Introduction
Autism Spectrum Disorder (ASD) is among the common childhood disorders that cause mental impairment among children, thus resulting in a wide range of difficulties. Autism Spectrum Disorder is defined as a neurodevelopmental disorder consequently characterised by variations in communication, the disparity in social interactions, repetitive behavioural patterns, and highly restricted interest in particular objects or activities, among other psychological challenges (Chiarotti & Venerosi, 2020). Evidence-based research estimates the global prevalence of autism among children and adolescents at 1%, with a significant comprehensive impact on the education sector (Lord et al., 2020). It is noteworthy, based on research evidence, that persons with autism have inherent learning disabilities, have challenges in socialising with their peers and are also predisposed to increased morbidity and low life expectancy compared to those without Autism (Bishop-Fitzpatrick & Kind, 2017). The spectrum of difficulties presented by those with autism creates an overall need to offer various support strategies to help mitigate the challenges faced.
Interprofessional collaboration is vital in the care and support of persons with autism spectrum disorders. Appropriate diagnoses of specific spectrums allow carers, parents and other healthcare professionals to offer emotional support, relational support, social support and access to essential information (Legg & Tickle, 2019). In tackling autism, correctly understanding environmental factors that precipitate and perpetuate a spectrum of difficulties experienced is vital to support the outcomes offered. This paper will discuss the impact of autism across some of the spectrum of abilities and explore the learning needs required & barriers to learning across a spectrum of abilities. Moreover, the paper will critically analyse some critical concepts across the spectrum of abilities, explore the environmental impact on the spectrum of abilities and mention rights, legislation and advocacy associated with ASD.
Impact of Autism across the spectrum of ability
Early diagnosis of autism spectrum disorder (ASD) is a fundamental step in managing and supporting persons with a neurodevelopmental disorder. A clear definition for diagnosing the spectrum of difficulties exhibited by those with ASD is significant in this endeavour as it would allow a targeted approach to the care and support for those with the condition. ASD diagnosis combines pervasive developmental disorder, autistic disorder, childhood disintegrative disorder and Asperger’s disorder (Hodges et al., 2020). The current diagnostic definition of ASD thus presents the condition as a collection of disorders with varied signs and symptoms, as exhibited in the various difficulties experienced by those with the condition. In children, signs and symptoms of ASD are usually identified from age two when they start developmental milestones, such as the ability to communicate using language (Mughal et al., 2022). From the age of two, some of the environmental factors that the children respond to and interact with become evident and easily identified as part of the signs and symptoms of ASD.
Childhood disintegrative disorder is part of the autism spectrum disorder. Available scientific data indicate that the disorder has a late onset in children and has the potential to erode previously acquired and developed skills, such as the ability to interact socially with people, language abilities, and motor functionality, among others (Mughal et al., 2022). Mughal et al. (2022) further argue that the condition, previously referred to as Heller syndrome, is a rare disorder and manifests at different ages among children. However, the most common onset age among children is three years. Cognition predictors, such as early speech and behavioural predictors, such as sensory processing, are some indicators of the severity of childhood disintegrative disorder (McDougal et al., 2020). Early diagnosis of childhood disintegrative disorder allows for timely management and treatment of the condition, which involves individualised therapeutic interventions for a better prognosis (Matos et al., 2022). In retrospect, autistic disorders must meet basic diagnosis tenets: impaired social interaction, impaired communication, and repetitive & restrictive behavioural tendencies toward specific activities or objects.
Asperger’s syndrome is another neurodevelopmental condition classified under autism spectrum disorder. Asperger’s syndrome is referred to by many scholars as level 1 autism and is associated with impaired language communication & social interaction, average or super cognitive abilities, and varied or no significant delays in language expression (Hosseini & Molla, 2022). The description of Asperger’s syndrome was pioneered by Hans Asperger in 1944 based on behavioural manifestations in select individuals together with impairments in social interaction and communication abilities (Hosseini & Molla, 2022). While impaired social interaction, communication, repetitive behaviour and restrictive interests are the central basic tenets of diagnosing various neurodevelopmental disorders under ASD, Asperger’s syndrome requires some additional considerations. For instance, diagnosis of Asperger’s syndrome entails the identification of at least symptoms showing impaired social interaction, at least one sign showing poor communication, at least two symptoms of impaired language, diagnostic criteria for other autistic disorders, and onset before three years (Hosseini & Molla, 2022). It is important to note that delayed social interaction and communication abilities negatively impact a child’s learning abilities hence necessitating the need to support children diagnosed with ASD at an early age.
Differing learning needs and barriers to learning across the spectrum of ability
Accessing a diagnosis for ASD is an absolute necessity in knowing the extent of limitations shown by the signs and symptoms, hence planning for support to both children and adults involved. Diagnosis of autism spectrum disorder enables a proper understanding of the conditions by both individuals and family members, promotes acceptance of the conditions and enhances the choosing of appropriate support measures available (Crane et al., 2018). Based on the severity of a given autism spectrum disorder, there is a significant negative on learning needs, especially among children. In the United Kingdom, the education sector is greatly affected by impaired social interaction, communication abilities and lack of interest in certain activities, as contributed by autism spectrum disorder (Chiarotti & Venerosi, 2020). A variety of signs and symptoms exhibited by children with ASD are direct barriers to their learning, hence the need to attend to their different learning needs. The barriers to learning for those with ASD are associated with the signs and symptoms used in the diagnosis of ASD—impaired social interaction, impaired communication and restricted interest in certain activities.
There exist high-functioning individuals with ASD who require a variety of learning needs. These individuals have heightened cognitive abilities and may not have learning difficulties but have impaired social interaction and communication abilities that predispose them to challenges (Southby & Robinson, 2018). Research evidence indicates that high-functioning persons with ASD are predisposed to poor physical and mental health that interferes with their learning process (Southby & Robinson, 2018). Additionally, these individuals cannot communicate, and some have impaired language; hence not able to connect correctly with teachers and instructors within the realms of education. Despite having heightened cognitive abilities that enhance their information processing, they require support in interacting with others and proper use of language in communicating ideas and thoughts. In the UK, the support provided to children with ASD within the education sector is aimed at minimising or eradicating barriers to learning and improving their quality of life concerning schoolwork (Bowman et al., 2021).
People with Asperger’s syndrome exhibit various barriers to learning that must be mitigated. For instance, such individuals often fail to initiate conversations, are less likely to share their interests, and display poor verbal communication. Moreover, they display abnormal body language or facial expression, repetitive speech patterns and lack interest in their peers (Hosseini & Molla, 2022). Display of the above signs and symptoms are significant barriers to the learning teaching and learning processes. Persons with autism spectrum disorder, therefore, must be exposed to an educational plan with interventions that are structured to mitigate the above challenges. An adequately structured curriculum targeting classroom-based models are used to foster learning experiences where communication and language handicap of those with ASD are also addressed accordingly (Hosseini & Molla, 2022). Educational interventions for persons with ASD primarily focus on enhancing and re-enforcing the ability to initiate verbal & non-verbal communication, promote the social life of the individuals and strengthen their motor skills (Pugsley et al., 2022). Moreover, speech and language therapy interventions are fundamental tenets in fostering learning and reducing the barriers to learning for children and adults with ASD (Hosseini & Molla, 2022).
Key concepts
People with autism spectrum disorder have various special needs, depending on the severity of the signs and symptoms they exhibit, hence require specific levels of inclusion in the education sector. Various educational interventions have been employed to help in the inclusion of children and young persons within learning institutions. The interventions include technology-based instructions, naturalistic instruction models, teaching & learning in inclusive settings, group-based social training, communication interventions for enhancing verbal & non-verbal skills, behavioural interventions, and exposure to post-school outcomes, among many other interventions (Odom et al., 2021). Some behavioural interventions are those employed to focus on enhancing play and attention, approaches for promoting social skills, and cognitive behavioural therapy (Weitlauf et al., 2014). In the UK, the inclusion of people with ASD in the education system is guided by various inclusion principles. The principles are designed to promote equity & access to available opportunities, reduce discrimination against persons with disability, provide appropriate early childhood education for children with ASD, promote a rights-based approach to dealing with ASD and allow people autistic children to develop to their full potential (Paraskevi, 2021).
Inclusive education for persons with ASD has been explored for years and is still in practice. In recent years, the inclusion of autistic children in mainstream schools was informed by the desire to reduce stigma associated with ASD and expose those with autism to the same facilities and ensure the integration of all learners (Paraskevi, 2021). Paraskevi (2021) further explains that including children and young people with ASD within mainstream classrooms together with those without autism serves to promote social interaction and helps develop communication skills necessary for survival in the outside world. Furthermore, Paraskevi (2021) argues that evidence-based research studies have revealed that the inclusion of children with and without special needs within the same school environment allows those without special needs to understand the former better and attend to their needs hence promoting the intended socialisation process.
Some models of disability used to explore challenges experienced by people with ASD are the social disability model, biomedical model and capabilities model. In the social model of disability in autism, the concept of neurodiversity among persons with ASD is underpinned. The social model explores the various social challenges that face persons with ASD, such as social interactions and poor language & communication, and seeks the removal of social barriers that may hinder people with ASD from attaining quality life (Bunbury, 2019). In the United Kingdom, the social model covers the inclusion and integration of special needs autistic learners within mainstream learning institutions and various special needs interventions that promote the social aspect of life for persons with ASD (Woods, 2017). Moving on, the biomedical model explores the etiology of autism and the medical interventions used to manage persons with autism and enlists the various limitations that the biology of autism projects on people with ASD (Smith, 2021). On the other hand, the capabilities model employs a human-rights approach to understanding challenges experienced by those with ASD. Smith (2021) further contemplates that the capabilities model details particular human rights issues covered by what autistic people can and cannot do, thus safeguarding their rights from a legal and human rights standpoint.
Environment Impact across the spectrum of ability
The immediate environment has a direct impact on supporting or hindering the ability of autistic individuals to communicate, have self-control, and be independent, among other challenges. For instance, participation in social interaction activities can promote social connectedness among adolescents and children with ASD (Krieger, et al., 2018). Social interaction activities thus form part of the immediate environment that enhances the ability of children with ASD to interact and communicate while also promoting integration among those without ASD within mainstream schools. Krieger, et al., (2018) further argues that exposing adolescents with ASD to out-of-school experiences enables them to connect with their peers, which further improves their independence and autonomy when they are finally incorporated into the general public in professional settings. Being included in occupational roles additionally helps to enhance social interactions hence better communication and modified behaviour for persons with ASD. According to Krieger, some of the common hindrances to improved communication, independence and self-control in the environment are an unconducive physical environment, inadequate support from staff members in occupational settings, discrimination at the workplace and changes in attitude. An unconducive physical environment may involve undesirable sounds likely to trigger particular behavioural responses from persons with autism.
Specific characteristics of the physical environment have a significant impact on the ability of children with autism to engage in learning activities. Characteristics such as lighting systems and background sounds in some instructional materials can either promote or hinder involvement in certain classroom activities while also triggering responses that interfere with self-control among autistic children (Dargue, et al., 2022). Teachers and instructors trained in special needs education must identify elements of the classroom environment that create undesirable behavioural responses from children with ASD or those that hinder their participation. Dargue, et al. (2022) further contemplate that the spacial arrangement of classrooms can also trigger negative behaviour, as some are particularly repulsed by a particular arrangement or patterns of objects, for that matter. More studies should be conducted on how specific physical environmental factors impact—negatively or positively—communication, autonomy, self-control and independence of persons with autism within educational settings. Special needs teachers, thus, must be on the lookout for inherent hindrances to the participation or overall concentration of learners with autism within their immediate physical environment and be able to make design changes in the instructional frameworks or learning materials to mitigate the situation.
Nature forms a fundamental part of the physical environment, influencing autistic persons in many ways. The self-determination theory is vital in promoting the psychological wellbeing and autonomy of persons with autism (Friedman, et al., 2022). Interaction with nature benefits children with ASD by providing opportunities to play, practice autonomy, and enhance their motor & social skills in one setting (Friedman, et al., 2022). Consequently, children with ASD are able to promote their verbal & non-verbal communication skills and social interaction skills and be involved in practical activities essential for their motor development. Furthermore, interacting with the physical environment allows persons with autism spectrum disorder to explore their inherent difficulty differences and understand one another, thus achieving more excellent knowledge on their own (Dargue, et al., 2022). In summary, interacting with the physical environment provides incentives that promote the development of communication, encourage social interaction, enhance the development of motor skills and provide opportunities for exercising personal autonomy.
Rights, Legislative and Advocacy Context
The Autism Act of 2009, passed by the UK parliament on the 12th of November, 2009, paved the way for an in-depth acknowledgement of the rights of persons with an autism spectrum disorder in the UK. The Act called for a government review of the strategies used to address autism in the UK—the strategy plans were consequently published in 2010 and 2014 (Smith, 2021). In retrospect, the National Health Service (NHS) formulated policies to tackle the challenges faced by people with ASD. Among the recent policies by the NHS is the NHS Long Term Plan 2019, which championed the introduction of “digital flags” for identifying incoming patients with ASD by 2023, intensification of support provided to persons with ASD exhibiting learning disabilities and establishment of regular health checkups for people with ASD (Smith, 2021). Smith (2021) further discusses the capabilities model as a rights-based approach to challenges facing persons with ASD—the model calls for the integration of people with ASD into society to ensure their participation to the fullest extent of their abilities, promotion of tolerance for persons with ASD, and discouraging the medicalisation autistic people, among many others.
Enhancing the human rights of people with ASD promotes their wellbeing and improves their quality of life. From the perspective of the capabilities model, the promotion of equality, discouragement of discrimination and acknowledgement of diverse abilities of persons with ASD are realised (Smith, 2021). Smith further contemplates championing the rights of persons with ASD allows for the conceptualisation of the legal challenges that they may encounter in life. Retrospectively, the Autism Act 2009 initiated the formulation of various government policies meant to encourage the inclusion of persons with ASD in educational and occupational settings. In summary, persons with ASD need to enjoy rights to their special needs in education, the right to be included in educational programs, the right to be allowed to explore their occupational capabilities, the right to equal treatment in all spheres of life and legal rights.
Advocacy for the realisation of the rights of persons with ASD has promoted the achievement of several milestones meant to improve their wellbeing. Autism advocacy in Scotland was boosted by the Autism (Scotland) Bill (SP Bill 44) tabled in the Scottish parliament in 2010, which sort to set up an autism strategy to look into the needs of people with ASD (Mullen, 2010). Autism interventions in the UK initially sort to make persons with autism “less autistic”, a move that was fiercely opposed by self-advocacy groups who argued that autism should be recognised as an essential part of a person’s life, not an abnormality to be extinguished (Leadbitter, et al., 2021). Leadbitter, et al., (2021) further contemplates that initial advocates for autism in the 2000s started as the neurodiversity movement, which called for a proper understanding of autism and its neurological differences. Autism advocates in Scotland argued that financial security could be fostered by a Scottish Autism Strategy, which would also enhance multi-agency collaborations (Mullen, 2010). In summary, advocates for the Scottish autism strategy resolved that strategies employed to tackle autism must encompass values such as dignity, privacy, choice, safety, the realisation of potential, equality and diversity (Mullen, 2010).
Conclusion
Autism spectrum disorder, as a neurodevelopmental disorder, presents challenges associated with social interaction, communication, repetitive behavioural patterns and restricted interest in specific activities. Due to various challenges experienced by individuals with ASD across the spectrum of abilities, there is a need for robust interventions that can offer support to persons with the disorder. Children and adolescents with ASD require special needs education to overcome challenges associated with learning disabilities, social interactions and communication (both verbal and non-verbal). However, the inclusion of persons with ASD in mainstream classrooms helps integrate them with persons without the disorder, thus allowing both sides to appreciate and learn from the differences presented. Also, the inclusion of persons with ASD in occupational settings will enable them to experience life in the outside world, thus promoting their ability to socialise and communicate.
Social, medical and capabilities models are used as conceptual and theoretical underpinnings that support various definitions associated with ASD. The models explore the need for social support, special needs education, inclusion & integration, human rights, legality and the role advocacy for persons with ASD. From a social standpoint, environmental factors influence abilities to socially interact, develop various motor skills through play activities and exercise autonomy. Exposing persons with ASD to the physical environment promotes their inclusion in multiple aspects of social, educational and occupational spheres.
Safeguarding the rights of persons with ASD is an absolute necessity. The Autism Act of 2009 gave rise to various government strategies and policies meant to support persons with ASD across various spectrum of abilities. The support provided has been in the form of special needs education, inclusion and advocacy for general rights.
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