basic document

People with an autistic spectrum disorder show impairments in social interaction, communication and imagination. As a consequence of these imparments they manifest a rigid patern of behaviour, including insistence on sameness, stereotyped movements, limited interests etc.

Impairments in social interaction

Both Kanner (1943) and Asperger (1944) were struck by the social impeirments of the children they described. The interaction problems of people with an autistic spectrum disorder are the main diagnostic criteria. Sometimes there is hardly any interaction possible, sometimes there is interaction but it lacks the reciprocity. Wing (1996) has formulated 4 subgroups according to social interaction.

- the aloof group does initiate and react to social interaction
- the passive group does respond to social interaction, but does not initiate contact
- the active but odd group makes contact but it lacks reciprocity; it can often be characterized as one-way-interaction
- the stilted group initiates and sustains contact, but it is often over formal and rigid.

These subgroups are helpful in describing the social functioning of the individual. During development the person with autism can shift from one subgroup to another e.g. from active but odd to passive in high-functioning people after puberty. This subgrouping also shows that although they can all have the same classification, the appearance of the social impairment can differ immensely.

Because of the different developmental path, especiallt the social development, people with a disorder in the autistic spectrum often fail to reach full understanding of emotions, lack the ability to engage in reciprocal relationships in adulthood and also fail to reach the full development of conscience.

Impairments in communication

The communication problems of people with an autistic spectrum disorder, manifest themselves both in the verbal and nonverbal components of communication. Being able to use communication is, on whatever level, the main condition to be able to function in society.

Pre-and Non-verbal communication

The problems in communication occur very early in childhood. Children with an autistic spectrum disorder have great difficulty acquiring joint attention behaviours. These include pointing in order to request ogjects or to comment to someone else about an object or event, and showing and giving objects to others to share interests. People with an autistic spectrum disorder seldom initiate social interaction (Lord & Magill, 1989). People with non verbal communication do not develop alternatives spontaneously. Teaching them augmentative communication is necessary.

Verbal communication

Although the percentages differ slightly, it is estimate that about 50% of the people with an autistic spectrum disorder never develop any useful speech. They are functionally mute. The group that does develop speech displays a variety of unusual features like echolalia, pronoum reversal, neologisms, metaphorical language and literal use of language. They show also problems in the language systems: in the language form (phonetics, prosody, syntaxis), in semantics and in pragmatics. Even high functioning persons with autism have language problems, in particular with the pragmatic aspects (Fay & Schuler, 1980; Tager-Flusberg, 1989).

Teaching people with autism to communicate, with whatever means, helps diminishing challenging behaviours (Van Berckelaer-Onnes, Dijkxhoorn & v.d. Ploeg, 1996).

Impairments in imagination

Children with an autistic spectrum disorder do not develop imaginary play spontaneously. They play is repetitive and the main goal often seems self-stimulation; e.g. spinning with objects, hitting two objects together etc. (Van Berckelaer-Onnes, 1994). Lack of imagination leads to a rigid pattern of behaviour and lack of understanding of others (lack of Theory of Mind). Although this impairment is most striking in children, it remains a problem through life.

As Lorna Wing (1996, pg.99) stated: " The value of true imagination and creativity is in associating past and present experiences and making plans for the future, ranging from the mundane what to do tomorrow to the grand plans for the whole of life".

"CODE OF GOOD PRACTICE on Prevention of Violence against Persons with AUTISM", December 1998, Project co-ordinated by Autism-Europe (Bruxelles) and support of the DAPHNE Initiative of the European Commision, pp.22 - 23.
Text of Ivette Dijkhoorn, University of Leiden (NL)