How does an ASD affect the individual?

The term Autistic Spectrum Disorder (ASD) is a relatively recent label used to recognize that there is a range of conditions or subgroups within autism that does not form a gradual continuum of disability or difficulty, but rather an uneven spectrum of conditions that are different but, at their heart, share a triad of impairments. This triad provides a focus for intervention.

The differences between the subgroups provide an ongoing focus for research by clinical and developmental psychologists but it is what each person with ASD has in common that can help us to understand their individuality, what they have in common with people without autism and promote their inclusion. All learners with ASD share the triad of impairments. This impacts on their ability to understand and use non-verbal and verbal communication. This ranges from a child without spoken communication who may need to be supported in communication through the use of objects, photos, pictures or symbols, to a child who appears to talk with ease using elaborate language beyond his or her years, but only on a small range of topics that interest him or her. The talk will often be a talk rather than a conversation because they find it difficult to take turns or understand the cues that govern conversation.

For example, a child who likes to talk about buses may be able to share his interest for a short while with his peers, but they may become bored eventually if the same information is shared again and again in minute detail without seeking the listener’s experience or views on the topic. Therefore, the skills that every other child has and knows without knowing they know, have to be taught to the child with ASD. They can become very isolated because everyone else knows, more or less, the secret rules to the game of social interaction. This is the second part of the triad and it impacts on the ability of learners with ASDs to understand social behavior which affects their ability to interact with children and adults. They find it difficult to understand the world at a social level. The fact that our behavior is governed by needs, hopes and expectations that we attribute to others all the time in order to make sense of the world of people.

The last area of the triad of impairment is the ability of learners with ASD to think and behave flexibly – which may be shown in restricted, obsessional or repetitive activities. There is a reliance on routine and a dislike of change so that changes have to be signalled and warned of well in advance. People with ASD may have limited and unusual areas of interest. For example, they may talk endlessly about dinosaurs, Thomas the Tank Engine, a cartoon program or bus routes. They may have to carry out tasks in certain prescribed ways because that is the way they first did it. This can constrain family life a good deal if parents have not been supported in developing structured management strategies to accommodate change and flexibility. In the classroom this ‘love of routine’ can be used to advantage as they are usually very structured places. However, it may still be that the implicit etiquette of school may need to be made visually explicit.

A word may have only one meaning for a learner with ASD so that humour, sarcasm and colloquialisms may be lost on the learner. Witness the look of fascination on the face of a child with ASD being told by his teacher who has just coughed, ‘Sorry, I have a little frog in my throat.’ Rather than avoid humour and sarcasm, we have to teach it so that the child learns about our world that is full of humour, gentle wind-ups and ribbing but also, and unfortunately, bullying. Taking things literally may cause problems in exam questions. I was once given a photocopy of a maths SAT paper of a boy with ASD. In the margin he had drawn a picture of a boy at a desk. This was because the instruction had said, ‘Show your working.’

Once we know this triad of impairments, we know that what we do to help the learner will have to address these needs. We have to use this knowledge to understand that the learner may not understand the world in the same way that people without autism do. Garry Mesibov of the TEACCH centre at the University of North Carolina has suggested that this difference might be thought of as a cultural difference, in that culture is a set of understandings about the world that guide our interaction with the world. For example, if we are scared of sudden noises to the extent that we might find them physically painful, we might be motivated to avoid at all costs potential encounters with situations that might produce loud and sudden noises, something that might puzzle another person who did not understand that culture. One can attribute many of the problems that occur with teaching learners with ASD in schools to this culture clash.

In a busy classroom, in a school under pressure to achieve, there can be an emphasis on the normalization of pupils by bringing them up to expected levels of performance using prescribed strategies. For the learner with ASD who likes explicit routine, such a standardization may be supportive provided it is communicated in a way that he or she can understand. The assumption that all children generally think and are motivated in the same ways, however, does not hold when we are dealing with learners with ASD.

The recent OFSTED Report on the inclusion of learners with special educational needs into mainstream schools (2003: 6) looked at practice in settings that were regarded as providing good provision and they noted that:

Attention to personal and social development was a high priority and paid dividends. Secondary schools found it more difficult to provide structured and consistent support for older pupils with SLD and, sometimes, ASD as their social skills and interests diverged increasingly from those of their peers.