Helping the autistic child

Although some people who have autism appear to improve as they get older their symptoms often appear to worsen during adolescence. Neither observation is surprising as many skills can be learned by repeated practice and adolescence is a time of emotional change, something the autistic is not well equipped to handle.

Any help given to the autistic child will need to be focused on developing speech skills especially in the areas of communication, social and thinking skills.

General Skills

Children with autism do not learn by observation like most other children. They need to be taught skills tasks in a directed and unambiguous way. Some activities may need the physical prompt of the teacher's hand over the child's as they are shown what to do. Repetition will usually be necessary.

Skills learned in one context will not necessarily be used in new situations. Teaching of any skill needs to be repeated in as many ways as possible of the situations where the child may need to use that particular skill.

Care needs to be taken not to confuse or overload the child with information and stimulation. Learning situations need to be well defined, distinct from other situations, have a clear start and a definite end. This kind of precision in planning will minimise the potential for confusion and anxiety. However care must be taken not to over emphasise predictability as this can lead to fear of change. Careful variation of how experiences are presented can widen the experiences and avoids inappropriate routines or repetitive behaviours. Similarly careful advance warnings of changes in events and activities can avoid some of the problem.

The autistic often needs more time to process information. Sometimes it can seem as if the child has given up or doesn't understand the task. While understanding may be weak it is the time spent which needs patience and additional support. Repeating the information, perhaps in a different form, may help.

Communication Skills

Language learning may be delayed and the child's language may also be distorted. Therefore many autistic children will be receiving speech and language therapy.

Early support might focus at first on articulation with much repetition of individual words especially those which act as labels for objects in the child's environment. Significant difficulties are also often seen with the appropriate use of verbs. Practice in the construction and use of phrases indicating actions with which the child is familiar can be supportive.

Modelling and role-playing of appropriate speech, especially as conversation, will help the child acquire language and communication skills which other children develop more easily. The development of pragmatic language, the ability to construct sentences which are appropriate to both message and context, is especially difficult because of the concrete nature of the autistic's thinking. Situation specific teaching can help generate a repertoire of context found "rules" which can expand over time. However, flexibility of application to new situations is likely to be limited. The autistic may not realise when communication has begun especially when their name is not used directly at the start Social skills

The limited ability of autistics to perceive another person's point of view and to recognise differences between contexts means that their interactions with others are likely to be less rewarding and successful. They can on the other hand, be over sensitive to criticism which they perceive as directed at themselves. Correction can, therefore, be very difficult. But by directing it towards the behaviours rather than the person correction can be helped by the tendency to detachment of autistics, can be less problematic.

Empathy is difficult to develop so specific teaching about feelings is needed. Opportunities to use events as starting points for discussion and to model appropriate responses need to be taken and used systematically. Discussing someone's upset or happiness, especially when appropriate behaviours can be seen or experienced, is valuable Thinking Skills

Autistic children lack imagination and this is often first seen in poorly developed play. The use of objects as symbols for real or imaginary people and objects is essential step in intellectual development. Autistic children may need to be shown how to play and encouraged to develop "pretend play". Experiences can be reinforced after the event by recalling them and role playing.

Making choices is often difficult and the pressure of needing to choose can lead to anxiety and agitation. Limiting the available choices reduces the potential for this difficulty. Using concrete examples is helpful as is a strategy for reinforcing and augmenting the child's skills Teaching approaches

Some of the methods used to teach autistics are controversial and have led to have polarised views. The all embracing approach of the Higashi, made famous by the schools in Boston, USA seems to have had some expensive successes but has not yet been transplanted to the UK. There are also concerns about the narrowness of the curriculum. TEACCH is a lightly structured approach which relies on building relationships within a structured and predictable framework. Holding therapy has yet to be evaluated fully but rejection of this method because of the potential for misunderstanding the intentions of the therapist may preempt research findings. Methodology which rely on communication skills seem to have potential but often lack the multidisciplinary support this complex condition requires.