/ 2 November 2004

The struggle to communicate

By all appearances, the property looks like any other in the affluent neighbourhood of Parktown West, Johannesburg. But once inside the reception area of the house, the multitude of pictures and photos packed on every wall suggests that this is no ordinary house.

This is the Key School for Specialised Education (KSSE), which caters for 15 children with autism. Jennifer Gous, head of the KSSE, says the many images are part of helping autistic children, who struggle to talk or communicate easily, to build a sense of recognition and connection with the world.

The KSSE was formed 34 years ago and admits children between the ages of three-and-a-half and 14. Its three educators each have the support of a class assistant. A psychologist, speech and occupational therapist, as well as a music teacher, are also available at the school.

Subtle details in the children’s facial features, movements and speech indicate that they’re not the same as other children. Gous says that, because autistic learners cannot communicate, “all the activities are meant to enhance communication to capture their attention so that they can reciprocate with us” (which explains the images on the reception wall).

“The school strives to make the children’s lives meaningful by providing them with skills that will make them independent and self-sufficient human beings,” says Gous.

The school’s in-house shop, which is managed by learners themselves, is one strategy to achieve this. The idea of the shop is to give learners real-life experience, as well as to empower them to do things on their own. “For instance,” says Gous, “they decide for themselves what they want to buy and how much it costs, as well as understanding how to work out change.”

The curriculum covers such aspects as group speech, occupational, play and music therapy. Occupational therapy deals with activities that mainly help learners to develop physically. Speech- therapy classes deal with learners’ communication skills.

The music room is a small, self-contained space with a piano and traditional African drums in different sizes. Gous says the music therapy is meant to encourage children to enjoy and appreciate music, while play therapy is designed to help the children explore the idea of playing, as autistic children struggle to play creatively and imaginatively.

According to Autism South Africas website, research shows autism affects one in 158 children under the age of six. It is believed to be on the increase, which could reflect improved diagnosis and social awareness of autism. Autism also occurs four times as often in boys than in girls. Although scientists are yet to discover why this is so, it is thought to relate to the chromosomal make-up of boys, which makes them more prone to developing disabilities than girls.

Autism is not a curable condition, but its effects can be effectively managed with the right intervention. Education is one of the most effective methods of reducing learners’ autistic symptoms, says Gous.

Autism can manifest itself in many different forms, and as a result this disability is now more often referred to as autism spectrum disorder (ASD). There are three main types of autism:

  • Kanner/Classic;
  • Asperger Syndrome; and
  • Savant Autism.

    Asperger syndrome is the form of autism that teachers are most likely to come across, as it is less severe and its sufferers can easily be part of normal or mainstream schooling. Besides symptoms such as isolating themselves and becoming fixated with certain objects, those with Asperger syndrome often perform well in subjects such as maths, making it easier to include them in mainstream classrooms.

    But Gous believes that the exposure of most educators to special-needs conditions is insufficient for them to recognise and manage the conditions effectively. She says there is often a tendency to confuse autism with other special-needs conditions, such as Downs Syndrome, fetal alcohol syndrome or cerebral palsy.

    In her view, autism is an “extreme form of special-needs condition that needs specialist training to handle”. One concern for Gous is the limited knowledge of autism, particularly among black parents. As a result, most learners at her school have been referred by paediatricians and therapists, not their parents or teachers.

    Given the highly specialised nature of teaching autistic children, the KSSE’s fees are steep: R24000 a year, while after-care sets one back a further R250 per month. Payment plans are negotiated with parents who cannot afford these fees. Although Gous is clearly passionate about her school, the continued lack of financial support, especially from the government, makes its future uncertain.

    For now, at least, the school is sustained thanks to private funding. But with this source of financial support also declining, these doors of learning may not remain open for that much longer.

    Characteristics of an autistic child

    The condition affects the following areas, also known as the triad of impairments:

  • Social interaction;
  • Language and communication; and
  • Behaviour and imagination.
  • There is little awareness of the existence of others or their feelings;
  • There is poor or absent ability to make appropriate social contact;
  • The child is aloof and indifferent to others;
  • The child dislikes being held, cuddled or touched;
  • The child has difficulty forming appropriate relationships with peers; and
  • The child prefers to play alone. Behaviour and imagination
  • Imaginative play is limited or poor;
  • There is a tendency to focus on minor things instead of an imaginative understanding of the meaning of the whole scene;
  • The child may display a limited range of imaginative activities;
  • The child may pursue activities repetitively and cannot be influenced by suggestions of change;
  • Play may appear complex, but close observation shows its rigidity and stereotyped pattern;
  • There is inappropriate use of toys in play;
  • The child may hold on to objects for the whole day; and
  • Tantrums may occur for no apparent reason. Language and communication
  • The development of speech and language may be abnormal, delayed or absent;
  • There may be minimal reaction to verbal input and the child sometimes acts as though deaf;
  • The presence of facial expression and gestures may be absent or unusual;
  • The child may repeat words, questions, phrases and sentences over and over again;
  • The child may launch into endless monologues about their special interests, without adapting to the needs of the listener;
  • Words and phrases may be used incorrectly;
  • Production of speech may be unusual; and
  • The child may find it difficult to initiate or take part in conversations.