A Unique Child

SEN: Understanding Autism

  • SEN: Understanding Autism
  • SEN: Understanding Autism
  • SEN: Understanding Autism
  • SEN: Understanding Autism
  • SEN: Understanding Autism
  • SEN: Understanding Autism

Educational psychologist Julia Dunlop outlines the key factors early years practitioners should consider when working with young children with autistic spectrum disorders…

The autism spectrum is an umbrella term used to describe a range of people who have a common set of characteristics relating to their ability to interact, communicate and make sense of the world. Wing & Gould (1979) described these three areas of difficulties as the ‘Triad of Impairments’.

At one end of the spectrum is the child with ‘classic’ autism, as described by Leo Kanner in the 1940s. This child is likely to be very aloof, have little or no language and to be extremely sensitive to changes in routine. At the other end of the spectrum is the child with Asperger syndrome. This child does have language and social interaction skills, but an odd way of using them. Rigid behaviour is still present, but in a more subtle form.

A diagnosis on the autism spectrum is arrived at following observation and assessment by a range of professionals within a multi-agency team. Children at the ‘classic’ end of the spectrum are, nowadays, frequently diagnosed before their third birthday. A child with Asperger syndrome, however, is unlikely to receive a diagnosis before they start school – although initial concerns will probably be raised during the preschool period.

Supporting assessment

Observations recorded by early years practitioners can provide invaluable information to those professionals involved in the diagnostic process, especially if these observations focus on the three areas of the ‘Triad’.

When observing a child’s social interaction skills, look out for whether they:

● return your smile

● spontaneously bring things of interest to show you

● come for comfort when upset

● can take turns in simple games

● get upset, or walk away, if others come close to them

● ever make the first move to seek interaction with others.

When observing a child’s social communication skills, notice whether they:

● follow your gaze when you look at something across the room

● point out things of interest (not just things they want)

● look towards something you are pointing out

● use social gestures – a nod, a wave, a shake of the head

● understand your gestures and facial expressions

● engage in two-way communication, naturally filling gaps with their own sounds or words

● ever mix up pronouns, perhaps saying, “He wants some juice” rather than, “I want some juice.”

Judge the extent to which the child’s behaviour is flexible by noting whether:

● genuine pretend play is present – rather than the repetition of the same sequence of actions over and over

● they ‘allow’ others to get involved in their play, perhaps changing the game slightly

● there is any insistence on certain routines – and distress if things happen in the ‘wrong’ order

● there is unusual sensory sensitivity – perhaps the sniffing toys or overreaction to sudden noises

● hands or fingers are moved in an odd or unusual way – for example, flapping or flicking.

As with all assessments, it is important to take account of the child’s developmental level and the context of the observations.

Developmental impact

A child on the autism spectrum has a different way of seeing and interpreting the world. This inevitably has an impact on the way they learn and interact. It’s useful for early years practitioners to consider three main areas.

From the perspective of the young child on the autism spectrum:

People are perplexing
Most typically, developing children have, by the age of four, become aware that other people have thoughts and feelings that may be different from their own. The young child on the autism spectrum may never realise this. This presents them with huge difficulties in ‘reading’ people. If you can’t make sense of people and find them unpredictable, this can be terrifying – leading to avoidance of social situations.

For example: Bertie used to love listening to music. When the music stopped, he just stood beside the CD player wailing. He didn’t realise that he had to go and ask Mum to change the CD.

The known is comforting, the unknown is terrifying
Young children with autism find it difficult to make connections, leading to problems in generalising skills learnt in one situation to another context. If connections aren’t obvious, everything seems new and frightening – no wonder they have a preference for the familiar.

For example: Ella, who’d been attending nursery for over a year, arrived one day and became inconsolably distressed. It took some time before staff realised that Ella’s upset was because they’d repositioned some items of furniture. Although a minor change as far as the other children were concerned, it had rendered the nursery unrecognisable to Ella – hence her terror.

This is my focus; I don’t know that your focus is different
When working with very young children, two commonly used strategies are to gain joint attention and to get the child to imitate. The young child on the autism spectrum often has an idiosyncratic focus of attention and will have no idea what you want them to look at – let alone be able to imitate. This is the case even when the child appears to be paying attention.

For example: Izzy was sitting amongst a group of children at storytime, looking towards the book. When asked, she had no idea what the story had been about, but she knew how many telegraph poles she’d seen in the pictures.

How can we help?

Early years practitioners are likely to be just one of a number of agencies involved in helping the child and supporting their family. It is in the child’s best interests if all these agencies work closely together. Within the setting, this will be coordinated by the SENCo.

Within the EYFS, practitioners can help the young child on the autism spectrum by:

● following the child’s lead, seeing what interests them, sitting beside them, then gradually sharing the activity

● slowly introducing other children, one at a time, to the activity – modelling and prompting turn-taking

● structuring activities so that the child’s role is obvious

● specifically teaching imitation skills

● giving clear visual clues to help prepare the child for changes

● creating situations which could prompt the child into using their language communicatively – for example, ‘forgetting’ to give them a straw for their milk carton

● exaggerating gestures and facial expressions to emphasise their meaning

● using photos and videos to help children recall tasks they’ve completed previously – helping them to connect episodes of learning.

The most fundamental thing we can do is to try to see the world as the child sees it – to understand their perspective. In this way, we can begin to present the world in a way which will help them to make sense of it, thus minimising stress and maximising learning.

Case study: Javid – age four years

Javid’s parents had been concerned about his development since he was 18 months old, particularly because he didn’t start to develop language. He also seemed very ‘distant’, as if he was unaware of other people. His play was repetitive: lining up cars or spinning their wheels endlessly. When Javid reached the age of two his family health visitor referred him for assessment at the local child development centre.

Following an assessment involving a paediatrician, educational psychologist, teacher and speech & language therapist, Javid was given a diagnosis of autism.

Javid’s entry to nursery at the age of three was planned carefully and staff were given advice and support by a specialist teacher. Despite this planning, it was soon clear that Javid became upset at less-structured times of the day. A simple picture timetable was introduced. At first this was just two pictures – emphasising: first this; then that. By the time he went to school, Javid’s timetable had a series of five pictures on it.

Javid could vocalise, but he still had no spoken language. The speech & language therapist helped to introduce the Picture Exchange Communication System (PECS) (Bondy & Frost 1996). This helped Javid begin to initiate communication with adults in the setting – he could hand over a picture to request things. In time, he would vocalise to gain the adult’s attention before making his request. By the time he went to school he had developed, and was using, a few single words.

Javid’s imitation and play skills were enhanced using Tabletop Identiplay (Beyer & Gammeltoft 2000). This activity uses two identical sets of toys: one for the child, one for the practitioner. Initially the adult copies what the child does. Later the child begins to imitate the adult’s actions.

Javid successfully transferred into Reception class following an extended induction period.

Before her retirement, Julia Dunlop was, for 12 years, a senior educational psychologist and early years specialist. She is the co-author of Autism in the Early Years – a practical guide and Asperger syndrome – a practical guide for teachers.