Promoting learning for children with autism: some schools may not be fully prepared to provide the learning environments required by the growing number of autistic children.

Autism was once considered to be a rare disorder. Today, the condition is so prevalent that almost everyone is familiar with the term "autism," and most of us know someone with the diagnosis.

It is widely accepted today that autism spectrum disorders affect approximately 1 in 166 children in our nation. In our own state, autism cases have increased four-fold over the past decade for the California Department of Developmental Services. According to the California Department of Education, between 1992-93 and 2002-03 the number of children with autism enrolled in our schools increased ten-fold.

While the increase in autism has been well documented, many schools may not be fully prepared to provide the learning environments required for children with the disorder. It is imperative for school administrators and educators to be aware of factors that promote and facilitate learning for students diagnosed with autism, each of whom requires special education services in order to reach his or her fullest possible potential at school. Some guidelines for accomplishing this are provided later in this article. First, here is some background on what is currently known about autism.

The hallmarks of autism

Autism is a neurodevelopmental disorder that usually becomes apparent by age 3 and persists throughout adulthood. It primarily affects communication and social interaction, creative or imaginative play, and coordination or motor skills; however, these hallmarks can vary quite a bit in terms of severity. The full range of symptoms is commonly referred to as "autism spectrum disorders."

In some cases, children are so affected by what is called "classic autism" that they are unable to function well in their families and communities. Children diagnosed higher on the spectrum, such as those with Asperger's syndrome, can at times seem barely distinguishable from their typically progressing peers.

While children with autism may express their core symptoms in different ways and in differing degrees, they have some common deficits: They have trouble communicating meaningfully with other children; they have difficulty maintaining normal peer relationships, especially in terms of understanding the perspectives of others; they have strong desires for order and routine; and they can be preoccupied with a narrowly focused range of activities, which are called "circumscribed interests," such as only being interested in talking and learning about the solar system or dogs or Power Rangers.

At the same time, they tend to have some strengths that can exceed those of their peers, including precocious reading and memory skills and heightened visual-spatial skills. These common features provide the best clues for developing interventions and learning environments that children with autism need in order to succeed in school.

Even though specific interventions should be developed to meet the needs of particular students, noted below are a few general guidelines that can help schools with their obligations to provide the least restrictive and most enriching learning environments for students with autism.

Four guidelines for schools

1. Be social "engineers." Children with autism do not always know how to take steps to enter a social group. They often want friends and talk about having friends, but they do not have strategies for initiating or sustaining interactions. It is therefore important for educators to encourage typically developing children to interact with them, which will help them stay connected both socially and academically.

For instance, you could assign lunch buddies to sit and socialize with children with autism, establish peer tutoring groups or create social skills groups to work together on social communications interactions. Another tactic is to establish small work groups for school projects. When small groups are not possible, be sensitive to the possibility of sensory overload for children with autism. They may need to spend some time alone and rejoin the group later.

2. Be clear and consistent about routines. Children with autism can have difficulty with transitions, but they respond very well to regular routines. Use written "scripts" to help children see and understand class schedules and rules, then consistently apply those scripts. You need to be very specific about the order in which activities will take place, where they will take place and how long they will last.

Be sure to use the same words to describe activities and tasks, repeat what needs to happen before each transition (e.g., "finish work") and identify what follows next (e.g., "recess"). Also provide plenty of warning before transitions. For instance, you might say, "We have five more minutes to finish this work before we go to recess." Then later say, "We have two minutes left to finish this work before we go to recess."

3. Use focused interests as a window of opportunity. When a child is interested in a particular subject, allow that expertise to flourish then use it to teach him or her other subjects. For example, if a student has a circumscribed interest in dolphins, you can use this subject to engage him or her in questions and answers with the entire class, slowly transition to questions to involve other sea creatures, then eventually query the student about what other children might want to know about those creatures.

This is a process that takes time, but it can ease students with narrow interests to engage peers and expand their own interests. Language and other social skills that come so much easier to other kids can be learned by autistic children when the skills are presented slowly and in incremental steps.

4. Embrace inclusive settings. Inclusive settings are crucial for all students with autism, especially if those environments are structured to help them stay on tasks and are not overwhelming. When exposed to a variety of social situations, children with autism build interaction skills they otherwise may not acquire.

Inclusion also helps all children succeed in academic and social endeavors. The earlier typically progressing students are introduced to students with disabilities, the earlier they begin to accept them as part of their classroom culture and everyday activities.

Resources for educators

The heterogeneity of autism, combined with rapid advances in clinical research and knowledge about the disorder, necessitates ongoing training opportunities for all educators. The M.I.N.D. Institute has several resources and future plans for providing these opportunities.

Educators interested in learning more about neurodevelopmental disorders can visit the M.I.N.D. Institute Resource Center in Sacramento, which offers a complete library of information and training materials.

The institute also sponsors a Summer Institute on Neurodevelopmental Disorders that addresses theoretical, research, education and treatment issues. A certificate program in neurodevelopmental disorders is in development, and a Ph.D. program is being planned in conjunction with the UC Davis School of Education.

M.I.N.D. Institute faculty can contract with school systems to help develop school-based programs for children with neurodevelopmeutal disorders. A teleconsultation program is now being developed that will allow school districts throughout the state to discuss their specific concerns with neurodevelopmental specialists.

An eventual goal is to establish an assessment and intervention school near the institute where current knowledge about K-12 education and neurodevelopmental disorders can be directly and immediately applied.

For more information or to offer ideas on how the research and education communities can work together on crafting education environments that better support children with autism, please e-mail [e-mail] or call [phone].

Closing in on a definition of autism

Autism is a complex disorder that likely has multiple causes. A major impediment to progress on understanding and treating the disorder is that there is currently no way to determine which form of autism a particular child might have. This limits scientific progress, clinicians' abilities to identify treatment strategies and educators' abilities to define the best school-based approaches.

The UC Davis M.I.N.D. Institute recently launched an interdisciplinary research project--the Autism Phenome Project--which will define the distinct biological and behavioral markers for different types of autism, along with phenotypic changes in the disorder over the course of time. Assessments include family history, environmental exposures, genomics, behavior, brain structure and function, immunology and proteomic profiles. The outcomes of this comprehensive, longitudinal study will allow medical providers to diagnose different forms of autism and implement specific, successful interventions as early as possible in a child's life.

Five common misperceptions about children with autism

While there is still a lot we need to know about autism, we know much more today about autism than we did just 10 years ago. We especially know more about what autism is not. Here are five common misconceptions about children with the disorder:

1. Children with autism never make eye contact. They might avoid eye contact, likely due to an initial inability to "read" certain social situations, or they may not use eye contact for communication, but they will look directly at their peers and teachers, especially those most familiar to them.

2. Children with autism are "unattached" to their parents. Do not be surprised or question the validity of an autism diagnosis if you see children with autism enjoying hugs, laughter or other close interactions with family members and showing preferences for favorite people. Autism is not a disorder of attachment.

3. Children with autism tend to exhibit intense aggression. Some children with autism can be intentionally aggressive, but this is the exception. Autism usually tends to increase the opposite sorts of behaviors, such as avoidance, greater compliance with rules and timidness with others, due to discomfort with or lack of an ability to understand social activities.

4. Children with autism dislike social interaction or attention. Children with autism may not know how to initiate social interaction or respond to attention from peers. In other words, they don't know how to have friends. Repeated exposure to common social situations increases their comfort with others, as well as their abilities to respond to social cues.

5. Children with autism do not respond to treatment. This is the biggest myth of all, since behavioral interventions are the most effective treatment that we know of for autism. Children with autism respond positively to well-designed interventions--including language interventions, social skills groups and learning strategies--regardless of their age or the severity of their symptoms. The earlier those interventions begin, the better the outcomes. Due to the diversity of the disorder, what we need to focus on is identifying the specific interventions that will work best for specific children.

--Source: Sally Rogers, professor of psychiatry and behavioral sciences, UC Davis M.I.N.D. Institute.

Ann M. Mastergeorge is a developmental and educational psychologist. She is an adjunct professor and researcher at the M.I.N.D. Institute and a faculty member of the department of Human Development and Family Studies at UC Davis. Her work includes research into the influence of early autism intervention practices.