Understanding Autism
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What is Autism?
Autism, or Autism Spectrum Disorder (ASD), is a complex neurobiological condition which is characterised by difficulties in social communication, repetitive behaviour and sensory processing or sensitivity to sensory stimuli. To date, the exact cause of ASD is unknown, but it is most likely a combination of inheritance and spontaneous, genetic mutations.
Social communication issues
Difficulty understanding non-verbal communication; e.g. body language and eye contact. Difficulty understanding when and how to appropriately respond in social interactions. Trouble developing, understanding and maintaining relationships.
Repetitive patterns of behaviour
Repetitive movements; e.g. flapping, rocking, lining up toys or repetitively flipping toys. Echolalia - repetition of speech or repeating phrases. Very narrow and intense interests. Intense attachment to unusual objects. Having very inflexible routines or ritualised patterns (verbal or non-verbal) in which small changes can lead to extreme distress.
Sensory processing or sensitivity
Over or under reactions to sensory input. An unusual interest in specific sensory experiences (excessively smelling or touching). A fascination with lights or movement.
The Three Levels of Autism
Autism was once 3 subcategories; Autistic Disorder, Asperger's Disorder and Pervasive Development Disorder. These have been replaced with the one diagnosis of Autism Spectrum Disorder (ASD).
Getting a Diagnosis
To be diagnosed, the individual needs to have shown these behaviours from early childhood, even if the disorder is not picked up until later in life. It is not uncommon for ASD to go unrecognised until the social needs of the individual exceed their ability to cope.
Behaviours
Tantrums, meltdowns and low tolerance of frustration.
Not doing what they are asked, told or expected to do.
Poor attention.
Dangerous behaviours.
Extremely rigid adherence to routines.
Poor social skills or lack of interest in social activities.
Fear, avoidance and anxiety.
Aggressive and/or self-injurious behaviours.
Problems transitioning between activities.
Problems at mealtimes and bedtimes.
Poor self-care skills.
Problem with academic performance.
Positive Behaviour Support
Positive
Behaviour Support (PBS) is a way of addressing problem behaviours in ASD. Behaviours serve a function, to either obtain or avoid.
To obtain - A child with ASD might flap their hands because it feels good to them, they are obtaining a pleasurable sensation from this action.
To avoid or escape - "I don't want to go to bed yet" as children with ASD generally have a deficit in their ability to communicate the behaviour might be something unreasonable to us, like, banging their head against the wall.
PBS allows carers to identify the function of the behaviours to ensure the child is supported in serving that function in more appropriate ways.
Assessing Problems - The ABC Model
Antecedents
The things that happen in the physical environment prior to the behaviour occurring. This can give us information about possible 'setting conditions' (what happened in the environment before the behaviour) and triggers. What happens before the problem behaviour? Think transitions, time of day, etc.
Behaviour
Accurately describe the behaviour. Consider: What did it look like? How often does it happen? How long does it last? How dangerous/disruptive is it? Instead of trying to stop these behaviours, help the child get their need met in a more functional/appropriate way.
Consequences
What is the outcome of the behaviour? What is the child getting out of the behaviour? Positive behaviour perspective encourages us to think about what the child is getting from the behaviour. The four main categories of consequences are; attention, getting what they want, sensory stimulation and avoidance or escape from an activity or stimulation.