Autism

Learning in autism is not a topic characterized by consensus. For example, the ability of autistics to learn is considered nonexistent in the typical everyday environment (Lovaas and Smith, 2003) and fundamentally impaired (Klinger et al., 2006), but so astounding that the cognitive literature as a whole is insufficient to explain it (Atkin and Lorch, 2006). Autistic learning is recognized as distinctive (Volkmar et al., 2004) and singled out as subhuman (Tomasello et al., 2005), but is also considered unremarkable compared to non-autistic learning (Thioux et al., 2006). These apparently disparate accounts may be the result of autistic learning, in contrast to autistic perception, attention, and memory, being investigated in a piecemeal, adhoc manner. This review will summarize a range of current and emerging proposals about autistic learning, examining each proposal’s empirical basis and adding historical and thematic perspectives. 

What is Autism?

Autism is a complex neurobiological disorder of development that lasts throughout a person’s life. It is sometimes called a developmental disability because it usually starts before age three, in the developmental period, and because it causes delays or problems in many different skills that arise from infancy to adulthood.

The main signs and symptoms of  Autism involve language, social behavior, and behavior concerning objects and routines:

● Communication—both verbal (spoken) and non­verbal (unspoken, such as pointing, eye contact, or smiling)

● Social interactions—such as sharing emotions understanding how others think and feel (sometimes called empathy), and holding a conversation, as well as the amount of  time a person spends interacting with others

● Routines or repetitive behaviors—often called stereotyped behaviors, such as repeating words or actions, obsessively following routines or schedules, playing with toys or objects in repetitive and sometimes inappropriate ways, or having very specific and inflexible ways of  arranging items

People with Autism might have problems talking with you, or they might not look you in the eye when you talk to them.  They may have to line up their pencils before they can pay attention, or they may say the same sentence again and again to calm themselves down.  They may flap their arms to tell you they are happy, or they might hurt themselves to tell you they are not.  Some people with Autism never learn how to talk. These behaviors not only make life challenging for people who have Autism, but also take a toll on their families, their health care providers, their teachers, and anyone who comes in contact with them.

Because different people with Autism can have very different features or symptoms, health care providers think of  Autism as a “spectrum” disorder—a group of  disorders with a range of similar features.  Based on their specific strengths and weaknesses, people with Autism spectrum disorders (ASDs) may have mild symptoms or more serious symptoms, but they all have an ASD.  This fact sheet uses the terms “ASD” and “Autism” to mean the same thing.

What causes Autism?

Scientists don’t know exactly what causes Autism at this time. Much evidence supports the idea that genetic factors—that is, genes, their function, and their interactions—are one of  the main underlying causes of ASDs.  But, researchers aren’t looking for just one gene.  Current evidence suggests that as many as 12 or more genes on different chromosomes may be involved in Autism, to different degrees.

Some genes may place a person at greater risk for Autism, called susceptibility.  Other genes may cause specific symptoms or determine how severe those symptoms are.  Or, genes with changes or mutations might add to the symptoms of  Autism because the genes or gene products aren’t working properly.

Research has also shown that environmental factors, such as viruses, may also play a role in causing Autism. While some researchers are examining genes and environmental factors, other researchers are looking at possible neurological, infectious, metabolic, and immunologic factors that may be involved in Autism. Because the disorder is so complex, and because no two people with Autism are exactly alike, Autism is probably the result of many causes.

What are some of the possible signs of autism?

Parents, caregivers, family members, teachers, and others who spend a lot of  time with children can look for “red flags.” Some may mean a delay in one or more areas of development, while others are more typical of ASDs. A list of  red flags appears to the right.

Possible Red Flags for Autism

●  The child does not respond  to his/her name.

●  The child cannot explain what he/she wants.

●  The child’s  language skills are slow  to develop or speech  is delayed.

●  The child doesn’t follow directions.

●  At  times,  the child seems  to be deaf.

●  The child seems  to hear sometimes, but not other  times.

●  The child doesn’t point or wave “bye­bye.”

●  The child used  to say a few words or babble, but now he/she doesn’t.

●  The child  throws  intense or violent  tantrums.

●  The child has odd movement patterns.

●  The child  is overly active, uncooperative, or resistant.

●  The child doesn’t know how  to play with  toys.

●  The child doesn’t smile when smiled at.

●  The child has poor eye contact.

●  The child gets “stuck” doing  the same  things over and over and can’t move on  to other  things.

●  The child seems  to prefer  to play alone.

●  The child gets  things for him/herself only.

●  The child  is very  independent for his/her age.

●  The child does  things “early” compared  to other children.

●  The child seems  to be  in his/her “own world.”

●  The child seems  to  tune people out.

●  The child  is not  interested  in other children.

●  The child walks on his/her  toes.

●  The child shows unusual attachments  to  toys, objects, or schedules (i.e., always holding a string or having  to put socks on before pants).

●  Child spends a  lot of  time  lining  things up or putting  things in a certain order.

In addition, your child’s health care provider will send your child for an evaluation if  you report any of  the behaviors listed below; such an evaluation would consider ASDs, among other possible causes.

What are the treatments for autism?

Currently there is no definitive, single treatment for ASDs.  However, there are a variety of ways to help minimize the symptoms and maximize learning.  Persons with an ASD have the best chance of  using all of  their individual capabilities and skills if  they receive appropriate behavioral and other therapies, education, and medication. In some cases, these treatments can help people with autism function at near­normal levels.

Some possible treatments for autism are explained below.  If  you have a question about treatment, you should talk to a health care provider who specializes in caring for people with autism. Behavioral therapy and other therapeutic options In general, behavior management therapy works to reinforce wanted behaviors and reduce unwanted behaviors.  At the same time, these methods also suggest what caregivers should do before or between episodes of  problem behaviors, and what to do during or after these episodes. 

Behavioral therapy is often based on Applied Behavior Analysis (ABA).  Different applications of ABA commonly used for people with autism include:  Positive Behavioral Interventions and Support (PBS), Pivotal Response Training (PRT), Incidental Teaching, Milieu Therapy, Verbal Behavior, and Discrete Trial Teaching (DTT), among others.

Keep in mind that other therapies, beyond ABA, may also be effective for persons with autism. Talk to your health care provider about the best options for your child.

Source : Eunice Kennedy Shriver National Institute of Child Health and Human Development. (May 2005) Autism Overview: What We Know. No. 05­5592.