What is Autism?

Autism is a life-long handicap that affects individuals differently. Autism is not always easy to diagnose in respect of putting individuals into delegated categories. There are varying degrees of autism one of which is Asperger’s Syndrome. At one time autism described people as being ‘simple’ or having ‘odd behaviour’, (Happe 1994), in local folktales. It was not until 1943 that autism was given its name by Leo Kanner, then one year later Hans Asperger, (1944), gave his definition. Although the two definitions vary, they did have some similarities: -

“Both Leo Kanner and Hans Asperger described children with a poverty of social interaction, failure of communication and the development of social interests.”
(Attwood, 1998, 15).

Autism is diagnosed according to behavioural criteria, although it is a syndrome with biological and genetic links (Happe, 1994). Lorna Wing and Judy Gould said that there were three features that could be used when diagnosing autism. These became known as “Wing’s Triad of Impairments in Autism”: – socialisation, communication, and imagination. Linked to this ‘triad’ is ‘Cognition’, which is developed in a normal child through the use of symbolic play.

Evidence suggests that Asperger’s Syndrome is more common than classic autism (Attwood, 1998), and has its own specific criteria for diagnosis. Although there are no criteria that are universally used to diagnose Autistic Spectrum Disorders there are different versions that can be chosen. The World Health Organisation, (W.H.O.), (1993), Peter Szatmari and colleagues, (1989), and Christopher and Corina Gillberg, (1989), all have produced criteria that can be used for assessment. Research indicates that the mean age for diagnosis is eight years old. Eisenmajer et al. (1996) identified six areas that lead to a diagnosis of Asperger’s Syndrome, taken from Attwood (1998):

Diagnosis of autism in early childhood
Recognition of features when first enrolled at school
An atypical expression of another syndrome
Diagnosis of a relative with autism or Asperger’s Syndrome
A secondary psychiatric disorder
Residual Asperger’s Syndrome in an adult

The Autistic spectrum is very broad and individuals will have their own extremes of difficulties. There are definite differences between those with classic autism and those with Asperger’s. The main differences being that although those with Asperger’s display classic autistic symptoms when younger, their social and conversation skills become more advanced. There are individuals with Asperger’s who develop the need to socialise, unlike those with classic autism.

Asperger’s Syndrome

A German psychiatrist, Hans Asperger (1906 ~ 1980), introduced this syndrome a year after Kanner first described autism. It was not until 1981 when Lorna Wing wrote a clinical diagnosis of Asperger’s did it generate major interest within the field.

The common features of Asperger’s taken from (Trevarthen, Aitken, Papoudi and Robarts, 1996,) are as follows:

Autistic social impairment
Clumsiness (usual but not necessarily present)
‘Concrete’ or pedantic speech
All absorbing circumscribed interests (usual)
Lack of appreciation for humour (commonly described)
No significant delay in language development
No significant delay in cognitive development

The term ‘High Functioning Autism’ is also used. In definition terms these are individuals that

“… Have the classic features of autism in early childhood, but later develop the ability to talk using complex sentences, develop basic social skills and an intellectual capacity within the normal range.”
(Attwood, 1993, 50).

Evidence has shown that there are no real differences between High Functioning Autistics and Asperger’s. It is a term that is used more readily in USA although English speaking countries are using this label instead of Asperger’s, dependent upon clinician’s preferences.

Individuals with autism may also suffer from other problems that may or may not be directly related to their condition. Learning difficulties in general or severe learning difficulties, and Semantic Pragmatic Language Disorder are other disorders, which can be associated with Asperger’s Syndrome. Individuals have some of the language features that sufferers of Asperger’s Syndrome present with, although milder.

Theory of Mind

In the last ten years, a new type of ‘cognitive theory’ has emerged in relation to the exploration and understanding of autism. ‘Cognition’ includes the development of a person’s memory, thinking, learning, and imagination. This is linked to the triad of impairment ~ socialisation, imagination and communication.

Children from the age of two are beginning to develop their cognitive ability through the use of symbolic play (Baron-Cohen, Leslie and Frith 1985). By the age of four the ‘normal’ child is able to understand that people have ‘beliefs and desires about the world’, which then will affect the way that people behave, this is known as the ‘theory of mind’. The autistic child has not progressed through the stages in order to develop the ability to empathise with other people. Various experiments using pictures and dolls have proven that autistic children do not have a ‘theory of mind’.

What is Flexibility of Thought?

People with ASD may have an impaired ability to use imagination to problem solve and predict outcomes on a day-to-day basis. Difficulties link to the ability to reflect back on ones own thinking and learning maybe further compounded by limited ability with regard to thinking about experiences not already encountered. This includes the ability to engage in pretend play, role-play and take part in curriculum activities that involve abstract thinking and the use of personal imagination. Therefore the effect this has on the person with ASD is that they may have difficulty predicting what could happen next or determining what is expected of him, this may lead to a learner becoming reliant on establishing routines and rituals to secure a familiar outcome in environments that are constantly changing. Pupils with ASD can sometimes resist attempts to change and adapt these routines.

The impairment may be displayed as the following:

Poor self-organisational skills and difficulties with structuring personal time productively.
Difficulties involving inappropriate behaviours and interactions with others. These difficulties often present during periods of unstructured time.
Reliance on rituals and set procedures.
The desire to preserve sameness with a resistance to change many people with ASD cite uncertainty as being their greatest fear. Many try to restore order by imposing their own personal rules to specific situations.
It is quite common for pupils with ASD to inform on peers who have broken school rules and may become anxious and outraged. Quite often pupils may attempt to adopt the role of staff and tell off other pupils.
Pupils often have difficulty replacing one method of learning with another and also generalising these skills to new areas.
A limited repertoire of interests and activities that are pursued to a fanatical level. Many chosen activities are also solitary in nature but the person with ASD may seek out others to ‘talk at’ about their interests.
Poor levels of incidental learning and limited imitation skills.
A lack of imagination and original thought. Pupils quite often may enact scenes from cartoons,

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What is Autism?