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By Maureen Aarons;Tessa Gittens

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Extra info for Autism: A Social Skills Approach for Children and Adolescents

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When Uta Frith's book, Autism: Explaining The Enigma, was published in 1989, the impact on remediation programmes was considerable. She described the cognitive impairments inherent in autism that made sense of Wing's Triad. Frith's work on theory of mind and central coherence encapsulated the essence of the difficulties experienced by children with autism and pointed the way to relevant approaches to teaching and intervention. Deficits in theory of mind are shown by the inability of children with autism to understand other people's ideas, thoughts and feelings.

The face of a child imposed on a single jigsaw piece makes an evocative and apposite logo for the UK National Autistic Society. It is important to remember that, in the natural history of the condition of autism, changes occur as children mature. Many of the overt features of autism may recede, so that by middle childhood the picture may be very different from that of early infancy. Autism does not go away, but presents in a variety of ways at different stages in a child's development. Because the picture does not stay the same, it is not at all unusual for a professional to meet an older child with behaviour and communication difficulties, and fail to notice the underlying social impairments.

The bathroom mirror can be used for naming body parts, or for peep-oh games. Items of clothes can be named, and linked to colours. Laying places at the table for the family, as well as visitors, can foster awareness of others and what is going to happen next. The aim of all these activities is to build bridges of understanding for the child about his environment and the larger world about him. Many ideas for simple interactive activities can be gleaned from sources such as books on working with children with disabilities, home-based programmes such as Hanen, Portage (see useful addresses, pages 8789) and, not least, the clinician's imagination, since books and programmes cannot always be flexible enough to account for the idiosyncracies of an individual child's problems.

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