September 28, 2009

It was a quiet day at Riverside today. Some students in the class went sailing in the morning and, due to a long traffic delay, did not return until late in the afternoon. Therefore, no formal activities were scheduled and I was given the chance to simply socialize with the students present and observe communication among the students in a natural and unstructured environment.

As communication differences are prominent in people with Autistic Spectrum Disorders, I think it would be helpful first to outline the basics of this impairment. Autism is a biologically based Pervasive Developmental Disorder with a possible genetic component. Over 520,000 people in the UK, about 1 in 110, are affected. Autism can be improved, but it is a permanent impairment and is often paired with learning disabilities, though some forms of autism are compatible with superior intelligence. Asperger Syndrome is a common component of the Autistic Spectrum and is often described as “high-functioning autism.” More info here.

From an outsider’s perspective, I have always found Autistic Spectrum Disorders to be challenging and fascinating; as the name indicates, severity and manifestation of impairment varies incredibly. Just in my classroom at Riverside, the range is apparent: I have never heard James speak, whereas Harry, who gave me a tour of the school on the first day, is familiar and friendly with every teacher and most pupils in the school.

Recently, autism has been a prevalent topic in news and culture. It is not uncommon to see “Autism Awareness” bumper stickers, read books like Mark Haddon’s The Curious Incident of the Dog in the Night-Time, or see movies like Adam, written and directed by Max Mayer. Speculation on the recent surge of ASD diagnoses has been a topic of debate, but many researchers have concluded that health professionals are simply better able to recognize the range of the disability. One discredited theory linked the rise in Autism diagnoses with the measles, mumps, and rubella vaccine.

The DSM definition is a bit lengthy, but I have included it below. Defined in section 299.00 of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), autism includes a total of six (or more) items from (1), (2) and (3), with at least two from (1), and one each from (2) and (3):

1. Qualitative impairment in social interaction, as manifested by at least two of the following:

  • Marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction
  • Failure to develop peer relationships appropriate to developmental level
  • A lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest)
  • Lack of social or emotional reciprocity

2. Qualitative impairments in communication as manifested by at least one of the following:

  • Delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)
  • In individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
  • Stereotyped and repetitive use of language or idiosyncratic language
  • Lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level

3. Restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following:

  • Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
  • Apparently inflexible adherence to specific, nonfunctional routines or rituals
  • Stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)
  • Persistent preoccupation with parts of objects

4. Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years:

  • Social interaction
  • Language as used in social communication
  • Symbolic or imaginative play

A prominent feature in autistic communication impairment is difficulty in understanding humor. The relaxation of the classroom struck me on my first day at Riverside; David and Mark are quick and witty and often harmlessly tease the students. (For example, Harry was asked why he caused the traffic jam as he returned from the sailing trip.) This made me a little uneasy at first; do such informal interactions belong in a classroom setting? Is it appropriate, practical, or even ethical to tease individuals who, biologically, may not understand the humor? Weren’t these men educators, and not friends or playmates? It didn’t take me long to realize that, as Math, English and History are the subjects of a mainstream education, social skills, life skills, communication, even humor and everything in between constitute the curriculum for these teens. David and the TAs have the unique challenge of gaining the students’ trust and friendship while maintaining respect as mentors.

DSM diagnosis info retrieved from the following webpage: