Children with learning difficulties or differences in relating and communicating may fall within a broad spectrum of diagnoses or challenges that includes language processing disorders, attention disorders, sensory or regulatory disorders, and Autism Spectrum Disorder. These challenges often involve a number of different underlying difficulties, including:
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Taking in sensations or information: the child may be under or over reactive to the information received through their senses of vision, hearing, touch, smell, taste and body awareness.
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Processing information: the child may have difficulty understanding or organising the sensory information they receives.
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Planning or executing responses: the child may have trouble using their body or thoughts to respond to the information they have taken in.
A child may develop unusual or concerning behaviors in response to these difficulties or differences. For example, a child may be so under reactive to sensation that they spins in circles in an attempt to increase their sensory input; another child, overwhelmed by the confusing information their receiving about his world may withdraw, finding security in lining up their cars over and over again. Examples of behaviors parents may observe, by area of difficulty, are:
Relating and emotion
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a tendency to avoid interaction
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difficulty paying attention
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limited eye contact with others
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repetitive statements, play, or behaviors
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failure to develop pretend play
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intense fears about ordinary objects, activities or events
Language/communication
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problems following simple directions
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echolalia, or repeating what has just been said
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difficulty making needs and desires known by gestures, words or play
Regulatory and sensory-motor
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difficulty dealing with changes in environment
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avoidance of hugs or light touch
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does not point to show you things
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poor coordination
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“self-stimulatory” behaviours: spinning, hand flapping, head banging
A child receives a diagnosis based on observation of the behaviours outlined above. However, though a child may share a common diagnosis with other children, each has a unique pattern of development and functioning. Each child is unique in their processing of sensory and other information, and their motor planning (the ability to plan and carry out actions). Some children are over reactive to sensations, such as touch and sound, while others are under reactive. Some children have relatively strong auditory memories, and can memorize entire scripts; others have relatively strong visual memories. Some children are able to plan and carry out a number of actions in a row, such as going upstairs, getting a toy, and bringing it back down, while others are only able to carry out one action at a time, becoming very fragmented in their behavior.
In addition to differences in sensory processing and motor planning, children differ in their basic mastery of the foundations for relating, communicating, and thinking. Some children with ASD can form relationships and engage in two-way communication, while others appear to be very self-absorbed and aimless. Some children can focus and attend and engage with others, but can only participate in a back-and-forth flow of communication in a limited way, finding it difficult to use language meaningfully or connect ideas together for logical and reflective thinking. Other children show some mastery of the basics, and the ability to engage in more complex communication as well as the ability to create ideas and use them logically, but are very limited in their capacity to apply these abilities to a broad range of situations. Therefore, while some children may exhibit common symptoms that lead to a diagnosis of an autistic spectrum disorder, their individual patterns – and therefore their developmental journeys – are quite varied.
Read “A New Look at Autism,” a letter from Dr. Stanley Greenspan, which sheds light on the modern way of understanding and supporting autistic individuals.
*American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013.
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