April for Autism Awareness
Once there lived a couple in my family who had been married for about 15 years. They were living a happy life of luxury and comfort, but there was something that made their life incomplete. It was the absence of a child in their life. After waiting for long they decided to adopt a child. All legal processes were finished and a little baby boy entered the family.
Days passed and the child was getting all that an infant needs to grow and nourish. When the baby was about 2 ½ years old the mother realized that he was not growing the way a child should develop in terms of milestones, language and cognitive functions. Further investigations revealed that the child was suffering with a neurodevelopmental disability which is defined as “disabilities associated primarily with the functioning of the neurological system and brain” (America’s Children and the Environment, 2015). On further investigation, it was clear that the child was suffering from Autism.
According to Nordqvist (2015), autism is ‘a complex developmental disability’. Autism presents itself during the first three years of a person’s life. The condition is the result of a neurological disorder that has an effect on normal brain function, affecting development of the person’s communication and social interaction skills”. Researchers state that the frequency of some neurodevelopmental disorders, most commonly autism and Attention Deficit Hyperactivity Disorder has increased over the last four decades (American’s Children and the Environment, 2015).
It is predicted that globally 1 in 160 children has autism (WHO, 2016), and the Center for Disease Control predicts an increase in autism burden up to 4 folds in upcoming years. In Pakistan, 350,000 children are suffering with this disorder (Fazli Azeem, Quresh, & Haider, 2016). Taking this prevalence into account, I decided to choose this topic for my paper. People with this disorder are usually subjected to stigma, discrimination and basic right exploitation (World Health Organization, 2016) therefore, it is very important to highlight it and make clear understandings about this disorder.
I have observed an autistic child in my family and every time I ask myself the reasoning behind this disorder. Digging into the literature, I identified that both genetic and environmental factors are responsible for it (Fatemi et al., 2012). According to a study done to identify link between genetic factors and autism, children with autism have abnormal gene pathways and expression which leads to improper functioning of the brain.
Likewise, it is a disease that initiates in the prenatal period and not after a child is born, but the symptoms start at toddler age (Rosas, 2016). Some prenatal conditions that include intrauterine infections, gestational diabetes and bleeding are associated for causing autism. Maternal medications especially, valporate, increases the risk of autism to 8 times (Chaste & Leboyer, 2012).
Besides these separate associations of genetics and environment with autism, gene and environment together may cause autism. To support this interaction, a study showed that 5-HTTLPR S/S genotype interacted with maternal smoking during pregnancy and became a cause for autism (Chaste & Leboyer, 2012). Furthermore, a biological finding shows that increased serotonin level in the brain can be taken as a cause for this disorder (Mostafa & AL-Ayadhi, 2011). Also, an abnormal cerebellar structure is identified in autistic children (Fatemi et al., 2012).
Continuing with the example of an autistic child mentioned above, autism greatly impacted the life of that child. According to DSM-V, the major areas that are affected in all those with autism include social communication, social interaction and repetitive patterns of behavior. However the disorder can be classified as mild, moderate or severe depending upon the level of these general impairments in communication, interaction and behaviors.
Jo Rudy (2016) describes the levels of autism. She says that in the case of mild impairment, a child can communicate verbally, appropriately with his age, although some part of speech could be distinctive. He needs support to learn effectively. These children involve themselves in different plays but cannot keep up with a same play for long hence, their play changes frequently.
In terms of sensory perceptions they show extreme responses to a stimulus. When dealing with a child having moderate level of disease, one can identify that the verbal communication is limited to words only. Some children copy others speech as they are unable to form their own sentences. These children may have intellectual disabilities making them difficult to learn.
More often, they are involved in some odd behaviors such as making noise, flapping or jumping repeatedly. They are extremely anxious and have minimal diet. Lastly,a child with severe impairment is very difficult to manage.Such a child has little or no verbal language, intellectual level is far below normal IQ level and have aggressive or self abusing behaviors.
It is impossible to involve such a child in activities and these types of children are often left isolated (Jo Rudy, 2016). There are many other features that an autistic child exhibits. It is very difficult for them to identify and understand others emotional expressions (Gaigg, 2012). Kanner (1943) in his first classic work on autism described it as an ‘‘innate inability to form the usual, biologically provided affective contact with people’’ (Erickson et al., 2011).
Simon Baron-Cohen (1995) in his book stated that ‘‘children with autism suffer from mind blindness. Already hampered by the inability to achieve joint attention with others, they become unable to build on that fundamental step to intuit what others are thinking, perceiving, intending, or believing. They become “blind” to others’ mental states’’ (Costandi, 2011).
Those who suffer with autism do not fulfill with the theory of mind, which is explained in a way that a human can infer others thinking and mental states. He can reflect on oneself and others’ content of mind, but those who are autistic lack this capability and are considered as ‘mind blind’ (Baron-Cohen, 2011). In order to lighten up the positive aspect of an autistic child, Uta Frith (1989) proposed central coherence theory. “Central coherence was the term given to a human being’s ability to derive overall meaning from a mass of details”. She explained strong central coherence as the ability to identify a big picture from a mass.
Contrary to this, if a child cannot identify a big picture from a mass it is termed as week central coherence. Those with autism lack the ability of strong central coherence but, when asked to identify fine details they can show their best. Frith refers to this ability as “a detail-focused cognitive style”. This ability of extreme focusing makes these children remarkable in areas such as music, memory and calculations (Booth & Happé, 2010).
After knowing all these impacts, I can reflect on the case of the child I encountered. This child had a mild form of autism; he was able to speak words but not complete sentences. The boy was very sensitive to loud voice and bright light. When exposed to these, he starts showing temper tantrums.
Along with this, it was his usual habit to smell food and then choose what to eat. He created a trouble when his hair or nails were trimmed. He would get very aggressive when someone could not understand what he demanded. Keeping all these negative impacts aside he had amazing strengths in memorizing and spatial tasks.
He could very well recognize a person whom he had met even once in his life. Autism is a disease that cannot be reversed. An autistic child can never reach at the intellectual level as that of a normal child, yet, focused teaching and training can bring up such children to a level of maximum learning and independence. A family plays an important role in achieving this progress. Accepting the fact that the child is autistic is the first step.
With this truth in mind, positive thinking should be the driving force. Children with autism cannot express and identify their self interest, so it is a challenge for their families to explore their interests. This can be done by spending ample time with these children. According to a study, the condition of an autistic child can worsen if he is left unattended without family support and care (Zuckerman, Lindly, Bethell, & Kuhlthau, 2014).
Once the interests are identified, exposing them to their interests helps in keeping them engaged with their favorite tasks for long. Giving challenges to an autistic child also open windows for their cognitive functioning. Psychotherapy also plays a vital role. There are many therapies that can be used for rehabilitation of a child with autism.
Basic therapies comprises of cognitive behavioral therapy, speech therapy and occupational therapy. According to a researcher “CBT addresses social skills in children with autism” (Anderson, 2012). It also helps in treating anxieties in children with autistic disorder (Scottish Intercollegiate Guidelines Network, 2016). Speech therapy is found beneficial in regards to enhance speech, vocabulary, verbal communication, non verbal communication and sentences formation (Batool & Ijaz, 2015).
Occupational therapy focuses on improving daily living skills of an autistic child, for example making a child learn how to eat, how to dress up, how to take care of themselves etc (American Occupational Therapy Association,2010). Other therapies may work for autism that involves Vision therapy, aqua therapy and dietary counseling (Peacock, 2012). After family and psychotherapies, comes the role of government in educating and creating awareness about the disorder. Parenting programs should be initiated on national and international level aiming to train parents on how to deal with these children.
This can be done through sessions and workshops that should not only target parents but also teachers who are devoting their services in dealing with these children, and the general public as well so that autistic children could not be stigmatized and isolated from the society instead they would get support and an enrich environment from all directions in their surroundings for their favourable development. Platforms such as schools and different organizations should be established aiming to fulfill the educational needs of these children. The purpose of providing education should be done in a way that they could live and learn without difficulties. They should be provided with an area where they could not suffer with any difficulty of being adjusted with those who are at a superior level of intellectual abilities.
In conclusion, on the basis of my experience with an autistic child I would say that these children demand time, care and attention. It is important to understand such child and their behaviors. Rewarding and appreciating them works best in their case. These children are very strict in following their routines so it is highly recommended not to change them as a slight change in their routine can shift their mood on a bad side.
Anderson, C. (2012). Cognitive Behavioral Therapy and Autism Spectrum Disorders | Interactive Autism Network. Iancommunity.org. Retrieved 9 October 2016, from https://iancommunity.org/cs/simons_simplex_community/cognitive_behavioral_therapy Autism spectrum disorders. (2016). World Health Organization. Retrieved 10 October 2016, from http://www.who.int/mediacentre/factsheets/autism-spectrum-disorders/en/
Baron-Cohen, S. (2011). Theory of mind in normal development and autism.
Prisme, 34. Retrieved from http://www.autism-community.com/wp-content/uploads/2010/11/TOM-in-TD-and-ASD.pdf
Batool, I. & Ijaz, A. (2015). Effectiveness of Speech and Language therapy for Autism Spectrum Disorder.JPPS, 12(1). Retrieved from http://www.jpps.com.pk/article/effectivenessofspeechandlanguagetherapyforautismspectrumdisorder_2455.html
Booth, R. & Happé, F. (2010). “Hunting with a knife and … fork”: Examining central coherence in autism, attention deficit/hyperactivity disorder, and typical development with a linguistic task. Journal Of Experimental Child Psychology, 107(4), 377-393. http://dx.doi.org/10.1016/j.jecp.2010.06.003
Chaste, P. & Leboyer, M. (2012). Autism risk factors: genes, environment, and gene- environment interactions.
Dialogues In Clinical Neuroscience, 14(03). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3513682/pdf/DialoguesClinNeurosci-14-281.pdf
Cognitive Theories Explaining ASD | Interactive Autism Network. (2016). Iancommunity.org. Retrieved 9 October 2016, from https://iancommunity.org/cs/understanding_research/cognitive_theories_explaining_asds COSTANDI, M. (2011).
Simon Baron-Cohen: Theorizing on the mind in autism. Spectrum. Retrieved from https://spectrumnews.org/news/profiles/simon-baron-cohen-theorizing-on-the-mind-in-autism/ DSM-5 Diagnostic Criteria. (2016). Autism Speaks. Retrieved 9 October 2016, from https://www.autismspeaks.org/what-autism/diagnosis/dsm-5-diagnostic-criteria
Erickson, C., Early, M., Stigler, K., Wink, L., Mullett, J., & McDougle, C. (2011). An Open-Label Naturalistic Pilot Study of Acamprosate in Youth with Autistic Disorder. Journal Of Child And Adolescent Psychopharmacology, 21(6), 565-569. http://dx.doi.org/10.1089/cap.2011.0034
Fatemi, S., Aldinger, K., Ashwood, P., Bauman, M., Blaha, C., & Blatt, G. et al. (2012). Consensus Paper: Pathological Role of the Cerebellum in Autism. The Cerebellum, 11(3), 777-807. http://dx.doi.org/10.1007/s12311-012-0355-9
FAZLI AZEEM, Q., QURESH, D., & HAIDER, I. (2016). The autism puzzle. DAWN. Retrieved from http://www.dawn.com/news/1173610 Gaigg, S. (2012). The Interplay between Emotion and Cognition in Autism Spectrum Disorder: Implications for Developmental Theory. Frontiers In Integrative Neuroscience, 6. http://dx.doi.org/10.3389/fnint.2012.00113
Jo Rudy, L. (2016). Where Does Your Child Fall on the Autism Spectrum?. Very Well. Retrieved from https://www.verywell.com/when-autism-is-mild-or-severe-3971485
Mostafa, G. & AL-Ayadhi, L. (2011). A lack of association between hyperserotonemia and the increased frequency of serum anti-myelin basic protein auto-antibodies in autistic children. Journal Of Neuroinflammation, 8(1), 71. http://dx.doi.org/10.1186/1742-2094-8-71
Nordqvist, C. (2015). What Is Autism. medical news today. Retrieved from http://www.medicalnewstoday.com/info/autism
Peacock, E. (2012). Top 8 Autism Therapies – Reported by Parents. Autism speaks. Retrieved from https://www.autismspeaks.org/blog/2012/09/25/top-8-autism-therapies-%E2%80%93-reported-parents
Rosas, A. (2016). The Possible Causes of Autism. Sabiduría: The Dr. Floyd F. Koch Honors College Peer-Reviewed Journal., 6-9. Retrieved from http://www.palmbeachstate.edu/honors/Documents/SabiduriaSpring2016Issue.pdf#page=6
Zuckerman, K., Lindly, O., Bethell, C., & Kuhlthau, K. (2014). Family Impacts Among Children With Autism Spectrum Disorder: The Role of Health Care Quality. Academic Pediatrics, 14(4), 398-407. http://dx.doi.org/10.1016/j.acap.2014.03.011
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