Dear Kindergarten Teacher,
I am a speech therapist and fellow educator who has been a subscriber to an internet ListServe for people interested in Autism. Through my experience working directly with Autistic children who are High Functioning Autistic (HFA) or have a diagnosis of Asperger's Syndrome (AS) and through information I have read on the ListServe I have created some suggestions on what you might do if you find yourself with one of these children in your classroom. None of the children I worked with had a diagnosis when I began to work with them. I went on the assumption that the child may be of normal intelligence, and deserves the chance to prove it. There are other articles on High Functioning Autistics and Asperger's Syndrome available. This is an area which is receiving much attention. RIGHTFULLY SO.
My hope is:
1. This article will increase your understanding of this type of Autism.
2. You will feel comfortable having a child like this in your classroom.
3. You will become an Advocate for early identification of AS and HFA children. This is to say that you may be instrumental in getting the child the diagnosis he needs to be successful. Children on the Autism Spectrum have other diagnoses such as PDD, PDD/NOS, ADD, or possibly no diagnosis at all. If a parent gave you this, they may need your help in confirming that their child is both Autistic and High Functioning. PLEASE do NOT send a child to a resource class (for children with low functional intelligence, with many behaviors) without determining his ability to learn. Children who have normal intelligence and who are placed into a class where mayhem occasionally reins supreme are going to feel like you would feel. Please think about that. Do not do this to a child.
4. You will fight for the benefit of having an AS or HFA child in your classroom, (many people have written concerning what a great learning experience it is for the other students in a class when there is a
special needs child and the students can feel that they have collaborated with the teacher to include this child in activities and have helped the child's progress). The children will understand and will be supportive if they are included in the process. The HFA/AS child may be gifted in certain areas such as language, math, or science and may repay the help he has received by being the class academic wizard. He may be the most intelligent person in class, or just average.
Onewyzgrl a member of the Autinet ListServe wrote:
..."I am not sure what the NY system is like, but in Pennsylvania the
kindergartens are very academic and unless your child is able to
understand 5 step instructions at one time, the idea of an aide may be
I'm not sure who specifically she was writing to, but she might as well have been writing to all parents of any c..
Child who's intelligence does not prevent their child from leaving Kindergarten with the attending skills needed to be promoted to first grade.
A child does not need sight, speech, or hearing to be of normal intelligence. He does not even need to ambulate on his own to be included in the public school kindergarten. He/she needs to be able to sit still for brief periods of time, five to ten minutes, and needs to be able to focus age appropriate receptive skills on the teacher.
There is only one thing that prohibits a HFA or AS child from being included in the regular open kindergarten classroom. This is behavior. If the child is not able to listen, he will not be able to focus, if he is not able to focus then the child will not be able to contribute to the class. This child, any child,will know instinctively whether or not they are a part of the whole. To include a child, any child, but especially an autistic child, in a place, any place, where they are not understood, not wanted, and not heard is hurtful. Conversely; to deny a child, any child, the right to be educated with his peers when he does understand and could contribute to the class, be wanted, and be heard is equally as hurtful.
How do we know which children are high functioning? Especially when autistic behaviors may have stood in the way of normaly developing cognitive skills. How do we get from the point where we see many autistic behaviors to a point where we see..
ã an intelligent, learning child who's autistic behaviors are less of a factor?
Autistic behaviors will diminish as a child learns new skills that he can regulate with evolving language. In recent postings on the ListServe several people have noted that in HFA/AS there is a tendency for language to develop slowly from birth to age 3 or 4, then to develop more appropriately from the age of 5 to 10. Many HFA/AS children have developed good enough language skills to cope fairly well in a Kindergarten Classroom with no intervention at all.
HFA/AS children have impaired pragmatic skills. These impaired pragmatic or social skills leave the child with an inability to accurately understand what people are saying due to an inability to process; abstract language, body language, intention of the speaker, facial expressions, and environmental cues.
In recent years Autism has come to be known as a spectrum disorder. This means that people who have Autism vary greatly in intelligence, severity, symtoms and other coexisting ailments, syndromes and conditions. This is also true within HFA/AS diagnoses. Still there are traits other than varying levels of impaired pragmatic skills that we expect to see in a child who is Autistic. Children who are on the Autistic Spectrum are identified and isolated from typical children by their impaired ability to understand appropriate social behavior with peers (pragmatic impairment), but also by their other "quirky" behaviors.
Some of the "quirky" behaviors may include but are not limited to: spinning things with surprising skill, finger or hand flapping, poor eye contact, intolerance to sudden loud noises, tantrums (often unexplainable), head rocking, body rocking, frequent high pitched screeches, demanding that they be able to carry a toy or totem wherever they go, focus on one thing or topic to an extreme, excessive fascination with one's own fingers, frequent walking on tip toes, an aversion to certain textures (like sand or glue), echo like speech (echolalia), poor toileting skills, poor ability to transition from one activity to another (won't start a nap, won't come to eat), impulsive behavior (taking their clothes off), obsessive behavior (plays only with one toy), . Some HFA and AS children are adept at mentally recording bites of language from TV shows (especially cartoons or other animated show, but also science fiction shows like Star Trek). You may also hear the child accurately repeat things that you or others have said so that the child seems to have an inventory of languae bites in his head. He will play the language tapes appropriately in conversation on occasion and play them innapropriately on occasion. Some HFA/AS children have a flat voice pitch, a sing-song vocal delivery, or a voice that is high pitched. Sometimes you may think the child has a hearing problem. Some traits or behaviors can be blamed on a skewed sensory system. Autistic people report that they: have had hallucinations, hear images, have an extra powerful sence of hearing or smell, and may have difficulty seeing things in direct light.
What Works? (Passive and direct behavior management interventions)
What kind of passive things can we do so the Autistic Child's behaviors are reduced to the point that we can begin teaching? Things that "might" work: Lower extraneous noise levels (fewer fluorescent lights, close any windows if loud traffic is nearby, allow the child to avoid noisy lunch rooms, reduce times when the teacher is talking while kids are talking, provide the child with individualized explanations), diet therapy (some kids are allergic to various foods and others have a deficiency of certain trace elements), vitamin therapy (B-6 is a current favorite),
audiological counseling, psychiatry (medications have helped many), picture exchange systems (some autistic people think in pictures and so using photographs is an excellent way for you to communicate with them especially if they are nonverbal, parental education, teacher education, community education, lots of love and understanding. Finally, and perhaps most helpful, providing the student with a resource person or aide (shadow) to assist with daily routines and activities. (The resource aide should probably start with full days and then can scale back as deemed appropriate. Once the child is familiar with the classroom routine he will only need assistance if the routine is changed. Classmates can be shown how to offer assistance). (Many little boys respond amazingly well to little girls who are willing to be a friend and advocate).(if no aide is available welcome the mother or father to do this. If they both work perhaps a psychology student from the local university or other hired hand can be found).
What are the direct approaches?: physical therapy (some autistic children have poor coordination, balance or strength), occupational therapy (Sensory Integration Therapy and fine motor control), speech and language therapy, LOVAAS or TEACCH or similar program (these are complete teaching philosophies that have been shown to work with some autistics), ..
m If the kindergarten teacher can keep the child in class until the child's behaviors have lessened to the point that learning can take place then the child is going to be able to start making good progress in communication and social skills. Such a child will eventually exhibit language skills that are nearly age appropriate. This is when the direct approaches do the most good.
Antagonizing a child who is Autistic when he is clearly having difficulty making sense of a specific activity may push him further into negative or self- stimulating behaviors. Do not demand appropriate behavior from an autistic child when he is being bombarded with sensory input he cannot control, (tantrumming). Direct behavioral management: time outs, scoldings, withholding toys or priveledges won't work until the child develops improved language skills and becomes less egocentric.
While you are waiting for the child's behaviors to lessen, exploratory learning can still take place within the classroom. The child should be free to go where he wants and to pick out what he finds of interest. Having a support person with the child during this exploratory time is crucial. This is passive intervention because the support person should follow the child's lead. The aide/shadow/assistant's job is to identify things by name and to model simple correct word combinations.
There is no need to get a response, this comes with time. The child should be encouraged in his abilities, allowing the child to focus his attention on one activity for five to fifteen minutes. When the child chooses to attend to an object or activity he needs someone there who can engage him in language development activities. The support person models age appropriate descriptions of the object or activity at hand (the school Speech Language Pathologist can help here). The support person should be educated so that he/she can in turn educate school staff and intercede for the child as necessary. The regular daily schedule should be followed as close as possible with the child's support person making transitions as painless as possible via the strategy of trying to put himself/herself into the Autistic Child's Shoes, (never do the opposite). Picture cards may help. When transitions or other scheduled events are not easy, and if the child should act out, for whatever reason, the aide or shadow needs to be right there to provide a non-judgemental, understanding person that the child can safely vent on without redress.
What does NOT work? Possibly the same passive and direct things listed above that did work with one child but won't work with another. This depends upon the child's emotional development or his/her personality. The only way you will know if something will work with an autistic child is to try it.
My experience is that a child who can focus enough to follow one step directions will learn to follow two step directions, then three and four and so on. This is dependent on the child being able to focus. Predicting when he will be able to focus depends on a host of variables. Try the passive behavior management techniques listed above, if these do not work, then offer the child exploratory learning opportunities (keep the child on your class roll). Let him or her know that they can be a part of the class on their terms! Thats OK! You will see that they will quickly begin wanting to try to do what the other kids are doing and will begin to make attempts to come from outside the circle of activities. Initially, these attempts will most likely quickly turn to disasters (the support person will be there for rescueing). Give the child elbow room he's learning!
Heres what I've done as a speech therapist, acting as the resource person. Followed the child around. Inside, outside, it doesn't matter, let him/her go where they want so long as the weather is agreeable. Never open a door for the child until the child requests for you to do so. ( I shrug my shoulders, use wide facial expressions (WHAT?), and model the words I want the child to say (start out with "open", advance to "open door", advance to "John open the door", advance to "Please John, Open the door", I always use say the model followed with a pause and then by the words "you say it", after a while they know when I say "you say it" they are going to try to say back to me exactly what I just said". It took about a month or so of daily door opening routines to get the child to reliably repeat one word, and several months to advance to phrases and sentences). (At five the child speaks in compound sentences).
The doors are big and the child cannot both turn the knob and pull. He knows I can open it, and that he has to learn to ask for help. I only withold opening the door until I see he has had enough and is ready to tantrum, and then I open it. This builds trust, since he understands that I am not going to push him too far, and will reliably help him when he asks or needs me to. It helps to have a sense of humor, I make sure he knows we are really playing a game (laughter is good medicine). After all this is passive intervention and I should follow as much as possible. Only switching to direct intervention when a suitable learning experience presents itself. I have gone for one to two hours at a crack with no direct intervention taking place. Making believe that I am a child and that the HFA/AS child is my older sibling and he is the leader. Still, I model words, and phrases as appropriate every chance I get, (it doesn't ever appear to put a damper on what he is wanting to do).
We have picked up ants and other bugs, sorted leaves, played in the puddles, thrown lots of stones, raced MatchBox cars (I carry them in my pocket) (we started out racing large rubber balls down a hill over several visits, it was a great activity that many of the other children at the day care participated in with us once we got started). (I found it beneficial to welcome any child into our activties when we were playing on the play ground and often brought toys that sparked interest and had to be shared).
Marching Activity: This is one of my favorite things to do early on when language skills are just beginning to develop. I find a large open room where we can be free from distractions. (I always held him u..
p so that he could turn the lights on when we entered the room and off when we left. He learned the words on and off shortly after open and close). I got myself a pair of drum sticks or other suitable noise maker and started a beat that we could march to. Off I would go beating my sticks and chanting march, march, march, march. Over many sessions, (I never got tired of it. It was so much fun). We learned; March, stop, go, clap hands, back up, turn around, etc. I believe there is something meditative about marching. It gets the heart beating and the lungs working. The brain is getting all the oxygen it needs. This little boy who was such a mess, suddenly became a little compliant marcher. He followed the commands like a new recruit. The proximity of the commands to the action helped him to tie language and functionality together. Frequently, I marched and he barked the orders, giggling outright as he made me stop and go, over and over again.
There were days when nothing I did, agreed with him, and I would have this screaming kid (whom I'm sure everyone thought I was killing) kicking me and throwing things at me. We sometimes ate lunch alone after he tantrummed within his classroom, and this was usually quite pleasant although the foods he ate were limited. Eventually he was able to eat with the others. At nap time I would lay down with him on his mat and read a book to him. When he tantrummed I would try to give deep touches by hugging him, stroking his forearms or putting my arm heavily across his back (this is sensory integration stuff).
His mother and I traded messages in a log book, and spoke as needed on the phone. Perhaps the one thing that helped me most was her support of me as I tried different things and we both learned about Autism. We didn't always agree and she was the one who always made the decisions about what we were ultimately going to do. I was fortunate to have her help, and always valued her opinion. I believe she felt the same way about
me. She was open and thoughtful, I tried to be as well.
Her child is now in Kindergarten, he can: count, spell, read, knows his colors, shapes, numbers, letters, and speaks quite well with adults. He continues to be dismissed quickly by normal children but his mother has finally found a special needs child who enjoys playing with him.
On a recent, and now rare visit to his after school I was quite surprised and delighted to find him engaged in conversation with another child. (Previously, I could always spot him on the crowded playground by simply searching for the child who was by himself). I went to where they were, so I could eaves drop, (the language he uses with me is quite different than the language he uses with his peers). I found out that the other boy was on time-out when the teacher came to let him know that his sentence had been served and the other boy was gone.
I sure do invite feedback to my essay from anyone and everyone.
Let me know what you think about my observations.
Thanks ahead of time.
John W. Clabaugh MS., CCC/SLP