Classroom Practices to Help Children with Autism

An essay about children with autism

The term ‘epidemic’ has been used to describe the increasing prevalence of children with Autistic Spectrum Disorder across Northern Ireland (Lui, King and Bearman, 2010). Cases of Autistic Spectrum Disordered have significantly doubled over the past decade as highlighted in statistics published by Waugh (2016). Morrier, Hess and Heflin (2011) acknowledge that a compelling number of cases of ASD have become increasingly more challenging with a pervasiveness of dual-diagnosis alongside considerably complex and specific needs. However, although there is greater awareness of ASD, there is still much misunderstanding and lack of support as many children remain with underlying and unaddressed behaviours leading to increasingly more cases of severe and challenging behaviours amongst children with a diagnosis of ASD (Safran, 2011). Defining Autistic Spectrum Disorders has rapidly evolved and led to many debates among researchers since its earliest studies by Kanner and Asperger (Lord and Jones, 2012). The current definition of ASD most commonly used upon diagnosis comes from the fifth Diagnostic and Statistical Manual of Mental Disorder (APA, 2013) defines Autistic Spectrum Disorders into two domains “social communication and restrictive and repetitive behaviours”.

The appropriate term of diagnosis for ASD is continently under evaluation as researchers continue to define Autistic Spectrum Disorder since the early work of Kanner and Asperger. The ‘atypical pattern of development’ displayed by those with ASD, has led to rapidly evolving definitions and much confusion regarding the terminology used for diagnosis upon diagnosis amongst educators, parents and physicians and psychologists (Phetarasuwan, Miles and Mesibov, 2009, pg. 206). The definition of the term ‘Autistic Spectrum Disorder’ was devised as an ‘umbrella term’ to describe children who displayed behaviours of classic autism and Asperger’s Syndrome.

The Camberwell Study by Wing (1979) classified a group of children who demonstrated Asperger’s criteria of high functioning autism, Kanner’s criteria of ‘classic autism’ and a group who demonstrated a mix of the both Asperger’s and Kanner’s criteria. The terminology of the ‘triad of impairments’ linked all three of these groups together (Wing, 2002), namely, the impairment of social interaction, impairment of social communication and impairment of social imagination (Wing, Gould and Gillberg, 2011, pg. 768 – 769).  All three of these impairments became the criteria upon which the DSM IV  (1994) developed their definition of Autistic Spectrum Disorder around diagnosing a child based on their behaviour and development surrounding these impairments. Recently, the publishing of the DSM V (APA, 2013) merged the three triads of impairments into two domains for defining and diagnosing ASD in children as ‘social communication and repetitive behaviours (Lord and Jones, 2012).

In Northern Ireland, statistics extracted by Waugh (2016) noted that there had been an increase of double the number of children diagnosed with ASD. Figures from the Northern Ireland School Census in 2015/2016 support the statistic by Waugh as 2.3% of children at school had been diagnosed with ASD, whilst in 2008/2009 figures displayed that only 1.2% of children were diagnosed with the disorder (Waugh, 2016, pg.4). These figures highlight a clear increase in the prevalence of ASD diagnosis amongst children in schools across Northern Ireland, illustrating a greater increase of the awareness of ASD across the population (NAS, 2016).  It is important for professionals and parents that testing used to diagnosis ASD in children is used for the best interest of the child and to benefit the child’s needs rather than a false diagnosis which will inhibit the child to reach their full potential (Lange, 2012). There are two tests that can be used as part of an early intervention approach to diagnosis children with ASD, the Checklist for Autism in Toddlers (CHAT), which is used when a child is between 18 – 24 months to extract information and behaviour that may lead to a social communication disorder (Iwata, DeLeon and Roscoe, 2013, pg. 271).  Related professionals may use Function Analysis Screening Tool (FAST) to extract information regarding exhibited behaviours to gain information on consequent events that correlate with the occurrence of problem behaviours (Iwata, DeLeon and Roscoe, 2013, pg. 271).    In recent years there has also been research surrounding brain tests and blood tests in diagnosing children with ASD however researchers argue that there needs to be large, longitude studies conducted for more validity and assurance for biological testing (Lange, 2012). Lange (2012) argues that “until it’s solid biological diagnosis is found, any attempts to use brain imaging to diagnose autism will be futile”.  The importance of testing children for ASD early when traits and behaviours are exhibited should be used to best meet the child’s needs and provide a range of appropriate strategies and providing effective intervention to help a child who receives a diagnosis as early as possible (Beck and McMurray, 2010).  This is theory is supported by trials conducted by Rogers and Vismara (2008) noted that early intervention programmes were “beneficial for children with autism, often improving developmental functioning and decreasing maladaptive behaviours and symptom severity at the level of group analysis”.

Children spend at least twelve years in formal education, therefore, for children with ASD their surrounding can become a throng of bewilderment through the difficulties faced during social interaction and their vulnerability to the range of stimuli they face every day (Jolliffe 1992, cited Howling 2004). Therefore, outbursts of challenging behaviour can be expected as children with ASD struggle to express their thoughts and feelings through communication difficulties, lack of understanding and familiarity of their surroundings and situations leading to high-levels of anxiety (Kietz and Dunn, 1997). In 1996 the Department for Education in Northern Ireland through the Code of Practice noted that children’s needs must be addressed as early as possible, supporting this theory with “the earlier that action is taken, the more responsive the child is likely to be”.  On the contray to this view research by Zager et al. (2012) as successful interventions for pupils with ASD are based on the teacher’s ability to address adapt and apply a variety of approaches based on pupils’ individual needs. Evidence has proven that early intervention can help a child with ASD behave more appropriately in their surroundings with a range of strategies and intervention programmes, however, each child with ASD exhibit different behaviours, demonstrate different difficulties with social communication and unique sensory issues, therefore each case of ASD is individual for each child (Maran, 2005). In turn, what may prove to be a successful intervention with one child, may not suffice for another, as each child requires different needs to be met (Rogers and Vismara, 2008).  Consequently, as an educator of pupils with special educational needs, each intervention programme and range of strategies put in place to address the needs of a child with ASD are specific, appropriate and individual to each child based on their needs and in the child’s best interest, anticipating a greater level of response than exclusively the age of the child. Twenty years on since the publication of the Code of Practice, educators and relevant professionals now have a greater understanding and knowledge of the needs, inhibitors and difficulties faced by children with ASD (Beck and McMurray, 2010). Teachers have an integral role in the lives of all pupils, but in particular pupils with ASD as it is critical for teachers to employ a range of assessments through formative and summative assessment, observations and communication with parents for early indicators and identification of difficulties faced by children with ASD (DENI, 1998). Coincidently, the importance of early intervention is brought to surface when addressing the needs for children with ASD, as the Code of Practice (DENI, 1998) notes that it is the role of the teacher in the first stage of the five-stage approach to “identify and register a child’s special educational needs” in preparation for appropriate and effective intervention. As Waugh (2016) highlights the increasing prevalence of ASD across Northern Ireland and the more challenging cases that arise throughout mainstream and special schools, it has become more problematic for teachers alone to contrive the needs of pupils with ASD (Morrier, Hess and Heflin, 2011). However, The Task for Autism (DENI, 2002, pg. 20) highlight the importance of a ‘Multi-Displinary Approach” to provide the most appropriate and effective programmes of intervention for children with ASD.  Implementing this theory into practice, the author has had experience teaching children with ASD and therefore devising individual educational planners (IEP) to invoke an effective plan to meet the needs of pupils with ASD and implementing a ‘Multi-Disciplinary Approach’. The author found for the best response from an implemented programme, working alongside occupational therapists in the planning process opened up greater insight into the sensory needs of children with ASD. This practice is supported by Baranek (2002) who highlighted that the modulation and ability to process sensory input would in turn have a positive effect on the child’s behaviour and ability to learn. Furthermore, the involvement of speech and language therapists brought to light appropriate and effective practice for developing children with ASD social communication, social interaction and play skills. The execution of this approach is supported by the General Teaching Council for Northern Ireland (GTCNI) (2007, pg.45) as teachers must “work with colleagues and others to create a professional community that supports the social, intellectual, spiritual/moral, emotional and physical development of pupils”.

The association between ASD and sensory processing difficulties was brought forward by the work of Dr. Jean Ayres, who outlined the seven sensory systems as “tactile, vestibular, proprioceptive, olfactory, gustatory, visual and auditory” (Ayres, 2005). The theory of ‘Sensory Integration’ was coined to explore how difficulties experienced by the sensory stems can affect the regulation and modulation of human behaviour (Ayres, 2005), which research and literature pose sensory processing as an integral factor in human behaviour (Dunn, 2007).  One of the earliest links between sensory issues and ASD was by Mesibov et al. (2004) highlighted that “many children with autism had abnormal responses to visual, vestibular and auditory stimuli”.  The author concurs with this theory however from practice-based experience, children with ASD in a classroom environment also demonstrate abnormal responses to olfactory, gustatory, proprioceptive and vestibular sensory stimulation.  Saunders (2005) highlights that difficulties with sensory processing can affect a child’s ability to partake in “daily life tasks at home and in school”. Moreover, the difficulties experienced by children with ASD and abnormal sensory processing can lead to anxiety, decreased social skills, poor attention, low self-esteem and poor motor skill development (Saunders, 2005). Coincidently, these challenges due to sensory issues can interfere with a child’s engagement in learning and social activity (Maran, Rubin and Laurent, 2005), as the severity of hypo- and hyper- sensitivities experienced by a child with sensory processing difficulties can restrict them for accessing the curriculum (Middletown Centre for Autism, 2016).  From classroom experience working with a pupil who has a very under stimulated sensory system with hypo-sensitivities, observations have shown the behaviours of this child to coincide with the above theory highlighted by Middletown Centre for Autism (2016).  This child demonstrates behaviours that are very lethargic, quiet with poor communication skills to express their needs and wants, very little energy leading to inattention and low mood/mood swings demonstrating low self-esteem.  However, as a teacher and by implementing theory into classroom practice with the guidance and advice from an on-site occupational therapist, strategies have been put in place in the form of a sensory diet performed by the pupil daily. This sensory diet implements a range of strategies to meet the child’s sensory needs and arouse their sensory system by providing them with stimulation to help this child overcome their lack of arousal and therefore reduce the challenges faced by the child as highlighted by Saunders (2005).  Therefore, this example of classroom practice highlights the significance of educators and relevant professionals working with children with ASD, demonstrating the need for awareness and appropriate practice to address and effectively plan interventions to alleviate sensory difficulties for pupils to enable children with ASD to access the full curriculum (Beck and McMurray, 2010).

Bibliography

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