Download Classroom Information: Complex Autism Spectrum Disorders

Classroom Information: Complex Autism Spectrum Disorders
All learners with Autism Spectrum Disorders (ASD) show different levels of severity in two core
domains (American Psychiatric Association, 2013):
1. Persistent issues in social communication. Learners may have difficulty initiating and
maintaining social communication.
2. Restricted/repetitive patterns of behavior, interests or activities. Learners’ may
demonstrate repetitive behaviors and restrictive behaviors that interfere with their
participation in learning.
Learners with complex ASD generally require substantial to very substantial supports. For
example:

Learners with complex ASD who require substantial supports may have unusual
communication patterns, or whose restricted or repetitive behaviors interfere with their
engagement in a variety of contexts.

Learners with complex ASD who require very substantial supports may rarely initiate or
demonstrate socially acceptable interactions, or demonstrate other repetitive or restricted
behaviors that interfere with their engagement in a variety of contexts.
Additional Issues Related to Intellectual Levels
Approximately 65 percent of persons with ASD also have accompanying intellectual challenges
(Matson & Shoemaker, 2009) and may involve:

How learners process information. For example, learners may see the minor detail in a
situation but be unable to see the broader picture. They may recognize symbols but not
appear to be able to connect them together to form the big picture. It may help to: Give
directions in steps; use concrete objects, pictures and symbols.

How learners see themselves and others. Learners may appear very egocentric. They
may have difficulty understanding how others think, feel or behave. It may help to: Explain
perspective of others and model appropriate social actions.

Remember that communication challenges may mask intellectual abilities. It may be
that the learner with complex ASD has a higher intellect, yet be unable to communicate this
to you.
Additional Issues Related to Mental Health
Approximately 67 percent to 70.8 percent of learners with ASD also have accompanying mental
health issues (Center for Autism and Related Disorders, 2009), including:
Anxiety
What you may see:

Excessive worry
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Classroom Information

Complex Autism Spectrum Disorders
Constant seeking of adult attention for comfort or reassurance
What may help:

Acknowledge the learner’s discomforts and provide reassurance

Teach relaxation techniques such as deep breathing exercises.
Obsessive Compulsive Disorder
What you may see:

Intense worry about others sneezing or coughing

Performing a function with great frequency in order to relieve stress rather than
achieve pleasure.
What may help:

Acknowledge the learner’s concerns and offer reassurance

Offer flexible escape routes or ‘safe zones’ when the learner is apparently stressed.
Depression
What you may see:

Significantly increased agitation or self injury

Temper outbursts.
What may help:

Provide clear and explicit organization for the learner

Offer constant reinforcement

Seek additional support (for example, a pediatric psychiatrist).
ADHD
What you may see:

Very strong reaction to sensory issues in the environment

Inattention or very easily distracted.
What may help:

Establish and maintain predictable routines

Minimize sensory stimuli (such as lighting, sound, smells, etc.)
Medications
Many learners with complex ASD may also be taking medication relating to mental health issues
and it is important to acknowledge that these medications may impact the learner in the
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Complex Autism Spectrum Disorders
classroom. It will be helpful to ascertain potential side effects and remember that learners taking
the same medication may have different responses to it.
Behavior and Communication
Behavior is a form of communication and has a communicative intent (Ganz, 2014; Whitaker,
2001). Learners with complex ASD may use behaviors to serve as a function in an attempt to
communicate one of the following:

To fulfill an emotional, physical or environmental need

To communicate a need to escape or avoid a situation

To demonstrate a struggle with communicating

To express a struggle with power or control

To satisfy a desire to get a response that they find entertaining (e.g., winding people up).
Suggestions for Practice

Remain calm. Think about tone of voice, body language and facial expression – keep it from
being emotional and threatening. Don’t take the behavior personally.

Teach and reinforce a classroom communication system that supports joint attention, and
facilitates expression of wants and needs in a way that is appropriate to others.

Conduct an assessment of the communicative intent of the learners’ behavior to determine
why the behavior is occurring.

Implement a reinforcement strategy to increase desired behaviors and reduce undesired
behaviors with a focus on providing positive feedback.

Be consistent and persistent. Develop explicit classroom structure and routines and
specifically teach students how to follow them.

Communicate clearly with students. Provide clear information and supports including
pictures, drawings, icons, real items, etc., making implicit expectations explicit.

Communicate with family members and others who are part of the teaching team. Share
observations, understandings and strategies with each other.

Conduct a classroom sensory inventory, such as the Sensory Profile School Companion
(Dunn, 2006).

Remember to use data to inform decisions.
References:
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders.
Washington, D.C.: Author.
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Complex Autism Spectrum Disorders
Center for Autism and Related Disabilities, University of South Florida (n.d.). Autism and mental
health issues. A guidebook on mental health issues affecting individuals with Autism
Spectrum Disorder. Retrieved from http://card-usf.fmhi.usf.edu/docs/
resources/CARD_ASDMH_Brochure092109.pdf.
Dunn, W. (2006). Sensory Profile School Companion: User’s manual. San Antonio ,TX:
Psychological Corporation.
Firth, U. (2008). Autism: A very short introduction. Oxford, UK: Oxford University Press.
Ganz, J. B. (2014). Aided augmentative communication for individuals with Autism Spectrum
Disorders. New York: Springer.
Lainhart, J., & Folstein, S. (1994). Affective disorders in people with autism: A review of
published cases. Journal of Autism and Developmental Disorders, 24, 587-601.
Matson, J. L., & Shoemaker, M. (2009). Intellectual disability and its relationship to autism
spectrum disorders. Research in Developmental Disabilities, 30, 1107- 1114.
National Autism Center (2009). National standards report. The National Standards Project –
addressing the need for evidence-based practice guidelines for Autism Spectrum
Disorders. Randolph ,MA: National Autism Center.
Whitaker, P. (2001). Challenging behavior and autism. Making sense – making progress.
London, UK: The National Autistic Society.
Wong, C., Odom, S. L., Hume, K., Cox, A. W. Fettig, A., Kucharczyk, S., … and Schultz, T. R.
(2014). Evidence-based practices for children, youth, and young adults with Autism
Spectrum Disorder. Chapel Hill, NC: The University of North Carolina, Frank Porter
Graham Child Development Institute, Autism Evidence-based Practice Review Group.
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