Wednesday, February 9, 2011

Things I've learnt - How Autistic Kids (and adults) think

So my first blog of notes is to do with "How Autistic kids (and adults) think"

The point of this section is to give an isight into why Autistic kids (and people) do the things they do. Why they act they way they do and to give some idea of "reasonable expectations". Autistic children have specific neurological deficits which they cannot change. The behaviours due to these deficits are fixed. It would be like asking a blind man to see - impossible. All we can do via behavioural programs and teaching is to create work-arounds for these children; so they can operate in the "normal" world and succeed.

There are three main deficits that are found within Autistic people. These are deficits in "Information Processing", "Executive Function" and "Theory of mind". These deficits account for a lot of the social difficulties Autistic people have. It is also responsible for the literal thinking and is a reason why "visual aids" are so useful regardless of the level of intelligence.

Information processing and Executive Functioning
People with Autism have impaired Information processing and Executive Function. Information processing can be described as the "filing cabinate" of our mind. Information processing takes all of the sensations we gain from our senses and co-ordinates and interprets them. It allows us to remember "past events" so that when we experience a sensation again we can immediately understand it and place it in context. Poor Information processing can be described as "waking up in a new country every day, where everyone talks a different language and has different rules. You have to re-learn how to live in your environment every day".

A table to the Information Processing system can be found here:

If one of the levels of the Informational Processing system is broken then all subsequent levels will also fail.

Executive Function oversee's Information processing. Executive Function allows us to:
  • Maintain attention and control of our impulses
  • keep ourselves free from distraction
  • Engage in mental planning and problem solving
  • Be flexible when plans change and transition to new situations
  • Apply the skills we have previously been taught
  • Self-monitor ourselves
When we have impaired Executive Function, we appear
  • Difficulty retaining information especially if it is delivered verbally. (Note: Verbal information is transient. As soon as the information is said, it is gone. Visual information is better for children with ASD).
  • Distracted
  • inflexible and rigid
  • impulsive
  • unable to deal with transitions
  • unable to problems solve
  • Poor organisational skills
  • poor self-monitoring
  • poor application of skills
  • learning may not transfer from one environment to another
  • student appears "lazy" and "non-compliant"
Theory of Mind
'Theory of Mind' (ToM) is also known as perspective taking and is deficit in children with ASD. ToM is also the root of empathy. Without ToM you are unable to Infer the feelings of others due to their body language or what they say. You cannot predict future behaviour of others and therefore you are unable to modify your own behaviour. A lack of 'Theory of Mind' causes:
  • Insensitivity to others' feelings
  • Inablility to take into account what other people know
  • Inability to negotiate friendships by reading and responding to intentions
  • Inability to read a listener's level of interest in one's topic
  • Inability to detect a speaker's intended meaning
  • Inability to anticipate what others might think of your actions
  • Inability to recognise and repair misunderstandings
  • Inability to deceive or understand deception
  • Inability to understand the reasons behind peoples actions
  • Inability to understand "unwritten" rules or conventions
Children with ASD are unable to understand that people have different thoughts to them. This leads to frustration as they automatically assume you MUST know what they are feeling and what they are trying to do, even if they don't communicate it. An example of this can be found in my son D. He loves playing Dinosaurs and will go up to children and roar loudly in their faces. Of course the other children just stare at him in incomprehension, but to D he feels he doesn't need to explain what he's doing because everyone he meets KNOWS he is playing dinosaurs. A lack of ToM also means you will never be embarrassed; because you don't realise other people have different thoughts about your actions, then you can never be upset or worried about what other people think. This is why the phrase, "Don't do that, what will people think?" will NEVER work with a child with ASD because they will automatically assume other people are thinking the same thoughts as them.

As with Sensory Integration (which will be discussed later), Information Processing, Executive Function and 'Theory of Mind', will be affected by external factors. This can lead to increased difficulties one day, but then fewer issues another. These factors can be:
  • Anxiety
  • Fatigue
  • Overwhelming sensory environments
  • level of emotional involvement (perspective taking is inversely proportional to your level of emotional involvement.
We have to remember that ToM and social thinking isn't usually taught and it is a fundamental skill from birth which is developed on through observation. Children with ASD are not born with this skill and cannot develop it automatically. Social thinking and ToM therefore have to be taught by rote using social rules and stories that are learnt. The best way to teach ToM is via "Video Modelling"

A note about Imagination and interests
Children with ASD have a preference for sameness. This can lead to restricted interests which can overtake everything else in their lives. It is important to remember that children with ASD have NO control over their interests, so therefore it is important to use the children's interest as a way to motivate the children as other strategies may fail.

The level of imagination a child may exhibit relates to the level and type of ASD a child has. Students a the less able end of the ASD spectrum have difficulties in their ability to engage in imaginative activities. Even during play activities where it is perceived that imaginative play is happening, it will be found on observation that the imaginative play is still restricted and repetitive.

In higher functioning Autism (including Aspergers), the level of imagination is higher, even to the point where there is TOO much imagination. Children in this situation may have difficulty distinguishing reality from fantasy; combining this with a lack of Executive Function can lead to serious problems. Imagine a child believing he can fly.

Because of the difficulties in imagination, there is no such thing as "free play" and play should be facilitated.

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