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Autism is defined by Wing and Gould (1978) as a spectrum disorder with an individual being identified as experiencing difficulties in three main areas. This is referred to as a 'triad' of impairment.
The three areas in which individuals with Autism Spectrum Disorders experience difficulty are:
- Social relationships
- Social communication
- Imagination and flexibility of thought
Individuals who are diagnosed with Autism, Autism Spectrum Disorders (ASD) and Asperger Syndrome (AS) are given a diagnosis because they experience all three of these difficulties. However, individuals with Autism, ASD or AS are all very different and will show different levels of understanding, disabilities and ability within this diagnosis. Some individuals will experience learning disability and others will have average or above average IQs.
When Leo Kanner (1943) first described individuals with Autism he made reference to more global intellectual impairments. Some individuals on the Autism Spectrum with severe learning disability are described as having ‘Kanner’s Autism’. However, Kanner also suggested that there is often no immediately accurate way to access the intellect or cognitive functioning of a person with ‘Kanner’s Autism’.
It is estimated that 75% of people with Autism also have some degree of learning disability, ranging from mild to severe. Individuals with a high level of intellectual functioning but still displaying the ‘triad’ of impairments may be described as having Asperger Syndrome or ‘High Functioning Autism’ (HFA). People with Asperger Syndrome generally have no language disorder although they still experience social communication difficulties.
There is evidence that early intervention and the provision of appropriate education, care and support can have a significant and positive effect upon the lives of individuals with Autism. There is however a wealth of testimony from parents and carers about the difficulties of getting a diagnosis and or of accessing appropriate services. (Unfortunately a significant number of people with Autism may have suffered a history of unsuccessful placements.) A good assessment and finding the right placement is therefore essential if the individual is to achieve his or her potential and enjoy the quality of life that should be theirs by right.
The debate over inclusion has been intense in recent years. For many children with Autism, inclusion in mainstream education is achievable and appropriate.
Specialist provision in the child’s home authority may be appropriate where this ensures that they have access to the level and nature of support that they require.
Some children will however require highly specialised support which may be impossible to create in their home authority area. Similarly some adults will require high levels of support and specialised help which local authorities would struggle to provide (because of the relatively low number of people requiring such services).
Children, young people and adults with severe Autism are one of the few groups with disabilities for whom inclusion into mainstream services is often not appropriate and in fact may be damaging. At times it requires parents, carers and professionals to act almost against their instincts, which are naturally to support and meet the needs of the individual in their home environment. Where it is not possible to meet the needs of a child, young person or adult at home a placement should be made available from which the individual can have their needs fully met and regular contact with their family or carers is an integral part of this provision.
Consistency and routine, over 24 hours a day, seven days a week and on occasions 52 weeks a year are necessary to provide the security that enables some individuals to maintain comfort and equilibrium in their day-to-day lives. It can be particularly difficult for parents and carers to achieve this continuity given the other pressures that impact upon their lives. They may for example, have more than one child or, may need to fit their caring responsibilities around full or part time employment. It is very important therefore that the Society provides services to children, young people and adults which support the growth and development of the individual but also strives to maintain their place within the family, community and society in general.
For some people with Autism the need for consistency and routine is paramount. Where this is the case the Society is able to provide education, care, social and vocational training on a 52 week basis. This can be particularly difficult for parents who wish to have their sons and daughters at home for weekends, holidays and special occasions. It is important therefore that we work to facilitate contact in a way that recognises or minimises distress to the individual with Autism but assures the most positive outcome for all concerned.
People with the most severe forms of Autism can present extremely challenging and violent behaviour that can put themselves and others at risk. They require constant supervision and support from specialist staff who know and understand them.
For those providing services the challenge is to create an environment where those with severe Autism, can be cared for, can engage in activities, learn, acquire skills and achieve their potential and quality of life whilst being safe, minimising risks to them and to others.
The following content has been kindly provided by The National Autistic Society (NAS) http://www.nas.org.uk
About autistic spectrum disorders
Although it was first identified in 1943, autism is still a relatively unknown disability. Yet autistic spectrum disorders are estimated to touch the lives of over 500,000 families throughout the UK.
People with autism are not physically disabled in the same way that a person with cerebral palsy may be; they do not require wheelchairs and they 'look' just like anybody without the disability. Due to this invisible nature it can be much harder to create awareness and understanding of the condition.
Because an autistic child looks 'normal' others assume they are naughty or the parents are not controlling the child. Strangers frequently comment on this 'failing'.
What is autism?
Autism is a lifelong developmental disability that affects the way a person communicates and relates to people around them. Children and adults with autism have difficulties with everyday social interaction. Their ability to develop friendships is generally limited as is their capacity to understand other people's emotional expression.
People with autism can often have accompanying learning disabilities but everyone with the condition shares a difficulty in making sense of the world.
There is also a condition called Asperger syndrome, which is a form of autism used to describe people who are usually at the higher functioning end of the autistic spectrum.
What are the characteristics of autism?
People with autism generally experience three main areas of difficulty; these are known as the triad of impairments.
- Social interaction (difficulty with social relationships, for example appearing aloof and indifferent to other people)
- Social communication (difficulty with verbal and non-verbal communication, for example not fully understanding the meaning of common gestures, facial expressions or tone of voice)
- Imagination (difficulty in the development of interpersonal play and imagination, for example having a limited range of imaginative activities, possibly copied and pursued rigidly and repetitively).
In addition to this triad, repetitive behaviour patterns and resistance to change in routine are often characteristic.
What causes autism?
The exact cause or causes of autism is/are still not known but research shows that genetic factors are important. It is also evident from research that autism may be associated with a variety of conditions affecting brain development which occur before, during, or very soon after birth.
Diagnosis
The earlier a diagnosis of autism is made, the better the chances are of a person receiving appropriate help and support.
Can people with autism be helped?
Specialist education and structured support can really make a difference to the life of a person with autism, helping to maximise skills and achieve full potential in adulthood.
What is Asperger syndrome?
1. Introduction
As soon as we meet a person we make judgements about them. Just by looking we can guess their age or status, and by the expression on their face or the tone of their voice we can tell immediately if they are happy, angry or sad and respond accordingly.
Not everyone has this natural ability. People with Asperger syndrome find it more difficult to read the signals which most of us take for granted. As a result they find it more difficult to communicate and interact with others. This leaflet explains the characteristics of Asperger syndrome and what can be done to help those affected.
Asperger syndrome is a form of autism, a condition that affects the way a person communicates and relates to others. A number of traits of autism are common to Asperger syndrome including:
- difficulty in social relationships
- difficulty in communicating
- limitations in imagination and creative play
However, people with Asperger syndrome usually have fewer problems with language than those with autism, often speaking fluently though their words can sometimes sound formal or stilted. People with Asperger syndrome do not usually have the accompanying learning disabilities associated with autism; in fact, people with Asperger syndrome are often of average or above average intelligence
Because of this many children with Asperger syndrome enter mainstream school and, with the right support and encouragement, can make good progress and go on to further education and employment.
2. Key characteristics
Asperger syndrome shares many of the same characteristics as autism. The key characteristics are:
Difficulty with social relationships
Unlike the person with 'classic' autism, who often appears withdrawn and uninterested in the world around them, many people with Asperger syndrome want to be sociable and enjoy human contact. They do still find it hard to understand non-verbal signals, including facial expressions, which makes it more difficult for them to form and maintain social relationships with people unaware of their needs.
Difficulty with communication
People with Asperger syndrome may speak fluently but they may not take much notice of the reaction of the people listening to them; they may talk on and on regardless of the listener's interest or they may appear insensitive to their feelings.
Despite having good language skills, people with Asperger syndrome may sound over-precise or over-literal - jokes can cause problems as can exaggerated language, turns of phrase and metaphors. A person with Asperger syndrome may be confused or frightened by a statement like 'she bit my head off'. In order to help a person with Asperger syndrome to understand you, keep your sentences short - be clear and concise.
Limitations in imagination
While they often excel at learning facts and figures, people with Asperger syndrome find it hard to think in abstract ways. This can cause problems for children in school where they may have difficulty with certain subjects such as literature or religious studies.
Special interests
People with Asperger syndrome often develop an almost obsessive interest in a hobby or collecting. Usually their interest involves arranging or memorising facts about a special subject, such as train timetables, Derby winners or the dimensions of cathedrals.
With encouragement interests can be developed so that people with Asperger syndrome go on to study or work in their favourite subjects.
Love of routines
People with Asperger syndrome often find change upsetting. Young children may impose their routines, such as insisting on always walking the same route to school. At school, they may get upset by sudden changes, such as an alteration to the timetable. People with Asperger syndrome often prefer to order their day according to a set pattern. If they work set hours then any unexpected delay, such as a traffic hold-up, or a late train, can make them anxious or upset.
These are the main features of the condition, but because every person is an individual, these characteristics will vary greatly and some may be demonstrated more strongly than others.
3. What causes Asperger syndrome?
The causes of autism and Asperger syndrome are still being investigated. Many experts believe that the pattern of behaviour from which Asperger syndrome is diagnosed may not result from a single cause. There is strong evidence to suggest that Asperger syndrome can be caused by a variety of physical factors, all of which affect brain development - it is not due to emotional deprivation or the way a person has been brought up.
4. Is there a cure?
Asperger syndrome is a developmental condition affecting the way the brain processes information and there is no 'cure'; children with Asperger syndrome become adults with Asperger syndrome. Much can be achieved to make life less challenging with appropriate education and support.
With time and patience people with Asperger syndrome can be taught to develop the basic skills needed for everyday life, such as how to communicate appropriately with people.
5. The importance of early diagnosis
Because the condition of people with Asperger syndrome is not as marked as those with autism, they may not be diagnosed for a long time. This can mean that their particular needs may go unrecognised and parents may blame themselves, or worse still blame their child for their unusual behaviour.
6. What does the future hold?
At present, there are few facilities specifically for children with Asperger syndrome. Some children are in mainstream schools where their progress depends on the support and encouragement of parents, carers and teachers. Some children with Asperger syndrome go to specialist schools for children with autism or learning disabilities.
Because their disability is often less obvious than that of someone with autism, a person with Asperger syndrome is, in a sense, more vulnerable. They can, sadly, be an easy target for teasing or bullying at school.
As they get older, they may realise that they are different from other people and feel isolated and depressed. People with Asperger syndrome often want to be sociable and are upset by the fact that they find it hard to make friends.
But the future for people with Asperger syndrome does not have to be bleak. Adults with Asperger syndrome can and do go on to live fulfilling lives, to further education and employment and to develop friendships.
In the workplace, people with Asperger syndrome can offer a great deal - punctuality, reliability and dedication - though informed and understanding employers and colleagues are essential.
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