Cognition
Child with autism may…
- Have an intelligence quotient that ranges from severely intellectually disabled to gifted
- Be nonverbal or be highly verbal
- Have rote memory that exceeds his or her ability to comprehend information
Individuals with autism manifest a number of characteristics that vary in appearance and severity. Cognition is no exception, and contributes to the wide spectrum of abilities and behaviors that are evident in autism. Individuals range in global cognitive abilities from those who are extremely talented and very high functioning to those who need extensive support for managing their daily routines. The debate continues about cognitive disabilities, measured as an intellectual quotient (IQ), in autism.
A core feature of autism includes developmental deficits or delays in the areas of verbal and nonverbal communication and social interaction. Longitudinal studies indicate that young children with verbal skill impairments are at increased risk for less favorable outcomes, often represented by a lowered IQ. Although many individuals with autism may have intellectual disabilities, recent research is exploring strength-informed assessments for individuals who may be minimally verbal, and we are learning to expand our understanding about their cognitive strengths. It is widely accepted, however, that the majority of individuals with autism will need assistance with language and communication skills.
Social Interactions
Child with autism may…
- Talk about unusual subjects
- Refer to a memorized script to converse or answer questions
- Be unable to understand the inferred meaning of idioms, metaphors, or comparisons
- Not understand sarcasm or jokes
- Be a literal thinker or interpreter of words
- Find it easier to answer questions given choices versus open-ended options
Most children with autism want to interact with others, but they struggle with knowing how to join in. Also, once they have joined in, they have difficulty maintaining their part of an interaction. Some abruptly push their way into a group, dominating the conversation with information about their favorite topic or using behaviors (e.g., pushing, hitting, crying) to communicate. Others may feel overwhelmed by not knowing how to initiate a communication action or being uncertain about the right time to join a conversation and, therefore, initiate very awkwardly or not at all. Yet others may not know how to initiate an interaction and depend on an adult to prompt an interaction.
Organization
Child with autism may…
- Have difficulty organizing information and routines
- Prefer structure and sameness
- Need explanations for transition or changes in schedule
- Need to be asked one question at a time, eliciting a concrete answer
- Have trouble with planning tasks or breaking down an assignment into parts
- Not be able to organize thoughts or recognize that he needs additional information to complete a given task
- Experience difficulty organizing information on a page; organizing thoughts; or determining order in which tasks should be done
It is often difficult to understand why individuals with autism have difficulty with organizational skills. Intuitively, it might seem that individuals with autism, who are literal, focus on small details, and like predictability, would inherently be organized. However, this is not the case.
The root of organizational challenges for children and youth with autism may be found in the definition of organization: coordinating separate elements into a structure with an implied relationship between separate elements and the coherent whole. When stated this way, the organizational challenges of individuals with autism become more obvious. First, a special challenge related to autism lies in understanding the relationship is between details and the whole. Second, individuals with autism have difficulty understanding details can be integrated to create a whole. Third, students with autism have difficulty understanding assumptions and expectations (information).
Daily Living Skills
Child with autism may…
- Prefer visual directions or instructions instead of verbal ones
- Have difficulty retaining and following verbal instructions
- Need cues for how and when to transition from one activity or place to the next
- Need direct instruction on daily living skills because they are not learned incidentally
Children with autism often demonstrate a delay in adaptive skills and behaviors: those skills needed for successful day-to-day living and adjusting to the world around them. Adaptive skills and behaviors include a range of domains and functionalities, such as asking a question or requesting help. Another area of adaptive skill includes self-care. Basic hygiene practices, such as brushing teeth or filing fingernails, can be difficult for individuals with autism due to a sensitive sensory system or an inability to learn these skills incidentally. As individuals get older, adaptive skills include talking on the phone, using a map, cooking, cleaning, and caring for a home.
School Subjects
Child with autism may...
- Prefer visual directions or instructions instead of verbal ones
- Find it easier to answer questions given choices versus open-ended options
- Have difficulty organizing information and routines
- Need to be asked one question at a time, eliciting a concrete answer
- Vary in level across domains, such as excelling in one area and having deficits in another
- Be able to work in a general education curriculum without modification or may need a modified functional curriculum
- Not learn from lectures; need visual lists, icons, and repetition to learn
- Use rote memory to “recite a fact” but have challenges in (a) drawing inferences, (b) sequencing events, (c) understanding and interpreting cause and effect and character motivation, and (d) using prediction and other complex reasoning skills
- Miss presentation of content information because thoughts are elsewhere and, being unaware that information has been missed, may fail to seek it out
- Know something in one setting but not another due to failure to generalize
Many academic problems experienced by students with autism are related to the innate characteristics of their autism spectrum disorder. These are often misunderstood and, as a result, interventions often do not address students’ underlying needs.
Seeing the Big Picture
Child with autism may…
- Have difficulty taking the perspective of others
- Struggle to understand and deal with abstract concepts and thoughts
Many individuals with autism react to and interact with the world around them from a single point of view. They focus on details and often miss how they themselves are intertwined with and impact the greater world around them. It is difficult to have a perspective of others if one is not aware of one’s own actions and thoughts. Perspective-taking includes not only an awareness of one’s own thoughts, perceptions, and ideas, but also an awareness of the potential thoughts, perceptions, and ideas of those around. Such awareness allows one to recognize and predict how one’s actions and reactions influence a situation or other people. It also allows one to step into the shoes of another person and see the world through his or her eyes.
Self-Regulation
Child with autism may…
- Have a preferred item or routine for comfort
- Be sensitive to even the tiniest stimuli in the environment
- Have difficulty processing and regulating sensory input
- Have difficulty organizing information and routines
- Have raised levels of anxiety
- Have difficulty understanding and regulating emotions
- Easily trigger into a meltdown if unable to regulate, predict, or control a situation
Individuals with autism have challenges with self-regulation, often brought about or aggravated by issues related to all of the sensory systems (see the following overview of the sensory systems), which may manifest in being either over- or under-sensitive to various stimuli. That is, they may be sensitive to touch, certain types of lighting, temperature, specific sounds, food, positions, etc. However, they may also lack sensitivity to or awareness of stimuli, such as not feeling pain or cold. In addition, they often cannot detect when they are experiencing sensory challenges. When asked if they are upset or uncomfortable, therefore, students with autism may reply in the negative, yet soon thereafter experience a tantrum, rage, or meltdown. In addition, they may not show the same affect as others when under stress or anxiety.
Failing to interpret students’ true emotional and sensory state, teachers may try to teach children with autism necessary skills when a meltdown or other behavioral episode has taken place. This is ineffective because students with autism have difficulty learning new skills when stressed or anxious. An important distinction must be made here: this does not mean that they will not be able to recite the new skill—only that they will likely not use the skill.
Finally, individuals with autism do not inherently know what to do to self-calm, refocus, or relax. In the absence of knowing how to return to a typical state of mind, the student with autism is sometimes the victim of tantrums, rage, and meltdowns.
Uncertainty
Child with autism may…
- Prefer structure and sameness
- Need explanations of transition or change in schedule
- Like to anticipate and predict the steps in a routine
- Prefer advanced notice or warning about individual steps in a process, changes in routine, or an upcoming transition
Children with autism need predictability, routine, and sameness. It gives them a sense of certainty and control throughout their day. Therefore, if something is out of the ordinary, whether it is something as seemingly simple as an item that is stored in a new place or an event that is added to the typical schedule, it might cause anxiety, confusion, and frustration. When the individual is unable to predict what will occur next, the result is a sense of discomfort and worry, which intensifies as the typically predictable circumstance becomes less so.
The same reaction can also be observed in interactions with others. Often individuals with autism have narrow, special, or unique interests as well as a single frame of reference—their own. Both of these characteristics may lead the individual to believe that his perspective or bank of knowledge is not only correct, but also the only point of view. Therefore, if someone challenges his point of view or disagrees with him, it may be difficult for him to be flexible and adapt to the new perspective being presented (refer also to "Seeing the Big Picture").
For some of the same reasons, transitioning from one activity to the next may be difficult, especially if there is not much warning or advance notice. Forewarning that an interruption is coming or that the conclusion of an activity is near allows the child to predict the change and to plan in advance for a variation of the schedule.
Understanding the Thoughts and Feelings of Others
Child with autism may…
- Fail to directly answer questions
- Be unable to understand the inferred meaning of idioms, metaphors, or comparisons
- Not understand sarcasm or jokes
- Be a literal thinker or interpreter of words
- Have difficulty recognizing and interpreting facial cues, body language, voice inflection, and gestures
- Be overwhelmed by multifaceted communication, such as lengthy utterances, multiple directions
- Have difficulty recognizing, interpreting, and empathizing with the emotions of others
Social reciprocity—the give-and-take that happens when communicating and interacting with others—is a core deficit in autism. Being able to identify and interpret the many subtle components of communication is essential for understanding what is being conveyed. Therefore, deficits in this area can seriously affect interactions with others.
Nonverbal cues such as facial expressions, body posture, and gestures all play a role in communication. They convey the thoughts, feelings, and intentions of others and guide our responses to those with whom we interact. Individuals with autism must be taught how to recognize nonverbal cues as well as how and when to respond to them appropriately. In addition to recognizing these cues from others, individuals with autism must also be taught the messages they send through their own posture, facial expression, proximity, and gaze.
Demonstrating how to use the body to express feelings or to show that they are listening will assist individuals in accurately conveying their intended message. Lastly, individuals with autism are typically literal interpreters of words and may not easily recognize idioms, metaphors, slang phrases, or sarcasm, causing confusion and lack of understanding in many everyday situations.