The Challenges of Autism

Autism is a pervasive developmental disorder (PDD) characterized by deficits in social
interaction and communication, and restricted, repetitive patterns of behaviour, interest and
activity (McGahan, 2001). In several cases, autism is associated with mental retardation.
“Individuals with autism may exhibit hyperactivity; short attention span; impulsivity;
aggression; self-injurious behaviours; odd responses to sensory stimuli; eating, sleeping,
motor or mood abnormalities; and difficulty comprehending the environment, thoughts,
emotions and needs of others (McGahan, 2001: 2).
These characteristics usually appear before the age of three, and boys are four times more
likely to develop autism than girls (McGahan, 2001: 8). There is also considerable individual
variation in the type and intensity of symptoms. Although our knowledge of autism disorders
has increased steadily over the past decades, researchers, clinicians and the families of
autistic children still face many challenges.
The complex causes of autism
There is still no definitive answer to the question of what causes autism. Researchers are
exploring a variety of different factors: genetic, medical, neurological and environmental.
Many parents and patient associations are concerned about the highly mediatised coverage
of a possible link between autism and the measles, mumps and rubella (MMR) vaccine.
However, there is no evidence from current studies that support this relationship (Wilson et
al, 2003).
Diagnosis: Improved accuracy but problems with access
Both researchers and clinicians agree that early, accurate diagnosis is
important to ensure early intervention, which in turn enhances the
chances to improve the quality of life, and educational and social
success

of

autistic

individuals

(http://www.cairn-

site.com/en/research2.html). Although the accuracy of diagnostic tests has improved
significantly in the past decade, there are still problems with access to these tests. In the
province of Quebec, for example, the diagnosis of autism requires evaluations by a number
of different professionals (psychiatrists, psychologists, speech therapists and occupational
therapists, etc) working within a healthcare system that is already resource-limited, and in a
variety of institutions and departments, (hospitals, clinics, schools, etc). In short, the
diagnosis requires several complex steps, and parents end up being placed on multiple

com/en/research4. Finally. as the expression of autistic symptoms varies between individuals. Lahaie from Autisme Montréal). HYPERACTIVE . the reality of adults living with autistic disorders is rarely examined by researchers or society in general. This situation not only jeopardises early intervention. These individuals all contribute. And access to rapid treatment is difficult for the same reasons as outlined above for diagnostic services. the identification and implementation of an optimal treatment regime is often a process of trial and error. autism is often accompanied by physical health problems like eating or sleeping disorders. There are still very few such programs in Great Britain and Canada.waiting lists. Moreover.html). some of whom may not be familiar with PDD or trained to intervene with individuals who exhibit unpredictable behaviour. to our understanding of autism and efforts to improve the quality of life of people living with autism. many families are left on their own to cope as best they can with the health problems of their autistic children (see our interview with Ms. This month. 2004). in their own unique way. Autistic adults: The forgotten ones Autism cannot be cured. or motor abnormalities. Unfortunately. However. but also generates considerable anxiety and anguish (Poirier and Kozminski. educational. The goal is to mitigate the symptoms in order to improve quality of life. The authors highlight the importance of implementing programs and services focused on the specific needs of autistic adults. 2008). Treatment: Needs versus available treatments and services Many behavioural. While more and more services are becoming available for autistic children and their families. drug and alternative therapies have been developed in an attempt to treat autistic disorders. The majority of autistic adults still requires assistance in day-to-day activities and is unable to hold employment or complete schooling (Howlin et al. efficacy at generating real and permanent changes in the core symptoms of autism has not yet been rigorously demonstrated for many treatments (http://www. A British study has shown that the core symptoms of autism persist into adulthood.cairn-site. These may require the intervention of specialists like endocrinologists or gastroenterologists. clinicians and researchers on autism. Hinnovic presents the perspectives of parents.

24 to 30 of them might have ADHD. Kids who have ADHD usually start having problems in preschool. No one gets ADHD on purpose. depending on who has it. Most kids with ADHD have problems concentrating and paying attention. or interrupt other people's conversations." "Don't you know where you put your lunch money?" "Stop fidgeting!" "Don't interrupt. but no one knows why. Kids with ADHD may spend a lot of time in the principal's office. In fact. about 9 may have ADHD. So if your school has 300 kids. talk too much."You're not paying attention. move around a lot. They can also act on impulse — this means doing things without thinking about them first. It's important to remember that everybody does these things once in a while. They have a disorder that means they might have problems paying attention or sitting still in their seats. But no one is sure why anyone has ADHD. Those letters stand for a condition called attention deficit hyperactivity disorder. It doesn't mean you have ADHD. Who Gets ADHD? About 9% of kids have ADHD. lazy. three times as many boys have ADHD. They might yell out the answers before other kids have a chance to raise their hands. or stupid. distracted. although scientists and doctors think that it probably has to do with differences in the way people's brains work. And ADHD isn't contagious — you can't catch it from someone like the flu. A kid might have a greater chance of developing ADHD if one of his or her relatives already has ADHD or another type of behavior problem. or if it sounds just like what you're used to hearing. . or forgetful. That means out of 100 kids. Boys have ADHD more often than girls. They might lose things and have trouble finishing assignments. Sometimes they do things that cause them to get hurt. They might change their friends a lot. What Are the Signs of ADHD? ADHD can cause kids to act in different ways. Sometimes they can be disorganized. Some kids with ADHD also might have trouble sitting still in class and waiting for their turn." Can you imagine what it would be like to hear people talk to you this way every single day? If you can imagine it. then you know what it's like to have ADHD. so it isn't ever anyone's fault. They may wiggle around in their seats. Kids who have ADHD are not bad.

and possessives. There are four major ways in which hearing loss affects children-1. . Speaking   Children with hearing loss often cannot hear quiet speech sounds such as "s. They also have difficulty with function words like the. Children with hearing loss have difficulty understanding words with multiple meanings. and learning. five. the less serious the ultimate impact. after." "t. This leads to misunderstandings and misuse of verb tense. 3. The earlier hearing loss occurs in a child's life. Specific Effects Vocabulary     Vocabulary develops more slowly in children who have hearing loss." "sh.Effects of Hearing Loss on Development It is well recognized that hearing is critical to speech and language development." "f. speech may be difficult to understand. The gap between the vocabulary of children with normal hearing and those with hearing loss widens with age. They may have a speaking pitch that is too high. It may have an impact on vocational choices. are. such as those with relative clauses ("The teacher whom I have for math was sick today. pluralization. Children with listening difficulties due to hearing loss or auditory processing problems continue to be an underidentified and underserved population. For example. 4. communication." and "k" and therefore do not include them in their speech. Sentence Structure    Children with hearing loss comprehend and produce shorter and simpler sentences than children with normal hearing. Thus. Children with hearing loss learn concrete words like cat. the more serious the effects on the child's development.") or passive voice ("The ball was thrown by Mary. Similarly. They may speak too loudly or not loud enough. an. Children with hearing loss do not catch up without intervention. equal to. Children with hearing loss often have difficulty understanding and writing complex sentences. 2. jump. and jealous. The language deficit causes learning problems that result in reduced academic achievement. and a.") Children with hearing loss often cannot hear word endings such as -s or -ed. Children with hearing loss may not hear their own voices when they speak. It causes delay in the development of receptive and expressive communication skills (speech and language). Communication difficulties often lead to social isolation and poor self-concept. nonagreement of subject and verb. and red more easily than abstract words like before. the earlier the problem is identified and intervention begun. the word bank can mean the edge of a stream or a place where we put money.

and timing of the support services children receive. Children with mild to moderate hearing losses. and unhappy in school. or poor rate of speaking. . Academic Achievement      Children with hearing loss have difficulty with all areas of academic achievement.They may sound like they are mumbling because of poor stress.or fourth-grade level. especially reading and mathematical concepts. quality. The level of achievement is related to parental involvement and the quantity. unless appropriate management occurs. poor inflection. The gap in academic achievement between children with normal hearing and those with hearing loss usually widens as they progress through school. particularly when their socialization with other children with hearing loss is limited. Social Functioning   Children with severe to profound hearing losses often report feeling isolated. achieve one to four grade levels lower than their peers with normal hearing. without friends. unless appropriate educational intervention occurs early. Children with severe to profound hearing loss usually achieve skills no higher than the third. These social problems appear to be more frequent in children with a mild or moderate hearing losses than in those with a severe to profound loss. on average.

inability to understand or use language.S. it is not intended to be a comprehensive research review. Each paper is intended as a first step to facilitate discussions that include individuals who do not know the disability. The information in these papers was obtained through a broad review of literature and Web sites of national agencies and organizations. Typically. drug abuse. neurological disorders.S. & Stephenson. students with these disabilities can become proficient readers. Understanding the characteristics of students with speech or language impairments that may affect reading is an important step toward developing effective instruction and appropriate assessments. Pendzick. Hearing loss. along with feedback and input from professionals in the disability areas. physical impairments such as cleft lip or palate. 2002). Fleischman. 2003). mental retardation. This paper is intended to begin a discussion of the issues surrounding reading and students with speech or language impairments. Yet with targeted interventions and accommodations in reading instruction and assessment. This paper provides: (1) an overview of the characteristics of students with speech or language impairments. and those who may know the disability but have not considered the interaction of the disability with reading or the assessment of reading through statewide testing. . Thus.5% of school-age ELLs with disabilities were identified with speech or language impairments (Zehler.Reading and Students with Speech or Language Impairments Students with speech or language impairments face unique challenges when reading. Creating accessible reading assessments based on accepted definitions of reading and proficiencies of reading requires knowledge of the issues specific to each disability and how they affect reading and the assessment of reading. approximately 23. schools (U. but not limited to. Department of Education. stuttering. Students with Speech or Language Impairments Approximately one million students 6-21 years of age in the United States received special education services for speech or language disabilities in the 2000-2001 school year. in this case speech or language impairments. to qualify for these services. Hopstock. These children have a number of receptive and expressive impairments. or voice impairments. (2) a description of common approaches to reading instruction. impaired articulation. and vocal abuse or misuse are all factors that can contribute to the severity of the speech or language impairment.982 K-12 English language learners (ELLs) received special education services for speech or language impairments in 2001-2002. ELLs must demonstrate difficulties with communication that are not related to the second language acquisition process and show that those difficulties are present in both the first and second language. and (3) assessment approaches and issues that surround the assessment of reading for students with speech or language impairments. It has been estimated that 83. comprising nearly 20% of all students with disabilities in U. The challenge of learning English and having a speech or language impairment adds another level of complexity to learning to read and demonstrating reading achievement (Muller & Markowitz. brain injury. including. 2004). The paper is one of several brief papers developed to contribute to the process of conducting research and developing accessible reading assessments for students with disabilities.

Tomblin. 1997). hallways. 1998). 2005). 2002).g. & Griffin. facilitate reading comprehension. Instruction for Students with Speech or Language Impairments Children with speech or language impairments may experience a range of challenges in the school setting due to their disability. and having difficulty with tests. sound counting. including seating students away from auditory or visual distractions. In this sense. Ball & Blachman. as well (Westby. complex classroom environments (ASHA. 2005). These challenges may be especially apparent in noisy. 2002) and these skills are known to be related to the successful acquisition of literacy (Adams.” and “finally. air vents. 2000. they may have difficulty with decoding. and letter-sound associations have been shown to improve decoding skills (e. or the ability to identify printed words through letter-sound correspondences.” “next. 2005a. Many techniques can facilitate reading success in the classroom for students with speech or language disabilities. & Zhang.b). Research has shown that children with speech and language impairments tend to show poor phonological awareness and other higher level phonological skills (Gillon.g. Second. children with speech and language impairments may have difficulty with reading comprehension because of their lack of facility with comprehending complex discourse (Bishop. Children with speech and language deficits can have reading problems that fall into two categories. Intervention efforts to improve comprehension of spoken language would be expected to generalize to comprehension of written language. Burns. using sequential words such as “first. having difficulty understanding and expressing language. with the potential to prevent academic issues later in life (ASHA.There is evidence of a relationship between language impairments and reading disabilities. Examples of these challenges that have been identified by the American Speech-Language-Hearing Association (ASHA) include misunderstanding social cues. the comprehension difficulties are secondary to their weak grasp of higher level language in any modality. 1991. monitoring sources of background noise (e. Fey. direct instruction and practice in phonological segmentation. establishing a consistent class time structure and routine. in turn. Teachers can improve the learning environment for children with speech or language impairments by manipulating their approaches in a variety of ways.. First. ensuring a child is paying attention before giving directions. These techniques are generally effective for all students. students with a history of language impairments are at risk for failure in reading achievement more than students without language impairments. In addition. showing poor judgment. 1997. For these difficulties. spoken or written. maintaining the student’s focus and attention. playgrounds. speaking slowly and clearly. Snow. ASHA cited research indicating that children who are not fluent readers by the fourth grade are likely to struggle with reading into adulthood. Ehren (2002) suggested that for students with speech or language impairments. it has also been suggested that word learning strategies might be . 2005). Although the connection between language impairments and reading difficulties is not causal or inevitable. street traffic). showing that a majority of native English speaking students who do not develop proficient reading skills in English had an early history of spoken-language deficits (Catts. Students who received intervention before age five had increased opportunity for overcoming speech or language impairments. Westby. the speech language pathologist might work with students on vocabulary instruction to.” and using visual cues and supports to aid comprehension.

Assessment of Students with Speech or Language Impairments Students with speech or language impairments may struggle on tests because their language impairments hamper their ability to understand directions or the wording of specific test items. and other characteristics create another? .implemented to facilitate reading fluency and understanding of meaning in context (McGregor. states. For students with speech or language impairments – who may have difficulty with sound/symbol connection. 2002) in kindergarten are excellent predictors of reading achievement in first and second grade for students in general. having a test read aloud to a student could disqualify the student from receiving a valid score. auditory processes. Testing environment accommodations. we do not know whether this holds true when children have speech or language impairments. whether the stakes are for the system or the student. They may also have increased test anxiety due to a history of struggling with academic tasks and the added pressure of high stakes assessments. or the scaffolding of language to support listening and expression in the context of literacy events. and schools typically allow students to use accommodations during testing. including noise buffers and amplification equipment. or clarified although there were scoring consequences in some states when this was done. 1993) and letter identification (Catts et al. Despite the work of several expert panels and national reading initiatives. even when administrators read them aloud. researchers are undecided about the extent to which reading fluency predicts overall reading ability for these students. Despite considerable evidence that rapid naming (Catts. Lazarus. In states’ 2003 accommodation policies. 48 states permitted tests to be read aloud. Morse. how to help students achieve it. Thirty-one states allowed directions to be repeated. or a variety of other accommodations. but only 3 allowed the read-aloud accommodation without any restrictions (Clapper. For instance. Thompson. were considered by a majority of states to be non-controversial accommodations. an assistive augmentative communication device. 2005). re-read.. And does this matter when it comes to state and district assessments? Are there aspects of these assessments that create a need for fluency skills? Do certain characteristics of students with speech or language impairments create one set of issues. 2005). there is still disagreement on what constitutes reading proficiency. In 14 states. To minimize the effects of the disability on test performance. additional time. use of a text book or dictionary. having the assessment broken down into smaller parts. and we know little about the accommodations typically used by ELLs with speech or language impairments. and language comprehension – what reading proficiency means. & Thurlow. and how educators measure it is even less clear. Measuring reading proficiency is not straightforward. districts. even for typical students. Accommodations for students with speech or language impairments may include having material read aloud. Few states have accommodation policies for ELLs with disabilities.

physical balance and coordination can be a challenge for visually impaired children. Starting at a new school or entering a new class can be particularly stressful. Since visually impaired children can't see everything around them. visually impaired children will feel stress in new or unfamiliar situations. Also. and prompt discussion with your child about different subjects. Emotional Stress o American Foundation for the Blind says that even in cases where the impairment comes on gradually or they've had a visual impairment since birth. Avoid rearranging furniture as well. particularly when they feel isolated from peers. as they can't always see the objects around them-they rely instead on sound and familiarity with their environment. visually impaired babies and children may not naturally develop an interest in objects or activities like other children. Engaging with the World and Developing Interests o According to Growing Strong. they don't know to investigate things further and ask questions. Visually impaired children also may occasionally feel sad or frustrated. Other things that family and friends can do to aid with coordination is to walk with the child through unfamiliar areas and install ramps as opposed to stairs when possible. Friends and family can help by listening to the child's concerns and encouraging the child to share his feelings. Family can help by always putting toys away in a designated area. since they can't interact with their environment the same way.Types of Problems a Visually Impaired Child Would Have By Chelsea Day. . while also keeping expectations of the visually impaired children high. Blind children rely entirely on sound and feeling. as well as items that make unique sounds. eHow Contributor Coordination o According to Family Connect. engage her with objects of varying textures and weights. Teachers can help by fostering understanding and open discussion about visual impairment within the class. Encourage your child to move about their environment and to ask questions when she can't understand something.

there are a few learning problems that visually impaired children may experience in any learning setting. and braille labels to help the child organize his or her schoolwork. Providing for the needs of special education students will certainly be one of your greatest challenges as a professional educator. Jabberwocky When working with special needs students. or other examples. Modification refers to changes to the instructional outcomes. which are very visual. Organization o Because they can't always see what objects are around them or specifics in terms of what papers are labeled. Children who are color blind may also benefit from large icons to label each subject. charts. the American Foundation for the Blinds also recommends labeling things in colors that the child can identify. Educators can help teach visually impaired children by including specific verbal explanations and tangible objects that children can touch and feel. For children who have some sight. reading comprehension. or spelling. between academic achievement and intellectual abilities in one or more of the areas of oral expression. . two terms you are sure to encounter are accommodation and modification. which is not the result of some other handicap. mathematical calculation. If educators use a board to draw out graphs.Learning Challenges o According to the National Federation of the Blind. Consider these tips and strategies. You may need to make accommodations for some and modifications for others. basic reading skills. and particularly in a traditional classroom. material. visually impaired children can't always see it or benefit from it. mathematics reasoning. written expression. Students with Learning Disabilities Learning disabled students are those who demonstrate a significant discrepancy. a change or decrease in the course content or outcome. or support process that will enable a student to accomplish a task more efficiently. An accommodation is a device. The same concept applies to physical exercises and group activities. including homework management. listening comprehension. The National Federation of the Blind recommends developing a storage system with bins. visually impaired children may have difficulty with organization. Teaching Students with Special Needs It is inevitable that you will have the opportunity (and pleasure) of working with special students in your classroom. folders.

Teaching learning disabled youngsters will present you with some unique and distinctive challenges. they need differentiated instruction tailored to their distinctive learning abilities. if not impossible. to stay on task for extended periods of time.  Has inflexibility of thought. so. often cannot control emotions.Following is a list of some of the common indicators of learning disabled students. they appear in varying degrees and amounts in most learning disabled students. These traits are usually not isolated ones. is difficult to persuade otherwise. Not only will these students demand more of your time and patience.  Is verbally demanding.  Has poor handwriting skills.  Has coordination problems with both large and small muscle groups.  Finds it difficult. rather.  Is easily distractible.  Has a weak or poor self-esteem.  Is easily confused.  Is spontaneous in expression.  Has a poor concept of time.  Has difficulty in following complicated directions or remembering directions for extended periods of time. Present tests and reading materials in an oral format so the assessment is not unduly influenced by lack of reading ability. rather. Use these appropriate strategies with learning disabled students:  Provide oral instruction for students with reading disabilities.  Has some difficulty in working with others in small or large group settings. too. . A learning disabled student …  Has poor auditory memory—both short term and long term. It is important to remember that learning disabled students are not students who are incapacitated or unable to learn.  Has a low tolerance level and a high frustration level. will they require specialized instructional strategies in a structured environment that supports and enhances their learning potential.

hear. Again.  Make activities concise and short. They need to see quickly the relationship between what was taught and what was learned. “I was particularly pleased by the way in which you organized the rock collection for Karin and Miranda. it is vitally necessary that learning disabled children utilize as many of their sensory modalities as possible. Long.” or “I like your work.”  When necessary. etc. .  Learning disabled students need and should get lots of specific praise. plan to repeat instructions or offer information in both written and verbal formats. drawn-out projects are particularly frustrating for a learning disabled child. “You did well. Provide learning disabled students with frequent progress checks.Invite students of varying abilities to work together on a specific project or toward a common goal. smell.” be sure you provide specific praising comments that link the activity directly with the recognition.  Encourage cooperative learning activities (seeTeaching with Cooperative Learning) when possible. Create an atmosphere in which a true “community of learners” is facilitated and enhanced. Let them know how well they are progressing toward an individual or class goal. for example. Instead of just saying. provide them with concrete objects and events—items they can touch. whenever possible. Whenever possible.  Learning disabled youngsters have difficulty learning abstract terms and concepts.  Give immediate feedback to learning disabled students.

eating. impulsivity. emotions and needs of others . or motor abnormalities AUTISM difficulty comprehending the environment.may exhibit hyperactivity. short attention span. odd responses to sensory stimuli. aggression. motor or mood abnormalities autism is often accompanied by physical health problems like eating or sleeping disorders. thoughts. self-injurious behaviours. sleeping.

HYPERACTIVE They can be disorganized. They may wiggle around in their seats. move around a lot. talk too much. . or interrupt other people's conversations. They can also act on impulse which means doing things without thinking about them first. They might lose things and have trouble finishing assignments. distracted. or forgetful.They have a disorder that means they might have problems paying attention or sitting still in their seats.

cannot hear quiet speech sounds such as "s. pluralization. Communication difficulties often lead to social isolation and poor self-concept." "t." "sh. Children with hearing loss do not catch up without intervention. and unhappy in school. and possessives. especially reading and mathematical concepts Children with hearing loss often cannot hear word endings such as -s or -ed. HEARING IMPAIRED feeling isolated. without friends." "f. difficulty with all areas of academic achievement. nonagreement of subject and verb. Thus.delay in the development of receptive and expressive communication skills The language deficit causes learning problems that result in reduced academic achievement. speech may be difficult to understand. The gap between the vocabulary of children with normal hearing and those with hearing loss widens with age. This leads to misunderstandings and misuse of verb tense." and "k" and therefore do not include them in their speech. . particularly when their socialization with other children with hearing loss is limited.

whether the stakes are for the system or the student. showing poor judgment. and having difficulty with tests. having difficulty understanding and expressing language. difficulty with reading comprehension because of their lack of facility with comprehending complex discourse difficulty with decoding.misunderstanding social cues. SPEECH IMPAIRED Struggle on tests because their language impairments hamper their ability to understand directions or the wording of specific test items. They may also have increased test anxiety due to a history of struggling with academic tasks and the added pressure of high stakes assessments. even when administrators read them aloud. or the ability to identify printed words through letter-sound correspondences. and language comprehension . difficulty with sound or symbol connection. auditory processes.

Blind children rely entirely on sound and feeling few learning problems that visually impaired children may experience in any learning setting. VISUALLY HANDICAPPED visually impaired babies and children may not naturally develop an interest in objects or activities like other children. including homework management. If educators use a board to draw out graphs. charts. feel stress in new or unfamiliar situations. and particularly in a traditional classroom.they can't always see the objects around them and they rely instead on sound and familiarity with their environment. or other examples. . particularly when they feel isolated from peers. visually impaired children can't always see it or benefit from it. since they can't interact with their environment the same way. difficulty with organization.