Saturday 30 March 2019

Triad of Impairments Part One - Communication Impairment.

Earlier this year, I was asked to present at a professional development for early childhood educators. The presentation? All about Autism and Sensory Processing Difficulties.

The presentation was received so well that I thought that I would use part of my presentation on my blog as I'm often asked questions about Autism and O and L. So here goes!! Part One focusing on the Triad of Impairments.

Individuals who have been diagnosed with Autism commonly have difficulties in three main areas, known as the Triad of Impairments. These areas are ....

1. Communication Impairment
2. Impairment in Social Interaction
3. Restricted and Repetitive Behaviours, activities and interests.

Before we begin to discuss these three areas, keep in mind that many of these traits are present in typically developing children. The difference in those diagnosed with ASD, is the intensity in which these traits present. In a child with ASD, the traits are much, much more intense and they are ongoing. I’m going to refer to children with Autism but all of these traits may be present in Autistic adults as well.

Children who have been diagnosed with Autism have a unique profile of communication development. While different skill levels in communication are seen – from non-verbal right through to verbal children with Autism, regardless of their skill level ALL have difficulty in a number of areas. Many remain significantly impaired throughout their lives in their ability to understand language and/or to communicate verbally. Those children who are considered to be high functioning will still have a communication deficit.

Those children who are non-verbal may understand more than they can speak. They may be highly intelligent and unable to verbalise their thoughts, needs and wants. Non-verbal also does not mean quiet. Often children who are non-verbal can be the loudest!

Children may talk at peers rather than talk with peers. They may want to exclusively talk about their favourite topic. This isn’t because they are eccentric or uncaring, they have major skill deficits in understanding the social use of language as well as being unable to understand Theory of Mind – they don’t understand that everyone doesn’t quite always think or feel the way that they do.

In children whose language does develop, their comprehension can often be very literal and as such they are very concrete thinkers. They may have difficulty in understanding abstract concepts or phrases such as “hold your horses” or “stop and smell the roses.” 

We have some very interesting conversations at home – “Your shoes are on the wrong feet! But I don’t have any other feet!” “Please put your shoes and socks on. Don’t you mean socks and then my shoes.” “We’re going to follow our noses! Why is your nose up in the air? I’m following it.” “Go and hop in the bath please.” That was a fun one to sort out! My children are bone fida smart alecs!

Often, a child’s thinking may be concrete, literal and detail focused, so that he or she may find it difficult to see the bigger picture. As an example, children with Autism may focus on a small ladybird on the corner of each page of a book, rather than the main pictures and the story.

Children whose language has developed may at times appear to be little encyclopedias in that they are able to talk your ear off about particular subjects. However in some cases, these children have better expressive language skills than receptive in that they can say more than they understand. Their comprehension of what they read or recite can be quite low. O's reading level is at a year 9 level (she's in grade 5!) however at times her comprehension of what she is reading is not quite up to that level yet.

Stay tuned for Part Two - Impairment in Social Interaction.

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