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1. Communication Deficits: Some children with autism are nonverbal and may use sign language, picture exchange systems or augmentative communication to communicate. Others are highly verbal but in a concrete or rote manner and lack understanding of abstract terminology and concepts. They may present with echolalia (repeating what was said without fully understanding the meaning of the words). Echolalia may be immediate or delayed. Delayed echolalia, sometimes called "scripting," are words and sentences the person with autism has heard in the past and are repeating them at a later time, frequently from movies or songs.
2. Social Deficits: Children with autism often lack imitation skills and therefore do not learn the way typical children do. They first need to be taught to imitate. Children with autism frequently have a difficult time understanding the thoughts and emotions of others. They may have difficulty "putting themselves in someone else's shoes" and may benefit from being taught social skills in a concrete and rote manner.
3. Repetitive Behaviors: Hand movements, lining up toys or other items, and getting stuck on a favorite topic are all examples of repetitive behaviors seen in autism. Rigidity in toy play is also common such as turning a toy car over to spin the wheels instead of playing with it in a symbolic way. Working to expand play skills is a target area for most children on the spectrum.
4. Although not part of the diagnostic criteria for autism as are the three areas above, most children on the spectrum demonstrate some type of sensory processing difficulties. Information taken in through the sensory systems (visual, auditory, tactile, olfactory [smell] and vestibular and proprioceptive [movement]) are not integrated and become "jumbled." Rather than an inability to absorb information about the environment, everything becomes absorbed which may lead to "shutting down" and retreat into a self-absorbed world. There is confusion in knowing which sensory channel needs to be attended to. For example, a child may not appear to attend to their name being called (auditory) because they are attending to visual input. Inability to integrate the visual and vestibular systems may lead to poor body awareness and general clumsiness which makes it difficult to learn to ride a bike or even stay on their chair without falling off at school. This confusion and uncertainty often leads to behavior seen in autism (covering ears to loud sounds, reacting aggressively to unexpected touch, tantrums) because they have such difficulty making sense of their world. Occupational therapists work to integrate incoming sensations through a "sensory diet" unique to each child to maintain optimal arousal levels for learning and promote an adaptive response.
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"We've seen more progress with you
in less
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- Kim and Bill Breeden, Parents, Medina, MN
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