Misra 1

Shruti Misra
Academy Capstone 6
McMennamy
November 18, 2016
Research Paper: Autism in Children
Introduction
Albert Einstein. Mozart. Daryl Hannah. Temple Grandin. Although at
first they may seem unrelated, all of these people share the common
denominator of being diagnosed with autism or are theorized to be on the
autism spectrum. Autism Spectrum Disorder (ASD) is highly multifaceted,
affecting no two individuals in the same way and having no single, clear-cut
cause. It is the leading neurological disorder in the United States, affecting
one in 68 children across the nation. Due to its exponentially increasing
diagnosis rate, it is of paramount importance to address the multitude of
issues that make up autism spectrum disorder and promote early
intervention and special education programs.
Sensory Issues
Chief among the symptoms of autism are sensory issues. Pervasive across the entirety of
the autism spectrum, sensory problems can range from one extreme to another, with some
individuals displaying too much responsiveness and others displaying too little. Hyposensitivity,
or under-responsiveness to stimulus, is most common in young children. This can present as
apparent deafness in response to sound or as a lack of sensory seeking behavior (Leekam).
Children who do not seek sensory stimuli may be perceived as antisocial, uncommunicative, and

Misra 2
removed from interaction. They may be unresponsive to common environmental stimuli and fail
to perceive changes in their conditions (Sicile). On the other hand, hypersensitivity, or
overreaction to stimulus, is less common and is generally negatively associated with
developmental age (Lane). The younger a child is, the more likely he or she is to be overly
responsive to certain stimuli. This can manifest as seeking sensory stimulus, such as a need for
pressure, or aggression when faced with unusual stimuli (Lane). In general, hyposensitivity is far
more prevalent in children with autism than hypersensitivity and has a greater connection to
autism as one of its major symptoms (Lane). However, it is important to realize that hyper and
hyposensitivity are not mutually exclusive. An individual may be hyposensitive in one sense and
hypersensitive in another (Grandin). For example, while a loud and unexpected noise may cause
an aggressive reaction (hypersensitivity), the touch of someones hand may elicit no reaction at
all.
Sensory problems can affect the entire range of the senses, including vision, hearing, and
touch. The majority of neurotypical individuals, people who are not on the autism spectrum,
attest to sight being chief among the major senses, with a vast array of data coming into the brain
solely through the eyes. However, the perceptual aspect of vision is highly compromised in many
individuals on the autism spectrum. Perception is the ability of the brain to process and make
sense of the information relayed through the eyes. While those with visual sensitivity generally
have normally functioning visual organs and can easily pass eye exams, the perception systems
in their brains are compromised (Grandin). In extreme cases, the sensitivity can manifest as
visual tune outs and white outs (in which vision completely shuts down and only blackness or
whiteness can be seen) when faced with unusual visual stimuli (Grandin). In other cases,
perceptual awareness may disappear. While individuals retain the ability to see shapes and

Misra 3
colors, nothing has meaning. In daily life, visual sensitivity can present significant impediments
to normal living. For example, some with autism are able to see sixty-second flickers. The
flickers represent the fact that household electricity turns on and off sixty times a second. This is
unnoticeable by neurotypicals, but in those with severe visual sensitivity, both eye strain and a
pulsating effect can occur (Grandin). Another major source of sensory problems is hearing. A
study conducted in 1999 found that children with autism have a hearing loss rate 18% greater
than children who do not fall on the spectrum (Kern). Like with vision, the hearing organs are
usually not damaged, but rather the processing systems in the brain are compromised. This lack
of normal sound processing may result in the inability to distinguish between sounds or hear
certain frequencies. For example, some are unable to hear consonants in words (Grandin). On the
other end, high sensitivity to sounds may result in becoming obsessed with specific noises; such
as flowing water or the sound of pencil on paper (Sicile). Other effects can be covering ears and
appearing deaf when faced with loud or unexpected sounds. Becoming desensitized to sounds
can result in echolalia (repeating words over and over again) or repeatedly singing TV
commercials and songs. Another major sense commonly affected in autism is touch. Tactile
sensitivity may manifest as an intense need for pressure stimulation while at the same time being
unable to tolerate touch (Grandin). Children who present this sensitivity withdraw when touched
unexpectedly as their nervous system does not have time to process the sensation. Some only
have the ability to feel touch when it is enacted with their direct knowledge (Grandin). Touch can
also play a role as a replacement for vision and hearing when individuals have low sensitivity
to them. Instead of seeing and understanding an object, those who have touch as their primary
sense must feel things to get an accurate representation of the world (Grandin). While vision,
hearing, and touch show the most obvious symptoms of sensory issues, sensory problems can

Misra 4
affect many other senses as well, including proprioception (awareness of the body), kinesthetic
(movements), and vestibular sensing (balance).
Sensory issues can lead to various emotional and behavioral responses. One of the major
effects is exacerbating maladaptive behaviors, behaviors that inhibit the ability to adjust to
particular situations. In individuals with autism, at least 50% of maladaptive behaviors can be
explained by sensory dysfunction, with taste/smell, auditory, and movement sensitivity playing
the chief roles in causing maladaptive behaviors (Lane). Sensory problems are also associated
with mental illness. Parents of children with significant sensory issues commonly report anxiety,
social problems, communication issues, and antisocial behaviors (Lane). Sensory problems can
cause specific responses related to the stimulus and sense affected. Fight or flight responses are
typical in individuals with high sensitivity. A fight response manifests as a form of aggression
while a flight response may appear as anxiety or panic attacks (Coursera). Aggressive responses
are usually due to sensory overload. For example, hearing a loud noise may lead to striking the
person or thing that made the noise (Sicile). In addition, many can only access one sensory
channel at a time. Rather than simultaneously processing many pieces of sensory information at
once, they can only focus on one task at a time; for example, not being able to process what a
person is saying if they are looking at the person (Sicile).
The symptoms and effects of sensory problems change through the years as the body and
brain develop. The most obvious symptoms of autism appear in infants of about 18 months of
age, although more subtle indicators may be present much earlier. Alongside the more commonly
known symptoms including repetition and withdrawal, the first sensory issues also develop. One
of the most apparent symptoms that appears early in development is the stiffness in a baby when
picked up (Sicile). As the infants get older, they are often found to display hyposensitivity

Misra 5
(under-responsiveness), avoiding stimulation rather than seeking it (Lane). Later, when
progressing into the child stage, many individuals display more symptoms of hypersensitivity
(over-responsiveness). While retaining some hyposensitive behaviors, they are more likely to
have overreactions to certain sounds or touches or become fixated on certain stimuli (Kern). In
general, the intensity of sensory issues decreases as the individual ages. Young adults usually
report that the severity of their sensory dysfunction lessened with age and they are better able to
manage their sensory issues. In addition, there is a definite correlation between improved
management of sensory symptoms and early diagnosis and treatment of autism.
Early Intervention
Early intervention is a key component of therapy, as the earlier autism is identified, the
more likely the brain will be able to learn and adapt to a greater degree of independent living.
Early identification plays a key role in increasing the effectiveness of autism therapy. While the
most common symptoms of autism are generally observed around the age of eighteen months to
three years and diagnosis can take much longer, researchers have found a number of small
indicators of autism in infants (Ricks). For example, a study monitoring the eye gaze patterns of
infants found that those who later developed symptoms characteristic of autism had atypical
patterns. Rather than focusing on the eyes and mouth, as is common in neurotypical infants,
infants later identified to be on the spectrum focused largely on the mouth areas, if on the face at
all (Ricks). This finding is significant as it may potentially provide a new way to diagnose autism
without relying on the classical symptoms of lack of social and communication skills and
repetitive and unusual behavior. Early identification can also help counteract the effects of major
brain differences between neurotypical children and children not on the spectrum. Early
childhood is a time of substantial neurological growth as children explore social environments

Misra 6
and develop communication skills. However, in children with autism, altered interactions and
lack of normal social development can preclude the development of social and linguistic brain
circuitry and hamper the formation of necessary neural connections (Dawson). Early intervention
can increase the opportunity for autistic children to experience different types of environments
and adapt to them, thereby increasing the chance of normal brain development. While there are
several different methods of early intervention therapy, many of them share the same basic
approaches. Every approach encourages greater social interaction and the formation of active
environments with strong foundations of care and support. For example, interventions focused on
promoting maternal sensitivity were found to be more effective than the majority of other types
of intervention (Dawson).
Traditional therapy models, used to treat the vast majority of children diagnosed with
ASD, are generally focused on behavioral analysis and increasing social, communication, and
independent living skills. Early Intensive Behavioral Intervention (EIBI) is a type of early
intervention therapy that is primarily focused on increasing language development, social, and
independent living skills from a young age. EIBI covers a range of therapies with central
principles of operant learning and focuses on the remediation of social, language, academic, and
independent living skills (Didden). The therapy is done in a structured one-on-one environment,
with components broken down into discrete trials and taught through reinforcement, shaping,
extinction, and prompting (Didden). EIBI is most effective with active parental participation and
intensive, frequent therapy sessions of 40 hours a week for at least two years (Didden). Another
method of therapy is the Early Start Denver Model, which can be considered as an amalgamation
of traditional and science based approaches. In contrast to the component-based EIBI, the
Denver Model is designed to improve several skills at once. Therapists create environments

Misra 7
where children must use various skills at the same time (Coursera). Another common therapy
program is the Life Skills and Education for Students with Autism and other Pervasive
Developmental Disorders (LEAP). The LEAP program is designed to include peers in the
therapy process in order to promote interaction and adaptation to the real world. The therapy
takes place in a classroom setting with 10 typical children and 6 autistic children between the
ages of 3 to 5. It incorporates both child and adult-directed interventions and fosters peer
interaction through techniques such as teaching children to be play organizers (Corsello).
Robot-Assisted Therapy
Recent research has found robot-assisted therapy to be a viable option for children on the
spectrum, as specially designed robots are able to elicit more comfortable social interactions than
adult therapists. While still in the research phase, many prototypes of robots have been proposed
and tested in order to identify the design garnering the most positive reaction from children on
the spectrum. The most basic divergence in design is between humanoid and non humanoid
robots. The obvious benefit of humanoid robots is their greater potential for generalization,
simulating actual human interaction in a carefully modulated environment. Humanoid robots can
mimic, to an extent, human mannerisms and emotions, allowing children with autism to more
accurately interact with real world environments (Ricks). However, human forms may cause
children with autism to become frightened and withdrawn. In these cases, non-humanoid robots
in non-threatening forms may be safe options that do not trigger unwanted reactions. Children
are able to better engage with such robots, which are also much simpler and more affordable
(Ricks). Advancements in robot technology have allowed robots to perform a multitude of
functions and initiate several different types of interactions with autistic children. For example,
Labo-1, a mobile robot, is able to play games such as tag with children (Ricks). Another robot,

Misra 8
KASPAR, is able to help children develop emotion recognition skills as the robot can represent
facial expressions with less complexity than real human faces, helping children focus on
recognizing emotions without experiencing sensory overload (Ricks). Robots also increase the
range of modes of interaction. Children are able to play with the robots in safe, unstructured
environments in a variety of positions and freely-chosen methods of interaction (Dautenham).
Robot-assisted therapy includes benefits that go beyond the scope of human-conducted therapy.
Robots are able to bridge the gap between the unpredictability and lack of control in normal
human behavior, which may frighten children, and the structured, repetitive behavior that autistic
children prefer. In addition, while children with autism may be uncomfortable with normal
human interaction, they are generally very comfortable around technology. Robots allow them to
freely explore and learn in a safe and predictable environment (Roles).
Currently, there has been some introduction of robots into common therapy programs
outside of experimental trials. Robots have been steadily modernized and modified as research
into appropriate uses and methods of robot therapy increases. For example, robots such as Leka
and Milo have been phased into therapy programs and are becoming integrated with traditional
therapy models (Firth). These robots contribute to a trend towards modernization in autism
therapy, incorporating technology to increase the scope and effectiveness of therapy through a
combination of active monitoring, simulations of real world environments, and methods
individualized to the child (Firth). However, progress is impeded by prohibitive costs. The cost
for a single robot numbers in the thousands. For example, a single Milo robot, a non-humanoid
robot considered to be on the lower end of the scale, costs $5000 (Firth). Although the Milo
robot has been approved for introduction into clinics, only 70 units are in use across the nation

Misra 9
(Firth). In order to be effectively become part of common therapy programs, the robots must
become more cost-efficient in order to reach families without sufficient means.
Special Education
As children with autism reach traditional school age and outgrow early
intervention programs, they are divided into a number of special education
programs depending on their needs and functioning levels. Most schools
offer a variety of special education classes designed to provide for the
specific needs of the student. There are several classes designed for different
functioning levels on the autism spectrum, ranging from less restrictive to
highly structured. General education classes are integrated classrooms
where children with autism work alongside neurotypical students in
traditional classroom environments with minimal intervention. General
Education with Supports are classes where autistic students are supervised
by a trained professional and are given additional services in order to further
their education (Sewell). Resource classes have built in supports, although
the environment is still not completely restrictive or structured. Resource
classes may still have some degree of integration with students not on the
spectrum (Sewell). SAILS (Succeeding in Academic & Independent Living
Skills), previously known as Life Skills classes, are self contained
environments, classes that are not integrated with general education
students. These classes focus on teaching adaptive behavior and
independent living skills through a number of specialized activities (Sewell).
FLaSH (Functional Living and School Health Services) classes are specialized

Misra 10
for students with neurological disorder and a physical disability and are the
only classes with a trained medical professional on hand at all times (Sewell).
Learning environments for students with autism must walk a line between
disorganized real world environments and the structured, restrictive
environments that autistic children prefer. Disorganized environments can
cause sensory overload and temper tantrums in children with autism, while
environments that are too restrictive will not allow students to learn adaptive
skills for independent living (Classroom). In addition, various supports must
also be provided. Visual supports include diagrams and images of tasks that
must be completed (Classroom). These promote understanding and
recognition skills as the images turn abstract concepts into concrete forms.
For example, the command Play Jenga with your friends may be broken
down into images of a Jenga set, taking out the pieces, friends, and playing
the game. Setting physical and visual boundaries are also important. These
allow students to know when to move on to different tasks and differentiate
between what behaviors are proper and which ones are not (Classroom).
However, while there are several special education services available to
students with autism, problems in the system can hamper effective learning.
Many individuals with autism have the disorder alongside a mental illness
such as bipolar disorder or schizophrenia. In the state of Texas, the mental
illness takes precedence over autism and students are placed into Behavior
Support Services classes, which are directed toward children with emotional
disturbances, including psychosis, ADHD, and dissociative disorder (Sewell).

Misra 11
In these classes, children with autism are treated in the same way as the
children who are not on the spectrum. While their mental disorder is treated,
they do not get the necessary treatment for autism. Other problems in the
system include children with intellectual disabilities (defined as having an IQ
lower than 70) alongside autism. Even when they are put into the proper
special education classes for autism, they are unable to get effective therapy
for their intellectual disability. In addition, when children are in classes where
they are perceived as different, they often become the victims of bullying
and social isolation (Sewell).
In recent years, there has been a movement to more closely integrate
special education children into general education classes in order to foster
peer interaction and simulate real world environments. In order to effectively
include children with autism into general education environments, teachers
must get proper training in order to learn how to deal with the behaviors of
their special education students. It is recommended that they also receive
assistance from social workers, therapists, counselors, psychologists, and
other professionals (Simpson). In addition, changes in classroom structure
and organization must occur. Teachers should get additional planning time in
order to plan individualized and alternative activities and develop
appropriate teaching methods (Simpson). However, while integration into
general education can help students adapt to real world environments and
learn social skills, they are also marked by significant challenges. Autistic
students are often othered by their neurotypical classmates and can easily

Misra 12
become victims of bullying. Studies have found that they are on average 20
times more likely to be excluded from school than their peers (Humphrey).
In addition, due to naivety and eagerness for social inclusion, their
classmates exploit many students with autism. They become easy targets for
ridicule, damaging their self-esteem and leading them to withdraw more
from social environments (Humphrey). Unable to deal with the problems of
bullying, the very thought of school can be distressing. There are some
solutions that have had success. Monitored peer group activities, such as
Circle of Friends, can lead to increased peer interaction and can help
challenge attitudes and stereotypes towards special education kids. Other
methods, including putting autistic children into groups with other students
who share their interests and passions, can spark friendships and increase
pupil motivation (Humphrey). Teachers also face significant challenges in
teaching special education students. Teachers are often ill prepared to
handle the irregular patterns of cognitive and educational strengths and
deficits, including splinter skills and isolated discontinuous activities that
students with autism demonstrate (Simpson). The skills and abilities of
children with autism may be hard to pin down as they can be dysfunctional in
one area while at a very high level in others, for example, being unable to
write, but able to do college level mathematics. Teachers also report not
getting enough training in special education needs. In most school districts,
special education training is restricted to professional development days
(Helps, et al.). This has led to teachers being unable to deal with the

Misra 13
aggressive behaviors and social and communicational difficulties exhibited
by autistic students. Due to a lack of comfort in interacting with special
education children, some teachers only have minimal interaction with their
autistic students, depending on support staff to prepare work for them
(Humphrey).
Low-income challenges
Low-income children with autism face difficult challenges in continuing
necessary therapy and education and wading through government programs
to secure limited funding. Current estimates of autism prevalence in the
United States indicate that roughly 163,000 children with autism across the
nation are living below the poverty line (Shattuck). These children are often
diagnosed late and do not get the opportunity to take part in early
intervention programs that can develop independent living skills and
adaptations in early childhood. Even when they do have access to special
education programs in school, they are unable to take advantage of intensive
therapy that can make a world of difference in their development. In
addition, due to lack of financial resources, they have very high dropout
rates from special education programs. Even those who manage to finish
high school are quickly disengaged from therapeutic services (Shattuck). Due
to a lack of development of independent living skills and communication
skills, these students have a low rate of employment after high school
(Shattuck). Options for families are further complicated by a maze of
different programs with long waiting periods. Medicaid is available for low-

Misra 14
income families, but does not cover the special education and therapeutic
services that are needed by children with autism. In these cases, families can
choose to become part of Medicaid Waiver programs (Sewell). Families must
demonstrate specific needs for these programs. For example, the Home and
Community Services Program (HCS) is available for children with autism with
an intellectual disability and the Community Living Assistance and Support
Services program (CLASS) is available for those with autism and related
conditions (Sewell). These programs cover an array of needed therapies and
special education services. However, both HCS and CLASS have exceedingly
long waiting periods due to the vast number of applicants and limited funds.
In many cases, it can take fifteen years or longer for families to gain access
to these programs (Sewell). Depending on the age of diagnosis, individuals
with autism may have already passed into adulthood before getting accepted
into the programs, missing their chances to take advantage of life-changing
early intervention and special needs programs.
Conclusion
Obstacles are present in every aspect of navigating the maze of autism
in a world made for neurotypical people. To be an individual with autism in
modern society remains a daunting challenge, and even now, awareness and
acceptance of autism are still rare. However, despite the ever-present
hardships, many people with autism are loath to be cured due to the
unique perspective on the world autism provides. After all, the majority of
the worlds prodigies are on the autism spectrum. Nevertheless, to thrive in

Misra 15
the global community, debilitating symptoms must be addressed and
independent living skills must be developed. This can be achieved through a
combination of early intervention and special education programs. Such
programs will allow children with autism to reach their full potentials and
take their place as important, contributing members of society.

Misra 16

Works Cited
Classroom Organization: The Power for Structure for Individuals with Autism Spectrum
Disorder. Region 13 Education Service Center. Online Course. 27 Oct 2016.
Corsello, Christina M., Early Intervention in Autism. Infants and Young Children: An
Interdisciplinary Journal of Early Childhood Intervention, vol. 18, no. 2, 2005, pp. 7485. Web. 10 Oct 2016.
Coursera: Autism Spectrum Disorder from the UC Davis Mind Institute. Web. 16
September 2016.
Dautenhahm, Kerstin. Roles and Functions of Robots in Human Society: Implications
from Research in Autism Therapy. Robotica, vol. 21, no. 4, 2003, pp. 443-452. Web. 1
Oct 2016.
Dautenhahm, Kerstin, et al. Towards Interactive Robots in Autism Therapy.
Pragmatics and Cognition, vol. 12, no. 1, 2004, pp. 1-35. Web. 11 Oct 2016.
Didden, Robert, et al. A Meta-Analytic Study on the Effectiveness of Comprehensive
ABA-based Early Intervention Programs for Children with Autism Spectrum
Disorders. Research in Autism Spectrum Disorders, vol. 5, no. 1, 2011, pp. 135-152.
Web. 26 September 2016.
Dawson, Geraldine. Early Behavioral Intervention, Brain Plasticity, and the Prevention
of Autism Spectrum Disorder. Development and Psychopathology, vol. 20, no. 3, 2008,
pp. 775-803. Web. 11 Oct 2016.

Misra 17
Firth, Shannon. "Autism Therapy From a Robot?" Medpage Today. MedpageToday, 09 Mar.
2015. Web. 18 Nov. 2016.
Grandin, Temple. Thinking in Pictures: And Other Reports from My Life with Autism.
N.p.: Vintage, 1995. Print.
Helps, Sarah, et al, Autism: The Teachers View. Sage Publications, vol. 3, no. 3,
1999, pp. 287-298. Web. 24 Oct 2016.
Humphrey, Neil. What does inclusion mean for pupils on the autistic spectrum in
mainstream schools? Journal of Research in Special Education Needs, vol. 12, no. 1,
2008, pp. 23-46. Web. 24 Oct 2016.
Kern, Janet K., et al. The Pattern of Sensory Processing Abnormalities in Autism.
SAGE Publications, vol. 10, no. 5, 2006, pp. 480-494. Web. 2 September 2016.
Lane, Allison E., et al. Sensory Processing Subtypes in Autism: Association with
Adaptive Behavior. Journal of Autism and Developmental Disorders, vol. 40, no. 1,
2010, pp. 112-122. Web. 8 September 2016.
Leekam, Susan R., et al. Describing the Sensory Abnormalities of Children and Adults
with Autism. Journal of Autism and Developmental Disorders, vol. 37, no. 5, 2007, pp.
894-910. Web. 8 September 2016.
Ricks, Daniel J., et al. Trends and Considerations in Robot-Assisted Autism Therapy.
Robotics and Automation (ICRA), 2010 IEEE International Conference, 2010. Web. 11
Oct 2016.
Sewell, Cheryl. Personal Interview. 27 Oct 2016.
Shattuck, Paul T., et al, Postsecondary Education and Employment Among Youth With

Misra 18
An Autism Spectrum Disorder. Pediatrics, vol. 129, no. 6, 2012, pp. 1043-1049. Web.
23 Oct 2016.
Sicile-Kira, Chantal. Autism Spectrum Disorder: The Complete Guide to Understanding
Autism. NY, NY: Perigee, 2014. Print.

Simpson, Richard L., et al, Inclusion of Learners with Autism Spectrum Disorder in
General Education Settings. Topics in Language Disorders, vol. 23, no. 2, 2003, pp.
116-133. Web. 23 Oct 2016.