Translated from: 別再說我耍自閉！用對方法，我也可以像你一樣從綁鞋帶到與人相處
Sitcom
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Finally, today is the day. Mary is walking her son, Little Johnny, who just turned 2 years old earlier this month to preschool. Recently, Mary and her husband, James, have started to notice that Little Johnny doesn’t seem to like hanging out with people much. He’s always sitting alone in the corners playing by himself and doesn’t show much sign of interest in sharing how’s he feels about the activity. Both Mary and James thought this might just be his being the only child of the family. Things would probably change for the better once Little Johnny starts going to school and learn to play with his classmates.
Upon walking into the classroom, Mary discovers that the nursery-class teacher happens to be teaching the whole class how to tie their shoelaces. After giving the teacher a nod of acknowledgment, she quickly bends over to comfort Little Johnny who seems very nervous standing behind. At the same time, she purposefully unties her shoelaces and pretends to learn tying shoelaces with the entire class of kids.
Mary: What is this?
Little Johnny: [Staring dully at the far end of the classroom] This…what…this?
Mary: Hey, here, look at me. Yes, what is this?
Little Johnny: [Still staring dully at the far end of the classroom] Yes…yes…
Mary: [Taking Johnny by the hand and walking toward his classmates] Come, let’s go learn how to tie shoelaces with them. It’ll be fun!
Suddenly, Little Johnny goes frantic and starts throwing whatever he grabs from the ground. After all the throwing madness, he then goes on screaming and kicking on the floor as if a sudden anger got the better of him and could find no way out. Johnny’s classmates who had been tying their shoelaces all these time were terrified. What, if anything, has happened to Johnny that so fiercely aroused his emotions? I welcome you to think of a time when somebody reacted so ferociously as Little Johnny when he/she was made to interact with people. This person you know seemed to be so sensitive toward any changes around him/her. Or perhaps, do you feel rather familiar to Johnny’s behaviors, as if you sensed his pain there?
Truth be told, Little Johnny is just like some other 10 million people on earth[1] living with autism symptoms. Autism may not be the most accurate term for the mental illness. According to the Diagnostic and Statistical Manual of Mental Disorders V (DSM-5) published by the American Psychiatric Association (APA), the medical terminology for autism should be “Autism Spectrum Disorder” (ASD in abbreviation), since carriers of the diagnosis all bear different levels of symptoms in terms of social interaction, emotion, behavior, and learning disadvantages. Some people may be at the far-left side of the spectrum (e.g. those with Asperger’s syndrome), which is considered as high-functioning autism and experience less learning difficulties. People on the far right-hand side, on the other hand, are low-functioning autistics and thus experience greater difficulty in self-management and learning.
Note [1]:According to the World Health Organization (aka. WHO), it is estimated that about 1 in every 160 children is diagnosed with autism spectrum disorder (WHO, 2019).
Today, I’ll be explaining more about what Autism Spectrum Disorder (ASD) is, and how we may accompany family, friends, peers, or students with this developmental disorder toward their path to better social inclusion starting with a small thing as little as tying shoelaces.
What is Autism Spectrum Disorder (ASD)
DSM-5 describes children with ASD as exhibiting two types of symptoms[2] (APA, 2013, P.50):
- Deficits in Social Communication and Social Interaction
- Unable to perceive the emotion of others and give proper verbal, emotional, and facial feedback among social interactions;
- Eye gazing or staring dully at other objects than the object of social interaction;
- Dislike social exchanges or making connections with other people, and often playing alone.
- Restricted and Repetitive Patterns of Behavior and Activities
- Involve in repeated or restricted patterns of behaviors or activities, such as arranging toys mechanically or flipping things around, or constantly repeat phrases or words spoken by others[3];
- Fixated about performing the same behaviors, activities, or life rituals, and can become highly irritated or angered upon experiencing changes;
- Highly focused on things of personal interest(s), and cannot tolerate being bothered or seem to have no awareness of the outside world;
- Highly sensitive toward external stimuli and can act aggressively in response.
Note [2] :If only the first type of symptoms are exhibited by the child, he/she will no longer be placed in the ASD category but rather in the Social Communication Disorder category, according to the newest APA version.
Note [3] :Kids like Little Johnny with autism spectrum disorder oftentimes repeat the words spoken by others, which a behavior termed medically as “echolalia”.
Attending to the Life of Kids with ASD: Tying Shoelaces
A group of researchers from the University of Auckland noted in a research done on a 14-year-old exhibiting ASD symptoms that instead of teaching children with ASD how to tie shoelaces step-by-step, it is more effective to teach them this life skill through backward chaining (Sadlier, Dixon, & Moore, 1992). Normally, when we teach someone how to tie their shoelaces, we prefer to start from the very first step toward the end. Backward chaining, however, starts the lesson from the end. That is to say, the educator helps the learner tie their shoelaces to the second last procedure and then hands the shoelaces over to the child to complete the final step. This way, the child may be encouraged to learn further about the skill and eventually learn to tie their own shoelaces (Rayner, 2011).
Another study using video-based intervention with the traditional approach (i.e. forward chaining) proves a great failure in teaching children with ASD to tie their shoelaces independently. All the kids in the intervention gave up before they learned the third step of the skill, whether they scored moderately or severely in the disorder. Tutorials starring the parents or siblings are of no use either (Rayner, 2011). It is thus suggested that backward chaining is the better way to go when teaching children with autism any procedural skills, such as tying shoelaces or cooking a meal, so that they may finally learn the skills themselves, and eventually enjoy their social life with others around (Rayner, 2011).
I hope by now you’ve become more acquainted to the developmental disorder and started to show an understanding for their inadvertent recklessness. If ever you have the opportunity to teach kids on this spectrum how to tie their shoelaces, I am sure you’ll do a perfectly great job!
References:
- APA (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Arlington, VA: American Psychiatric Association.
- NIMH. (n.d.). Autism Spectrum Disorder. NIH. Retrieved from https://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd/index.shtml
- Rayner, C. (2011). Teaching students with autism to tie a shoelace knot using video prompting and backward chaining. Developmental Neurorehabilitation, 14, 339-347.
- Sadlier, J., Dixon, R. S., & Moore, D. W. (1992). Use of changing criterion procedure incorporating backward chaining to teach an autistic youth to tie shoe laces. Australian Journal of Special Education, 15, 14-16. Retrieved from https://www.cambridge.org/core/services/aop-cambridge-core/content/view/EA37BED8BAAB547216970BA6CEA5822F/S1030011200022508a.pdf/use_of_a_changing_criterion_procedure_incorporating_backward_chaining_to_teach_an_autistic_youth_to_tie_shoe_laces.pdf
- WHO. (November 7, 2019). Autism spectrum disorders. World Health Organization. Retrieved from https://www.who.int/news-room/fact-sheets/detail/autism-spectrum-disorders
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