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interesting article on autism. sorry its a bit longFrequently Asked Questions about Autism
Temple Grandin, Ph.D.
Assistant Professor
Colorado State University
Fort Collins, CO 80523, USA
1. How do I know if my child has problems with sensory over
sensitivity?
Sounds or visual stimuli that are tolerated by normal children may
cause pain, confusion and/or fear in some autistic children. Sensory
over sensitivity can vary from very slight to severe. If your child
frequently puts his hands over his ears, this is an indicator of
sensitivity to noise. Children who flick their fingers in front of
their eyes are likely to have visual sensitivity problems. Children
who enjoy a trip to a large super-market or a shopping mall usually
have relatively mild sensory sensitivities. Autistic children with
severe sensory sensitivities will often have tantrums and other bad
behavior in a shopping mall due to sensory overload. These children
are the ones who will most likely need environmental modifications in
the classroom. Older children and adults, who remain nonverbal and
have very little language, often have more severe sensitivities than
individuals with good language. Children with auditory or visual
sensitivity will often have normal hearing and visual acuity tests.
The problem is in the brain, whereas the ears and eyes are normal.
2. What sights and sounds are most likely to cause sensory overload
or confusion in the classroom?
Every autistic child or adult is different. A sound or sight, which
is painful to one autistic child, may be attractive to another. The
flicker of fluorescent lighting can be seen by some children with
autism and may be distracting to them. It is mostly likely to cause
sensory overload in children who flick their fingers in front of
their eyes. Replacing fluorescents with incandescent bulbs will be
helpful for some children. Many children with autism are scared of
the public address system, the school bells or the fire alarms,
because the sound hurts their ears. Screeching electronic feedback
from public address systems or the sound of fire alarms are the worst
sounds because the onset of the sound canNOT be predicted. Children
with milder hearing sensitivity can sometimes learn to tolerate
hurtful sounds when they know when they will occur. However, they may
NEVER learn to tolerate UNexpected loud noise. Autistic children with
severe hearing sensitivity should be removed from the classroom prior
to a fire drill. The fear of a hurtful sound may make an autistic
child fearful of a certain classroom. He may become afraid to go into
the room because he fears that the fire alarm or the public address
systems may make a hurtful sound. If possible, the buzzes or bell
should be modified to reduce the sound. Sometimes only a slight
reduction in sound is required to make a buzzer or bell tolerable.
Duct tape can be applied to bells to soften the sounds. If the public
address system has frequent feedback problems, it should be
disconnected.
Echoes and noise can be reduced by installing carpeting -- carpet
remnants can sometimes be obtained from a carpet store at a low cost.
Scraping of chair legs on the floor can be muffled by placing cut
tennis balls on the chair legs.
3. Why does my child avoid certain foods or always want to eat the
same thing?
Certain foods may be avoided due to sensory over sensitivity. Crunchy
foods such as potato chips may be too loud and sound like a raging
forest fire to children with over sensitive hearing. Certain odors
may be overpowering. When I was a child I gagged when I had to eat
slimy foods like jello. However, some limited food preferences may be
bad habits and are not due to sensory problems. One has to be a
careful observer to figure out which foods cause sensory pain. For
example, if a child has extreme sound sensitivity, he should not be
required to eat loud, crunchy foods; but he should be encouraged to
eat a variety of softer foods. When I was a child my parents made me
eat everything except the two things which really made me gag. They
were under-cooked slimy egg whites and jello. I was allowed to have a
grilled cheese sandwich everyday for lunch, but at dinnertime I was
expected to eat everything that was not slimy.
To motivate a child to eat something he does not like, it is
recommended to have a food he really likes such as pizza right in
front of him along with the food he dislikes. He is then told that he
can have the pizza after he eats a few bites of peas. It is important
to have the pizza right there in front of him to motivate eating
something he does not like.
4. How do I toilet train my autistic child?
There are two major causes of toilet training problems in children
with autism. They are either afraid of the toilet or they do not know
what they are supposed to do. Children with severe hearing
sensitivity may be terrified of the toilet flushing. The sound may
hurt their ears. Sometimes these children can learn if they use a
potty chair which is located away from the frightening toilet. Due to
the great variability of sensory problems, some children may like to
repeatedly flush the toilet but they are still not trained. The
thinking of some autistic children is so concrete that the only way
they can learn is to have an adult demonstrate to them how to use the
toilet. They have to see someone else do it in order to learn. Some
children with very severe sensory processing problems are not able to
accurately sense when they need to use the bathroom. If they are calm
they may be able to feel the sensation that they need to urinate or
defecate, but if they experience sensory overload they cannot feel
it. This may explain why a child will sometimes use the toilet
correctly, and other times he will not.
5. Why do some autistic children repeat back what an adult has said
or sing TV commercials?
Repeating back what has been said, or being able to sing an entire TV
commercial or children's video is called 'echolalia.' Echolalia is
actually a good sign because it indicates that the child's brain is
processing language even though he may not be understanding the
meaning of the words. These children need to learn that words are
used for communication. If a child says the word 'apple,' immediately
give him an apple. This will enable the child to associate the
word 'apple' with getting a real apple. Some autistic children use
phrases from TV commercials or children's videos in an appropriate
manner in other situations. This is how they learn language. For
example, if a child says part of a breakfast cereal slogan at
breakfast, give him the cereal.
Autistic children also use echolalia to verify what has been said.
Some children have difficulty hearing hard consonant sounds such
as "d" in dog or "b" in boy. Repeating the phrase helps them to hear
it. Children who pass a pure tone hearing test can still have
difficulty hearing complex speech sounds. Children with this
difficulty may learn to read and speak by using flash cards that have
both a printed word and a picture of an object. By using these cards
they learn to associate the spoken word with the printed word and a
picture. My speech therapist helped me to learn to hear speech by
lengthening hard consonant sounds. She would hold up a ball and
say "bbbb all." The hard consonant sound of "b" was lengthened. Some
autistic children learn vowel sounds more easily than consonants.
6. How should educators and parents handle autistic fixations on
things such as lawn mowers or trains?
Fixations should be used to motivate schoolwork and education. If a
child is fixated on trains, use his interest in trains to motivate
reading or learning arithmetic. Have him read about trains or do
arithmetic problems with trains. The intense interest in trains can
be used to motivate reading. It is a mistake to take fixations away,
but the child needs to learn that there are some situations when
talking about trains is not appropriate.
The idea is to broaden the fixation into a less fixated educational
or social activity. If a child likes to spin a penny then start
playing a game with the child where you and the child take turns
playing with the penny. This also helps to teach turn taking. A train
fixation could be broadened in studying history. A high-functioning
child would be motivated to read a book about the history of the
railroad. One should build and broaden fixation into useful
activities. My career in livestock equipment design started as a
fixation on cattle chutes. My high school science teacher encouraged
me to study science to learn more about my fixation.
High functioning autistic and Asperger teenagers need mentors to help
them develop their talents into a career skill. They need somebody to
teach them computer programming or graphic arts. A local computer
professional could serve as a mentor or the individual may be able to
take a programming class at a community college. Many parents wonder
where they can find a mentor for their teenager. Try posting a notice
on a bulletin board at a university computer science department or
strike up a conversation with the man in the supermarket checkout
line who is wearing a badge with the name of a computer company on
it. I found one of my mentors in the business world when I met the
wife of his insurance agent.
7. What is the difference between PDD and autism?
Autism and PDD are behavioral diagnoses. At the present time there
are no medical tests for autism. Autism is diagnosed based on the
child's behavior. Both children diagnosed with autism and PDD will
benefit from education programs designed for autistics. It is
essential that children diagnosed as PDD receive the same education
as children diagnosed with autism. Both autistic and PDD children
should be placed into a good early education program immediately
after diagnosis. Children diagnosed with PDD tend to fall into two
groups: (1) very mild autistic symptoms, or (2) some autistic
symptoms in a child who has other severe neurological problems.
Therefore, some children diagnosed as PDD may be almost normal; and
others have severe neurological problems such as epilepsy,
microencephaly or cerebral palsy. The problem with the autism and PDD
diagnoses is that they are NOT precise. They are based only on
behavior. In the future, brain scans will be used for precise
diagnosis. Today there is no brain scan that can be used for
diagnosing PDD nor autism.
8. Why is Early Intervention important?
Both scientific studies and practical experience have shown that the
prognosis is greatly improved if a child is placed into an intense,
highly structured educational program by age two or three. Autistic
children perform stereotypic behaviors such as rocking or twiddling a
penny because engaging in repetitive behaviors shuts off sounds and
sights which cause confusion and/or pain. The problems is that if the
child is allowed to shut out the world, his brain will not develop.
Autistic and PDD children need many hours of structured education to
keep their brain engaged with the world. They need to be kept
interacting in a meaningful way with an adult or another child. The
worst things for a young two to five year old autistic child is to
sit alone watching TV or playing video games all day. His brain will
be shut off from the world. Autistic children need to be kept
engaged; but at the same time, a teacher must be careful to avoid
sensory overload. Children with milder sensory problems often respond
well to Lovaas-type programs. However, children with more severe
sensory processing problems may experience sensory overload. There
are two major categories of children. The first type will respond
well to a therapist who is gently intrusive and pulls them out of
their world. I was this type. My speech therapist was able to "snap
me out of it" by grabbing my chin and making me pay attention. The
second type of child has more neurological problems, and they may
respond poorly to a strict Lovaas program. They will require a
gentler approach. Some are 'mono-channel' because they cannot see and
hear at the same time. They either have to look at something or they
have to listen. Simultaneous looking and listening may result in
sensory overload and shutdown. This type of child may respond best
when the teacher whispers quietly in a dimly illuminated room.
A good teacher needs to tailor his/her teaching method to the child.
To be successful, the teacher has to be gently insistent. A good
teacher knows how hard to push. To be successful, the teacher has to
intrude into the autistic child's world. With some children the
teacher can jerk open their "front door;" and with other children,
the teacher has to sneak quietly in their "back door."
9. Why does my child want to wear the same clothes all the time?
Stiff scratching clothes or wool against my skin is sandpaper ripping
off raw nerve endings. I am not able to tolerate scratching clothes.
Autistic children will be most comfortable with soft cotton against
their skin. New underwear and shirts will be more comfortable if they
are washed several times. It is often best to avoid spray starch or
fabric softeners that are placed in the dryer. Some children are
allergic to them. [Note: Caretakers and teachers should also avoid
the use of perfume because some children hate the smell and/or they
are allergic to it.]
Even today at the age of 49, I have had to find good clothes and work
clothes that feel the same. It takes me up to two weeks to habituate
to the feeling of wearing a skirt. If I wear shorts during the
summer, it takes at least a week before long pants become fully
tolerable. The problem is switching back-and-forth. Switching back-
and-forth can be made more tolerable by wearing tights with skirts.
The tights make the skirt feel the same as long pants.
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pixie
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A great explanation of ASD and I'm sure people who don't live with ASD can understand a little more from that piece.
So many of the things were typical of my son but thankfully now he doesn't have as many sensory problems, he eats much better, sleeps better but is still intolerant of "surprises", such as visitors arriving unexpectedly etc.
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