitive, and stereotyped patterns of behavior, interests, and activities (Zager, 1999). All three of the features that are apparent in children with PDDs affect social interactions, potentially causing stress for the children, as well as those people who interact with the children.
Most of the current definitions of autism highlight the importance of the appearance of social and language deficits (Zager, 1999). If you were to read Cheryl Seifert’s book, Theories of Autism, you would see that autism is defined as a “sign of central nervous system damage, in which withdrawal and affectlessness are secondary symptoms (1990). The central nervous system damage is what causes the withdrawal and affectlessness to occur in children with autism. You may be wondering if all students who show withdrawal and do not seem to show emotion are autistic. If you look for the definition according to the United States Department of Education, you will find that it has defined autism as:
A disability significantly affecting verbal and nonverbal communication and social interaction, generally evident before age three, that adversely affects educational performance. Other characteristics often associated with autism are engagement in repetitive activities and stereotyped movements, resistance to environmental change or changes in daily routines, and unusual responses to sensory experiences. The term [autism] does not apply if a child’s educational performance is adversely affected primarily because the child has a serious emotional disturbance (Slavin, 2003).
This definition is reinforcing the fact that the emotional disturbance is the secondary symptom, second to the central nervous central damage. An emotionally disturbed child is not always a child with autism.
Another definition that I have found to be helpful is in the Handbook of Developmental Disabilities: Resources of Interdisciplinary Care, is:
Autism is a developmental disability that significantly affects verbal and nonverbal communication and social interaction. Associated characteristics often include repetitive activities, stereotyped movements, resistance to change and unusual responses to sensory stimuli (Kurtz, 1996).
I like this definition because it summarizes exactly what autism is and what its characteristics are without using medical jargon. This definition is important to a teacher because it states that autism is a “developmental disability” and that it “significantly affects verbal and nonverbal communication and social interaction.” A teacher who has a child with autism must be able to understand why a child with autism may or may not speak, or why he/she has difficulty with, or is not capable of, some social skills. Looking at this definition, it is clear that the child is not being difficult; he/she is demonstrating the characteristics of the disability.
HISTORY OF AUTISM
Autism is considered to be the most complex developmental disability, due to the many characteristics that are found within the autistic spectrum (Huebner, 2001). As was mentioned earlier, autism varies in severity in each individual, causing the need for an autistic spectrum to be created. The autistic spectrum ranges from very mild autism all the way up to very severe autism, with many variants in between. In order to better understand children with autism, it is important to know about the history of autism itself. It is necessary that the teacher know that the child is not entirely responsible for the characteristics he/she displays, but it is the autism that causes these characteristics; therefore, the more that is known about autism, the better able the teacher will be to accommodate the child who has autism. Educators who know the history of autism will be more aware of the characteristics that accompany the impairment, possibly allowing them to experiment more with different strategies. This experimentation with strategies enables the teacher to find more and better ways to include each individual student with autism in the general classroom in a way that helps them to become successful.
As you begin to research the history of autism, you will find in almost every book you read that autism is usually associated with the syndrome described by Leo Kanner, a child psychiatrist, in 1943. Kanner chose the term autism to emphasize the social deficits that are apparent in children with autism. Unfortunately, the term autism had been previously used to describe a withdrawal into fantasy in schizophrenia. This overlap caused some confusion, especially since autism and schizophrenia are not related (Zager, 1999). Autism differs from schizophrenia in phenomenology, genetics, and biological correlates. Autism and schizophrenia may appear to have similar symptoms, making careful assessment necessary in order to make a correct diagnosis (Huebner, 2001). Childhood schizophrenia is characterized by delusions, disorganized thinking, or hallucinations; all of these ‘symptoms’ develop later in childhood that the symptoms of autism (Huebner, 2001).
In his first description of autism, Kanner gave nine features which would identify a child as having autism: inability to develop relationships; delay in the acquisition of language; non-communicative use of spoken language after it develops; delayed echolalia; pronominal reversal; repetitive and stereotyped play; maintenance of sameness; good rote memory; and normal physical appearance (Aarons, 1992). These nine points were eventually reduced by Kanner to two essential features of autism: maintenance of sameness in children’s repetitive routines and extreme aloneness, with onset within the first two years (Aarons, 1992). Kanner’s original description of autism pointed out that children with autism show ‘extreme aloneness from the very beginning of life.’ Autistic children have been characterized with the following traits since 1943: isolated play, unusual language traits, insistence on ritual behaviors, and resistance to change; all of these traits are forms of characteristics that Kanner first described (Zager, 1999). Kanner’s description was a breakthrough, because, before Kanner, children with autism were thought of as psychotic or mentally deficient (Trevarthen, 1998).
As you continue to delve into the history of autism, you will notice that along with Kanner, Hans Asperger, an Austrian psychiatrist, was also discovering a form of autism. Maureen Aarons and Tessa Gittens stated in their book that at approximately the same time that Kanner was describing autism, Hans Asperger, recognized a pattern of abnormal behavior in a group of adolescents. Asperger called this pattern an autistic “psychopathy,” which means an abnormality of personality (Aarons, 1992). Both Kanner and Asperger used the word autistic to describe the marked problems with social interaction seen in the children they were studying (Huebner, 2001). They both appeared to be trying to connect autism to childhood schizophrenia, because the two disabilities seemed to share many of the same characteristics; however, as stated previously, they are two entirely different disabilities.
Researching farther into the history of autism, you will most likely find that there was another psychiatrist who played a major role in theorizing causes of autism. In Theories of Autism, it is stated that after Kanner’s original study, the majority of theories on autism came from the work of Bruno Bettelheim, a child psychiatrist. Bettelheim bases his theories on the similarities between the behaviors of autistic children and prisoners in German concentration camps. Some of the prisoners would show no reactions to the cruelest experiences, which, in Bettelheim’s mind, was the way autistic children defied their parents, who, he believed, had rejected their children. Bettelheim felt that autism develops after birth and was the result of cruel or careless parents. The child was presumed to have withdrawn from his/her home environment out of despair. Psychoanalytic constructs blamed parents for the deficits apparent in their child with autism. This blame caused many parents to feel incredible guilt, because they believed that they had done something wrong that had caused their child to withdraw from affection. According to Cheryl Seifert, Bettelheim’s theories were developed during a time when no one seemed to know what to do with autistic children, nor did they take much interest in them. In trying to exterminate the autistic behaviors, Bettelheim’s therapy was based on two principles: helping the child avoid everything that might reactivate memories form infancy, and encouraging self-initiated activity. His theory of autism as a psychosis was only a hypothesis, which has not been proven by any research. Seifert believes that Bettelheim had a tendency to empathize so completely with the children with autism that he elevated their condition to heroic proportions. Despite a lack of evidence, Bettelheim’s psychoanalytic theory was the basis of therapy offered to autistic children until the 1970s. This therapy recommended that the child be removed from his/her parents to a totally different environment (Seifert, 1990).
Temple Grandin, a woman with autism and also an expert on the subject, states that the old theory of autism, popularized by Bruno Bettelheim’s theories, places the blame on what was called the “refrigerator mother.” Now, it is believed that autism is caused by neurological abnormalities that cause the child to pull away from what most people consider normal touching and hugging, and not any cruel or cold actions of the mother. Grandin also feels that there is a possibility that secondary damage to the brain, which could be caused by a defective nervous system, also adds to the child’s retreat from comforting touches from the mother (Grandin, 1995). Touches that seem comforting to most children seem threatening and hurtful to children with autism, due to the supposed neurological impairments. Grandin recalls having clothing that she couldn’t bear wearing, because the material felt as though it was rubbing her skin raw. She felt that way because her nerves were extra-sensitive due to the neurological impairments (Grandin, 1995).
CHARACTERISTICS OF AUTISM
Once you are familiar with the history of autism, you should definitely do some research to find the common characteristics that children with autism exhibit. According to Scheuermann and Webber, characteristics of autism can be categorized as either behavioral excesses or behavioral deficits. Behavioral excesses are those behaviors that occur too often, such as tantrums, screaming, self-stimulation, self-abuse, echolalia, aggression, and refusal. Behavioral deficits are classified as those behaviors that do not occur enough. Some common behavioral deficits found in children with autism are receptive language, expressive language, communicative intent, social skills, self-care, compliance, attending, eye contact, work skills, play skills, and academic skills (Scheuermann, 2002). When working with a student with autism, it is important to determine what behavioral excesses and behavioral deficits the student has in order to help the student in social and academic situations. The IEP will most likely be beneficial, because it should include a report from the child psychologist, who will note some of these excesses and deficits. As a teacher, your job will be to help the student decrease his/her number of behavioral excesses and deficits. If a child has behavioral deficits in attending, academic skills, social skills, and compliance, then those are the major areas in which the student will need to improve in order to be successful in a regular education classroom.
The most commonly found symptoms of a child with autism are: no speech or abnormal speech, lack of eye contact, frequent temper tantrums, oversensitivity to touch, the appearance of deafness, a preference for being alone, rhythmic/stereotypic behavior, aloofness, and lack of social contact with parents and/or siblings (Grandin, 1995). Many of these behaviors can be distracting in the classroom, so it is important to begin working with the student in order to make the classroom situation more comfortable for all involved. If possible, it would be a good idea for you to inform peers about autism in a positive manner, so that they won’t ostracize the student with autism. It is important for the students in your class to understand why their peer behaves the way he/she does and that many times, that student is unable to control his/her own behavior.
In the book Autism and the Crisis of Meaning, Alexander Durig states that there are some core characteristics of autism. The first of these characteristics deals with inability to establish social relationships. Most children with autism are unable to interpret the emotions of other people. There is a large range of social abnormalities that are apparent in children with autism, including: unresponsiveness to people, lack of attention to people, seeing a body part (e.g. hand) as a detached object, lack of eye contact, treating people as inanimate objects, lack of behaviors that is culturally appropriate, likeliness to pay attention to the non-social aspects of a person (e.g. eye color), unaware of others’ feelings, and a lack of social perceptiveness (Baron-Cohen, 1993). Children with autism often have trouble making eye contact as well as physical contact. This makes face-to-face conversations frightening and intrusive in the mind of an autistic child, because most people try to maintain eye contact throughout a conversation (Durig, 1996). This inability to relate to other people in a social situation is the most well-known characteristic of autism (Baron-Cohen, 1993).
The child’s inability in regards to forming social relationships is demonstrated in a variety of ways: absence of smiling in social situations or the appearance of a smile or laughter without an apparent reason; lack of direct eye contact; preference for interaction with inanimate objects instead of with people; aversion to physical contact; inappropriate play behavior; no special recognition of familiar people; and no apparent desire to make friends (Scheuermann, 2002). As a teacher, you realize that social relationships are very important in an educational setting, especially due to the amount of cooperative learning that is done. After researching characteristics of autism, and finding all the information regarding the social problems that come with autism, you know that students with autism need to be able to gradually work their way to working with other students. If your students are aware of the problem, they will most likely be a big help when it comes to being patient and accommodating when working with a child with autism in groups. In my experience, children are very understanding when a person has a disability and can often see past it.
The second core characteristic of children with autism is impaired communication, according to Durig. Many children with autism have difficulties with pronominal language, causing them to speak of themselves in the third person (Durig, 1996). When holding a conversation with a child who switches pronouns around, another child may become very confused as to whom the child with autism is speaking about. You need to be aware of this difficulty in order to try and keep frustration to a minimum whenever possible. Students with autism have a hard time generalizing language from one situation to another (Durig, 1996).
Individuals with autism may have communication abilities ranging from totally nonverbal to superior reading and vocabulary skills (Scott, Clark, & Brady, 2000). Common language deficits found in students with autism are: concrete and inflexible language, the student does not share personal thoughts or feelings; lack of conversational flow; and inability to talk about topics that they find uninteresting (Scott, et al., 2000). Because of their inability to read body language and understand the meanings of vocal intonations, children with autism may feel anxiety when placed in a situation that requires them to interpret expectations or demands of others (Durig, 1996). In a classroom, a child is constantly surrounded by many other children and some adults. Body language is a huge factor in the classroom, and if the child is unable to read body language in order to understand when another child’s feelings are hurt, there is the possibility for major social problems to occur. If a TSS is not available for the child, you will be responsible for intervening and helping the child with autism to communicate as effectively as possible with his/her peers. If the student with autism is unable to comprehend the different intonations used throughout the school day, he/she will not know the differences between praising and scolding. Perhaps instead of using your voice, there could be signal that the student recognizes as telling him/her that he/she did well on a task (e.g. thumbs up) or he/she needs to work harder (e.g. thumbs down). This strategy will be much less frustrating for the student, because he/she will know what the signal means, but is less obvious to the other students in the classroom.
When it is necessary for a person with autism to speak to someone else, many times he/she will feel more comfortable using a telephone, because distracting visual input is eliminated (Grandin, 1995). In a classroom, however, it is impossible for the student to speak to his/her classmates, and the teacher, over a telephone. Instead of using a phone, eliminate as much visual stimuli as possible around the student’s seat, even if it means placing him/her slightly away from the class. This can be rationalized by the fact that it will make him/her more comfortable when communicating. Communication plays a key role in education. Students must be able to communicate effectively with teachers and other students. You need to be aware of the communication difficulties that are caused by autism and make accommodations that will work for the individual with autism. It may be easier for a student with autism to communicate through writing that face-to-face. It is necessary to remember that the students are your top priority, and it is your responsibility to do all that is possible, within reason, to help every one of your students to succeed.
You will find that there are many resources which discuss echolalia as a way in which many children with autism rely on echolalia to help them communicate in a social setting. It is important for you to understand echolalia and its benefits as well as its disadvantages to children with autism. Temple Grandin, an expert in the field of autism, feels that echolalia is a technique that helps individuals with autism understand what is being said and helps them to develop language skills (Grandin, 1995). The term echolalia means that the individual repeats words or phrases that someone else has said, using the exact same intonation, without actually understanding the conventional meaning (Scheuermannn, 2002). Echolalia occurs due to the child’s inability to respond independently linguistically and behaviorally in a social setting (Durig, 1996). There are three types of echolalia: immediate, which occurs when the child instantly repeats something that was just said; delayed, occurring when something the child heard at an earlier time is repeated; and mitigated, which is the repetition whit some unique variation, usually pronominal (Scheuermann, 2002). Echolalia, if present, could pose a problem, because other students may see it as copying and think that the student with autism is teasing, when, in reality, he/she is just trying to learn how to speak/behave in a social setting. When preparing your class for a child with autism, it might be worthwhile to discuss echolalia as a symptom of autism and explain that the child is just trying to learn the proper way to interact.
If you are a teacher in one of the younger grades, you will be concerned with actions outside of academically structured time; for example, during recess. How will your student with autism interact with the other children in a less-structured environment? Generally speaking, children with autism are unable to engage in normative peer interaction without being taught how to do so. Because children with autism must be taught how to play, playing with other children often becomes ritualized, instead of the imaginative and spontaneous play seen in children without autism (Durig, 1996). Children with autism have a tendency to require specific instructions in order to exhibit social reciprocity during play. Students with autism can be taught how to take turns and share during play through direct instruction, teaching the students to share with adults before sharing with other children (Scott, et al., 2000). In this way, children with autism are not unlike other children. Many young children need to be taught that it is important to share with other people.
Perhaps you would feel more comfortable if you were to pair your student with autism up with another student, one who is honest, caring, and reliable. It is important for you to learn about the ways in which students with autism may or may not interact with their friends. Students with autism tend to have a hard time finding and keeping up friendships, because friendships are based on shared interests and a willingness to share personal feelings. Keep in mind that students with autism have difficulty interacting when they are not interested in the subject and have a hard time sharing their personal feelings. The lack of communication skills present in most children with autism is another large problem when it comes to maintaining friendships (Scott, et al, 2000). Some children with autism may not understand spoken language, whereas their peers may not understand gestures that some children with autism may use, causing a type of language barrier (Grandin, 1995).
As you research the characteristics of autism, you will find that there are some children with autism who have amazing abilities. Within the autistic disorder, there is a peculiar pattern of intellectual abilities. While the constraining behavioral profile still applies, the intellectual and artistic abilities of some children with autism go beyond normative levels (Durig, 1996). According to Scott, Clark, and Brady, in their book, Students with Autism: Characteristics and Instructional Programming, an unusual characteristic that is found in a small number of children with autism appears as exceptional strengths, or “savant,” abilities. This savant group comprises of about ten percent of children and adults who are diagnosed with autism (Grandin, 1995). These savant characteristics may consist of calendar calculation, map recall, musical score memory, mathematical computation, or artistic abilities. Baron-Cohen defines calendar calculation as the ability to say on which day of the week any date will fall. Children with autism who have this ability appear to apply the rules governing a calendar automatically, seemingly unaware that they are doing so (Baron-Cohen, 1993). Many students with savant skills lack critical, basic functional skills involving social interaction, communication, and self-care. This causes educators to feel unsure of what they should focus on when working with the student with autism, further developing the student’s savant skills or developing the student’s social skills. An educator’s job is to empower the student to empower his/her students to become more productive and independent members of society; therefore, the educator must further develop the student’s savant skills as well as develop the student’s social skills (Scott, et al, 2000). In order to fully include a student who has savant skills, it would be beneficial to make sure he/she knows how great his/her abilities are and incorporate them into the classroom. There may be ways to combine working on social skills as well as savant abilities.
One of the most noticeable characteristics of autism is repetitiveness. Throughout the history of autism research, this characteristic is the most difficult to explain (Durig, 1996). Students with autism may attract attention for their repetitive behaviors. They are very likely to resist change and want to remain in the same routine for every day. Something such as changing seats, which usually occurs once every one or two months in an elementary classroom, can be very upsetting for a student with autism, because they do like the repetitiveness and the sameness. Playing a game may result in the same ending every time, again because of the repetitiveness. Having lunch at a different time or having a late start upsets the student’s schedule and also the student. If changing seats causes the student to become agitated, can you imagine what it must be like to change schools or classrooms or teachers? Every year the student will probably have to undergo changes within his/her school. Temple Grandin used the picture of walking through a doorway to represent the change that was occurring when she graduated from high school. She told herself that she was just walking through a doorway (Grandin, 1995).
Now that you are familiar with the definition, history, and characteristics of autism, you are ready to include a child with autism into your classroom. Including a child with autism in your classroom is possible. It really can be done. No matter how difficult it may seem, there are many ways to make it work. You will have many people supporting you both in the school and out. There are several books that discuss ways in which to include a child with autism. Glancing through them to get ideas might help you feel more comfortable with having a student with autism in your classroom, as long as you remember that each student is different, and there is not a one-size-fits-all guide to including a child with autism in your classroom. You have to try different things, and not everything will work. If you find something that doesn’t work, you can either throw it out or alter it so that it does work. You are now familiar with the background of the disability, which will be a big help in understanding what this student is going through.
Baron-Cohen, S., & Bolton, P. (1993). Autism: The facts. NY: Oxford University Press Inc.
Durig, A. (1996). Autism and the crisis of meaning. Albany, NY: State University of New York Press.
Grandin, T. (1995). Thinking in Pictures: And Other Reports From My Life With Autism. New York: Vintage Books.
Huebner, R.A. (2001). Autism: A sensorimotor approach to management. Gaithersburg, MD: Aspen Publishers, Inc.
Scheuermann, B., Webber, J. (2002). Autism: Teaching does make a difference. Stamford, CT: Wadsworth Learning.
Scott, J., Clark, C., & Brady M.P. (2000). Students with autism: Characteristics and instructional programming for special educators. San Diego, CA: Singular Publishing Group.
Seifert, C.D. (1990). Theories of autism. Lanham, MD: University Press of America, Inc.
Trevarthen, C., Aitken, K., Papoudi, D., & Robarts, J. (1998). Children with autism: Second edition.. Philadelphia, PA: Jessica Kingsley Publishers.
Zager, D. B. (Ed.). (1999). Autism: Identification, Education, and Treatment. Mahwah, NJ: Lawrence Erlbaum Associates, Publishers.