As we look at some of the most commonly observed characteristics of children with autism spectrum disorders, remember these important points. Some children on the spectrum are very severely affected in most or all domains of functioning, while others are only mildly affected. There is considerable overlap of the conditions along the spectrum, meaning that children with different diagnoses may share many characteristics. On the other hand, two children with the same diagnosis may be affected in markedly different ways. “There is no single behavior that is always typical of autism and no behavior that would automatically exclude an individual child from a diagnosis of autism” (National Research Council, 2001, p. 11).
Impaired Social Relationships
Many children with ASD have difficulty perceiving the emotional state of others, expressing emotions, and forming attachments and relationships. Parents often report that their attempts to cuddle and show affection to the child are met with a profound lack of interest on the child’s part. The child seems not to know or care whether he is alone or in the company of others.
Many children with ASD fail to exhibit social gestures such as showing and pointing things out to others or waving and nodding their head at others. Although some children with ASD “demonstrate basic gestures such as pulling, pushing, or leading others by the hand to get things they want, the use of these gestures typically lacks any social component; the child seems to be using the adult just as a means to an end” (Professional Development in Autism Center, 2004).
Deficits in joint attention are very common in children with ASD (Stahl & Pry, 2002). Joint attention refers to such behaviors as looking where someone else is looking, as when a baby notices that his mother has turned her head to look at something and does the same, or when the baby turns its head or eyes in the direction that someone is pointing. Joint attention allows the young child and another person to interact with the same frame of reference, an important factor in the development of language and social skills.
Communication and Language Deficits
About half of children with autistic disorder are mute; they do not speak, but they may hum or occasionally utter simple sounds. The speech of those who do talk may consist largely of echolalia—verbatim repetitions of what people around them have said—and non-contextual speech phrases without any apparent communicative purpose. For example, Murphy (2003) reported that throughout the day a 7-year-old boy with autism repeated phrases he had heard from movies, cartoons, television shows, announcers of sporting events, and teachers during math instruction such as the following:
“Hermione, we need to go find Harry!”
“Hi Squidward!”
“Angelica, help me!”
“Today’s Noggin show was brought to you by your good friends at McDonald’s.”
“Jeff Gordon rounds the far outside turn!”
“Add five carry the one.”
Some children with ASD have acquired an impressive vocabulary but do not use it in appropriate or useful ways.
A common characteristic of children with autism is the concrete or literal processing of verbal information. Straightforward cause-and-effect relationships and questions that have a definite answer are more easily understood than abstract concepts or idiomatic expressions. For example, “the concept of using an umbrella to stay dry in the rain is very concrete and easy for a child with autism to understand, whereas an idiomatic figure of speech such as ‘it’s raining cats and dogs,’ may prove incomprehensible to a child with autism” (Professional Development in Autism Center, 2004).
One of the most common deficits of children with autism is their lack of understanding of the social meanings of language. Michelle Anderson provides the following example:
Many children with ASD can learn to request and label items, but understanding the subtleties of humor is often something that remains confusing into adulthood. That’s why we were so excited one day when Sammy came up with a new response to an old question. Sammy had been taught to answer the question “What is your mommy’s name?” Then one day in December he surprised us all when instead of answering “Chris Hall,” he looked right at us with a serious face and responded, “Chris—mis.” Three seconds later he started cracking up and saying, “Mommy is Christmas!” “Mommy is Christmas!” We all laughed along with him; and since then, he has come up with many more jokes to delight everyone around him. (personal communication, 2004)
Intellectual Functioning
Children with autism spectrum disorders span the entire range of IQ. A diagnosis of autism can be made in a child with severe or profound mental retardation as well as in a child who is intellectually gifted. Although autism spectrum disorders occur across the full range of intellectual abilities, between 70% and 80% of individuals with autistic disorder also have mental retardation (Romanczyk, Weinter, Lockshin, & Ekdahl, 1999). The terms low-functioning autism and high-functioning autism are sometimes used to differentiate individuals with and without mental retardation.
Uneven skill development is a common characteristic of autism, and about 10% to 15% of children exhibit “splinter skills”—areas of relatively superior performance that are unexpected compared to other domains of functioning. For example, a child may draw very well or remember things that were said a week before but have no functional language and will not make eye contact with others.
A very few persons are autistic savants, people with extraordinary ability in an area such as memorization, mathematical calculations, or musical ability while functioning at the mental retardation level in all other areas (Kelly, Macaruso, & Sokol, 1997; Treffert, 1989). The betting calculations by Raymond in the movie Rain Man are illustrative of savant syndrome.
Many children with autism exhibit overselectivity, the tendency to focus on a minute feature of an object or a person rather than the whole. For example, if shown a guitar for the first time, a child might focus on the sound hole and not consider anything else about the instrument, such as its size, shape, other parts, or even the sound that it makes. This overselectivity interferes with the child’s understanding of what a guitar is—the totality of its parts and function. The tendency to overselect hinders his learning of new concepts and interferes with his ability to interpret relevant meaning from the environment.
Another tendency often seen in individuals with autism spectrum disorder is obsessive attention on a specific object or activity. This focused attention may last for a long time if uninterrupted and is often very difficult to break. For instance, if a child with autism has focused his attention on trains, he may continually choose to play with trains and resist playing with other toys. Focused attention may impede his ability to shift attention to other people or activities, such as a parent who is entering the room or another child who is attempting to join his play.
Some children with autism possess a strong aptitude for rote memory for certain things. For example, a child with autism may be able to name all of the Cy Young Award winners in the major leagues and repeat the script of an entire video verbatim. Yet the same child may have difficulty recalling what he did during recess or remembering the sound that the letter k makes.
Unusual Responsiveness to Sensory Stimuli
Many children with autism react to sensory stimulation in atypical ways. This takes the form of over- and underresponsiveness to sensory stimulation. An overresponsive (hypersensitive) individual may not be able to stand certain sounds, dislike being touched or the feel of certain textures, and refuse to eat foods with certain smells or tastes. In her autobiography, Thinking in Pictures and Other Reports of My Life with Autism, Temple Grandin (1995) describes how overly sensitive skin and certain sounds bothered her as a child.
Washing my hair and dressing to go to church were two things I hated as a child. . . . Scratchy petticoats were like sandpaper scraping away at raw nerve endings. . . . loud noises were also a problem, often feeling like a dentist’s drill hitting a nerve. They actually caused pain. I was scared to death of balloons popping because the sound was like an explosion in my ear. Minor noises that most people can tune out drove me to distraction. . . . My ears are like microphones picking up all sounds with equal intensity.
An underresponsive (hyposensitive) child appears oblivious to sensory stimulation to which most people react. Some children with autism do not seem to feel pain in a normal way. Some underresponsive children will spin round and round, rock back and forth, or rub and push things hard into their skin to create additional forms or higher intensities of stimulation. It is not uncommon for an individual with autism to display a combination of both over- and underresponsiveness—for example, being hypersensitive to tactile stimulation but unresponsive to many sounds.
We may move directly in front of the child, smile, and talk to him, yet he will act as if no one is there. We may not feel that the child is avoiding or ignoring us, but rather that he simply does not seem to see or hear. . . . As we get to know the child better, we become aware of the great variability in this obliviousness to stimulation. For example, although the child may give no visible reaction to a loud noise, such as a clapping of hands directly behind his ears, he may orient to the crinkle of a candy wrapper or respond fearfully to a distant and barely audible siren. (Lovaas & Newsom, 1976, p. 308)
Insistence on Sameness and Perseveration
Children with autism often have issues about routines or repetitive behaviors. Many demonstrate an obsessive need for sameness. They may have great difficulty when home or classroom routines are changed, possibly throwing huge tantrums. They may insist upon having everything in the same place all the time and get very upset if anything is moved. Sometimes a verbal child with autism may show this desire for sameness in a preoccupation with a certain subject or area of interest to the exclusion of all others. This child may talk incessantly about one topic, regardless of how bored his listeners are with it, and show no interest in anything else. He may ask the same question over and over, regardless of the reply.
Ritualistic and Unusual Behavior Patterns
Some children with autism engage in ritualistic routines and repetitive behaviors. They may exhibit stereotypic behavior, very repetitive acts such as rocking their bodies when in a sitting position, twirling around, flapping their hands at the wrists, or humming a set of three or four notes over and over again. A child may spend hours at a time gazing at his cupped hands, staring at lights, spinning objects, clicking a ballpoint pen, and so on.
Problem Behavior
Students with autism are more likely to exhibit behavior problems that might take the form of aggression toward others and/or themselves.
Often the parents report that the child sometimes bites himself so severely that he bleeds, or that he beats his head against walls or sharp pieces of furniture so forcefully that large lumps rise and his skin turns black and blue. He may beat his face with his fists. . . . Sometimes the child’s aggression will be directed outward against his parents or teachers in the most primitive form of biting, scratching, and kicking. Some of these children absolutely tyrannize their parents by staying awake and making noises all night, tearing curtains off the window, spilling flour in the kitchen, etc. (Lovaas & Newsom, 1976, p. 309)
Positive Attributes and Strengths of Students with ASD
Reading descriptions of communication impairments, skill deficits, and behavioral excesses experienced by individuals with ASD, you may find it easy to overlook their strengths and positive attributes. Not all individuals with ASD are always unattached to those around them or behave in a stilted manner. As Greenspan and Weider (1997) remind us, many children with autism are “quite loving and caring, thoughtful and creative” .
As we might expect, there is a noticeable difference between descriptions of autism and Asperger syndrome by people with and without the conditions (Kluth, 2004). While people without the disabilities tend to focus on the impairments to normal functioning, a number of people with autism and Asperger syndrome have described positive features associated with their disability. For example, Temple Grandin (1995), an adult with autism who has a Ph.D. in animal science and designs environments and equipment to improve the humane and healthful handling of livestock, describes positive features associated with her disability:
I think in pictures. Words are like a second language to me. I translate both spoken and written words into full-color movies, complete with sound, which run like a VCR tape in my head. When somebody speaks to me, his words are instantly translated into pictures. Language-based thinkers often find this phenomenon difficult to understand, but in my job as an equipment designer for the livestock industry, visual thinking is a tremendous advantage.
Liane Willy (2001), a woman with Asperger syndrome, writes:
We can describe a situation like no one else. We can tell you what intangibles feel like and secret flavors taste like. We can describe for you, in unbelievable depth, the intricate details of our favorite obsessions.
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