Understanding Autism

Working with the child who may have autism

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I’ve been told a child in my class is autistic. There’s so much talk about it these days, but I’m still a bit confused. What is the best way to work with this child in my classroom?

Autism is a developmental disorder that involves many challenges. Autistic children have trouble forming relationships. They also have difficulty understanding and responding to emotional signals from others. Other challenges include using language, using words creatively, using imagination, and, later, thinking abstractly. These are the core forms of the deficit called autism. This condition is also associated with some typical symptoms that are not only present in children with autism. It’s important to keep in mind that these symptoms may be present in children with other challenges as well. Symptoms include:

• self-absorption
• repetitive, self-stimulatory behavior
• repeating words over and over again
• motor movements, such as hand-flapping

Again, these behaviors can also be seen in children who have less severe challenges. These actions alone should not be considered signs of autism. Instead, a teacher should look for the core challenges listed above.

Understanding Children’s Uniqueness An important point to remember when trying to understand how to help such children is that, though children with this diagnosis share a common descriptive label, every child with autism is different. Some children are overreactive to things such as touch and sound while others are very underreactive to touch and sound. The overreactive child needs extra soothing, while the child who is underreactive needs his teacher to be very energetic and animated.

To help any particular child, you have to know how he is unique. We have developed the DIR (Development, Individual Difference, and Relationship-Based) model to help us do this.

Promoting Interactions The DIR Floortime Model addresses individual differences by looking at:

• the way each child takes in, processes, and understands new experiences
• the way he reacts to things such as touch and sound
• the way he comprehends visual experience
• the way he plans actions
• his level of handling relationships

For example, a child with autism who is just beginning to learn how to engage and interact with others may sometimes be very self-absorbed and wander the room aimlessly. Helping him requires meeting him at his level and persuading him to want to relate to others. He may be occupied, for example, with a little car he likes to hold. His teacher might take the car in her hand, or put it on her head, as a playful way of enticing him into interacting with her. The same child might be very underreactive to touch and sound, have low muscle tone, and be very passive. A teacher would have to use a higher energy level and be very animated to grab his attention. As the teacher engages him, she starts helping him move up the developmental ladder.

The general goal for a teacher of an autistic child is to, within the scope of resources available to her, create learning relationships tailored to the needs of the particular child. For some children, accomplishing this goal may require having an aide to provide extra help in a preschool or kindergarten program. Other times, classroom volunteers might help. ECT

Stanley I. Greenspan, MD, is co-author, with T. Berry Brazleton, MD, of The Irreducible Needs of Children (Perseus Press, 2000). Dr. Greenspan is a clinical professor of psychiatry, behavioral science, and pediatrics at the George Washington University Medical School.

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