Autism

Autism spectrum disorder (ASD) and autism are both general terms for a group of complex disorders of brain development. These disorders are characterized, in varying degrees, by difficulties in social interaction, verbal and nonverbal communication and repetitive behaviors.

ASD can be associated with intellectual disability, difficulties in motor coordination and attention and physical health issues such as sleep and gastrointestinal disturbances. Some persons with ASD excel in visual skills, music, math and art.

The exact causes of autism are not yet understood but researchers believe genetic, environmental and neurological factors play a part.

In fact autism is probably not one single condition but encompasses a group of disorders that have their roots in a variety of different causes, but which result in similar problems.

Researchers are examining a number of specific genes that could contribute to the disorder. It's likely that autism occurs when a small number of genes interact in a specific way, possibly linked to some external event or factor.

The genetic link means a predisposition to autism may be inherited and can run in families. Brothers or sisters of a child with the condition are 5-6% more likely to develop it themselves.

A variety of other environmental factors that affect development before, during or soon after birth, may also play a part.

Researchers believe that if a child is exposed to certain situations it may trigger the disorder. These potential triggers include if the mother has an infection or smoked during pregnancy and if the father is over 40 years old.

Despite reports suggesting a possible link between MMR vaccination and autistic spectrum disorders, scientific evidence has confirmed the vaccination does not increase the risk.

 

Supporting Assessment

Observations recorded by early years practitioners can provide invaluable information to those professionals involved in the diagnostic process, especially if these observations focus on the three areas of the ‘Triad’.

 

When observing a child’s social interaction skills, practitioners will look out for whether they:

● return your smile

● spontaneously bring things of interest to show you

● come for comfort when upset

● can take turns in simple games

● get upset, or walk away, if others come close to them

● ever make the first move to seek interaction with others.

 

When observing a child’s social communication skills, practitioners will notice whether they:

● follow your gaze when you look at something across the room

● Point out things of interest (not just things they want)

● look towards something you are pointing out

● use social gestures – a nod, a wave, a shake of the head

● understand your gestures and facial expressions

● engage in two-way communication, naturally filling gaps with their own sounds or words

● ever mix up pronouns, perhaps saying, “He wants some juice” rather than, “I want some juice.”

 

Practitioners will judge the extent to which the child’s behaviour is flexible by noting whether:

● genuine pretend play is present – rather than the repetition of the same sequence of actions over and over

● they ‘allow’ others to get involved in their play, perhaps changing the game slightly

● there is any insistence on certain routines – and distress if things happen in the ‘wrong’ order

● there is unusual sensory sensitivity – perhaps the sniffing toys or overreaction to sudden noises

● hands or fingers are moved in an odd or unusual way – for example, flapping or flicking.

 

As with all assessments, practitioners will take into account the child’s developmental level and the context of the observations.

 

Developmental Impact

A child on the autism spectrum has a different way of seeing and interpreting the world. This inevitably has an impact on the way they learn and interact. It’s useful for early years practitioners to consider three main areas.

From the perspective of the young child on the autism spectrum:

People are perplexing
Most typically, developing children have, by the age of four, become aware that other people have thoughts and feelings that may be different from their own. The young child on the autism spectrum may never realise this. This presents them with huge difficulties in ‘reading’ people. If you can’t make sense of people and find them unpredictable, this can be terrifying – leading to avoidance of social situations.

For example: Bertie used to love listening to music. When the music stopped, he just stood beside the CD player wailing. He didn’t realise that he had to go and ask Mum to change the CD.

 

The known is comforting, the unknown is terrifying
Young children with autism find it difficult to make connections, leading to problems in generalising skills learnt in one situation to another context. If connections aren’t obvious, everything seems new and frightening – no wonder they have a preference for the familiar.

For example: Ella, who’d been attending nursery for over a year, arrived one day and became inconsolably distressed. It took some time before staff realised that Ella’s upset was because they’d repositioned some items of furniture. Although a minor change as far as the other children were concerned, it had rendered the nursery unrecognisable to Ella – hence her terror.

 

This is my focus; I don’t know that your focus is different
When working with very young children, two commonly used strategies are to gain joint attention and to get the child to imitate. The young child on the autism spectrum often has an idiosyncratic focus of attention and will have no idea what you want them to look at – let alone be able to imitate. This is the case even when the child appears to be paying attention.

For example: Izzy was sitting amongst a group of children at storytime, looking towards the book. When asked, she had no idea what the story had been about, but she knew how many telegraph poles she’d seen in the pictures.

 

How Can We Help?

Early years practitioners are likely to be just one of a number of agencies involved in helping the child and supporting their family. It is in the child’s best interests if all these agencies work closely together. Within the setting, this will be coordinated by the SENCo.

 

Within the EYFS, practitioners can help the young child on the autism spectrum by:

● following the child’s lead, seeing what interests them, sitting beside them, then gradually sharing the activity

● slowly introducing other children, one at a time, to the activity – modelling and prompting turn-taking

● structuring activities so that the child’s role is obvious

● specifically teaching imitation skills

● giving clear visual clues to help prepare the child for changes

● creating situations which could prompt the child into using their language communicatively – for example, ‘forgetting’ to give them a straw for their milk carton

● exaggerating gestures and facial expressions to emphasise their meaning

● using photos and videos to help children recall tasks they’ve completed previously – helping them to connect episodes of learning.

 

The most fundamental thing we can do is to try to see the world as the child sees it – to understand their perspective. In this way, we can begin to present the world in a way which will help them to make sense of it, thus minimising stress and maximising learning.

Further Information

 

The National Autistic Society: www.autism.org.uk

 

Talk about Autism: www.talkaboutautism.org.uk

 

Autism Education Trust: www.autismeducationtrust.org.uk

 

The Autism Research Centre: www.autismresearchcentre.com

 

Research Autism: www.researchautism.net

 

Autistica: www.autistica.org

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