Nothing Is Really Obvious
In many of my lectures, presentations and books, I have spent some time talking about the importance of ensuring that individuals on the spectrum understand the hidden curriculum. These are the unwritten rules and expectations that are often unclear to people with autism. I have finally realized that the items covered by the hidden curriculum are often poorly worded, misleading, and sometimes amusing. For example, the following is wording on an actual sign found in a bathroom: Toilet out of order, please use floor below. The sign really means to use the restroom located on the next floor or story down. But is that what the sign really says? I appreciate my friend, Judy Endow, for bringing this to my attention. Is it up to people with autism to understand hidden meanings, or is it up to those without autism to be more obvious?
Everyday Changes And Horizontal Planning
Some everyday changes or new situations a person with autism may need preparation for might include:
- leaving the house
- having visitors at your house
- going somewhere new, such as the dentist
- switching between activities or tasks during play or learning
- doing things in a different order from time to time for example, having a bath/shower before dinner rather than afterwards
- eating new foods
These frequent changes that may occur on a daily basis are known as horizontal transitions.
Many people on the spectrum have;strong visual learning and thinking styles.;Visual strategies can therefore be an effective way in which to communicate upcoming changes. Common visual strategies used in horizontal transition planning include Social Stories, social scripts, task lists, schedules such as timetables, daily planners and calendars. The National Autistic Society have published a thorough;guide;on the various uses of visual supports.
When visiting a new place, having photos to prepare the individual;for what to expect can be helpful. Pictures can be obtained through websites or by exploring a location via the Google maps street view function. Requesting images may also be an option, for example, contacting the doctors practice and requesting a recent image of the doctor and the consult room in advance of the appointment.
Where Can I Get More Information
For more information on neurological disorders or research programs funded by the National Institute of Neurological Disorders and Stroke, contact the Institute’s Brain Resources and Information Network at:
Office of Communications and Public LiaisonNational Institute of Neurological Disorders and StrokeNational Institutes of HealthBethesda, MD 20892
NINDS health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the National Institute of Neurological Disorders and Stroke or any other Federal agency. Advice on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient’s medical history.
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First Things First When Treating Anxiety
We don’t have much data about how we should go about prescribing these medications in autism, so we recommended ‘starting low and going slow.’
So, what should doctors do before prescribing one of these medications?
In 2016, a second group of doctors, also led by Dr. Vasa, published advice for primary care providers treating anxiety in youth with autism.11 In an interview, she explained, “We don’t have much data about how we should go about prescribing these medications in autism, so we recommended ‘starting low and going slow.'” That means doctors should start with a low dose and slowly increase it, while monitoring the patient’s reactions to it. “These kids are very vulnerable to side effects,” said Dr. Vasa, director of education and training, and associate professor of psychiatry, at the Johns Hopkins University School of Medicine in Baltimore, and Kennedy Krieger Institute.
Other medications that might be used to address symptoms of anxiety include:
- the supplement melatonin or blood pressure medicine clonidine for insomnia,
- blood pressure medicines clonidine or guanfacine for aggression, self-injury and irritability that may occur with anxiety, and
- the beta-blocker propranolol, or the tranquilizer lorazepam, for anxiety caused by a temporary situation, such a medical procedure or stressful event.11
The New Age Of Diagnosing Asd Reflects The Spectrum
Using DSM-IV, clinicians could diagnose patients with four separate pervasive developmental disorders:
- Autistic disorder
- Aspergers disorder
- Pervasive developmental disorder not otherwise specified
Across various clinics and treatment areas, clinicians were not consistently applying these separate diagnoses. DSM-5 provides a new, accurate way of diagnosing autism related disorders.
The latest edition of the Diagnostic and Statistical Manual of Mental Disorders no longer includes Aspergers syndrome as a separate diagnosis. Instead, it includes the characteristics of Aspergers syndrome within the broader category of the autism spectrum. Patients diagnosed with any of the four pervasive developmental disorders should still meet the criteria for ASD in DSM-5.
DSM does not outline treatment for ASD but it does recognize that determining an accurate diagnosis is the practitioners first step in creating a treatment plan.
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Tools And Strategies For Productivity At Work
While autism presents differently in everyone, many adults on the spectrum can find it difficult to stay organized, manage their time, and keep track of tasks. For example, it may prove challenging for adults with ASD to plan out tasks ahead of time, or to follow unclear or broad instructions without details. The use of assistive technology, such as visual or electronic aids, to keep track of details and break large tasks into smaller steps can prove greatly helpful in such situations. Employers should be made aware of employee needs in these areas.
Many people with autism are capable of excelling in their jobs with the proper tools and instruction. One study among people with ASD found that predictable workplace duties were key for success in employment. In other words, once employees find a rhythm with a consistent duty with clear instructions, they are far more likely to succeed. Communicating this with employers, and working together to find the proper match in terms of expectations and communication style, may be part of a wider strategy in tailoring ones work to ones strengths.
Prevalence Of Autism Spectrum Disorder
One in every 68 children has been identified with autism spectrum disorder. The disorder occurs in people of racial, ethnic and socioeconomic backgrounds. ASD is five times more common in boys than in girls.
Autism spectrum disorder tends to occur more often in those with certain genetic or chromosomal conditions. About one in ten children with ASD also have Down syndrome, tuberous sclerosis, fragile X syndrome or other chromosomal and genetic disorders.
Fragile X syndrome is a genetic condition that causes a range of developmental problems that include learning disabilities and cognitive impairment. FXS is the most common known single gene cause of ASD, according to The National Fragile X Foundation. Other genetic causes of ASD include deletions of chromosome 15q, tuberous sclerosis and other rare genetic conditions
Tuberous sclerosis is a genetic disorder that causes non-malignant tumors to form in many different organs, primarily in the brain, eyes, kidneys, lungs, skin and heart. About half of all people with tuberous sclerosis complex develop ASD, according to the Tuberous Sclerosis Alliance.
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Social And Academic Challenges For Teens With Autism Spectrum Disorder
Autism spectrum disorder is a neurological disorder that impacts a persons ability to relate to their peers, communicate with others, control their emotions, follow instructions, and transition throughout the day. The symptoms and characteristics of ASD vary greatly and range from mild to severe. However a common issue that many adolescents with ASD struggle with is known as the triad of impairments which include nonverbal and verbal communication, social behavior, and flexible thinking. In this blog post, we will share specific ways that these challenges are manifested in teens with ASD.
1. Teens with ASD experience challenges with nonverbal and verbal communication
- Difficulty understanding others
- Difficulty communicating their own thoughts and feelings
- Difficulty processing and retaining verbal information
- Trouble recognizing other peoples feelings
- Doesnt pick up on nonverbal cues
- Slow to develop functional speech
- Limited to a literal understanding of language
- Short attention spans
- Tendency to throw frequent tantrums for reasons others do not understand
- Does not use or recognize many facial expressions
What Makes Teens with Autism Spectrum Disorder Different?
Communication and Social Differences
Strong Cognitive Rigidity
Executive Functioning Deficits
Appearance and Hygiene
Learning Difficulties And Disabilities
Around 10 to 16 per cent of people have trouble with learning. This can be caused by: developmental delay; poor coordination due to motor skill problems, emotional issues and traumas; lack access to appropriate education; interrupted school attendance; or health issues.
Some people, around 2 and 4 per cent, have academic or intellectual abilities that are considered below those of the average person, these are called learning disabilities, and include:
- Dyslexia: problems with reading, spelling and writing.
- Dysgraphia: difficulties expressing through the written word, including spelling, handwriting and written composition.
- Dyscalculia: problems understanding numbers, maths and thinking quantitatively.
- Dysphasia: problems with oral language including speech and comprehension.
Studies have shown that there is an increased prevalence of reported cases of autism among children with a learning disability. This means its important for parents and carers to seek advice from teachers and professional support providers about developmental delays specific to learning and academia.
For more information about learning difficulties or disabilities go to Understanding learning difficulties on the Australian Government Department of Education website.
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Motor Skill Disorders And Body Function Difficulties
Motor skills are defined as movements and actions of the bodys bone and muscle structure. They are referred to into two categories, gross motor skills and fine motor skills.
Gross motor skills relate to the movement and coordination of the limbs and other large body parts, and impact activities such as running, crawling and swimming.
Fine motor skills relate to smaller movements occurring in the wrists, hands, fingers, feet and toes, and impact actions such as picking things up, writing carefully, or even blinking.
Motor skill disorders impact a persons ability to perform movements requiring fine and/or gross motor skills, and the number of motor difficulties in people with autism has been identified as relatively high.
Other common bodily functions have also been related to autism, including sleep, gastrointestinal and feeding difficulties.
Researchers have found sleep disturbance to be the second most common physical co-condition found in people with autism, after epilepsy.
Studies have also found that around 50% of individuals with autism experience some form of gastrointestinal problems.
Autism: Parents Face Challenges Too
Autism spectrum disorder refers to a set of related conditions that affect social interaction, communication, and behavior. The impact can range from mild to severe. It mostly appears in early childhood, and it normally continues into adulthood. Some people with autism spectrum disorder are highly gifted in a specific field.
Apart from difficulties with social communication, people with autism spectrum disorder tend to have restricted interests. Other key features include repetitive behavior and a need for routine.
In the United States, the Centers for Disease Control and Prevention report that ASD affects 1 in every 68 children. Boys are 4.5 times more likely to be affected than girls.
Bringing up a child with autism can be challenging for parents, especially when other people do not understand the issues.
Children with ASD experience the world differently from most people. They often have difficulty expressing themselves. Sensory issues can affect how they smell, hear, or see things. They may find it impossible to eat foods of a particular color, for example.
Parents can find it difficult and embarrassing when their child demonstrates unusual behaviors in public. The website Parent Coaching for Autism lists a number of behaviors that might be considered unusual.
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What Challenges Do Autistic Students Face
Perhaps the most well known trait of autism is difficulty with social skills, including recognizing and responding to other peoples feelings, reading nonverbal cues, and navigating social norms. Language development and communication difficulties are common challenges in students with ASD that are often inextricably intertwined with issues related to socialization so much of human socialization is related to verbal and non-verbal communication.
Students with ASD may struggle with sensory processing and may avoid or seek out sensory input. Some students will have difficulty completing tasks or planning ahead, while others may find it difficult to break a pattern of thinking to approach a problem in a new way, as executive functioning may be a challenge. Motor skills can be impaired in students with ASD, and may require a great deal of concentration or effort that interferes with a students ability to concentrate on the material being presented.
Intellectual Disability And Developmental Delays
Intellectual disability can be diagnosed when a child who is six years or older has an below 70 as well as difficulties with daily tasks. In children under six years, the term developmental delay is used when children have significant cognitive and language delays.
Intellectual disability varies from person to person. Autistic children with intellectual disability might have uneven skills, so there might be some things that theyre quite good at and others they find hard.
In most cases, autistic children have more trouble with verbal skills like talking, listening and understanding than with non-verbal skills like doing puzzles or drawing.
How common is intellectual disability in autistic children?In the past, it was thought that 50-60% of autistic children had intellectual disability or developmental delays. But its now thought to be 20-30%, with another 20-25% having borderline intellectual disability with an IQ of 71-85.
This drop might be because IQ testing for autistic children has improved, support and education is better at addressing autistic children’s learning needs, and more children without intellectual disability are being diagnosed with autism.
Some researchers have argued that some childrens developmental delays might be caused by their social learning difficulties, rather than being a separate condition.
Find out moreIntellectual disability
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Supporting Students With Autism In The Classroom
Perhaps because they socialize differently, students with ASD tend to need explicit instruction to gain skills that other students might pick up without even trying. Its important that adults provide students with clear, simple instructions regarding what is expected, even it if seems obvious to others. Young students might need explicit instruction in how to pretend play, while older students may need clear and specific directions related to how they should enter the classroom and set up for learning. Discrete Trial Teaching is one method for teaching skills explicitly.
One defining characteristic of people with ASD is a tendency toward restrictive and repetitive behavior in the form of routines. These self-imposed routines help a child with autism who doesnt always understand the rules of the world around them to feel safe and make the world a bit more predictable. Teachers can help redirect harmful routines by establishing helpful routines with students. By explicitly teaching students instructional and non-instructional routines, the teacher is making the classroom a predictable and manageable environment for them.
While establishing routines, be sure to include instructional breaks. Breaks can help students by reducing or providing sensory input and helping to focus their attention on the task at hand.
Physical Fitness And Obesity In Autism
Physical fitness is tied to another health concern in autism. Beginning in the toddler years, American youngsters with ASD have a higher risk of being overweight or obese than other children.9 This pattern continues into adulthood. U.S. teenagers with autism are more than twice as likely to be obese as adolescents who don’t have a developmental disability.10 Adults with autism have higher rates of obesity, as well as health conditions that can be caused or aggravated by obesity, such as diabetes, high cholesterol and high blood pressure.11
Theories abound as to why obesity is more common in autism. Some people with autism take medications, particularly certain antipsychotics, that may cause weight gain. Many have extremely picky eating habits, insisting on eating only a few foods that may be high in calories.12 Children and youth with autism tend to be less physically active than kids who do not have developmental disabilities.13-14 According to the Centers for Disease Control and Prevention, regular physical activity is important for maintaining a healthy weight.
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Contribution Of Specific Sleep Problems
Table 3 summarizes the linear models examining the relationship between ASD symptom severity and problem behavior as moderated by each of the specific sleep domains: 1) bedtime resistance, 2) sleep onset delay, 3) sleep duration, 4) sleep anxiety, 5) night waking, 6) parasomnias, 7) disordered breathing, and 8) daytime sleepiness.
Table 3 Linear models summarizing the relationship between ASD symptom severity and problem behavior as moderated specific sleep disturbances.
As is evident from Table 3, sleep duration, disordered breathing, and daytime sleepiness were found to significantly moderate the relationship between ASD symptom severity and problem behavior. To detail the nature of these interactions, the sections below outline the simple slopes analyses and JohnsonNeyman results.
Moderating Effect of Sleep Duration
Moderating Effect of Disordered Breathing
Moderating Effect of Daytime Sleepiness
How Does Asd Affect Communication
The word autism has its origin in the Greek word autos, which means self. Children with ASD are often self-absorbed and seem to exist in a private world in which they have limited ability to successfully communicate and interact with others. Children with ASD may have difficulty developing language skills and understanding what others say to them. They also often have difficulty communicating nonverbally, such as through hand gestures, eye contact, and facial expressions.
The ability of children with ASD to communicate and use language depends on their intellectual and social development. Some children with ASD may not be able to communicate using speech or language, and some may have very limited speaking skills. Others may have rich vocabularies and be able to talk about specific subjects in great detail. Many have problems with the meaning and rhythm of words and sentences. They also may be unable to understand body language and the meanings of different vocal tones. Taken together, these difficulties affect the ability of children with ASD to interact with others, especially people their own age.
Below are some patterns of language use and behaviors that are often found in children with ASD.
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