Journal Summaries, Article Review Example

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Article Review

“An Application of the Picture Exchange Communication System (PECS) with Children with Autism and a Visually Impaired Therapist”

This article explores the usefulness of modifying the Picture Exchange Communication System (PECS) so that it can be used by instructors with visual impairments.  PECS was created as a facilitative tool meant to improve communication between non-verbal children and their teachers, family members, and peers in order to develop their social and communicative skills.  According to Charlop and colleagues (2008), PECS is a valuable resource for autistic children because it is simple to administer, low in cost, and can be used with children who have limited verbal, motor, and gestural skills.  Research regarding the use of PECS with autistic children has found an increase in communicative behaviors and a decrease in behavioral problems.  Charlop and colleagues’ (2008) study modified PECS cards with braille so that a visually impaired therapist would be able to work with her autistic students.  This has significance because it illustrates how people with disabilities can work with other disabled people, thus giving back to their community and improving their own personal sense of worth and importance (Charlop et al., 2008).  This study didn’t look at using modified PEC cards with visually impaired autistic children.  However, the implications of Charlop and colleagues’ work illustrates how modified PEC cards might be used in the future to work with Abdurrahman Mimany so that he might develop his communication skills.  Currently Abdurrahman has limited communication skills in the classroom, and would clearly benefit from a simple system like PECS which aims to help autistic children understand how communication can impact on their immediate environment (Charlop et al., 2008).

“Identification and Intervention for Students who are Visually Impaired and Who Have Autism Spectrum Disorders”

This article addresses the growing prevalence of children with autism spectrum disorders in the classroom, along with the increased likelihood that autistic children will display further neurological disabilities such as visual impairment.  Li (2009) questions whether visually impaired children who display autistic behaviors such as rocking and hand flapping are actually autistic or are exhibiting behavioral problems due to their visual disabilities.  Li (2009) also notes that autistic children with visual impairments are becoming more common in standard classroom environments, thus demonstrating the need for educators to have a comprehensive understanding of the physical, emotional, and cognitive needs of this unique population.  The article provides a number of concrete and practical steps which educators can take when developing programs for their autistic and visually impaired students, noting that this can be difficult because each child’s specific disabilities and subsequent classroom requirements will be different.  However, Li’s (2009) summary of effective principles and strategies provides a solid framework for educators to use when designing a student-specific learning program.  Many of the strategies which Li suggests would be helpful when implementing a program for  Abdurrahman Mimany, especially the emphasis on providing autistic and visually impaired children with a classroom environment which embraces routine and reliable schedules which the children can come to depend on.  Additionally, Li’s suggestion that educators incorporate non-disabled children into the classroom to model behavior and provide further social stimulation would be very valuable for Abdurrahman, given that he currently has limited opportunities to engage with his peers.

“Are Language and Social Communication Intact in Children with Congenital Visual Impairment at School Age?”

This research study looks at the commonalities in social development between children with visual impairments and those who are autistic, noting that both groups are vulnerable to delayed social development, especially amongst their peers.  Tadic and colleagues (2010) analyzed the language and social communication skills of a group of sighted 6-12 year-olds and compared their data against a group of visually-impaired children in the same age range.  Their research found that while visually-impaired children tended to do better on standardized testing than their sighted peers, they had difficulty communicating on par with the sighted children at a social and pragmatic level (Tadic et al., 2010).  As well, based on reports from the visually-impaired children’s parents, this population often demonstrated social and communicative difficulties that are similar to those experienced by children with autism spectrum disorders.  Tadic and colleagues (2010) emphasize that parental reports can be an invaluable resource when developing specific educational and developmental plans for children with visual impairments.  Thus, when working with Abdurrahman Mimany, it is crucial that his parents, brother, and other relatives are utilized as a source for information on his communication and social skills when not in the school environment.  Currently, his brother has expressed that Abdurrahman has had little or no difficulty developing strong relationships with his immediate family.  This contrasts strongly with the kinds of relationships Abdurrahman has developed at school, which are currently limited to his teacher and worker.  Clearly, he would benefit from an intervention plan which emphasizes building peer relationships through the creation of positive social opportunities.

“Social Communication Difficulties and Autism Spectrum Disorder in Young Children with Optic Nerve Hypoplasia and/or Septo-Optic Dysplasia”

 This research study aimed to determine whether children with Optic Nerve Hypoplasia (ONH) and/or Septo-Optic Dysplasia (SOD) were more likely to develop autism spectrum disorders than children without these visual impairments.  Parr and colleagues (2010) evaluated the case note records and performed a number of specific assessments on a group of visually-impaired children who ranged in age from 10 months to 6 years old.  Regardless of whether autism spectrum disorder behaviors manifest themselves, Parr and colleagues emphasize the critical problem that visual-impairments pose for the social, physical, and cognitive development of children.  This can include the regression of newly developed skills as well as an increased potential for those children with profound visual impairments to develop autistic-like symptoms.  The researchers suggest that this problem may stem, in part, from the social deprivation that occurs for children who are unable to communicate effectively at either an auditory or verbal level (Parr et al., 2010).  Parr and colleagues (2010) note the need to determine the level of visual impairment so as to understand what role the child’s visual-impairment plays in their social and communicative difficulties.  Currently, the level of Abdurrahman Mimany’s visual dysfunction is not entirely clear.  Any educational plan developed for Abdurrahman would benefit from comprehensive testing to determine his level of visual-impairment.  This is especially necessary because his communication skills at home are reported to differ greatly from those exhibited in the classroom, suggesting that he may possess a higher level of functioning than was originally thought.

“Developing a Schedule to Identify Social Communication Difficulties and Autism Spectrum Disorder in Young Children with Visual Impairment”

This article explores alternative methods through which clinicians can evaluate visually-impaired children for autism spectrum disorders.  Currently, many of the observational tools used to assess and diagnosis children for autism spectrum disorders and social communication problems rely on visual behaviors and cues such as eye contact and gestures.  Thus, these methods are ineffective in evaluating children with visual impairments, leading Absoud and colleagues (2011) to offer an alternative method for evaluating this population.  The Visual Impairment and Social Communication Schedule (VISS) utilizes observational techniques which are not vision dependent including play behaviors and social interactions in a clinical environment (Absoud et al., 2011).  Specifically, the researchers looked at areas such as a child’s ability to make and receive social contact, to respond to verbal stimulus, and to engage in functional, symbolic, and imaginative play.  The VISS is aimed primarily at pre-school aged children because of the importance in early diagnosis for providing successful intervention strategies for children with autism spectrum disorders.  Although  Abdurrahman Mimany is 8 years old, and thus substantially older than the children who were involved in Absoud and colleagues’ (2011) study.  As well, Abdurrahman has already been diagnosed with autism, which was the key reason for using VISS as an observational tool.  However, he could still benefit from a VISS evaluation because it would give clinicians a stronger understanding of his social and communicative behaviors in a clinical setting, as opposed to the educational and home environments in which he has currently been observed.

“Autism Spectrum Disorders and Visual Impairment are Here to Stay: Using an Expanded Core Curriculum to Implement a Comprehensive Program of Instruction”

This article explores the ways in which an expanded curriculum for visually impaired autistic students can improve their educational experiences and long term scholastic outcomes.  Gense and Gense (2011) suggest that core educational programs need to be revised and reimagined to take into account the specific cognitive, physical, and emotional needs of this population in an academic environment.  Currently, there is a lack of evidence-based research dealing with this specific subject, a knowledge gap which limits the ability of educators to respond to the specific needs of their students with proven intervention and curricular methods.  However, Gense and Gense (2011) suggest that many parallels can be drawn between what is already known about core curriculum and autistic and visually-impaired students in order to develop a comprehensive program which will provide both an educational framework and the opportunity for expansion of the curriculum in areas which are especially important to this population.  The assessment information and comprehensive instruction program, when coupled with an emphasis on the generalization of skills, allows educators to develop educational plans which are adapted to each student’s particular strengths and limitations (Gense & Gense, 2011).  The authors also suggest that educators may be hindered by a lack of information about what specifically to teach children who are both autistic and visually-impaired, and suggest that any comprehensive curriculum should include organizational and social skills as well as utilizing adaptive technologies where applicable.  For example, combining auditory instructions and cues with braille could help Abdurrahman Mimany develop a whole range of new social and organizational skills.

“Creating an Educational Program for Young Children who are Blind and who have Autism”

 This article suggests that a team approach is crucial to developing effective educational programs for visually-impaired autistic children, especially because there is no medical test to determine an autism diagnosis.  Thus, observational assessments by professionals including social workers, neurologists, and speech and language pathologists is key to providing the insights necessary to develop a specific educational plan for each child (Jamieson, 2004).  Jamieson (2004) also identifies five vital skills which should be developed in any early intervention program, and states that those programs which have been successful have uniformly taught students to be aware of their surrounding environment, to imitate others, to attempt communication, to socialize, and to use toys in an appropriate manner.  As well, a very structured teaching environment with a low student/teacher ratio will help to facilitate a supportive and successful learning environment by providing the child with predictable routines guided by a reliable and trusted educator (Jamieson, 2004).  Family involvement is another predicator of success in early intervention programs, especially when the parents of autistic and visually-impaired children are provided with the opportunity to access further resources such as parental support groups.  Jamieson’s (2004) suggestion that parental involvement can play an important role in reinforcing the skills a child learns at school illustrates the necessity of working closely with  Abdurrahman Mimany’s parents and older brother, who has taken a vested interest in Abdurrahman’s educational success.  Their observations of Abdurrahman at home will also provide further insight into his needs when developing educational strategies.

“Commentary on Providing Services to Students with Autism Spectrum Disorder”

This article looks at the role played in the early-identification of children with Autism Spectrum Disorders (ASD) to ensure positive academic and social outcomes.  Cohen (2011) acknowledges that she has no experience working with visually-impaired children, and so has limited her comments to those which primarily concern children with ASD (although many of the educational techniques can also be applied to visually-impaired children).  While there are many evidence-based intervention strategies which have been proven to lead to positive outcomes among ASD children such as visual supports, positive reinforcement systems, and functional communication training, it is difficult to find a particular strategy to deal with the social needs of the ASD child.  It’s crucial, Cohen (2011) states, to avoid generalizing the ASD population, especially because this spectrum of disorders can manifest themselves in multiple ways.  Additionally, Cohen (2011) notes that some adults with ASD, especially those who are high-functioning, have expressed their need for acceptance that “this is who they are; they are different and should be accepted as such” (p.327).  Accepting the essential nature of Abdurrahman Mimany does not mean that his teachers and educational support workers need cease any attempt to develop a stronger relationship with him or work to provide him with language and social skills.  Instead, it means that all of those who work with Abdurrahman in a supportive capacity need to recognize that he cannot be changed from a child with visual disabilities and autism into a child without these challenges.  Thus, the energy of his support team is best spent helping him to adapt to his environment and develop practical and foundational skills to further integrate him into the classroom environment.

References

Absoud, M., Parr, J.R., Salt, A., & Dale, N. (2011). Developing a schedule to identify social communication difficulties and autism spectrum disorder in young children with visual impairment. Developmental Medicine & Child Neurology, 53: 285-288.Doi:10.1111/j.1469-8749.2010.03846.x

Charlop, M.H., Malberg, D.B., & Berquist, K.L. (2008). An application of the picture exchange communication system (PECS) with children with autism and a visually impaired therapist. Journal of Developmental and Physical Disabilities, 20: 509-525.doi:10.1007/s10882-008-9112-x

Cohen, S. (2011, June). Commentary on providing services to students with autism spectrum disorder. Journal of Visual Impairment & Blindness.

Gense, M.H. & Gense, D.J. (2011). Autism spectrum disorders and visual impairment are here to stay: Using an expanded core curriculum to implement a comprehensive program of instruction. Journal of Visual Impairment & Blindness: 329-334.

Jamieson, S. (2004). Creating an educational program for young children who are blind and who have autism. Re:View, 35(4): 165-177.

Li, A. (2009). Identification and intervention for students who are visually impaired and who have autism spectrum disorders. Teaching Exceptional Children, 41(4): 22-32.

Parr, J.R., Dale, N.J., Shaffer, L.M., & Salt, A.T. (2010). Social communication difficulties and autism spectrum disorder in young children with optic nerve hypoplasia and/or septo-optic dysplasia. Developmental Medicine & Child Neurology, 52: 917-921. doi:10.1111/j.1469-8749.2010.03664.x

Tadic, V., Pring, L., & Dale, N. (2010). Are language and social communication intact in children with congenital visual impairment at school age? The Journal of Child   Psychology and Psychiatry, 51(6): 696-705. doi: 10.1111/j.1469-7610.2009.02200.x

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