Friday, October 4, 2013

GASP "Do you think it's Autism?"

I have to admit that nothing really gets under my professional skin more than another professional hypothesizing a diagnosis of autism when a child is behaving in maladaptive or aberrant ways. And there are a couple of reasons for this...

First, even if it is autism, are you going to change the CONTENT of what you're teaching? We don't have autism academic curricula. What we do have are efficacious and potentially effective, evidence based interventions and ways of teaching. That is to say, you may have to change your teaching methods.

Second, autism presents as a set of symptoms related to neurobiology. What do I mean by that? I mean that there are certain aspects of brain wiring and chemistry that are different -- the same is true of AD/HD and other neurobiological conditions. Some of their behaviors may be automatically maintained. That is, it feels good, like if you squeeze your hands when overly stressed and feel more relaxed afterward. So the function of that behavior may serve one function, but then you run over and scream "STOP FLAPPING!" and now flapping not only feels good, but it's a way to gain adult attention. This is especially problematic because of the communication deficits which typically present with a diagnosis. However, always remember that the brain is a muscle. It can be exercised like any other muscle can, just in different ways. Through repeated practice, inductively teaching skills, and making sure those skills generalize and remain mastered. Think of that practice as a sports practice. You don't just go out onto the court and start hitting 3 point shots -- you practice, practice, practice, and then on game day, you're better suited to make those shots.

Third, operant behavior is learned through contingencies of reinforcement or punishment. And all behavior serves a function. A response class is shaped up through contacting consequences and then evoked under certain environmental conditions with that learning history at play.

Lastly, it shouldn't matter. Especially at the 0-3 years and K, 1, 2 grades. All children learn skills to access the curriculum and be successful. If a child does not engage in, let's say, a set of behaviors that signal they're paying attention, then those skills/prerequisite behaviors need to be explicitly, and inductively taught. If you keep telling a child -- any child -- to "show me your paying attention," and they're not, then saying it over and over again is not going to help build the behavioral repertoire required for the learner to "show you" they are ready. If you call a learner's name, and they don't respond, saying it 5 more times probably won't help. And if it does, a learner should still respond to their name upon hearing it the first time. After your vocal, if they don't respond, get in there and prompt! Just be sure you can effectively fade your prompts over time.

All in all, I find it distressing when people immediately jump to thinking a child may have autism. "They're not following directions, I think it's autism!" Well, what if they're hard of hearing? Why does that not enter into your "hypothesis?" This bandwagon of educators proposing autism left and right is unprofessional and has got to stop not only because it's just bad practice, but because it continues to perpetuate the stigmas (and not the positives) associated with autism as being the diagnosis for poorly behaved children -- it's tautological and unhelpful.

Please, always remember that you are the adult -- the educator -- and that the children in your care deserve your time, patience, differentiation, and playing to their differences to provide them with skills that will allow them to be successful students, adults, and members of the community.