Definition of autism needs some refining
True or False? Any child who constantly lines up objects such as cars or toy animals has autism. The answer is false. Perseveration with items, such as lining up cars over and over again, can imply autism. However, a child who has sensory processing issues or gross motor problems may also do the same behavior. This may be the child’s way to handle stressful situations or it may be how she handles being overwhelmed. Perseveration, however, can be an indicator of autism but it is not a defining fact.
The criteria issues for autism involve relationships, communication and cognitive development. A red flag for autism may be a young child that is having difficulty expressing feelings towards key individuals in their life such as a parent or siblings. The inability to communicate or recognize gestures and emotional expressions is an indicator of autism. For example, a child should recognize a face of anger as a warning sign to change a behavior that is unacceptable. A good question to ask is "Can the child verbally express a feeling rather than facts?" Does the child typically say informational phrases such as "I see a brown dog?" vs. "I love my dog because he makes me happy." Autism by definition is a sensory perception disorder that severely effects communication whether the child is intellectually delayed or intellectually gifted.
Soon, the American Psychiatric Association will complete its fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSMV). This will be the first major revision of the manual in 17 years. A lot of controversy is already surrounding the new manual even before it has even been completed. It is expected that the current definition and criteria for receiving a diagnosis for autism will be changed and narrowed.
As a teacher, it is obvious in the classroom which children exhibit "classic autism" vs. those children who function more readily in both academics and society as a whole. Yet, the number of children receiving the autism label has increased dramatically. The reality in today’s classroom is that children currently labeled with autism have extreme differences in their abilities. Something does need to be changed. Yet, parents are justly concerned that changing the definition of autism could result in less educational services for those children who are on the milder end of the autism spectrum.
Over the years, a wide range of children diagnosed with autism have passed through the teacher’s classroom. She remembered two children in particular. Homer was one of her more recent students. He came into the room nonverbal and extremely aggressive. The teacher knew that the major problem for the boy was his inability to communicate. He loved to take cars and line them up to calm himself from the inability to understand what was expected from him. The teacher thought of the boy as a young Helen Keller. Like Helen, the boy’s inability to explain his wants and needs led to strong temper outbursts. Over time, with Picture Exchange Communication, Eric Carle interactive books, ABA (Applied Behavioral Analysis) work, TEAACH and lots of visuals, the boy began to change. He discovered to his delight that using pictures brought what he wanted. He wanted lots of things including Popsicles, gummy bears and fish crackers. Like Helen, his transformation wasn’t an immediate change. Change steadily occurred with the boy as he learned to communicate initially through pictures and later by voice activated communication devices. Homer was definitely a child with classic autism.
Then there was Olive. Olive was initially placed in a PPCD unit for children just entering the education system. She was extremely active and difficult to control at first. When Olive came into the teacher’s room, the girl discovered all kinds of sensory objects and lots of rewards for good behavior. Within a matter of months, the girl’s behavior changed and she was able to function well in the classroom. Over a series of weeks, the girl was able to go out into general education and do some of the same work as her classmates. Olive initially needed help in her classroom so she could catch up with her peers, and catch up she did. In Olive’s case, she too had an autism label just like Homer. The question remains in Olive’s case, does she have autism or does the girl really have sensory and or gross motor issues? Hopefully, the new definition coming out on autism will better define the disability to ensure that children receive the best possible services for their own particular needs. To be labeled incorrectly can result in inappropriate placement in the educational system with some diminished expectations on a child’s true ability level.
Pamela Gross Downing, a special education teacher can be reached at downpamg@aol.com.
