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ASD is a neurodevelopmental disorder that affects how one perceives and socialises with others. The two primary characteristics of ASD, as stipulated in the DSM-5 (2013), is firstly, a persistent impairment or deficit in social communication and social interaction and secondly, restricted, repetitive patterns of behaviour, interests, or activities. These impairments need to be present in early childhood and limit a child’s daily functioning, even if symptoms are only recognised later in the child’s life. “Diagnoses also reflect a myriad of factors including the age at which a child’s difficulties become apparent, the length of time certain behaviours may be present, the combination of symptoms and the severity of different symptoms” (Carrington & Harper-Hill, 2015:2). According to Landsberg et al. (2016:402), “the various manifestations of behaviour we observe in learners with ASD are not part of the disorder but rather a response to how they experience and understand the world.”

“ASD is almost universally regarded as a life-long condition, although the severity of cognitive, language, social and adaptive skill impairments varies widely among children and across time within children” (Helt, Kelley, Kinsbourne, Pandey, Boorstein, Herbert & Fein, 2008:339). Previously known as pervasive developmental disorder with various subtypes, including autistic disorder, Rett disorder, childhood disintegrative disorder, Asperger disorder, and pervasive developmental disorder not otherwise specified, ASD now encompasses all these under one term, known as Autism Spectrum Disorder.

Symptoms of ASD are classified into three clusters; Social Reciprocity (the difficulty in engaging in the back-and-forth flow of social interaction); Social Communication (difficulty in initiating and maintaining social relationships and engaging in a socially acceptable manner); and lastly, Restricted, Repetitive Patterns of Behaviour, and Interests/Activities.

Restricted, repetitive patterns of behaviour may present itself as verbal echolalia (the repetition of words, phrases, intonation, or sounds of the speech of others); stimming (Self- stimulatory behaviour, the repetition of physical movements, sounds, or repetitive movement of objects); or any other behaviour or compulsions that the child may become fixated with as a pattern.

Figure 2.1: Triad of symptom clusters and impairments of ASD

2.2.2.1 Social reciprocity and communication

Social interactions can be challenging for learners with ASD. They may find it difficult to understand the body language of others, initiate conversation or adequately respond to social interactions, all of which form the basis of learning and communicating in a classroom. Their inability to reciprocate emotions and maintain eye contact and other facial expressions can lead to a failure in peer relationships (American Psychiatric Association, 2013). One can see how challenging and demanding a school learning environment can be for a child with ASD. Consequently, learners with ASD tend to avoid social interactions as they do not find them enjoyable (Cotugno, 2009; Lindsay, Proulx, Thomson & Scott, 2004; Ashburner, Ziviani & Rodger, 2010; Anderson, Oti, Lord & Welch, 2009). “Children with ASD are predisposed to social isolation by virtue of their disorder and may have difficulty maintaining social

relationships, tracking a sequence of actions, developing conversational topic, empathising, fathoming non-literal meanings and participating in imaginative play” (Ochs, Kremer-Sadlik, Solomon & Sirota, 2001:400).

2.2.2.2 Restricted, repetitive behaviours and interests

Learners with ASD often display repetitive behaviours, becoming fixated on a particular object, ritual or interest. Repetitive behaviours can manifest in the learner’s motor- movements, speech or the use of objects. They find it difficult to be flexible either in topics of conversation, routine or forms of play (American Psychiatric Association, 2013). Repetitive motor mannerisms are stereotyped or repetitive movements or posturing of the body while restricted patterns of interest are defined as a limited range of interests that are intense in focus (Autism Speaks, 2017). Repetitive movements often occur when a learner is anxious, for example, a change in routine. To self-soothe, they will often use these self- stimulating movements to calm themselves through stimming or echolalia (American Psychiatric Association, 2013; Rotherham-Fuller & Mac Mullen, 2011).

Children with ASD invariably find comfort in following the same routine every day and can become quite inflexible regarding routines. If the routine is disrupted, the learner often becomes upset and may resort to self-stimulating behaviour to calm themselves (American Psychiatric Association, 2013; Humphrey & Symes, 2011; Duerden, Oatley, Mak-Fan, McGrath, Taylor, Szatmari & Roberts, 2012; Kargas, López, Reddy & Morris, 2014).

Humphrey and Symes (2011) postulate that learners with ASD often prefer an environment that provides them with a low sensory experience. The reason for this is that such learners are frequently sensory sensitive, meaning they can find sound, touch and visual stimuli overwhelming. This sensory sensitivity differs from learner to learner, depending on the level of sensitivity to sensory input and processing, whether hyper- or hypo-sensitive (Humphrey & Symes, 2010; Marco, Hinkley, Hill & Nagarajan, 2011; Lindsay et al., 2014). Schools can present a myriad of continuous stimuli, a cacophony of sounds, leading to a child with ASD becoming overwhelmed. Procuring an in-class learning facilitator can alleviate the stress associated with sensory overload.

Being a spectrum disorder, each child with ASD will present with uniquely different needs and severity of impairments. Additionally, “the educational needs of learners on the autism spectrum can change over time and as children learn to communicate and participate in

school, behaviour, for example, may improve or become more challenging” (Carrington & Harper-Hill, 2015:2). The use of learning facilitators can be a valuable conduit between the learner and the educator by not only modelling socially appropriate behaviour, but also buffering and translating the social cues for the student.