It is important to realize that these behaviors are not simply the child misbehaving, but are instead symptoms of something else going on in the child’s life.  Consider the behavior to be a form of communication; that there is something else that the child is trying to express.

By identifying the trigger, it becomes more likely you will be able to develop effective strategies that can allow your child to better communicate their needs and interact with others in a less hurtful way that is much more friendly.

Consider the various most common triggers:

- Sensory sensitivities and overstimulation - children with autism often suffer from sensitivities to various kinds of sensory input, causing them to feel over-stimulated and overwhelmed. The cause of the problem can sometimes be difficult to track down, but could be something as simple as a tapping sound, a flickering fluorescent light bulb, or a sweater that has a texture that the child doesn’t like.  By eliminating the stimulant or working with your child to overcome the oversensitivity to that stimulant, this problem can be reduced or resolved.

- Attempts to attract attention or connect with a person - children on the spectrum often struggle with social situations, especially the subtleties of communication.  It could be that your child has been attempting to capture the attention of another person, or simply desires that attention, and then simply chooses the wrong method of achieving this goal.  In this situation, social stories and PECS can be very helpful for demonstrating that hitting is painful to the other person and there are much friendlier and more pleasant ways to attract a person’s attention.

- Frustration - a child with autism will often struggle to be able to express him or herself verbally, especially in times of heightened emotion.  When the child is having a hard time getting a message across, sometimes they will give up on verbal expression altogether and will resort to simply lashing out due to the frustration.  In these cases, you may work with the child on self-calming techniques, slowing down the attempt to speak in order to cut down on the urgency to rush to talk that makes verbal communication more difficult. Try giving your child a phrase such as “please wait a moment” or “I have something to say” that can be rehearsed and then spoken at these moments in order to give them time to gather his thoughts and make a new attempt at saying what needs to be said.

- Processing delays - many autistic children experience processing delays in the absorption and comprehension of conversations or direct requests.  This causes some verbal messages to become garbled and too difficult to understand, as these children are unable to keep up with the pace of the conversation.  In these situations, make sure to speak in shorter sentences instead of longer complex ones.  You can also show your child how to request that the speaker talk more slowly in order to give him or her the chance to keep up with the instructions or conversation.  This will minimize frustration and can help to prevent the child from lashing out.

These aren’t the only triggers for hitting among autistic children, but they are among the most common.  Work with other parents, teachers, and other adults who spend time with your child in order to help to track down the triggers that are causing his or her outbursts so you can find ways to work to improve these behaviors

Using an MRI scan, an image of the grey matter of the brain is generated. Then, another technique for imaging is utilized for reconstructing the MRI scans and creating 3D images which can be measured in terms of shape, structure, and thickness - each meticulous assessments which identify the very root of an autism spectrum disorder. This ability to examine the makeup of the grey matter in a most subtle and complex fashion allows the scientists to utilize biological markers instead of depending on characteristics of personality and behavior in order to determine whether or not a person may have autism.

Until this time, the diagnosis of an autism spectrum disorder is one that has been long and drawn-out. It requires personal accounts from the people who are closest in the lives of the patient, such as friends and family members. It relies very heavily on the accuracy and reliability of the accounts and a team of experts is required.

Leading the study was a lecturer from the Department of Forensic and Neurodevelopmental sciences from the Institute of Psychiatry at King’s College London, Dr. Christine Ecker. She stated that there is tremendous value to this new, fast, and accurate diagnostic tool for autism. She went on to say that it may assist in easing the requirement for highly time consuming, emotional, and expensive processes for diagnosis, as are currently endured by the families of autistic individuals, as well as the patients themselves. Ecker looks ahead to further testing to see if these techniques may also be used on children.

Supervising the research was Professor Declan Murphy, who is a Professor of Psychiatry and Brain Maturation at the Institute of Psychiatry. Murphy stated that the simple fact of being able to diagnose patients means that these people can begin right away to improve their quality of life and start to manage the symptoms of the condition. Each individual has his or her own way of being affected with the condition, where some can live independently while others will require support from a specialist; yet others with more severe forms of the condition may not be able to communicate at all. The earlier the condition is identified the better the chances of minimizing the effects.

Chair of the Medical Research Council’s Neuroscience and Mental Health funding board, Professor Christopher Kennard, said that by combining the knowledge that is known from neuroscience labs with that from clinical and neuropsychological evaluation, the key has been discovered in creating this method of diagnosis. He stated that from now on, this will make a significant impact on the quality of life for both the autism patients and their families.

Sources:
King’s College London (2010, August 11). Adult autism diagnosis by brain scan.
ScienceDaily.
http://www.sciencedaily.com/releases/2010/08/100810203505.htm

New Brain Scan Diagnoses Autism In Adults
http://www.medicalnewstoday.com/articles/197424.php

The automated Language Environment Analysis (LENA) system was designed to use recordings of vocalizations to label infants and children, then submitting the recordings to automatically undergo an acoustic analysis that outlines the pre-verbal vocalizations to the researchers.  This allowed those scientists to note that the pre-verbal vocalizations of children who had autism could be easily distinguished from children who were developing typically, up to an accuracy of eighty six percent.  The LENA was also capable of identifying the children who were autistic from those who were typically developing and from those who had a language delay by using the automated vocal analysis.

The scientists used the technology to analyze 1,486 day-long recordings made from 232 different children by using an algorithm with a foundation of 12 acoustic parameters that are linked with vocal development. Among those parameters, the most relevant seemed to be those that focused on the syllabification, which is the capability of a child to clearly formulate syllables using rapid jaw and tongue movements throughout vocalization.  Even infants are able to demonstrate voluntary syllabification control in their voices during their first few months, improving these skills as they learn language.

The children with an autism spectrum disorder showed few signs of development based on the parameters shown by the link between the parameter values and the age of the children (from one to four years old). Conversely, among typically developing kids and the children who had language delay, each of the twelve parameters demonstrated development o a statistically significant nature.

The leader of the team of scientists was a professor from the University of Memphis, D. Kimbrough Oller, who is also the chair of excellence in audio and speech language pathology.  Oller said that the findings were proof of the theory that automated vocalization analysis in mass quantities can be included among scientific vocal development research.

Though the speech abnormalities of autistic children have been investigated for more than two decades, the actual characteristics of the voice have not been added among the standard diagnostic criteria for autism, according to the University of Kansas’s Steven F. Warren, professor of applied behavioral science and vice provost for research.  Warren was a contributor to the study and identified the technology’s potential for screening for autism.

Warren believes that LENA, which permits large amounts of language research to be collected and analyzed inexpensively, can have a meaningful impact on autism screening, assessment, and diagnosis.  As this form of analysis is not dependent upon the use of words but instead uses patterns of sound, it can be highly assistive in screening for autism spectrum disorder across speakers of any language.  Warren added that as far as data has shown, the actual physics of human speech remain the same among all people.

Sources:
University of Kansas. Autism has unique vocal signature, new technology reveals. ScienceDaily. http://www.sciencedaily.com/releases/2010/07/100719162645.htm

Autism Detected In Unique Vocal Signature Of Baby Talk
Written by: Catharine Paddock, PhD
Copyright: Medical News Today
http://www.medicalnewstoday.com/articles/195465.php

The study was completed by almost 1,300 members of the American Academy of Child and Adolescent Psychiatry in order to analyze the patterns of clinical practice in terms of the uses of over-the-counter and prescription drugs for children and adolescents who are suffering from insomnia.  The responses of the participants allowed Owens and the team to conclude that insomnia is a serious problem among approximately thirty percent of the children and adolescents overseen by the participating psychiatrists.

The survey also showed that among those cases, in a typical month, ninety six percent of the psychiatrists recommended prescription medication to help manage the insomnia, while eighty-eight percent recommended non-prescription medication alternatives for the same purpose.  The recommended medications that were prescribed to help the children sleep ranged from ADHD (Attention Deficit-Hyperactivity Disorder) sedatives, to antihistamines, or even antidepressants. Other medicines that were also recommended were anticonvulsants and antipsychotics, depending on the behavioral and psychiatric diagnosis the patient had received.

Dr. Owens is also a professor from The Warren Alpert Medical School of Brown University.  She noted that the psychiatrists prescribe the sleeping drugs to their child patients in order to try to minimize the impact of sleep deprivation on their ability to function during the day. However, she also stated that the psychiatrists did take the side effects and the limited evidence regarding their efficacy into account before deciding whether or not to prescribe.  Though wide ranges of sleep medications were frequently prescribed the participating psychiatrists did note that they had considerable concerns about the overall suitability of sleep drugs for child use.

The survey participants stated that more than seventy five percent of their monthly patients were of school-age and they each saw approximately seventy children every month; most of whom were six years old or more. As the patients increased in age, so did their tendency for insomnia.  The survey results indicated that over twenty percent of preschool-aged children and a third of school-aged children suffered from a form of insomnia.

The team of researchers stated that previous studies have indicated that several forms of non-medical therapies, such as relaxation techniques, cognitive behavioral therapies, and sleep restrictions can be effective for treating childhood insomnia.  Owens noted that though there currently aren’t any hypnotic medications that have been approved specifically for use in children younger than eighteen years of age, when treating the symptoms of insomnia, it is common practice to prescribe medications or recommend non-prescription medicines among children and adolescents who have co-existing psychiatric disorders or special needs.

She concluded that the medical community treating children should attempt to set up an understanding of effective insomnia treatments based on solid evidence. Furthermore, a more thorough understanding of insomnia in children with psychiatric disorders in terms of their long-term prognosis and their quality of life is required.

Source:
Lifespan. Our children aren’t sleeping and we’re medicating them, survey finds.
ScienceDaily. http://www.sciencedaily.com/releases/2010/07/100726123928.htm

However, it is worth bearing in mind that not all children with an autism spectrum disorder are well suited to traditional team sports such as soccer or basketball due to impaired coordination skills. That being the case, it doesn’t mean that kids with autism can’t still participate in sports; it simply means that the correct sports need to be selected.

As with typically developed kids, most autistic individuals will each have specific sports that they enjoy and are good at. That said, there might be a smaller pool from which to choose because impaired motor, communication, and social skills can make some team sports too overwhelming to be enjoyable for some children with autism. Individual sports are generally a great deal more fun for autistic kids. Examples of these sports are as follows:

1. Swimming - this is a great sport for kids, even when they would generally struggle with holding and throwing a ball. Even those with limited motor skills can handle basic swimming strokes, splashing, and play in the water. Furthermore, as the child learns different strokes, he or she could think about joining a swim team since it is an individual competition even though it is a group effort.

2. Track and Field Games - though these games are often taught to older children, there is no reason that younger kids can’t practice running, jumping, and throwing, too. Autistic kids can get a great deal of enjoyment from track events, which don’t require much in terms of communication skills, even when the child is on a track team.

3. Horseback Riding - this sport is so good for autistic children that it is sometimes called hippotherapy since it is known to be not only great exercise, but highly therapeutic as well. It is common for autistic children to be able to communicate more easily with animals such as horses and dogs than it is for them to communicate with other kids and adults.

4. Bowling - though bowling can be a loud sport and may take some getting used to for children with sound sensitivities, bowling is a sport that often has a great deal of appeal for autistic kids. Though it is an individual sport, they can play against someone else or on a team, allowing them the opportunity to socialize without having the actual sport rely on the child’s social skills. As it is a repetitive sport with a pleasing result - knocking down pins and watching them be set up again by the machine - many autistic children find that they have lots of fun while bowling and they look forward to the opportunity to do so.

5. Hiking - being able to head out for a walk or a hike in the tranquility of nature can be great for the whole family. That said, children with autism often find that the sights, sounds, smells, and other sensations of moving through nature can be a great stress reliever. Whether you go alone with your child or as a part of a hiking group, this can be great exercise and a relaxing time as well.

Examples of behaviors that seem to be innocent but can be treating an autistic person without dignity include action such as talking about the person as though he or she is not even there.  This is a very easy habit to build, especially in the case of children who are non-verbal.  Fortunately, with a bit of thought, it is also a very simple habit to break.  When the autistic person is present, carry a conversation as though that person is an active participant so that he or she does not feel excluded or alienated.

Another example is a lack of privacy.  Though it may be time to change the diaper of an autistic child, for instance, this doesn’t mean that it needs to be announced openly in public. There are topics that are personal and private for everyone and they should not be treated as less private just because the person has autism.  That person also has dignity and has the right to privacy in his or her life.  In a similar effort, the child can be taught to close the bathroom door when using the toilet, and to change clothing in their bedroom so that they learn how to maintain their own privacy.

Parents and caregivers often make statements with the intention of helping a child to understand, but do so in a way that can be embarrassing to an autistic child.  For example, if a child is tilting an ice cream cone or a beverage precariously, it is easy to be inclined to say something along the lines of  “the last time you did that, you spilled it all over yourself”, even when other people can hear. 

The intention of the statement may have simply been to remind the child that the action produces a consequence, so the behavior should be corrected.  However, when past mistakes are rehashed, or proclaimed for all to hear, it can be hard on the child’s self esteem and take away his or her dignity. Positive statements are all that are needed to correct this behavior.  For example, “keep the cup upright so it doesn’t spill”.

Another aspect of dignity is an individual’s independence.  This is an area where autistic people frequently struggle as they do indeed rely on their parents and caregivers for assistance in many ways.  This reliance is not the problem.  After all, if a person - any person - needs help with something, there is no shame in receiving assistance.

The issue is created when parents and caregivers become accustomed to simply doing everything for their autistic children simply because it is easier to do it that way and not because their autistic child is incapable of accomplishing the task.  They may also do everything for their child because they feel obligated to do so. 

However, everyone - including autistic children - can appreciate some autonomy in their lives.  This can include even simple daily decision-making such as what they would like to wear or what they feel like eating.  By teaching autistic children the skills to make their own decisions and do some tasks on their own - or with the assistance of someone else - instead of having everything done for them, they can achieve a larger amount of control over their own lives.

Sensory disorders are among the most common symptoms of autism and providing autistic children with a range of different kinds of stimulation can also offer a series of important benefits.  This type of stimulation provides nourishment for the different sensory organs and the parts of the brain responsible for interpreting the information received by those sensory organs.

It is comparable to the way eating different nutrients provides different benefits to the body, except that in this case, it is a sensory diet.  To avoid deficiencies in the senses, the right “nutrients” need to be consumed through proper sensory stimulation.  Autistic children whose senses are properly stimulated tend to be more alert, focused, organized, and calm.

This being said, it is easy for an autistic child’s senses to be over-stimulated. Sensations that typically developed children may not even notice, such as a flickering fluorescent light bulb or the buzzing of an electronic device, can be overwhelming and highly upsetting for children who have an autism spectrum disorder.  Equally, forms of stimulation that would have no appeal to typically developed children, such as some types of flashing light, can often be fascinating to autistic children.

For this reason, sensory toys have been carefully chosen with the autistic child in mind, to allow just the right amount of sensory stimulation, without becoming overwhelming or upsetting.  They allow the child to exercise and develop the senses, without causing discomfort or distress.

These toys can be used on their own, or they can be combined with other types of therapy.  This being said, if the child is undergoing other kinds of therapies, it is always recommended that the child’s therapist be consulted before starting the use of the toys, to ensure that they are suitable and compatible with the therapy in question.

Sensory toys are designed in order to provide different specific kinds of stimulation and results.  There are those for sensory integration, such as sensory stimulation, vestibular balance, body awareness, and fine and gross motor development.  They can also be helpful in encouraging other areas of development such as sequencing, language development, and facial recognition. They often work in conjunction with floor play and other similar types of play-based therapies, but could be used with other techniques as well, such as occupational therapy.

Sensory toys are best used in ways that combine different forms of stimulation, instead of just one toy on its own.  This makes certain that all of the senses are properly stimulated, and that each one is stimulated in different ways.  For example, toys for tactile stimulation should not simply provide one texture, but should allow the child to feel and manipulate a range of different texture options hard or rough, to wriggly or soft and even sticky or slimy. Sound stimulation toys should have funny noises, musical noises, whispery noises, whistling noises or clapping noises.  These toys should encourage the children to use their hands and fingers to develop their motor skills that will also be useful for pushing buttons, doing up zippers, or even holding a pencil.

Look for these toys at toy stores with special needs sections, or use the internet to find the best selections as well as the most appealing prices.

Examples of sensory toys/activites include:

Tactile Processing: Play doh, foam, wet/dry sand, slime etc.
Proprioceptive sensory issues: Whole body actions involving pushing, pulling, lifting, playing, and moving.
Regulating sleep/wake cycles: weighted blankets, nature or white noise machines, vibrating mattresses and or pillows.
Vestibular movement: swinging, rocking toys, ride on toys, trampolines, therapy balls.
Sensory dysfunction regarding oral input: whistles, wind instruments, straws, textured teething rings or spoons, edible play doh.

Among the most common ideas to explain toe walking is that people with autism are frequently hypersensitive to tactile experiences.  Since they don’t like the sensation of having the bottom of the foot in contact with anything, they walk on their toes in order to minimize the amount of contact. 

This is supported by the fact that toe-walking is much more common when the individual is barefoot than when wearing shoes or socks.  Treatments that work with this particular theory focus on reducing the sensory hypersensitivity, especially in the feet.  It will generally use techniques such as therapeutic brushing and various tactile input desensitization efforts at different grades.

Another theory that is commonly accepted is that the autistic child is attempting to provide him or herself with proprioceptive input.  Proprioception is a type of awareness that occurs unconsciously regarding the position of the body within the space around it.  It is created through the input provided by nerve receptors that are located within the muscles, ligaments, tendons, and connective tissues while they are contracted or compressed.  As autistic people often have poor judgment of their bodies within the area around them, they contract their foot muscles through this change in position in order to increase the amount of proprioceptive input that they can receive.

Sensory integration theory suggests that this input can also be a calming and balancing one, meaning that individuals who practice toe-walking behaviors may be unconsciously trying to provide themselves with a soothing sensation.  Treatments designed to deal with toe-walking based on this theory typically focus on giving other types of proprioceptive input to the individual.  This can include foot stomping, using a trampoline, wearing shoes with more traction, walking in sand, or taking part in other traction and compression-related activities.

A third theory about toe-walking in autistic individuals suggests that toe walking is a symptom of a vestibulo-visual system that is malfunctioning.  This has been proposed by therapeutic optometrists who have noted that while the focal vision of autistic people tends to be satisfactory, their ambient vision is often weak. Ambient vision is that which is linked to other forms of sensory input which allows for the perception of three dimensions and the movement within the surrounding space.  It also allows us the perception of distance and movement within a space. 

Autistic people frequently have “tunnel vision”; meaning that they are able to see only a small portion within the visual field, or they may also have alternating vision, where they see a separate image with each eye, as opposed to the single image formed by both eyes when their images are processed in the brain. Tunnel vision could lead to toe-walking as autistic people may see the world as two-dimensional and may therefore not be able to properly perceive motion and distance.  Treatment based on this theory can include the use of vision training and prism lenses.

It must also be remembered that every case of autism is different and every autistic person is an individual.  Therefore, while there may be only one explanation for toe-walking among people with an autism spectrum disorder, it could also be the case that there are several explanations for this one behavior type among people with this condition and treating it may be a matter or narrowing it down to the right one.

President of Individual Differences in Learning of Howard County, Maryland, as well as co-chair of the Innovative Technology for Autism (ITA) committee for autism speaks, Katharina Boser, stated that there are a wide variety of technological devices that can be very helpful for autistic people at different functioning levels and with different symptoms.

Many of the technologies to which Boser referred were shown at the recent International Meeting for Autism Research (IMFAR), which was held in Philadelphia and was sponsored by the International Society for Autism Research as well as by Autism Speaks.

Boser noted that among other benefits, the easily predictable nature of robots, technological toys, and computer-generated avatars makes them a method for teaching new skills with a very low level of threat or upset to autistic children.  Conversely, people themselves are unpredictable.  The reliability of robots and other similar devices make them highly predictable.  They won’t make sudden, sharp movements or other unexpected behaviors.

Moreover, as Boser added, people who suffer from autism are generally more highly engaged by objects than they are by people, making objects an important motivator.  Where an autistic child might not engage easily or willingly with a person, a “robot that cares” might be a much more attractive option.  One of the examples demonstrated was a toy dinosaur that purred and moved its head when petted.  This device encouraged the children to smile and interact with something in a way that they may not with a person.  By practicing the interaction with the various devices, children with autism often start to look at their parents or other people when speaking.

Another cited example was “Crush”, the turtle, which was an interactive Disney theme park attraction.  As it turned out, the “Turtle Talk with Crush” show was highly attractive to many autistic children, drawing their attention and their willingness to interact with it.  This attraction has become very helpful to children who are low-functioning and low-verbal.  After the Turtle Talk with Crush show and its meet-and-greet afterward, the kids who had attended were more likely to repeat the words that Crush had said, smile, laugh, and clap.

A third example was geared toward children with Asperger’s Syndrome.  It featured a wristband that they could wear and that would display various parts of their physical state such as their heart rate.  Boser explained that this allowed them to connect with the response their body has to various circumstances so that they can better understand the way they feel and link their emotions with their physical response.  This way, they can come to learn about what reactions are appropriate for different situations.

From toys to high-tech gadgets, technology is becoming ever more helpful to people with autism in teaching them about social interaction and minimizing other symptoms that are common to the condition.

Source:
The Fight Against Autism Goes High Tech
By Amanda Gardner, HealthDay Reporter
http://www.medicinenet.com/script/main/art.asp?articlekey=117332

Fortunately, there are five steps that can be taught by parents that can help these kids deal with teasing as it happens, to know what they should say when they are being teased, and what to do when feeling distressed to the point that they are unable to properly verbally express themselves.  These five steps provide the autistic child with a structured formula that guides them through teasing and shows them what they should do at every point, including when to seek the assistance of an authority and when it is appropriate.

The five steps are as follows:

1. Ignore the teasing and walk away - Using a bored voice and with a neutral/uninterested expression on the face, walk away from the children who are teasing, perhaps saying something to the effect of “so?” or “whatever”.  Often, simply not reacting to the taunting of the child who is teasing is enough to make it stop. 

2. If this doesn’t work, state the words “Please stop it, it makes me feel upset” - Sometimes teasing done among friends is only intended to be a lighthearted razzing, with nothing malicious meant by it.  However, children can cross the line without knowing they’ve done it.  It is at these times that it is best to simply and calmly let the friends know that their teasing has gone too far and that the teasing doesn’t feel friendly anymore.  Friends will generally respect this when they know that feelings are being hurt.

3. Say “Stop it, I don’t like it” - Make sure that when this is said, the voice is firm and loud.  It should have a very stern sound to it.

4. Say “Stop it, or I’ll tell the teacher” - Or, replace “teacher” with another adult authority who is nearby. Whether the teasing is in the playground, in the yard, or elsewhere, make sure the statement refers to an adult who is close by.

5. Follow through with Step Four - Walk away from the teasing child and find a teacher or adult and then tell that person what is happening.  Step Four should not be an idle threat, but should be a warning about what will actually happen.  When teasing is out of control and upsetting, it is important for the autistic child to know that they can tell an adult authority what is going on so that they can put a stop to the behavior.

When speaking to the person who is teasing, it is important for the autistic child to be able to look the person in the eyes.  This makes a big difference in the effectiveness of each step.  However, eye contact can be very challenging for autistic children.  For this reason, parents may choose to teach a little trick to their children.  From about 5 feet away, it is difficult for someone to tell if an individual is looking them in the face or directly in the eyes.  Therefore, the child can simply learn to speak from a certain distance away and look at the other child’s face (the bridge of the nose or forehead is a good spot) in order to appear to be making direct eye contact.

With these steps and little tricks, the teasing may not go away, but they do give an autistic child a structured way to behave in response to this unpleasant behavior.