Including children with autism in early childhood settings

Including children with autism in early childhood settings There is no denial that children with autism can be challenging for early childhood educators. Educators might feel perplexed, frustrated or even hurt in spite of their concerted efforts. This essay sets out to discuss the prevalence of autism in New Zealand/Aotearoa, its manifestation and identification, and some basic strategies for educators to successfully include children with autism in the early childhood settings. What is autism? Autism is short for Autism Spectrum Disorders. Autism New Zealand Inc. (2005) gives the following definition: An Autism Spectrum Disorders is a life-long developmental disability affecting social and communication skills. It is defined by New Mexico Public Education Department [NMPED] (2004) as a neurobehavioral syndrome characterized by onset prior to age 3. Characteristics include severe differences in interaction with other people, communication deficits, as well as restricted and stereotyped patterns of interest and behaviours. (p.8). Due to the different severity and manifestation, autism is used to describe all the diagnosis sharing the common characteristics of autism, including Asperger syndrome (difficulty in understanding non-verbal signal but might with normal language development and cognitive development) (Autism New Zealand Inc., 2005). In Aotearoa, 1 person in 100 has autism, including Asperger syndrome. That is an estimation population of 40,000 people. Boys are more likely to have autism 4 times than girls (Autism New Zealand Inc., 2005). Large-scale survey conducted in United States and England suggests autism affect 4.5 out of 1,000 children. Recent estimation even goes up to as high as  ¼% to  ½% of the population. According to epidemiological survey, the latest figure for people with autism worldwide is 1 in every 150 children and 1 in every 83 boys (Autism-world, 2007). Despite the prevalence of autism, its cause remains much unknown. Current research worldwide has identified biological or neurological differences in the brain for the cause of autism, but has not found the explanation for such differences yet (NMPED, 2004). In some cases, the various conditions affecting the brains such as maternal rubella, tuberous sclerosis and encephalitis cause the autism (Autism New Zealand Inc., 2005). However, it is 100 % certain that autism is not caused by bad parenting, mental illness, or poorly behaved children (NMPED, 2004, p.8), nor family income, lifestyle and educational levels (Massachusetts Department of Education [MDoE], 1998). More and more researches have attested to the effectiveness of intensive early intervention for the children with autism (Dawson Osterling, 1997, cited in Woods Wetherby, 2003). It is indicated by researches worldwide that intervention provided in the first three years are most effective (Harris Handleman, 2000, cited in Woods Weatherby, 2003). As more and more children are attending early childhood services, it is imperative for early childhood educators to identify the early signs for autism in children and refer them to special services for thorough and comprehensive diagnosis (NWPED, 2004). Most children with autism have significant social communication/ language delays (NWPED, 2004). Early childhood educators are to be aware of the following early warning signs in the communication areas: no babbling, pointing or gesturing by 12 months; no single words by 16 months; no 2 word spontaneous phrases by 24 months; no response to name; ANY loss of language or social skills at any age (NWPED, 2004; Woods Wetherby, 2003). It is strongly suggested by a multidisciplinary consensus panel endorsed by the American Academy of Neurology and Child Neurology Society and nine professional organisations (Filipek et al., 1999, cited in Woods Wetherby, 2003) that educators resort to immediate further evaluation if they notice any of the mentioned signs in children. Wetherby et al. (2000, cited in Woods Wetherby, 2003)) suggest that parents and professionals need to be conscious especially when children seem to show deficits in joint attention and symbolic communication. Deficits in joint attention means children have difficulties in coordinating attention between people and objects. Signs to look for are identified as below: children have problem in responding to a social partner; children cant shift gaze between people and objects; there is no sharing of affect or emotions with other people; children fail to follow others gaze, point or draw others attention to share experiences. Deficits in symbolic use are characterised by problems in (a) using conventional gestures, (b) understanding and using conventional meanings for words, and (c) using objects functionally and in symbolic play (Woods Wetherby, 2003, p. 181). Children with autism dont use much of conventional gestures, such as waving, showing or pointing as discussed in the deficits of joint attention, nor symbolic gestures like head nodding or miming actions. Instead, idiosyncratic, unconventional or inappropriate behaviours might be detected in them, such as they might be aggressive and throwing tantrums all the time or they might hurt themselves. Children with autism are found to use significantly more syllables with atypical phonation, such as squeals, growls, and yells (Sheinkopf, Mundy, Oller, Steffens, 2000, cited in Woods Wetherby, 2003). For those children with autism who does learn to talk, echolalia that is imitating others speech is often found. Children with autism also show noticeable deficits in make-believe and functional play (Woods Wetherby, 2003). It should be noted children with autism are characterised by a constellation of the above mentioned symptoms: impairments in social and communication skills, limited or lack of joint attention and symbol use. Due to the different developmental ability of each child, the symptoms or diagnostic features might be different from one another. Most importantly, these signs are only significant indicators rather than the decisive factor for the diagnosis (Woods Wetherby, 2003; NWPED, 2004). By now, there is no medical test to diagnose autism, but referral should be made to a paediatrician, a child development service, or specialised early intervention service provider (Ministries of Health and Education, 2008) by the concerned educators after gaining parental consent (New Zealand Tertiary College, 2010). To successfully engage children with autism in early childhood settings, it is pivotal for educators to acknowledge their rights to be included in a supportive environment where they can grow and learn side by side with their peers (Vakil, Welton, OConnor, Kline, 2009, p.322). On the legislation and policy level, Education Act 1989 and Human Rights Act 1993 mandate equal rights for all children with diverse needs, and make it unlawful to discriminate or treat unfairly the children with diverse needs because of their varied needs. In the early childhood sector, it is clearly expressed and stressed in the curriculum framework Te WhÄ riki (Ministry of Education [MoE], 1996) and Quality in Action: Implementing the Revised Statement of Desirable Objectives and Practices (MoE, 1998) that there should be equal learning opportunities for all children irrespective of their ability. In 2000, New Zealand government developed Special Education 2000 to advocate inclusion of children with diverse needs and increasing opportunities for them in the early childhood and school sector (NZTC, 2010). On the personal level, it is the educators responsibility to meet different childrens varied needs when choosing to work with children. To successfully include children with autism begins with educators commitments to inclusion. Children with autism deserve and have the same right as every other child to be included in the early childhood settings. When acknowledging children with autisms rights to be included in the early childhood settings, it is also essential to recognise the challenges and difficulties faced by the educators. Some basic strategies are suggested here to help educators to successfully engage children with autism in their centres. First and foremost, it is crucial for educators to learn about autism and how it affects the childrens thinking, behaviour and learning (Mells, 2002). Children with autism think differently from most of other children. Due to limited comprehension skills, they might find it hard to adjust to changes of environment or activity as they cant predict what might happen next. To enable children with autism to cope with change, educators can devise a set of rules about how things happen focusing on a piece of detail information rather than focusing on the bigger picture (Mells, 2002). Children with autism have greater skills in visual processing than auditory (Friend, 2008, cited in Vakil et al., 2009). Educators can better inform and support them with visual cues (Ganz Flores, 2010). Different children with autism have different intolerable things, or even different intolerable levels to the same thing. Some of them might be highly sensitive to the scrap sound of the chair or the smell of lunch box. It is pivotal for educators to follow childrens leads, get to know them in person and tune in to their individual needs. Educators can find out more about the children with autism referring to the books, relevant guidelines, and websites. It is also wise practice to talk to family and carer who already know a great deal about the individual childs preferences (Mells, 2002; NMPED, 2004). Working in teams and parental involvement are fundamental to the success of the inclusion. Educators need to work in teams with anyone who contribute to the childs programme, such as family/whanau, specialist teachers, specialist service providers (e.g. MoE/GSE staff, special needs specialists), speech-language therapist, occupational therapist, physiotherapist and the teacher aide to share each others expertise and apply consistent strategies for the childs best benefit. The Individual Educational Plan meeting is a great resource for educators. During the meetings, educators can have access to the other specialists information about the individual child and helpful strategies to interact with him/her successfully. Educators can also express his/her concerns and get them sorted out within the team. Meanwhile, educators can share how the child is doing in the early childhood setting to facilitate decision-making within the team (Moltzen, 2005). Another essential element in the success ful inclusion is to work in collaboration with parents/ caregivers, and whanau. It is highly stressed by Mells (2002), Fraser (2005) and Vakil et al., (2009) the importance of parental involvement for the best outcomes of the child. To work in collaboration with parents and family/whanau, educators are to understand and respect their feelings, and to value their voices and choices. Parents go through a range of emotions when they learn about the childs special needs: shock, denial, anger, sadness, detachment, reorganisation and adaptation (Fraser, 2005, p.134). It is important to acknowledge and show understandings to their feelings. Collaboration with parents enables mutual exchange of support and information about the child between educators and parents (Fraser, 2005). Vakil et al., (2009) indicate that educators need to apply family-centred practices: familys concerns, preferences should be valued and attended to; familys involvement should be secured and actively seek to. When interacting with children with autism, it is advocated that educators apply evidence- based practices and developmentally appropriate practices (Vakil et. al., 2009). Evidence-based practices are practices that have been attested by research and can better inform educators what to do to achieve desired outcomes, such as Universal Design for Learning, informal and formal assessments relating to learning, differentiated instruction, and direct explicit instruction (Dunst, Trivett, Cutspec, 2002, cited in Vakil et al., 2009). To successfully engage children with autism, educators need to provide accommodation and modifications, merging special education and general practices to adjust to their needs. It is also vital to apply developmental appropriate practices to make the children feel accepted, cared for, and supported. Children with autism are characterised by triad of impairment in ability to communicate, socialise and think or imagine (Mells, 2002). Irrespective of their ability, children with autism deserve the same right to be included in the early childhood setting with the educators support. Educators need to be aware of the early signs and symptoms, and refer them to relevant services for a thorough and comprehensive diagnosis after discussing the concern with parents. To successfully include children with autism, educators need to commit to inclusive teaching, work in collaboration with other professionals, parents and whanau. Most importantly, educators need to learn about the child in person, and to proactively learn more about effective practice to include the child referring to relevant helpful resources on the ongoing basis.