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Wednesday, November 21, 2012

What is Autism Anyway?

Ever heard the Indian fable of the blind men and the elephant?


A king asks a group of blind scholars to tell him what an elephant is like. Each defines the elephant based on his limited contact with the animal - the one at the tail describes the elephant as a rope, the one at the leg says "no, it's like a pillar", the one at the belly argues that clearly an elephant is like a wall, the one at the ear says "it's like a fan!", the one at the tusk thinks an elephant is just like a sword, and the one at the trunk would stake his life on the fact that an elephant is the same as a tree branch. In some versions of the story a big melee follows with each scholar willing to fight to the death to defend their learned viewpoint.

Sound familiar?

The field of autism is plagued with arguments over definitions, diagnosis, treatment and philosophy - and for the most part, this has not been helpful to ASD individuals and their families. The constant conflict causes discussions to go around in circles, as each faction searches for an elusive all-encompassing theory that explains "autism".

But what if the blind men listened to each other? In some versions of the story, this happens. What if we recognized that different perceptions and perspectives could illuminate pieces of a larger truth? One that could only be understood by looking at all of the information, all together, without bias and preconceptions? What if we stopped arguing and started listening?

For what it's worth, to start the discussion, I'll share my perspective:

My practice is unusual, in that I work with individuals over a long stretch of time. The 2-yr-old that comes through my door stays with me through preschool, elementary school, high school and beyond. This has challenged all of my original "learned" viewpoints and changed my view of what autism is. I'm not sure that a single one of my preconceptions about the diagnosis has survived.

In my practice I bring the best that I have to each person that I see, and therapy never looks exactly the same for any two of them - I match the intervention to the individual. Some are very verbal (note: the first time language "suddenly" appeared in one of my clients, I thought my therapy and I had caused it; the next time it happened, I realized that some individuals are just "set" to do this language burst), some are moderately verbal and some are very low verbal. The difference in outcomes reflects differences in the individuals from the start - no "one size fits all" treatment or developmental path.

What am I left with in terms of answers? One thing. The question is wrong. The question "What is autism?" and the related question "What is the one definitive standard treatment for autism that will result in a 'successful' outcome for all?" are misguided and misleading. Autism is not just one thing. Defining autism as a "spectrum" is a good start, but the next step is realizing that members of that spectrum are the most "individual" of individuals, and that one approach, one definition, one philosophy or theory is never going to define, treat or educate them all.

Real life and real people are messier (and more interesting) than neat diagnostic boxes. Maybe if we all recognize our own blindness, the limitations of our knowledge and the complexity of the question, we could work together and do better for the people we are seeking to help.

- Posted using BlogPress from my iPad

Saturday, November 10, 2012

Scrambled Sentences - using drawing to support language development

In my last post, I shared one of the specific ways drawing can be used to support the development of conventional language. Today, I'll give another quick tutorial about a different teaching technique which I find useful.

Scrambled Sentences is an activity that focuses on grammar and the way in which word order affects the overall meaning of a sentence.

Words are written on slips of paper, and assembled into a sentence like a puzzle. This allows your student to focus on word order and sentence meaning without having the task complicated by spelling difficulties, word-finding problems, etc.

The student reads the sentence out loud, and if there are problems with the word order (eg. the sentence breaks basic grammatical rules), I will move the "problem" words up and out of the sentence so the student can try again. Always remember that you are teaching, not testing, and this is a gentle way to say "oops, a couple of words out of order, try again".

Then the student draws what they think the sentence means.

Here is a picture that my friend Kevin drew for me in our session this week:


The sentence is "Mr. Bean is sitting on Teddy". I've used these characters because they are favourites of Kevin's. You could do this activity (and I have done this activity) using any theme (Thomas the Tank Engine & Friends, SpongeBob, Dora the Explorer, animated wrenches and screw-drivers .... the sky and your imagination are the only limits) - working through high interest topics is the best way to get the kind of focused attention and energy necessary to work through the tricky challenges of language learning.

The sentence type that Kevin and I focused on this week was sentences where the agent of the action and the object of the action are interchangeable (the above sentence could just as well have been "Teddy is sitting on Mr. Bean"). His drawing lets me know if he is getting the meaning that is coded by the grammar (word order) of the sentence, and whether he understands the meaning of the individual words used.

Here is the finished larger picture that includes three scrambled sentence puzzles:


Take a look at the drawing for the sentence "Kevin is picking up Raymond". He read the sentence aloud perfectly, and transcribed it accurately in legible hand-writing. The picture he drew was interesting, and let us know that what he thought the sentence meant and what we thought the sentence meant were two different things. He interpreted "picking" as "packing", so this is a picture of Kevin packing up his brother Raymond in a suitcase (and Raymond is not unhappy about it!). Love this.

Again, let me say, we are teaching not testing. Kevin's drawing is not wrong. What his drawing does is highlight the difference between what he understood from the written language and what we assumed he understood from the written sentence. It made an opportunity to discuss the difference between the very similar looking and sounding words "picking" and "packing" (and we all enjoyed the humour of the picture) ... I also love the nonchalant way that Mom is carrying Dad around (she's quite a super woman!).

All of these activities are about teaching in a relaxed atmosphere of shared enjoyment. They are about discovering what's going on in another person's head. And the visual humour that comes through in many of my student's drawings is an indication of the subtleties of intellect that hide behind a less verbal exterior.

Try it out. Have a good time. And please feel free to share your drawings with us!

Sheila B

PS. For a more extensive visual tutorial of this technique, click on the link below to access a teaching video from our YouTube channel:

Scrambled Sentences - A Grammar Teaching Tool