AutismAutism
Autism is a complex developmental disability that typically appears during the first three years of life. The result of a neurological disorder that affects the functioning of the brain, autism and its associated behaviors have been estimated to occur in as many as 1 in 500 individuals (Centers for Disease Control and Prevention 1997). Autism is four times more prevalent in boys than girls (Autism: Basic Information) and knows no racial, ethnic, or social boundaries. Although autism manifests itself at an early age, it doesn’t worsen as a child ages (webofcare.com).
Autism impacts the normal development of the brain in the areas of social interaction and communication skills. Children and adults with autism typically have difficulties in verbal and non-verbal communication, social interactions, and leisure or play activities. The disorder makes it hard for them to communicate with others and relate to the outside world. In some cases, aggressive and/or self-injurious behavior may be present. Persons with autism may exhibit repeated body movements (hand flapping, rocking), unusual responses to people or attachments to objects and resistance to changes in routines. Individuals may also experience sensitivities in the five senses of sight, hearing, touch, smell, and taste. However, autism isn’t a condition a child will grow out of. ?Autism doesn’t occur because of inadequate parenting. The causes of autism are unknown, therefore prevention isn’t possible? (Autism: Basic Information third edition).
Over one half million people in the U.S. today (Autism: Perspective) have autism or some form of pervasive developmental disorder. Its prevalence rate makes autism one of the most common developmental disabilities. Yet most of the public, including many professionals in the medical, educational, and vocational fields, are still unaware of how autism affects people and how they can effectively work with individuals with autism.
What Causes Autism?
Researchers from all over the world are devoting considerable time and energy into finding the answer to this critical question. Medical researchers are exploring different explanations for the various forms of autism. Although a single specific cause of autism is not known, current research links autism to biological or neurological differences in the brain. In many families there appears to be a pattern of autism or related disabilities? which suggests there is a genetic basis to the disorder?although at this time no gene has been directly linked to autism. The genetic basis is believed by researchers to be highly complex, probably involving several genes in combination.
Several outdated theories about the cause of autism have been proven to be false. Autism is not a mental illness. Children with autism are not unruly kids who choose not to behave. Bad parenting does not cause autism. Furthermore, no known psychological factors in the development of the child have been shown to cause autism.
How is Autism Diagnosed?
There are no medical tests for diagnosing autism. An accurate diagnosis must be based on observation of the individual’s communication, behavior, and developmental levels. However, because many of the behaviors associated with autism are shared by other disorders, various medical tests may be ordered to rule out or identify other possible causes of the symptoms being exhibited.
Since the characteristics of the disorder vary so much, ideally a child should be evaluated by a multidisciplinary team which may include a neurologist, psychologist, developmental pediatrician, speech/language therapist, learning consultant, or another professional knowledgeable about autism. Diagnosis is difficult for a practitioner with limited training or exposure to autism. Sometimes, well-meaning professionals have misdiagnosed autism. Difficulties in the recognition and acknowledgment of autism often lead to a lack of services to meet the complex needs of individuals with autism.
A brief observation in a single setting cannot present a true picture of an individual’s abilities and behaviors. Parental (and other caregivers’) input and developmental history are very important components of making an accurate diagnosis. At first glance, some persons with autism may appear to have mental retardation, a behavior disorder, problems with hearing, or even odd and eccentric behavior. To complicate matters further, these conditions can co-occur with autism. However, it is important to distinguish autism from other conditions, since an accurate diagnosis and early identification can provide the basis for building an appropriate and effective educational and treatment program. Sometimes professionals who are not knowledgeable about the needs and opportunities for early intervention in autism do not offer an autism diagnosis even if it is appropriate. This hesitation may be due to a misguided wish to spare the family. Unfortunately, this too can lead to failure to obtain appropriate services for the child.
What are People with Autism Like?
Children within the pervasive developmental disorder spectrum often appear relatively normal in their development until the age of 24-30 months, when parents may notice delays in language, play or social interaction. Autistic children have difficulties mixing with regular children. There can also be an absence of eye contact. ?When directly in front of the child, they may look in every other direction except the individual in front of them? (OutReach). Autistics also have trouble ?fitting in? because of an apathetic interest in what other children are doing. They tend to be passive or don’t want to be touched. On the other hand; autistics can also have an interest in what others are doing. They can become overly aggressive or have a crying tantrum for no apparent reason (COSAC). Any of the following delays, by themselves, would not result in a diagnosis of a pervasive developmental disorder. The following areas are among those that may be affected by autism:
-Communication (language develops slowly or not at all; uses words without attaching the usual meaning to them; communicates with gestures instead of words; short attention span),
-Social Interaction (spends time alone rather than with others; shows little interest in making friends; less responsive to social cues such as eye contact or smiles), –Sensory Impairment (may have sensitivities in the areas of sight, hearing, touch, smell, and taste to a greater or lesser degree),
-Play (lack of spontaneous or imaginative play; does not imitate others’ actions; does not initiate pretend games),
-Behaviors (may be overactive or very passive; throws tantrums for no apparent reason).
Every person with autism is an individual, and like all individuals, has a unique personality and combination of characteristics. There are great differences among people with autism. Some individuals mildly affected may exhibit only slight delays in language and greater challenges with social interactions. The person may have difficulty initiating and/or maintaining a conversation, or keeping a conversation going. Communication is often described as talking at others (for example, monologue on a favorite subject that continues despite attempts of others to interject comments). People with autism process and respond to information in unique ways. Educators and other service providers must consider the unique pattern of learning strengths and difficulties in the individual with autism when assessing learning and behavior to ensure effective intervention. Individuals with autism can learn when information about their unique styles of receiving and expressing information is addressed and implemented in their programs. The abilities of an individual with autism may fluctuate from day to day due to difficulties in concentration, processing, or anxiety. The child may show evidence of learning one day, but not the next. Changes in external stimuli and anxiety can affect learning. They may have average or above average verbal, memory or spatial skills but find it difficult to be imaginative or join in activities with others. Individuals with more severe challenges may require intensive support to manage the basic tasks and needs of living day to day.
While no one can predict the future, it is known that some adults with autism live and work independently in the community (drive a car, earn a college degree, get married); some may be fairly independent in the community and only need some support for daily pressures; while others depend on much support from family and professionals. Adults with autism can benefit from vocational training to provide them with the skills needed for obtaining jobs, in addition to social and recreational programs. Adults with autism may live in a variety of residential settings, ranging from an independent home or apartment to group homes, supervised apartment settings, living with other family members or more structured residential care. An increasing number of support groups for adults with autism are emerging around the country. Many self-advocates are forming networks to share information, support each other, and speak for themselves in the public arena. More frequently, people with autism are attending and/or speaking at conferences and workshops on autism. Individuals with autism are providing valuable insight into the challenges of this disability by publishing articles and books and appearing in television specials about themselves and their disabilities.
What are the Most Effective Approaches?
Evidence shows that early intervention results in dramatically positive outcomes for young children with autism. While various pre-school models emphasize different program components, all share an emphasis on early, appropriate, and intensive educational interventions for young children. Other common factors may be: some degree of inclusion, mostly behaviorally-based interventions, programs which build on the interests of the child, extensive use of visuals to accompany instruction, highly structured schedule of activities, parent and staff training, transition planning and follow-up. Because of the spectrum nature of autism and the many behavior combinations that can occur, no one approach is effective in alleviating symptoms of autism in all cases. Various types of therapies are available, including (but not limited to) applied behavior analysis, auditory integration training, dietary interventions, discrete trial teaching, medications, music therapy, occupational therapy, PECS, physical therapy, sensory integration, speech/language therapy, TEACCH, and vision therapy.
Studies show that individuals with autism respond well to a highly structured, specialized education program, tailored to their individual needs. A well designed intervention approach may include some elements of communication therapy, social skill development, sensory integration therapy and applied behavior analysis, delivered by trained professionals in a consistent, comprehensive and coordinated manner. The more severe challenges of some children with autism may be best addressed by a structured education and behavior program, which contains a one-on-one teacher to student ratio or small group environment. However, many other children with autism may be successful in a fully inclusive general education environment with appropriate support.
In addition to appropriate educational supports in the area of academics, students with autism should have training in functional living skills at the earliest possible age. Learning to cross a street safely, to make a simple purchase or to ask assistance when needed are critical skills, and may be difficult, even for those with average intelligence levels. Tasks that enhance the person’s independence and give more opportunity for personal choice and freedom in the community are important.
To be effective, any approach should be flexible in nature, rely on positive reinforcement, be re-evaluated on a regular basis and provide a smooth transition from home to school to community environments. A good program will also incorporate training and support systems for parents and caregivers, with generalization of skills to all settings. Rarely can a family, classroom teacher or other caregiver provide effective habilitation for a person with autism unless offered consultation or in-service training by an experienced specialist who is knowledgeable about the disability.
A generation ago, the vast majority of the people with autism were eventually placed in institutions. Professionals were much less educated about autism than they are today; autism specific supports and services were largely non-existent. Today the picture is brighter. With appropriate services, training, and information, most families are able to support their son or daughter at home. Group homes, assisted apartment living arrangements, or residential facilities offer more options for out of home support. Autism-specific programs and services provide the opportunity for individuals to be taught skills, which allow them to reach their fullest potential.
Families of people with autism can experience high levels of stress. As a result of the challenging behaviors of their children, relationships with service providers, attempting to secure appropriate services, resulting financial hardships, or very busy schedules, families often have difficulty participating in typical community activities. This results in isolation and difficulty in developing needed community supports. The Autism Society of America is here for you.
Is There a Cure?
Understanding of autism has grown tremendously since Dr. Leo Kanner first described it in 1943. Some of the earlier searches for cures now seem unrealistic in terms of today’s understanding of brain-based disorders. To cure means to restore to health, soundness, or normality. (Stewart 1999) In the medical sense, there is no cure for the differences in the brain, which result in autism. However, better understanding of the disorder has led to the development of better coping mechanisms and strategies for the various manifestations of the disability. Some of these symptoms may lessen as the child ages; others may disappear altogether. With appropriate intervention, many of the associated behaviors can be positively changed; even to the point in some cases, that the child or adult may appear to the untrained person to no longer have autism. Although there is no cure for autism, there is hope. With proper therapies children with autism can grow into individuals that can benefit society. Autistic can hold jobs and raise families. Huge strides have been made in trying to find a cure. ?There are many parents, doctors, researchers, and educators working hard everyday with the common goal of finding a cause and cure.? (Sandler 1999).
Bibliography
Bibliography
Center for Disease Control and Prevention, Online Internet. 4 June 1999. Available http://www.cdc.gov/od/foia/foi.htm
Basic Information third edition. The New Jersey Center for Outreach and Services for the Autism Community Inc. 1995.
AUTISM: A Lifetime of Service Options. New Jersey Center for Outreach and Services for the Autism Community, Inc. 1998.
AUTISM: Perspectives on the Family. New Jersey Center for Outreach and Services for the Autism Community, Inc. 1998.
?What is Autism.? COSAC 1995.
Gladsberg, Beth ?Research in Genetic Etiology of Autism.? OutReach Fall/Winter 1999: Hyde, Margaret O.
Is This Child Crazy?. Philadelphia: The West Minister Press, 1983 Potio, Paul A.
?Autism Awareness.? Update. Winter 1999: Sandler, Adrian D.
?Lack of Benefit of a Single Does of Synthetic Human Secretin in the Treatment of Autism.? The New England Journal of Medicine (1999): Stewart, Mark A.
Raising a Hyperactive Child. Random House, 1970. Web of Care. Online. Internet. 22 Feb. 2000. Available http://www.webofcare.com
Bibliography
Center for Disease Control and Prevention, Online Internet. 4 June 1999. Available http://www.cdc.gov/od/foia/foi.htm
Basic Information third edition. The New Jersey Center for Outreach and Services for the Autism Community Inc. 1995.
AUTISM: A Lifetime of Service Options. New Jersey Center for Outreach and Services for the Autism Community, Inc. 1998.
AUTISM: Perspectives on the Family. New Jersey Center for Outreach and Services for the Autism Community, Inc. 1998.
?What is Autism.? COSAC 1995.
Gladsberg, Beth ?Research in Genetic Etiology of Autism.? OutReach Fall/Winter 1999: Hyde, Margaret O.
Is This Child Crazy?. Philadelphia: The West Minister Press, 1983 Potio, Paul A.
?Autism Awareness.? Update. Winter 1999: Sandler, Adrian D.
?Lack of Benefit of a Single Does of Synthetic Human Secretin in the Treatment of Autism.? The New England Journal of Medicine (1999): Stewart, Mark A.
Raising a Hyperactive Child. Random House, 1970. Web of Care. Online. Internet. 22 Feb. 2000. Available http://www.webofcare.com
Medicine and Health Care
