Part A: Drawing on evidence from research and literature, describe how the core features of ASD
will impact upon a pupil with ASD throughout the school day. Critically consider the impact on
learning, social interactions and behaviour in various contexts.
Part B: Critically consider the sensory processing patterns commonly associated with Autism
Spectrum Disorders and discuss how a multisensory room can be used to address these sensory
processing difficulties in a school setting. Include evidence from current literature and research.
Abstract
Following SENDO (2005) the rights of all children, despite their need, to be
educated in mainstream education was strengthened.
As a result many
children with Special Educational Needs, and in particular Autistic Spectrum
Disorders, are being educated in the mainstream school. This essay, which
is split into two sections focuses on the main features associated with ASD
and how this may impact upon a child in various settings throughout the
school day. The second part of this essay goes on to address how certain
difficult situations may be alleviated through the use of a multisensory room.
Particular emphasis is given to current practice based on recent research.
Part A:
While there is no single definition for Autistic Spectrum Disorders (ASD), according to DENI
(2011, p.4), " ASD describes a group of conditions characterized by three main areas of difficulty
known as the Triad of Impairments," a term originally coined by Wing (1971). This refers namely
to the difficulties children with ASD experience in communication, interaction and imagination.
With reference to the policy of educational provision for children with ASD, Dybvik (2004)
highlights that it is becoming increasingly likely that such children are being educated in
mainstream schools. However, Humphrey and Lewis (2008) express their concerns about the
quality of their experiences in these settings due to the core features of this Pervasive
Developmental Disorder (PDD). While it is important to recognise that every child with ASD is
individual and the manifestations of the triad may vary among children (DENI 2011) due to the
1
limitations of this essay I will examine the core features of ASD and how these may exhibit
difficulties for a pupil in a Post Primary School.
One of the most striking features of children with ASD is their limited use of language (Rimland
1962) and while the reasons for such may vary from child to child, it has been estimated that only
forty to fifty percent of people with ASD develop a functional verbal language (Bogdashina 2005).
While some children with ASD may appear to have excellent expressive language their receptive
language may be very poor, inhibiting all understanding (Frith 1989).
Indeed, in a classroom,
teachers often give verbal instruction, which Seach (1998) points out is inappropriate for children
with ASD as there is often reduced comprehension or it takes them longer to process information.
Evidently it may appear that such children are being ignorant of the teacher or they may be slower
to respond to instruction. Furthermore, with reference to echolalia (often used by children with
ASD), Shaberman (1971) highlights that children may be able to clearly pronounce and repeat
previously heard words without actual comprehension of the spoken word. In a classroom, this may
emerge when a child is presented with a question. Attwood (1998) suggests that children may
understand that an answer is expected and because the question hasn't been understood, a previously
learnt, irrelevant phrase is offered as a response. Particularly in a Post Primary school, this may
invoke laughter and jeering from other pupils.
Moreover, the umbrella term of communication encompasses non-verbal gestures and body
language, which according to Powers (1989) go unnoticed by children with ASD perhaps due to
the fact that eye contact is limited or avoided (Aarons and Gitens 1996). For this reason, children
with ASD may experience difficulties expressing or reading others' feelings and emotions perhaps
resulting in unintentional upset. Bogdashina (2005) points out that sarcasm is used increasingly in
the teenage years yet children with ASD cannot read such and often interpret 'playground banter' as
2
extremely hurtful. Therefore, it can be seen that communication is not a 'stand-alone' difficulty and
in parallel Baron-Cohen and Bolton (1993) highlight the implications of poor communication skills
with the development of social interaction.
Due to a range of factors including communication difficulties, limited or immature social
interaction is another defining feature of ASD (Frith, Happé and Siddons, 1994). Wing (1971)
suggests that often children with ASD behave as if other people do not exist which parallels
research done by Humphrey and Symes (2011, p.409) which showed that the students with ASD,"...
spent more time engaged in solitary behaviours and less time engaged in co-operative interaction
with peers." On the other hand, Bauminger (2002) suggests that such children may have the desire
for friendships but due to limited social and emotional understanding, they don't know how to
adequately interact which may result in social isolation. In school, this may be particularly evident
in the canteen or playground when these children are left alone which could lead to depression and
loneliness.
Furthermore, as the key skill of 'working with others' is a core aspect of the curriculum, the
integration of group work activities in the classroom may be distressing for pupils with ASD and
according to Nah and Poon (2010) have a detrimental effect on receptivity to learning. In such
situations, these children may interrupt discussion as Heavey, Phillips, Baron-Cohen and Rutter
(2000) and Parsons, Mitchell and Leonard (2005) explain that children with ASD often violate
social rules as they don't know how to interpret social cues. Ultimately this links back to their
difficulties with non-verbal communication. For these reasons, children with ASD may prefer to
work alone or be exploited by the other pupils and do the work of the entire group. Another key
aspect of the curriculum is the development of creativity and due to the 'degrees of mindblindess' in
3
children with ASD (Baron-Cohen 2008) they may find it extremely difficult to participate in role
play or creative writing tasks.
In addition to this, Nah and Poon (2010, p.187) state, "....there is an increased tendency to rely on
their personal experiences and idiosyncrasies to guide their decision making and understanding."
For example, although the child may receive praise from the teacher for answering every single
question, they may be unaware that in a Post Primary school, it is not 'cool' to do so in order to gain
peer acceptance. This reflects the tendency of children with ASD to be strict rule followers which
links to the third characteristic of ASD-repetitive behaviours and restricted interests.
While repetitive behaviours and restricted interests is a common feature for all children with ASD,
"Behaviours falling under the descriptions 'restricted and repetitive' and 'lacking in creativity and
imagination' are extremely various both within and across individuals" (Boucher, 2009, p.186).
According to Sickelmore (2009) the deficits in creative and abstract thinking can cause a rigid way
of doing things and Roberts (1997) highlights that children with ASD may become distressed by
even the smallest changes to routine. This may cause significant problems, especially in a Post
Primary school where there is often distribution to the normal timetable due to special assemblies,
fire drills and weather for example. Even the change in bus or taxi driver one morning may account
for distress and upset for a pupil with ASD for the remainder of the school day. With reference to
this, Boucher (2009, p.186) comments, "Anxiety or stress may contribute to a preference for
familiar routines and insistence on sameness or dislike of novelty." Therefore, less structured
subjects that allow for more pupil autonomy, such as Art and Home Economics may be dreaded by
pupils with ASD. However due to their restricted interests, Bogdashina (2005) highlights that
insistence on familiarity may hinder the development and acquisition of new skills. Furthermore
the focus on minute detail may cause pupils with ASD to lose grasp of the 'bigger picture' and miss
4
out on intended learning. Finally, with reference to social relatedness, a child with ASD's insistence
to talk only about their particular area of interest, at the exclusion of all else may be a hindrance in
developing good friendships with their peers.
In conclusion, it is important to point out that while children with ASD experience many difficulties
and challenges namely in the areas of communication, social interaction and repetitive behaviours
during the school day, they can also bring a wonderful new dimension to the classroom by putting a
new perspective on various situations. According to DENI (2011) it is important to build upon
pupils' unique strengths by enabling them to experience a classroom most conducive to their
preferred learning style. Sickelmore (2009) highlights that most children with ASD are visual
learners and when consistent visual support is in place, the stress levels will be reduced which in
turn may encourage communication, interaction and the ability to cope with new situations.
Part B:
Sensory Processing (SP) refers to the involuntary process by which sensory messages are received
by the nervous system, interpreted by the brain and turned into responses for use (Miller 2006 and
Pollock 2006). When such a system is effective, an individual can extract the information they need
in order to make sense of the world around them (Smith Myles, Tapscott Cook, Miller, Rinner and
Robbins 2000) but often children with ASD experience SP difficulties as they process sensory
information differently than typical children (Kern, Trivedi, Gaver, Crannemann, Andrews, Savla,
Johnson, Mehta and Schroeder 2006 and Botts, Hershfeldt, and Christensen-Sandfort 2008). This
in turn may inhibit their learning and development as Entz (2009) and Miller (2006) are in
agreement that sensory learning is the foundation of all learning. While SP isn't part of the
diagnostic criteria of ASD, it is often an overriding factor (Crane, Goddard and Pring 2009) which
5
Ives and Munro (2002) view as a primary deficit rather than a secondary feature. While children
with ASD may experience difficulties in each of the seven sense systems including tactile, auditory,
proprioceptive, vestibular, visual, gustatory and olfactory, due to the limitations of this essay I will
draw upon a few examples primarily from the first four and consider how such may be addressed
through the use of a multisensory room in school.
According to Notbohm (2005), the SP difficulties associated with autism are arguably the most
critical to understand as cognitive and social learning cannot break through to a child who,
"frequently feels overloaded, disorientated and unsettled in his own skin" (p.5). However, it is
important to note that all children are different and will respond to various stimuli in different ways
in accordance with their sensory profile (Dunn 1999 and Kern et al 2006). Furthermore, Ives and
Munro (2002, p.23) highlight that an individual child may present, "a mixed profile of
hypersensitivity in certain areas, contrasting with hyposensitivity in others " and acuity across the
child's senses may even vary from day to day (Notbohm 2005). To demonstrate such, Ives and
Munro (2002) give the example that a child may hate gentle maternal embraces but love rough and
tumble play.
Indeed in a school setting, SP difficulties, if not addressed, may become an escalating problem as
"...some individuals perceive harmless sensory input as threatening and potentially dangerous"
(Smith Myles et al 2000, p.17). Tactile defensive children may perceive a gentle touch as extremely
painful and act in accordance with what they felt by hurting another child. On the other hand, a
tactile sensory seeking child may engage in self-injurious behaviour such as biting themselves in
order to satisfy a particular sensory need.
6
However in the classroom particularly, there is a strong reliance on the auditory system, which
Greenspan and Weider (1997) describe as the most frequently impaired for children with ASD.
Such children cannot, "identify the voice of the teacher as the primary sound to which they should
be attuned" (Notbohm, 2005, p.12) in the presence of seemingly irrelevant background noise such
as pencil sharpeners, lawn mowers and flies for example (Ives and Munro 2002). Frith (2003),
believes that such can be explained by the hypothesis of 'stimuli over selectivity' in which minor
details are fixated upon at the exclusion of more important ones which Ashburner, Ziviani and
Rodger (2008) consider can lead to academic underachievement.
Furthermore, impairments to the vestibular and proprioceptive senses can greatly hamper or halt
everyday motor functions (Notbohm 2005) which will impact upon a child's ability to perform
everyday tasks such as tying their shoes, carrying a lunch tray or opening a milk carton (Smith et
2000). As gross motor skills are also affected and children with ASD often experiences difficulties
in praxis (Baranek 2002), many children with ASD shy away from sport as the demand placed on
several sensory systems is heightened. This may include assuming certain positions, listening for
instruction, performing numerous gross motor skills, and communicating with teammates for
example (Notbohm 2005).
Therefore, as everyday sensory experiences are too overwhelming or perhaps not stimulating
enough for children with ASD, Fowler (2008, p.9) suggests that controlled multisensory rooms
should be used to, "..act as a catalyst to provide a kick start to sensory engagement," which should
theoretically be translated into the regular environment. While multisensory rooms are artificially
engineered environments consisting of equipment to create particular sensory experiences,
Cartwright and Wind-Cowie (2005) highlight that it is the support and quality of provision made by
teachers, not the equipment itself, that makes the room successful. Indeed, Fowler (2008) strongly
7
advocates that multisensory stimulation should be highly structured in order to create an
environment most conducive to learning by appealing to the specific needs and interests of the
individual.
In order to achieve such, a carefully devised programme consisting of learning intentions and
success criteria should be in place (Leekam, Nieto, Libby, Wing and Gould 2007 and Notbohm
2005) whereby the reactions of the child in relation to various sensory experiences are observed,
recorded and reviewed for future planning. Through careful planning the teacher can create an
environment which eliminates distractions (e.g. visual stimuli can often be distracting for children
with ASD) and direct the pupil's attention to specific objects that may support their understanding
of their regular external environment (Fowler 2008). However, only when a child feels safe and
free from anxieties can real learning occur and indeed McMahon (1997) believes that a
multisensory room provides a safe, relaxing setting as the visual effects through the bubble tubes
provide an environment similar to that in the womb.
Once this 'state of calm' has been established the teacher can begin facilitating the tailored, childspecific plan, sometimes known as the sensory diet (Fowler 2008). Through the programme the
teacher should explain the purpose of each activity and how it should help that child further their
understanding of the outside world. Many activities may be adopted but I will select a few in
relation to the aforementioned sense systems.
The physio roll (or more commonly known as the peanut roll) is an excellent activity that offers
proprioceptive, vestibular and tactile input. In order to maximise the sensory experience, textured
toys may be placed at a distance from the roll and the child should position themselves accordingly
8
on the roll and move in order to retrieve the toy. Through such, the child can decide how much
proprioceptive
or vestibular input they receive which supports Cartwright and Wind-Cowie's
(2005) theory that children should self-regulate and become independent learners.
As children with ASD are often tactile defensive (Ayres 1979) and often perceive even light touch
to be harmful, the use of hand massage may enable children to see that some tactile experiences can
be pleasant. In parallel, the use of deep shoulder pressure can be both relaxing (Leekam et al 2007)
as well as encourage the sense of body awareness. Furthermore, these activities can be translated
into the classroom, and by embedding such into everyday activities the child is given a sense of
control (e.g. demonstrating hand massage or deep shoulder pressure to their peers) which Notbohm
(2005, p.19) believes "...greatly enhances their ability to engage both cognitively and socially."
Furthermore, Fowler (2008) agrees that multisensory experiences shouldn't be confined to the
multisensory room but should be available throughout the school day.
However, it must be
highlighted that, no matter what activities are selected for use, the teacher must explain how these
may correspond to everyday contexts and by doing so the child may begin to attend to the voice of
the teacher (which will hopefully be translated into the classroom).
In conclusion, it seems to me, based upon my research that sensory issues are not just another
aspect of ASD but rather they are crucial to a child's overall ability to function. Indeed this quote
by Notbohm (2005) encapsulates the demands put on children with ASD who already cannot cope
with the overwhelming sensory input, "... and into this shrieking, blinding hurricane of sensory acid
rain we insert the expectation that this child, 'Pay attention,' 'behave,' learn, adhere to social rules
and communicate...." Therefore, neglecting a child's sensory challenges prohibits the teacher from
even coming close to discovering their overall capability (Baillon, van Diepen and Prettyman
2002). For this reason it is essential that teachers address the specific needs of each individual and
9
ensure multisensory experiences are available throughout the whole school day in conjunction with
one-one sessions in the multisensory room.
10
References:
Aarons, M. and Gitens, T. (1996) "The Handbook of Autism: A guide for Parents and
Professionals." 2 edn. London: Routledge.
Ashburner , J. Ziviani, J. and Rodger, S. (2008), "Sensory Processing and Classroom Emotional,
Behavioural and Educational outcomes in Children with Autism Spectrum Disorder." American
Journal of Occupational Therapy, 62(5), pp.564-573.
Attwood, T. (1998) "Asperger’s syndrome." London: Jessica Kingsley.
Ayres, A.J. (1972), "Sensory Integration and Learning Disorders." Los Angeles: Western
Psychological Services.
Ayres, A.J. (1979) "Sensory Integration and the Child." Los Angeles: Western Psychological
Services.
Baillon, S. van Diepen, E. and Prettyman, R. (2002), "Multisensory Therapy in Psychiatric Care."
Advances in Psychiatric Treatment, 8(6), pp.444-450.
Baranek G.T. (2002), "Efficacy of Sensory and Motor Interventions for Children with
Autism."Journal of Autism and Developmental Disorders, 32, pp.398-422.
Baron-Cohen, S. (2008) "Autism and Asperger Syndrome: The Facts" New York: Oxford
University Press.
Baron-Cohen, S. and Bolton, P. (1993) "Autism: The Facts." New York: Oxford University Press.
Bauminger, N. (2002) "The Facilitation of Social-Emotional Understanding and Social
Interaction in High-Functioning Children with Autism: Intervention Outcomes." Journal of Autism
and Developmental Disorders, 32, pp. 283-298.
11
Bogdashina, O. (2005) "Communication Issues in Autism and Asperger Syndrome." London: Jessica
Kingsley Publishers.
Botts, B.H., Hershfeldt, P.A., Christensen-Sandfort, R.J. (2008), "Snoezelen: Empirical Review of
Product Representation." Focus on Autism and other Developmental Disabilities, 23 (3), pp.138147.
Cartwright, C. and Wind-Cowie, S. (2005), "Profound and Multiple Learning Difficulties." London:
Continuum International Publishing Group.
Crane, L., Goddard, L. and Pring, L. (2009), "Sensory Processing in Adults with Autism Spectrum
Disorders." Autism, 13, pp.215-228.
DENI, (2011) "Resource File for Special Educational Needs" [Homepage of DE], [Online].
Available: http://www.deni.gov.uk/08_the_autistic_spectrum_pdf [17/10, 2011].
Dunn, W. (1999), "The Sensory Profile." San Antonio, TX: Psychological Corporation.
Dybvik, A.C. (2004) "Autism and the Inclusion Mandate." Education Next, 4, pp. 42-49.
Entz, S. (2009), "Picture This: Photography Activities for Early Childhood Learning." California:
Corwin Press.
Fowler, S. (2008), "Multisensory Rooms and Environments: Controlled Sensory Experiences for
People with profound and Multiple Disabilities." London: Jessica Kingsley Publishers.
Frith, U. (1989) "Autism and Theory of Mind" in GILLBERG, C. (ed), Diagnosis and Treatment of
Autism. New York: Plenum Press, pp. 33-52.
12
Frith, U., Happé, F. and Siddons, F. (1994) "Autism and Theory of Mind in Everyday Life." Social
Development, 2, pp. 108-124.
Frith, U. (2003), "Autism: Explaining the Enigma." Oxford: Blackwell Publishing.
Greenspan, S. & Weider, S. (1997), "Developmental Patterns and Outcomes in Infants and Children
with Disorders in Relating and Communicating: A chart review of 200 cases of children with
Autism Spectrum Disorders." Journal of Developmental and Learning Disorders, 1, pp.87-142.
Heavey, L., Phillips, W., Baron-Cohen, S. and Rutter, M. (2000) "The Awkward Moments Test: A
Naturalistic Measure of Social Understanding in Autism." Journal of Autism and Developmental
Disorders, 30, pp. 225-236.
Humphrey, N. and Lewis, S. (2008) "Make me Normal: The Views and Experiences of Pupils on
the Autistic Spectrum in Mainstream Secondary Schools." Autism: An International Journal of
Research and Practice, 12, pp. 39-62.
Humphrey, N. and Symes, W. (2011) "Peer Interaction Patterns among Adolescents with Autistic
Spectrum Disorders (ASDs) in Mainstream Schools." Autism, 15(4), pp. 397-420.
Ives, M. and Munro, N. (2002), "Caring for a Child with Autism: A Practical Guide for Parents."
London: Jessica Kingsley Publishers.
Kern, J.K., Trivedi, M.H., Gaver, C.R., Crannemann, B.D., Andrews, A.A., Savla, J.S., Johnson,
D.G, Mehta, J.A. and Schroeder, J.L.(2006), "The Pattern of Sensory Processing Abnormalities in
Autism." Autism, 10 (5), pp.480-494.
13
Leekam, S.R. Nieto, C., Libby, S.J., Wing, L. and Gould, J. (2007), "Describing the Sensory
Abnormalities of Children and Adults with Autism." Journal of Autism and Developmental
Disorders, 37, pp.894-910
McMahon, L. (1997), "The Handbook of Play Therapy." New York: Routledge.
Miller L.J. (2006), "Sensational Kids." USA: Penguin Group.
Nah, Y.H. and Poon, K.K. (2010) "The Perception of Social Situations by Children with Autism
Spectrum Disorders." Autism, 15(2), pp. 185-204.
Notbohm, E. (2005), "Ten Things Every Child with Autism Wishes you Knew." Arlington: Future
Horizons.
Parsons, S., Mitchell, P. and Leonard, A. (2005) "Do Adolescents with Autistic Spectrum Disorders
Adhere to Social Conventions in Virtual Environments." Autism, 9, pp. 95-117.
Pollock, N. (2006), "Keeping Current in Sensory Integration." Can Child Centre for Childhood
Disability Research, 3.
Powers, M. (1989) "Children with Autism: A Parent's Guide." Rockville: Woodbine House Inc.
Rimland, B. (1962) "Infantile Autism." New York: Meredith Publishing Company.
Seach, D. (1998) "Autistic Spectrum Disorder: Positive Approaches for Teaching Children with
ASD." Tamworth: NASEN.
Shaberman, R.B. (1971) "Autistic Children." London: Stuart and Watkins.
Sickelmore, P. (2009) "Autism Training and Support." Available at
http://www.autismtraining.net/html/triadoi.html [Accessed 17/10, 2011].
14
Smith Myles, B., Tapscott Cook, K., Miller, N.E., Rinner L. and Robbins, L.A. (2000) "Asperger
Syndrome and Sensory Issues: Practical Solutions for Making Sense of the World." Kansas: Autism
Asperger Publishing Company
Wing, L. (1971) "Autistic Children: A Guide for Parents." London: Constable & Co.
15