Early Intervention Paper

Difficulties in social communication limit successful outcomes for students struggling with autism spectrum within the mainstream school setting because they impact across all areas of the curriculum. Austic individuals have the following triad of impairments: social interaction, communication and imagination. This triad refers to their inability to engage in shared social interactions often making them seem aloof or disinterested, limiting their social communication. In addition, a lack of purposeful or pragmatic speech for efficient communication and impaired non-verbal aspects of communication, cause difficulties in social communication across a number of areas. Social imagination is also impaired and abstract or imaginative thinking is difficult for students with autism spectrum condition. Subsequently, individuals with autism spectrum have significant difficulties with social communication and can experience limited success in a social setting. The most significant approach to explaining the triad of impairments seen in social communication difficulties of an individual with autism is based on the Theory of Mind (ToM) hypothesis. This

development in the cognitive approach to teaching social skills is based on the Theory of mind approach in autism provide an alternative to behavior based techniques (Parsons and Mitchell 2002).
Verbal language is without a doubt, the key component of communication, but social communication is much more than words. Communication is the use of both nonverbal behavior, such as eyes, facial expressions, gestures and verbal behavior, such as speech and spoken language. Our verbal and nonverbal communications are used to express wants, needs, and feelings, to share ideas to solve problems and to connect with others. To be successful as a communicator requires more than verbal and non-verbal abilities. It is not only sending clear messages of communication but also responding to another’s verbal or non-verbal messages and successfully interpreting this communication. The World Health Organization (1992) defines the characteristics of autism as including the limited use of non-verbal behaviors such as eye gaze and body posture, limited ability in social interaction and problems developing peer relationships, limited spontaneity in showing and sharing interests and limited social emotional reciprocity.
The cognitive approach to understanding autism focuses on memory, perception, thinking and language. It is also based on the concept that the brain processes information to direct or justify how we behave. Social messages need interpretation, and taking meaning from language is central to the success of conversation, as it requires the ability to interpret written, nonverbal and verbal messages. To understand the more subtle social conventions or ‘unspoken rules’ of social interaction is very difficult for the autistic student, as these often need to be explicitly explained (Parsons and Mitchell, 2002). At times, even after explicit and repetitious explanations social rules, expectations, understanding and social comprehension continue to be abstract to individuals with autism. Understanding gestures, facial expressions, the meaning behind words, waiting and listening and then responding correctly are all part of effective social communication skills that are difficult for the austic student as they require Theory of Mind, something austic individuals are lacking.
Theory of mind is referred to as the ability to reflect on the contents of one’s own and other’s minds, including beliefs, desires, intentions, imagination, emotions, behaviors and actions (Baron Cohen 1997), all of which can be scarce as early as within the first year of life. Although the development of social communication is usually gained gradually, the achievement and understanding of unspoken rules sometimes doesn’t happen at all for the autistic student. Therefore, there is a need to teach these explicitly and clearly. Social and communication stages can be seen and achieved at particular stages in a student’s development; an awareness of these from an early age can highlight what is missing for the autistic individual. The absence of response or interest in areas such as recognition of significant voices or facial expressions, mimicking and watching, learning to speak, are all key within the first years of development for successful social communication. If the rules or principles of ToM are explicitly taught the individual with autism is eventually able to monitor their own behavior for acceptable social development (Parsons and Mitchell, 2002). This work supports the early intervention of this explicit teaching for maximum benefits in lifelong learning.
Similarly, early intervention focusing on social and communication strengths and challenges, suggests that early intervention makes substantial differences to social skill development of individuals with autism (Mundy and Crowson, 1997).

Highly structured, intensive early intervention may lead to significant developmental gains. When dealing with children of preschool age, a critical focus area is the non-verbal communication skills, as these have a significant effect on the social skill development and development of social behaviors both at this age and as an adult. While there is not one conclusive list of the full range of verbal and non-verbal impairments of communication of autistic student’s language impairments; these impairments are obvious and specific both in early childhood autism as well as later in life (Wing,

2010).

In the context of the classroom, social communication deficits impact across the social aspects of language communication (DoE UK, 2002). These can include a student’s inability to wait and understand time. They may also exhibit a socially inappropriate manner, such as shouting out in class, interrupting adult conversations or constantly asking questions. They have an inability to ‘read’ or understand the significance of gestures, facial expressions, vocal intonations or body language. There is also an inability to empathize with others as autistic individuals have a literal understanding of language and find difficulty transitioning between activities and locations including a change of routine. Timetable changes or change of staff, sharing, waiting, sensory difficulties, turn taking, unstructured time, free play, assembly, break time, lunchtime or group work can all be difficult for the autistic student. Difficulties with pragmatic speech, that is, the use of language appropriate to the social context is another social communication struggle for students with autism. Using pragmatic language involves context and often the student with autism has difficulties realizing that their conversation or that of another’s is either or both inappropriate or irrelevant. In particular, recognizing what is the wrong or right thing to say in a particular social setting is a struggle.

The cognitive approaches to autism maintain the assumption that this approach receives information from our senses which is processed by the brain and that this processing directs how we behave or at least justifies how we behave the way that we do. A behavioral approach is scientific and is changing in its understanding and techniques beneficial to the effective teaching of students with autism. A behavioral approach considers individual student goals and appropriately instructs and targets these. Skills such as social communication are emphasized to enable the individual to become independent and successful both within the school setting and privately.
By breaking down desired skills into manageable steps to be taught from the simplest to the more complex, the behavioral intervention is hopefully ongoing and the individual is able to use these skills when it is necessary. Understanding humor and figurative speech is an example of this. The difficulties for the student understanding figurative speech and humor can be seen in the classroom when the entire class shares a joke but the autistic student doesn’t understand what is funny. The autistic student will tell you repeated facts or a story many times, regardless of whether they had told you previously. In addition to this, difficulties in taking-turns within a conversation and being sensitive to the others within the conversation are also common for individuals with autism.
Behavioral interventions teach specific social behaviors in practical and adaptive ways and include methods such as the consistent and appropriate use of visual aids, particularly explicit pictures showing step-by-step instructions that explicitly teach a skill or instruction. This can be done in a discrete and systematic manner encouraging the appropriate behavior. The visual picture or symbol acts as a prompt reminding the student of the necessary behavior required in the situation he is placed. Video modeling and virtual reality are also interventions that have had success for teaching social communication deficits in autistic students. They are both easily applied in the school and home setting as student’s access to technology is usually available.
The principle aspect of behavioral intervention being that the student completes the tasks, the long term goal of cognitive reasoning may come later. To assist the student struggling with social communication difficulties, best practices would need to include strategies that can ideally be implemented as early possible, as targeting social difficulties at an early age can have beneficial effects (Mundy and Crowson, 1997).
The neuroscience behind the theory of mind deficit in autism is being investigated using both functional neuroimaging and studies of acquired brain damage (Stone, Baron-Cohen & Knight, 1999). These investigations suggest that key neural regions for normal mindreading such as the amygdala, orbito-frontal cortex, and medial frontal cortex are impaired in the autistic student. Again, focusing on early childhood intervention to develop particular strengths of the child’s brain, rather than trying to correct missing behaviors is a more beneficial (Laurent Mottron, University of Montreal).
Social communication is not only impaired through the autistic individual’s lack of theory of mind but a weak central coherence which is the tendency to processes information in parts rather than wholes and the failure to pull together information to develop clear and meaningful ideas (Frith, 1989). This inability to link smallest parts together to see the whole has a negative aspect on the student’s success in a classroom setting. Weakness in central coherence may explain why the autistic student has good memory for details within a story but fails to recall the overall storyline. For example, the individual can remember specifics when reading but has limited understanding of the whole story, which as older students are expected to analyse character and events for information beyond the literal becomes increasingly difficult. This is a significant barrier and impacts on successful individual academic outcomes.
Varied approaches are used to assist autistic students and, as no two people with autism are the same, success differs in approaches, support and therapies and interventions. Examples of these include biomedical interventions which are used to restrict problems such as gastrointestinal issues, immune or nutritional problems or imbalances. Motor interventions aim to improve the movement of the whole body or parts of the body. Sensory interventions make use of or aim to improve sensitivity to one or more of the senses. Social stories and comic strip conversations assist individuals in gaining greater social understanding and the list continues. Not all of these interventions are effective in assisting students reach successful school outcomes.
Behavioral teaching and coaching approaches to learning social skills in the classroom have included highly structured, explicit teaching. These are often one-to-one, with repetitive tasks or imitating behaviors. Examples, such as visual supports are very important and because language can be an issue, the visuals provide a way to communicate and assist in the processing of information. Visual aids are a key effective practice within the school setting for autistic students. Effective approaches for improving social communication need to allow for key elements that include repetition of a task or skill and rote learning of social rules. These can be done effectively within the classroom setting verbally and through visual prompting. Ideally, the fading of these prompts will, over time, mean the student will come to an understanding and a consideration of how their own behavior impacts on others, that is, an understanding of other minds.
Practice of these skills in both educational and private settings through repetition or role-play is vital to success; however, there are limitations to these in both environments and despite best intentions, one-to-one assistance is not ensured in either. Common and effective practices vary between individuals in their home and their educational settings. These limitations need to be considered, particularly those concerning the person working with the individual and the individual’s particular needs. Regardless of the choice of method, each should be flexible in their endeavor to build on individual strengths and potential to increase individual motivation and progression.
The introduction of technology as a teaching tool has given varied and valuable options to assist the individual in the area of social communication. Such examples of this have been the introductions of virtual reality technology and video–role modeling. These are means of combining strategies to assist students with autism improve their social communication skills and social understandings. Video role modeling offers a new perspective for the student, as it provides a perfect tool for allowing students to practice behaviors in role-play situations whereby they can learn rules, repeat tasks, make connections and gain insights into their own mind and that of others. In virtual reality practices, sensory experiences come from inside the game itself, the student blocks out those from outside and the equipment used provides the sensory experience needed or wanted. While virtual reality has its limitations in assisting learners to transfer things they learn to the real world (Parsons et al), it provides students with the opportunity to practice what it is like to be other people and see the world differently, something their limited imaginations find difficult. Through their ability to role-play, the individual gains insights into minds of others’ a well as their own.
In an educational setting dependent upon the severity of the individual’s level of impairment, a substantial amount of intervention is needed to cover either one or many of these areas. A significant issue impeding effective practice within schools is the level of support required to assist the student adequately. Some approaches referred to in this paper are accommodating, flexible and novel methods to social problem solving and to effective social skills training; however, importantly, it needs to be noted that these are used to supplement and enhance teaching practices not replace them.
The effects of social skills communication impairment for a student within a school setting can be negative and lead to a challenging and unsuccessful school experiences including exclusion, bullying, loneliness and a lack of sincere and lasting friendships. These effects can be specific to the individual but as each individual on the autism spectrum is unique, tailoring these methods to their needs is necessary. An early intervention is key to long-term improvements. The acquisition of interventions at an early age leads to life–long individual learning and understanding. The aim is that from this, the student is assisted in making judgements and has a greater capacity for reasoning and understanding themselves and others thus lessening the significant barriers the experience from the impact social communication difficulties cause while achieving successful school outcomes.
In part two of this assignment a behavioral intervention is discussed whereby a shift in behavior is seen and measured through the behavior exhibited and communicated over a short period of time. A cognitive shift often being immeasurable, involves a longer period of time concerning change, reflection and understanding of this change for the individual. It is important to remember that cognitive processes are examples of proposed ideas. That is, we cannot directly see processes such as thinking but we can infer what a person is thinking based on how they act. The outcomes of this may not be seen until they are generalized across settings; such as school and home and social situations.