How can we identify and support students with autism spectrum disorders?
Autism Spectrum Disorder (ASD) is a developmental disorder whose symptoms include a lack of social skills, difficulties with language and communication, and repetitive behavioral patterns.[i] ASD diagnoses have increased significantly over the past several decades and currently affect 1 in 68 children.[ii] The condition is about 4.5 times more common in boys and can affect boys and girls differently.[iii]
ASD starts in early childhood (ages two to four) and lasts throughout life.[iv] While there is no known cure, there are therapies and strategies that can build skills and increase functioning. Because people with ASD behave, interact, and perceive the world in unique ways, they often learn differently than other children. They also need special support aimed at addressing the deficits caused by their ASD.
Some people with ASD can function at the same level as their peers and perform well academically, while others are severely disabled and require extensive support.[v] Furthermore, as children with ASD age, some skills may improve while others remain impaired.[vi] While 46% have average or above average intelligence, intellectual ability varies widely across the spectrum.[vii] Just as importantly, 83% of children with ASD have another developmental or neurological disorder such as intellectual disability, mood disorder, obsessive compulsive disorder, anxiety, or psychosis.[viii]
Early in their development, most children begin to realize that other people have thoughts, feelings, and perspectives that are different from their own.[xiv] With this concept of theory of mind, they pick up the ability to intuit the mental states of other people based on verbal communication and nonverbal cues like tone of voice and facial expression.[xv] Because children with ASD lack theory of mind, they often have trouble intuitively understanding what other people are thinking and feeling.[xvi] Teachers of students with ASD should be intentional and explicit in their communication and aware that their attempts to communicate may be received differently than they would be by other children.
Applied behavior analysis (ABA) is a therapy that uses positive reinforcement to teach students with ASD skills and behaviors that can help them function more easily in society and perform better in school.[ix] For example, ABA rewards certain social behaviors, such as focusing on another person during conversation, that do not develop naturally in children with ASD. Research has found that ABA can improve vocabulary skills, non-verbal IQ, and other cognitive and communication skills.[x] ABA is most effective when it is started early in childhood, continued for a minimum of two years, delivered intensively (as much as 40 hours a week), and includes caregivers in treatment.[xi]
Educational programs should be designed by experts to address the unique learning needs of children with ASD.
Educational programs for children with ASD should be designed in conjunction with trained professionals who can support both the students and educators. Since autism is a spectrum disorder, what works for one student may not work for another student. Research suggests that programs are most effective when both the instruction and learning environment are highly structured, with clear goals, regimented schedules, and thorough planning[xii]; however, it is important that each student be considered on an individual basis. Successful programs involve families and provide both curricular content and learning supports tailored to the needs and challenges of each child.[xiii] They also use a functional approach to problem behavior that looks at root causes and uses proven techniques for behavior change. Evidence-based strategies, such as those articulated through the National Professional Development Center on ASD, can be useful guides for designing school-based programs.
Raising a child with ASD has been linked to elevated levels of stress among parents of both younger and older children.[xvii] One study found that mothers of children with ASD had higher levels of stress than mothers of children with other kinds of developmental disabilities.[xviii] Informal social support from family, friends, and other families with children with ASD is associated with reduced parental stress, increased optimism and psychological well being, and lower levels of depression.[xix] Outcomes for parents and children are interconnected: when parents experience less stress they can offer more support for their children, and, conversely, when children with ASD have improved functioning, this can reduce parental stress. For example, sleep difficulties are common in children with ASD and can negatively affect their daytime behavior. Sleep interventions that improved the sleep patterns and daytime behavior of children with ASD were also found to improve family functioning and reduce parental stress.[xx]
Autism & Cognition
The Autism & Cognition subtopic explores how autism influences brain development, thinking processes, and emotion.
Autism & Behavior
The Autism & Behavior subtopic includes research about behaviors of people with autism and/or intellectual disabilities.
Autism & Communication Skills
The Autism & Communication Skills subtopic explores the development of language and communication skills among children with autism.
Autism & Social Skills
The Autism & Social Skills subtopic includes research on how children with autism develop social skills and engage in social interactions, and interventions that can be used to improve social skills.
Autism & Families
The Autism & Families subtopic describes the experiences of parents and families of children with autism spectrum disorders, and/or other developmental or intellectual disabilities. Several studies in this subtopic focus on parent/family stress.
Autism & Intervention Programs
The Autism & Intervention Programs subtopic includes research on community and school-based behavioral, social, and psychological interventions for children with autism spectrum disorders and their families.
Genetic Disorders & Development
The Genetic Disorders & Development subtopic explores how genetic disorders such as Fragile X and Williams Syndrome affect a child’s behavior and development.
Autism & Sensory Processing
The Autism & Sensory Processing subtopic describes how individuals with autism engage in sensory processing, which is how the brain organizes information gathered through the senses and uses it to direct action and behavior. It also includes studies on how autistic individuals’ sensory processing relates to their participation in home and school activities, and related interventions.
Autism & Other Conditions
The Autism & Other Conditions subtopic explores research on the experiences of individuals with autism and additional mental health issues.
[i] The association between the social and communication elements of autism, and repetitive/restrictive behaviours and…[Review] Kuenssberg R, Mckenzie K, Jones J in RES DEV DISABIL (2011)
[ii] Centers for Disease Control and Prevention (2015). Autism Spectrum Disorder (ASD). Accessed March 27, 2016 from http://www.cdc.gov/ncbddd/autism/data.html.
[iii] Centers for Disease Control and Prevention (2015). Autism Spectrum Disorder (ASD). Accessed March 27, 2016 from http://www.cdc.gov/ncbddd/autism/data.html.
Review of gender differences in core symptomatology in autism spectrum disorders [Review] Rivet TT, Matson JL in RES AUTISM SPECT DIS (2011).
[iv] Early Identification of Autism Early Characteristics, Onset of Symptoms, and Diagnostic Stability [Review] Webb SJ, Jones EJH in INFANT YOUNG CHILD (2009)
[v] Standardizing ADOS Scores for a Measure of Severity in Autism Spectrum Disorders[Article] Gotham K, Pickles A, Lord C in J AUTISM DEV DISORD (2009)
[vi] Do Autistic Symptoms Persist Across Time? Evidence of Substantial Change in Symptomatology Over a 3-year Period in…[Article] Pellicano E in AJIDD-AM J INTELLECT (2012)
Autism after adolescence: Population-based 13- to 22-year follow-up study of 120 individuals with autism diagnosed in… [Article] Billstedt E, Gillberg C, Gillberg C in J AUTISM DEV DISORD (2005)
[vii] Centers for Disease Control and Prevention (2015). Autism Spectrum Disorder (ASD). Accessed March 27, 2016 from http://www.cdc.gov/ncbddd/autism/data.html.
[viii] Levy, Susan E., et al. “Autism spectrum disorder and co-occurring developmental, psychiatric, and medical conditions among children in multiple populations of the United States.” Journal of Developmental & Behavioral Pediatrics 31.4 (2010): 267-275.
Leyfer, O. T., Folstein, S. E., Bacalman, S., Davis, N. O., Dinh, E., Morgan, J., … & Lainhart, J. E. (2006). Comorbid psychiatric disorders in children with autism: Interview development and rates of disorders. Journal of autism and developmental disorders, 36(7), 849-861.
Matson, J. L., & Nebel-Schwalm, M. S. (2007). Comorbid psychopathology with autism spectrum disorder in children: An overview. Research in developmental disabilities, 28(4), 341-352.
[ix] Matson, J. L., Turygin, N. C., Beighley, J., Rieske, R., Tureck, K., & Matson, M. L. (2012). Applied behavior analysis in Autism Spectrum Disorders: Recent developments, strengths, and pitfalls. Research in Autism Spectrum Disorders, 6(1), 144-150.
[x] Peters-Scheffer, N., Didden, R., Korzilius, H., & Sturmey, P. (2011). A meta-analytic study on the effectiveness of comprehensive ABA-based early intervention programs for children with autism spectrum disorders. Research in Autism Spectrum Disorders, 5(1), 60-69.
[xi] Peters-Scheffer, N., Didden, R., Korzilius, H., & Sturmey, P. (2011). A meta-analytic study on the effectiveness of comprehensive ABA-based early intervention programs for children with autism spectrum disorders. Research in Autism Spectrum Disorders, 5(1), 60-69.
Matson, J. L., Turygin, N. C., Beighley, J., Rieske, R., Tureck, K., & Matson, M. L. (2012). Applied behavior analysis in Autism Spectrum Disorders: Recent developments, strengths, and pitfalls. Research in Autism Spectrum Disorders, 6(1), 144-150.
A comparison of intensive behavior analytic and eclectic treatments for young children with autism [Article; Proceedings Paper] Howard JS, Sparkman CR, Cohen HG, Green G, Stanislaw H in RES DEV DISABIL (2005)
Parent inclusion in early intensive behavior interventions for young children with ASD: A synthesis of meta-analyses…[Review] Strauss K, Mancini F, Fava L in RES DEV DISABIL (2013)
[xii] Iovannone, R., Dunlap, G., Huber, H., & Kincaid, D. (2003). Effective educational practices for students with autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, 18(3), 150-165.
[xiii] Iovannone, R., Dunlap, G., Huber, H., & Kincaid, D. (2003). Effective educational practices for students with autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, 18(3), 150-165.
[xiv] Intuition and autism: a possible role for Von Economo neurons [Review] Allman JM, Watson KK, Tetreault NA, Hakeem AY in TRENDS COGN SCI (2005)
[xv] Baron-Cohen, S., Leslie, A. M., & Frith, U. (1985). Does the autistic child have a “theory of mind”?. Cognition, 21(1), 37-46.
Lee, H. J. (2011). Cultural factors related to the hidden curriculum for students with autism and related disabilities. Intervention in School and Clinic, 46(3), 141-149.
[xvi] Baron-Cohen, S., Leslie, A. M., & Frith, U. (1985). Does the autistic child have a “theory of mind”?. Cognition, 21(1), 37-46.
Theory of Mind in Adults with HFA and Asperger Syndrome [Article] Spek AA, Scholte EM, Van Berckelaer-Onnes IA in J AUTISM DEV DISORD (2010)
Baron‐Cohen, S., Jolliffe, T., Mortimore, C., & Robertson, M. (1997). Another advanced test of theory of mind: Evidence from very high functioning adults with autism or Asperger syndrome. Journal of Child Psychology and Psychiatry, 38(7), 813-822
[xvii] Davis, N. O., & Carter, A. S. (2008). Parenting stress in mothers and fathers of toddlers with autism spectrum disorders: Associations with child characteristics. Journal of autism and developmental disorders, 38(7): 1278-1291.
[xviii] Estes, A., Munson, J., Dawson, G., Koehler, E., Zhou, X. H., & Abbott, R. (2009). Parenting stress and psychological functioning among mothers of preschool children with autism and developmental delay. Autism, 13(4): 375-387.
[xix] Ekas, N. V., Lickenbrock, D. M., & Whitman, T. L. (2010). Optimism, social support, and well-being in mothers of children with autism spectrum disorder. Journal of autism and developmental disorders, 40(10): 1274-1284.
[xx] Malow, B. A., Adkins, K. W., Reynolds, A., Weiss, S. K., Loh, A., Fawkes, D., Katz, T., Goldman, S.E., Madduri, N., Hundley, R., & Clemons, T. (2014). Parent-based sleep education for children with autism spectrum disorders. Journal of autism and developmental disorders, 44(1): 216-228.