Learning Guide
Autism and support strategies
23374 Describe autism and support strategies to assist a person with autism / Level 3 / 3 creditsName:
Workplace:
Contents
Introduction 2
How to use your learning guide 2
What you will learn 2
About autism 2
Diagnosing autism 2
Features of autism 2
Impairments associated with autism 2
Gender and autism 2
Key events in the history of autism 2
Proving support 2
Meet the people in the profiles 2
Social communication 2
Verbal and vocal communication 2
Non-verbal communication and body language 2
Impact 2
Characteristics, adaptations and support tips 2
Social communication examples 2
Social interaction 2
Impact 2
Characteristics, adaptations and support tips 2
Social interaction examples 2
Restricted, repetitive behaviours, interests and activities 2
Impact 2
Characteristics, adaptations and support tips 2
Examples of restricted, repetitive behaviours, interests and activities 2
Sensory perception 2
Impact 2
Characteristics, adaptations and support tips 2
Sensory examples 2
General support strategies 2
Managing the environment 2
Stress, anxiety and behaviour 2
Stress/anxiety examples 2
Strategies to reduce stress 2
Teach new skills 2
Use support networks and agencies 2
Who is a specialist? 2
Autism Guidelines 2
Support examples 2
Specific support strategies 2
Social stories 2
Visual strategies 2
Picture exchange communication system 2
Sensory integration therapy 2
Sensory support 2
SPELL 2
Applied behaviour analysis 2
TEACCH 2
Further information 2
Autism and support strategies (US 23374] Learning Guide © Careerforce – Issue 3.0 – August 2017
Introduction
This learning guide is about learning how to work effectively with a person with autism.
How to use your learning guide
This guide supports your learning and prepares you for the unit standard assessment. The activities and scenarios should be used as a general guide for learning.
This guide relates to the following unit standard:
· 23374 Describe autism and support strategies to assist a person with autism (level 3, 3 credits).
This guide is yours to keep. Make it your own by writing notes that help you remember things, or where you need to find more information.
Follow the tips in the notes column.
You may use highlight pens to show important information and ideas, and think about how this information applies to your work.
You might find it helpful to talk to colleagues or your supervisor.
Finish this learning guide before you start on the assessment.
What you will learn
This topic will help you to:
· understand the typical features of autism.
· understand how autism may impact on a person’s life.
· understand how to support a person with autism.
About autism
Autism is a lifelong neurological condition resulting from a brain that is either formed differently or works differently than usual. It affects how people communicate, how they relate to other people, and how they make sense of the world around them.
It was thought to be a rare condition but it’s now understood that autism affects one in 66 people. In New Zealand it is estimated that over 65,000 people have autism. This means it’s more common than each of cerebral palsy and Down syndrome.
The brain of a person who has autism processes information differently. What you usually notice when you are with a person with autism is they:
· have differences with social communication, both verbal and
non-verbal.
· have differences with social interaction.
· think differently, and may have restricted, repetitive patterns of behaviour, interests and activities (RRB).
People with autism may say they also experience sensory difficulties such as sensitivity to light, colour, sound, smell, taste, touch, movement or balance.
Historically many people with autism were institutionalised. They were told they lacked ‘social skills’ and were trained to modify their behaviour. Even now there can be an expectation that people should hide their condition and pretend to be ‘normal’. Today the world is recognising what adaptations can be made in their environment, and is also appreciating the valuable contribution people with autism made to the world.
It has been said that autism is a distinct culture and identity, similar to that of the deaf community. Be mindful of language use, talking about the people first – a person with autism, rather than saying an autistic person.
There are a wide range of effects of autism and the term ‘autism spectrum’ is often used.
Many who consider themselves autistic prefer the term autisim spectrum condition (ASC) rather than use the word disorder as in autism spectrum disorder (ASD).
Diagnosing autism
Getting diagnosed as being on the autism spectrum can be a challenge. A person’s general practitioner (family doctor) can refer the person to a specialist who can make a diagnosis. Autism is usually formally identified by a multi-disciplinary team of health professionals, led by a paediatrician (for children and young people) or a psychiatrist or clinical psychologist (for adults).
There are no special medical tests that can detect autism so diagnosis is made by identifying whether the person has impairments in communication, social interaction and restricted, repetitive patterns of behaviour, interest and activities.
This is usually done by a multi-disciplinary team which includes at least two or three people from the following:
· a paediatrician.
· a psychologist.
· a psychiatrist.
· a speech-language therapist.
· an occupational therapist.
This team of people will:
· observe the person in different settings.
· talk to the person and those who know the person well.
· test particular skills.
· look at the person’s medical history.
Another way autism can be diagnosed is by a single clinician (eg a paediatrician, psychiatrist or psychologist) who uses a set of criteria to decide if the person has autism. The criteria used most often in New Zealand are outlined in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM).
Onset of autism is almost always from birth or before age three, but it may not be diagnosed until later in a person’s life.
Having a diagnosis can be helpful for two reasons:
· it helps people with autism (and their families) to understand why they may have certain strengths and weaknesses and what they can do about them.
· it makes it easier for people to access services and support.
Autism New Zealand has a video on diagnosis of autism on YouTube which can be found on www.autismnz.org.nz/about autism
Features of autism
Throughout this learning guide there are profiles of people on the autism spectrum. As you read about them you might notice that you have some of these features too. In fact, we probably all do, but most of us do not have autism. It is the combination and intensity of these features that makes up autism.
Some of these features can be challenging for people with autism, and some of them are strengths. The unit standard talks of ‘enabling and disabling‘ effects of autism.
Disabling refers to some of the challenging aspects for people with autism. It may be a person, an item, an event, or a lack of something that prevents a person from doing what they would like to do.
Enabling means making something possible. It can refer to the ability of the support worker, family/whānau and others to support the person to carry out activities of daily living, to implement positive life planning changes and to create safe environments for personal health and wellbeing.
As you read the learning guide, look for the enabling or positive aspects or strengths that come with being on the autism spectrum.
For example, many people with autism find it hard to see the ‘bigger picture’, but this often means that they have great attention to detail.
Another example of a strength is that rituals, rules and repetitive behaviours of special interests could benefit learning processes as people are motivated to know more about their interests.
Here are some positive aspects of autism that could be incorporated in comments on enabling. People with autism:
· can focus on their interests for long periods of time.
· are non-judgmental.
· are imaginative.
· are passionate.
· are logical.
· are loyal.
· are gifted.
Impairments associated with autism
It is possible for a person to have autism and also have other impairments alongside their autism.
For example, a person could have cerebral palsy and autism; another person may have Down syndrome and autism and another may have a visual impairment and autism.
Some conditions are more common than others in people who have autism. Some conditions that commonly occur together with autism are:
· intellectual/learning disability or learning difficulties.
· epilepsy, a disorder producing recurrent, unprovoked seizures.
· Fragile X syndrome, a genetic disorder causing mental impairment.
· tuberous sclerosis, a genetic disease causing benign tumours.
If the person you are working with has more than one impairment, it’s important to understand the characteristics of each impairment and to determine which strategies work for you and the person you are working with.
A person with autism may not have any other conditions.
The cause of autism is believed to be a complex mix of neurological and genetic factors.
There is no link between autism and vaccines.
Gender and autism
There are more males than females diagnosed with autism.
A 2007 study The epidemiology of autism spectrum disorders found that autism averages a 4.3:1 male-to-female ratio.
A 2013 study Sex differences in autism spectrum disorders found that several sex-differential genetic and hormonal factors may contribute.
Now it is believed that many girls miss diagnosis as early studies on autism were primarily with boys and their abilities and development.
A 2016 publication Quantifying and exploring camouflaging in men and women with autism identifies that some people, particularly females, camouflage or hide their social communication difficulties.
Women may be under- or mis-represented in autism data as females use specific coping and adjustment strategies, such as social-imitation strategies, to fit in. Their autism is thus less visible than males with autism, whose social behaviour can be quite conspicuous.
Key events in the history of autism
Autism has been recognised for over 100 years and thinking about the condition has changed dramatically during that time.
1908: The word autism is used by psychiatrist Eugen Bleuler to describe a group of schizophrenic patients who were especially withdrawn and self-absorbed.
1943: American child psychiatrist Leo Kanner published a paper describing 11 children who were highly intelligent but displayed "a powerful desire for aloneness" and "an obsessive insistence on persistent sameness." He names their condition ‘early infantile autism’.
1944: German scientist Hans Asperger describes a ‘milder’ form of autism, which became known as Asperger’s syndrome. The cases he reported were all boys who were highly intelligent but had trouble with social interactions and specific obsessive interests.
1964: Bernard Rimland, a psychologist and parent of a child with autism, published Infantile Autism: The Syndrome and its Implications for a Neural Theory of Behavior.
1977: Research on twins finds that autism is largely caused by genetics and biological differences in brain development.
In the 1980’s Asperger’s research was translated into English and research on autism gained momentum.
1980: ‘Infantile autism’ is listed in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM).
With this recognition, people begin to be diagnosed as being autistic.
1987: The DSM replaces ‘infantile autism’ with a more expansive definition of ‘autism disorder’ and a checklist of diagnostic criteria.
1994: Asperger’s syndrome is added to the DSM, expanding the autism spectrum to include milder cases.
2013: The fifth edition of the DSM, the DSM-5, describes autism as a single condition with different levels of symptom severity in:
A Impaired social communication and/or interaction.
B Restricted and/or repetitive behaviours (RRBs)
Autism spectrum disorder (ASD) now describes what were previously four separate disorders, including Asperger’s disorder, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified (PDD-NOS).
There may also be clinical specifiers such as, with or without intellectual impairment; with or without language impairment; associated with a known medical or genetic condition or environmental or acquired condition; associated with another neurodevelopmental, mental or behaviour disorder.
/ The full set of DSM criteria can be seen on www.autismspeaks.org/what-autism/diagnosis/dsm-5-diagnostic-criteria2016: The second edition of the New Zealand Autism Spectrum Disorder Guideline by the Ministries of Health and Education was re-published (first published 2008). This publication provides guidance on recognition of signs and symptoms of autism and referral of people for formal diagnosis and effective ways to support people.
2016: The United Nations launched Autism 2030: Inclusion and Neurodiversity. Significant points include:
· Autism is a neurological variation.
· Autism involves unique social interactions, non-standard ways of learning, keen interests in specific subjects, an inclination towards routines, challenges in typical communications and particular ways of processing sensory information.
· People with autism can expect to experience full and meaningful lives as an integral part of society which includes quality education, decent work, and economic growth in a society where active partnership is in progress and inequality is reduced.
Proving support
It is your role as the support worker to be aware of autism and demonstrate acceptance, recognition and respect for people with autism. Knowing about autism will help you to understand the people you support.
All people on the autism spectrum are individuals. Like us, each person has skills, strengths, difficulties, likes and dislikes, and their own culture and preferences. Each of these factors influences how someone behaves and learns which, in turn, influences the types of strategies that will suit the person best.
There are many adaptations and support strategies that you can adopt which are beneficial for people with autism when supporting them.
Making adaptations within the person’s home, workplace or learning environment can be useful for the individual. Some people will require ongoing support while others do not.
Remember to always communicate with the person to make sure they are comfortable with what you are doing.