Autism spectrum disorders and Asperger’s disorder

Autism is the name of a group of developmental disabilities linked to significant social, communication and behavior challenges. Children with a disorder on the spectrum usually show signs around 30 months. Families may notice that in interactions, the child does not smile, cuddle, laugh or eagerly seek to participate in games. Instead, the child seems to be “apart,” uses repetitive routines and odd behaviors, and shows communication problems as well as a lack of social awareness or interest in relationships.

Beyond the core social and relational challenges, children’s behaviors truly demonstrate a spectrum. For example, some children with autism are very intelligent, and perform well academically. Others may demonstrate severe mental retardation. Some go on to lead independent lives, while others may remain more dependent.[1]^{, [2]}

Autism is increasingly prevalent, and affects some groups of children more than others.

Since the 1990s, public health researchers have been tracking increasing rates of autism diagnoses; in 2014, one in 68 children received this diagnosis. The increase may be due to the fact that more people understand the signs and symptoms and seek medical help, a rise in cases of autism, or both.

There is no known cause for autism. In fact, a national Study to Explore Early Development (SEED) is investigating genetic, environmental, pregnancy and behavioral factors. Scientists believe genes play a role, in part because children who have a sibling with autism are more likely to be on the spectrum. Some prescription drugs used during pregnancy have been linked to higher rates of autism. Children born to older parents are at a higher risk, and it is five times more common among boys than girls.^{1, 2} Life-saving vaccines, including those with thimerosal, are not linked to higher rates of autism.[3]

School staff can reduce stigma around mental disorders and support care teams.

Early detection and intervention efforts, such as special education, can help kids develop important coping skills and get treatment, such as speech therapy for language delays, and talk therapy to reduce disruptive behaviors. Families may seek help from a variety of providers, including psychologists, pediatricians, speech pathologists and local first responders. But there is no cure for autism. So creating a supportive and safe school environment is important to ensure that all children can succeed, no matter what stage they have achieved in a treatment or health plan.

Children with autism are often withdrawn. They may fail to respond to people by avoiding eye contact, refusing to speak, or using language that is hard for others to understand. They often have personal rituals and an intense need to maintain order. These behaviors can be socially isolating for the child, and may lead to increased bullying. Teaching social skills and encouraging positive peer relationships can help.

Children with autism demonstrate other challenging behaviors that can be stressful for their caregivers. Rates of aggression are higher among children with autism disorders than children with other intellectual disability. School staff may notice tantrums, screaming, hitting, kicking or destroying things. Research suggests that some children with autism are more likely to be aggressive toward caregivers, including those who exhibit repetitive behaviors, especially self-injury; children who show signs of severe social impairment; and children who are from a high-income family. Careful observations at home and at school, coordinated by a professional, can often reveal the root causes of these behaviors, which can be addressed directly.[4]^{, [5]}

Schools can implement evidence-based interventions to support students with autism.

The National Autism Center’s “Evidence-Based Practice and Autism in the Schools” highlights well-researched interventions for children with autism spectrum disorders.

• Antecedent interventions modify the environment to reduce problem behaviors and build skills.
• Behavioral treatments emphasize the impact of positive and negative consequences to reinforce behaviors.
• Joint attention interventions explicitly teach children to focus on an object or activity together.
• Modeling, or demonstrating target behaviors, can help children with autism to understand the routines inherent in activities.
• Naturalistic teaching helps children master a skill in a controlled context, then slowly generalize to more diverse and realistic settings.
• Peer training establishes structures that put other children at the center of the intervention such as “play groups,” “friend circles” or “buddy mediation.”
• Pivotal response treatment creates situations in which the student will be motivated to learn, with the goal of increasing independence for new environments.
• Schedules provide predictability and promote greater independence among children with ASD, especially during transitions.
• Self-management interventions guide students to reinforce, monitor and evaluate their own behaviors.