This month we took the opportunity to learn more about ASD (Autism Spectrum Disorders) and to see how early learning and care providers can support autistic children and work collaboratively with their families to support the development and wellbeing of autistic children.
We spoke to Kristy Capes, Centre Manager at La Trobe University Community Children's Centre, an early learning service which offers specialised support to children with autism spectrum disorders, and she was kind enough to share her expertise and autism insights with us.
As a starting point, what is autism?
Autism Spectrum Disorder (ASD) describes a group of developmental disorders in which people diagnosed with ASD demonstrate difficulties across three core areas:
- Social skills
- Repetitive behaviour
- Communication
All individuals with ASD are affected differently. Some people with ASD need a lot of help in their day-to-day lives, while others need little to none. Some people with ASD are not cognitively affected, while some people experience challenges in this area.
ASD often becomes apparent in childhood, so at what age might youngsters be diagnosed?
While children with ASD can be diagnosed as young as two and identified as being at-risk of developing ASD from 12 months, most children are not diagnosed until after age four, and ASD is a lifelong disability.
What ASD-related behaviours should parents and educators look out for?
There are signs across core developmental areas that may indicate that a child is at-risk of developing ASD.
According to Autism Speaks, there's a risk of ASD if a child exhibits the following:
- No big smiles or other warm, joyful expressions by six months or later
- No back-and-forth sharing of sounds, smiles or other facial expressions by nine months
- No babbling by 12 months
- No back-and-forth gestures, like pointing, showing, reaching or waving by 12 months
- No words by 16 months
- No meaningful, two-word phrases (not including imitating or repeating) by 24 months
- Any loss of speech, babbling or social skills at any age
What can educators do if they see these signs in a child in their care?
Sometimes educators are the first people in a child's life to observe that a youngster is not meeting typical developmental milestones.
If an educator has concerns, it is important that they share these concerns with the child's parents/care-givers in a sensitive way. For example, in a one-on-one meeting that focuses on the educator's observations of the child's development (rather than 'diagnosis') and suggests helpful ASD resources.
And what steps can parents take?
If parents have concerns about their child's development, it is important they speak with their doctor. In consultation with them, the GP will refer the child to a paediatrician who can coordinate for them to undergo a diagnostic process.
There's also a free app called ASDetect which shows parents if their child is at 'low' or 'high' risk of ASD. ASDetect provides assessment results via email which can then be shared with the child's paediatrician.
Also, if parents feel their medical practitioner is not supportive or they have ongoing concerns, it's recommended that families get a second opinion.
What are the benefits of early intervention programs for children on the autism spectrum?
Dr. Wendy L. Stone and Theresa Foy DiGeromino explain the importance of early intervention in a really clear way on the Autism Speaks website:
"There is no debate or doubt: Early intervention is your child's best hope for the future. Early attention to improving the core behavioural symptoms of autism will give your child – and the rest of the family – several important benefits that you will not gain if you take a wait-and-see approach until your child enters school at age four or five.
A good early intervention program has at least four benefits:
- It will provide your child with instruction that will build on his or her strengths to teach new skills, improve behaviours, and remediate areas of weakness.
- It will provide you with information that will help you better understand your child’s behaviour and needs.
- It will offer resources, support, and training that will enable you to work and play with your child more effectively.
- It will improve the outcome for your child.
For these reasons, an intervention program for your child should be implemented as soon as possible after he or she receives a diagnosis."
What role do educators play in ASD early intervention programs?
This varies between services and according to their role within the service. It will also vary according to the skill level, knowledge and experience of the individual educator.
In our service all of our educators are trained in delivering our intervention model, the Early Start Denver Model (ESDM), in the play and daily routines that form the playroom curriculum, for example, small group experiences and meal times.
In addition, some of our educators are certified as ESDM therapists and so are involved in assessing and developing programs for individual children in addition to implementing these programs with children as part of our group program.
A core responsibility of an educator, particularly the lead educators, is to plan how to target all the children’s individual objectives as part of the whole-group playroom curriculum.
What challenges may educators in mainstream early childhood settings face when caring for children with autism?
The challenges vary according to many factors, including:
- The level of support in their centre, including opportunities for professional development
- Their access to support from external specialists and how collaboratively they engage with these specialists
- Their level of experience, knowledge and understanding of ASD
- Whether they and the family are working collaboratively
In terms of collaboration, how can educators and parents work together to get the best results for a child with autism?
It is really important for educators and families to collaborate to achieve the best outcome for the child. And they can do this by identifying learning objectives to work across both environments, and regularly communicating on how these learning strategies are progressing, for example, by sharing strategies. It's important that all the key adults in the child's life implement a consistent approach – consistency is key!
Do you think autistic children benefit more by attending autism-focused early learning and child care centres? Or can mainstream centres provide an equally beneficial environment?
This is a really interesting question! Currently, our service is researching whether children receiving early intervention in mainstream early childhood centres make the same gains as children receiving early intervention in segregated, autism-specific centres.
This research program involves specialist staff developing the child's early intervention program, including by assessing the child every three months and developing an individual curriculum for the child based on this assessment, and then training educators in mainstream centres to implement the early intervention as part of their playroom curriculum and program.
This is the final year of this pilot research program and we will be publishing a paper with the results sometime in the near future.
I would also add that typically it is not possible to make a general statement about one environment being more beneficial for all children than other environments. Many factors need to be considered by the family when choosing the most appropriate setting for the individual child, such as whether the child requires a more structured or more flexible environment.
With all this in mind, where can parents and educators learn more about autism and how to get better outcomes in the early learning and care environment?
I would recommend accessing information and resources through a range of organisations with expertise in this field. For example:
- AutismSpeaks
- The Raising Children Network
- The Victorian Education Department
- Amaze
- The Better Health Channel
Thanks so much for your time, Kristy.
