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Frequently Asked Questions About Autism

1. How do I know if my child has problems with sensory over sensitivity?

   Sounds or visual stimuli that are tolerated by normal children may cause pain, confusion and/or fear in some autistic children. Sensory over sensitivity can vary from very slight to severe. If your child frequently puts his hands over his ears, this is an indicator of sensitivity to noise. Children who flick their fingers in front of their eyes are likely to have visual sensitivity problems. Children who enjoy a trip to a large supermarket or a shopping mall usually have relatively mild sensory sensitivities. Autistic children with severe sensory sensitivities will often have tantrums and other bad behavior in a shopping mall due to sensory overload. These children are the ones who will most likely need environmental modifications in the classroom. Older children and adults, who remain non-verbal and have very little language, often have more severe sensitivities than individuals with good language. Children with auditory or visual sensitivity will often have normal hearing and visual acuity tests. The problem is in the brain, whereas the ears and eyes are normal.

2. What sights and sound are most likely to cause sensory overload or confusion in the classroom?

   Every autistic child or adult is different. A sound or sight, which is painful to one autistic child, may be attractive to another. The flicker of fluorescent lighting can be seen by some children with autism and may be distracting to them. It is most likely to cause sensory overload in children who flick their fingers in front of their eyes. Replacing fluorescents with incandescent bulbs will be helpful for some children. Many children with autism are scared of the public address system, the school bells or the fire alarms, because the sound hurts the ears. Screeching electronic feedback from public address systems or the sound of fire alarms are the worst sounds because the onset of the sound canNOT be predicted. Children with milder hearing sensitivity can sometimes learn to tolerate hurtful sounds when they know when they will occur. However, they may NEVER learn to tolerate Unexpected loud noise. Autistic children with severe hearing sensitivity should be removed from the classroom prior to a fire drill. The fear of a hurtful sound may make an autistic child fearful of a certain classroom. He may become afraid to go into the room because he fears that the fire alarm or the public address systems may make a hurtful sound. If possible, the buzzes or bell should be modified to reduce the sound. Sometimes only a slight reduction in sound is required to make a buzzer or bell tolerable. Duct tape can be applied to bells to soften the sounds. If the public address system has frequent feedback problems, it should be disconnected. Echoes and noise can be reduced by installing carpeting - carpet remnats can sometimes be obtained from a carpet store at a low cost. Scraping of chair legs on the floor can be muffled by placing out tennis balls on the chair legs.

3. Why does my child avoid certain foods or always want to eat the same thing?

   Certain foods may be avoided due to sensory over sensitivity. Crunchy food such as potato chips may be too loud and sound like a raging forest fire to children with over sensitive hearing. Certain odors may be overpowering. However, some limited food preferences may be bad habits and are not due to sensory problems.

4. Why do some autistic children repeat back what an adult has said or sing TV commercials?

   Repeating back what has been said, or being able to sing an entire TV commercial or children's video is called "echolalia." Echolalia is actually a good sign because it indicates that the child's brain is processing language even though he may not be understanding the meaning of the words. These children need to learn that words are used for communication. If a child says the word "apple," immediately give him an apple. This will enable the child to associate the word "apple" with getting a real apple. Some autistic children use phrases from TV commercials or children's videos in an appropriate manner in other situations. This is how they learn languages. For example, if a child says part of a breakfast cereal slogan at breakfast, give him the cereal.

   Autistic children also use echolalia to verify what has been said. Some children have difficulty hearing hard consonant sounds such as "d" in dog or "b" in boy. Repeating the phrase helps them to hear it. Children who pass a pure tone hearing test can still have difficulty hearing complex speech sounds. Children with this difficulty may learn to read and speak by using flash cards that have both a printed word and a picture of an object. By using these cards they learn to associate the spoken word with the printed word and a picture. Some autistic children learn vowel sounds more easily than consonants.

5. How should educators and parents handle autistic fixations on things such as lawn mowers or trains?

   Fixations should be used to motivate schoolwork and education. If a child is fixated on trains, use his interest in trains to motivate reading or learning arithmetic. Have him read about trains or do arithmetic problems with trains. The intense interest in trains can be used to motivate reading. It is a mistake to take fixations away, but the child needs to learn that there are some situations when talking about trains is not appropriate.

6. What is the difference between PDD and autism?

   Autism and PDD are behavioral diagnoses. At the present time there are no medical tests for autism. Autism is diagnosed based on the child's behavior. Both children diagnosed with autism and PDD will benefit from education as children diagnosed with autism. Both autistic and PDD children should be placed into a good early education program immediately after diagnosis. Children diagnosed with PDD tend to fall into two groups: (1) very mild autistic symptoms, or (2) some autistic symptoms in a child who has other severe neurological problems. Therefore, some children diagnosed as PDD may be almost normal; and others have severe neurological problems such as epilepsy, microencephaly or cerebral palsy. The problem with the autism and PDD diagnoses is that they are NOT precise. They are based only on behavior. In the future, brain scans will be used for precise diagnosis. Today there is no brain scan that can be used for diagnosing PDD nor autism.

7. Why is Early Intervention important?

   Both scientific studies and practical experience have shown that the prognosis is greatly improved if a child is placed into an intense, highly structured educational program by age two or three. Autistic children perform stereotype behaviors such as rocking or twiddling a penny because engaging in repetitive behaviors shuts off sounds and sights which cause confusion and/or pain. The problem is that if the child is allowed to shut out the world, his brain will not develop. Autistic and PDD children need many hours of structured education to keep their brain engaged with the world. They need to be kept interacting in a meaningful way with an adult or another child. The worst things for a young two to five year old autistic child is to sit alone watching TV or playing video games all day. His brain will be shut off from the world. Autistic children need to be kept engaged; but at the same time, a teacher must be careful to avoid sensory overload. Children with milder sensory problems often respond well to Lovaas-type programs. However, children with more severe sensory processing problems may experience sensory overload. There are two major categories of children. The first type will respond well to a therapist who is gently intrusive and pulls them out of their world. The second type of child has more neurological problems and they may respond poorly to a strict Lovaas program. They will require a gentler approach. Some are "mono channel" because they cannot see and hear at the same time. They either have to look at something or they have to listen. Simultaneous looking and listening may result in sensory overload and shutdown. This type of child may respond best when the teacher whispers quietly in a dimly illuminated room. A good teacher needs to tailor his/her teaching method to the child. To be successful, the teacher has to be gently insistent. A good teacher knows how hard to push. To be successful, the teacher has to intrude into the autistic child's world. With some children, the teacher can jerk open their "first door," and with other children, the teacher has to speak quietly in their "back door."

8. Why does my child want to wear the same clothes all the time?

   Autistic children will be most comfortable with soft cotton against their skin. New underwear and shirts will be more comfortable if they are washed several times. It is often best to avoid spray starch or fabric softeners that are placed in the dryer. Some children are allergic to them. [Note: Caretakers and teachers should also avoid the use of perfume because some children hate the smell and/or they are allergic to it.] The problem is switching back and forth. Switching back-and-forth can be made more tolerable by wearing tights with skirts. The tights make the skirt feel the same as long pants.

More to come..
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