Richman Shira - Raising a Child with Autism

Raising a Child with Autism

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ISBN 978 1 84310 825 2

eISBN 978 1 84642 085 6

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Raisinga Child with Autism

A Guide To Applied Behavior
Analysis For Parents

Shira Richman

Jessica Kingsley Publishers
London and Philadelphia

First published in the United Kingdom in 2001

by Jessica Kingsley Publishers

73 Collier Street

London N1 9BE, UK

and

400 Market Street, Suite 400

Philadelphia, PA 19106, USA

www.jkp.com

Copyright 2001 Shira Richman

The right of Shira Richman to be identified as author of this work has been asserted by her in accordance with the Copyright, Designs and Patents Act 1988.

All rights reserved. No part of this publication may be reproduced in any material form (including photocopying or storing it in any medium by electronic means and whether or not transiently or incidentally to some other use of this publication) without the written permission of the copyright owner except in accordance with the provisions of the Copyright, Designs and Patents Act 1988 or under the terms of a licence issued by the Copyright Licensing Agency Ltd, Saffron House, 6-10 Kirby Street, London EC1N 8TS. Applications for the copyright owners written permission to reproduce any part of this publication should be addressed to the publisher.

Warning: The doing of an unauthorised act in relation to a copyright work may result in both a civil claim for damages and criminal prosecution.

Library of Congress Cataloging in Publication Data

Richman, Shira. 1972

Raising a child with autism: a guide to applied behavior for parents / Shira Richman.

p. cm.

Includes bibliographical references.

ISBN 1-85302-910-6 (alk. paper)

1. Autistic children. 2. Autistic children--Behavior modification. 3. Parents of autistic children. 4. Autism. I. Title

RJ506.A9 R535 2000

618.928982--dc21

00-047818

British Library Cataloguing in Publication Data

A CIP catalogue record for this book is available from the British Library

ISBN 978 1 85302 910 3

eISBN 978 1 84642 698 8

Contents

In loving memory of Leon Lantz, my grandfather and my
inspiration as a writer and as an individual.

To Evan, my husband, for always believing in me and
for his unconditional love and support, without which I could
not have written this book.

With special thanks to our parents, Esther
and Mervin Verbit and Miriam and Paul Richman, for raising
us with much patience and love.

Thank you to all the children with whom I have worked,
to their wonderful parents, and to the professionals who
taught me much along the way.

CHAPTER 1

What is Autism?

Signs and symptoms of autism

Autism is a pervasive developmental disorder that affects approximately ten to fifteen out of every ten thousand children. Its onset usually occurs prior to thirty months of age, but only becomes easily detectable when the childs failure to develop communicative language becomes apparent.

Childhood disintegrative disorder shares the same symptoms as autism, but in this condition normal development is exhibited for the first two years of life, followed by a significant loss of previously acquired skill. Autism occurs in boys about three times as often as it occurs in girls, and its specific etiology is not yet known.

The diagnostic standard used to identify autism is called the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association, fourth edition, or the DSM-IV, published in 1994. It includes twelve diagnostic criteria grouped into three categories: social interaction, communication, and activities and interests. Individuals affected with autism will not necessarily have all of the signs and symptoms associated with the disorder. Although they may exhibit similar symptoms, no two children with autism are alike. In order to be diagnosed with autism, a child must exhibit two criteria from the first category, two criteria from the second category, and one from the third. Here is a closer look at each diagnostic category within the DSM-IV:

Social interaction

Children with autism do not have proper use and understanding of nonverbal behaviors, nor do they exhibit age-appropriate social interaction. A child with autism may:

exhibit little if any eye contact

be unable to read facial expressions or respond to social cues and gestures, such as waving and pointing

fail to interact and to develop appropriate peer relationships

prefer isolation and appear uninterested in other people

use people as tools by guiding their hands in order to retrieve an object that the child desires

exhibit minimal or no initiation and play skills.

In infancy a child with autism may not exhibit an anticipatory response to being picked up and may not like to be held. He may not play peek-a-boo or visually follow the coming and going of his caregiver. As a toddler, the child may not exhibit normal stranger anxiety, and may show either little or extreme attachment to people.

Communication

Children with autism show qualitative disturbances in speech as well as quantitative ones. In other words, the speech of children with autism is not merely delayed, but is not evenly developed. Inappropriate use of language may include:

echolalia (rote repetition of words and/or phrases)

a monotonous tone lacking pitch or intonation

lack of social imitative play and spontaneity and variation in language use

pronoun reversals

a discrepancy between receptive and expressive language with no concept of abstractions such as danger.

Approximately forty percent of children with autism do not develop language at all, nor do they try to compensate through the use of alternative methods of communication such as gestures or mime. Those who do develop speech do not use their speech skills to converse with others appropriately.