Autism in Children
AUTISM IN CHILDREN
Jabeen ObarayI chose this topic because it is one of personal significance. This past summer, I worked with the Developmental Disabilities Health Alliance, in a Developmental Disabilities Center at Robert Wood Johnson, and got to work with many autistic adults, viewing them from a psychological perspective, as I worked with a psychologist in that setting (guess that's the psych major in me). Being a minor in education, this week I will start my field work in a school with autistic children, and plan to attend graduate school next year (knock on wood) to obtain my Masters in special education, specifically in terms of working with children with severe disabilities like Autism and Down's syndrome. Currently I work at the Child Study Institute (in all that free time Bryn Mawr allows for) with children with developmental delays, and one of the children in the class has a form of Autism, known as PDD. So, for me, this topic is not only one I find interesting, but one which is also particularly relevant to my academic pursuits. When you're in the field of education, often times people will ask you "Why are you doing that?" (well, because I couldn't cut it pre-med of course...). And then they find out you're doing Special Ed., and then they really want to know why you want to do it. Well, the closest thing to an answer I can come up with is that there's something in my heart that tells me it's where I belong. So here's a little bit about a disorder which will be prevalent in my life...and maybe get you to see a little bit of the frustration that parents and teachers alike feel in dealing with such an uncertain and uncontrollable disorder.
So what exactly is autism? What are it's causes, pathways, and cures? Well, the thing is, no one really knows for sure. Autism was first described by Leo Kanner in 1943. It is known to affect 1 in 500 Americans, and boys are four times more likely than girls to have autism. (8) Though there are many individuals living with autism whom are adults, much of the research and focus is on children. This is due to the fact that up until recently, very little has been known about individuals with autism, and they were lumped together into the category of mental retardation, or placed in institutions (from 1800-1938, it was referred to as childhood schizophrenia). (11) There is also the fact that in terms of intervention, it is most sensible to focus on children, as they are the most likely to benefit from it.
Autism falls under the category of Pervasive Developmental Disorders, which also includes Asperger's Disorder, PDD not otherwise specified (atypical autism), Rett's Disorder, and Childhood Disintegrative Disorders, all of which differ in their severity and functioning ability. (12) Autism is often described as a Spectrum Disorder, so that symptoms can be present in a numerous amount of combinations, ranging from any way from mild to severe. This makes it difficult to identify a "standard" type of autistic individual. Several terms which are used to describe children within the spectrum are: autistic-like, autistic tendencies, autism spectrum, high-functioning, low functioning, etc. Like any other person, those with autism are individuals, each with their own variation of symptoms and severity. (1) There are also autistic savants, individuals who have extraordinary capabilities (think Dustin Hoffman in Rain Man). (17) This also makes it difficult to know which treatment will be effective for which individual.
The various syndromes of autism have been called: infantile autism, autistic disorder, pervasive developmental disorder and childhood psychosis. The basic criteria for the autistic syndromes are as follows: 1) early onset (before 3-5 years of age), 2) severe abnormality of reciprocal social relatedness, 3) severe abnormality of communication development, 4) restricted, repetitive and stereotyped patterns of behavior, interests, activities, and imagination; and possibly 5) abnormal responses to sensory stimuli. (11) Many areas can be affected by autism, such as:
* 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: Child 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: Child may have sensitivities in the areas of sight, hearing, touch, smell, and taste to a greater or lesser degree;
* Play: There is a lack of spontaneous or imaginative play; does not imitate others' actions; does not initiate pretend games;
* Behaviors: Child may be overactive or very passive; throws tantrums for no apparent reason; perseverates (shows an obsessive interest in a single item, idea, activity or person); apparent lack of common sense; may show aggression to others or self; often has difficulty with changes in routine. (1)
In order to be diagnosed with autism, an individual must have eight of the following sixteen characteristics, all based on observation (as there are no medical tests per se by which to identify autism):
* Marked lack of awareness of the existence of feelings of others * Absence of, or abnormal seeking of comfort at times of distress * Absence of, or impaired imitation * Impairment in making peer relationships * No mode of communication such as communicative babbling, facial expression, gesture, mime or spoken language * Abnormal non-verbal communication with eye to eye gaze, facial expressions or body posture * Absent imaginative activity: play acting, adult roles, fantasy characters, lack of interest in imaginary events * Abnormalities in speech production: volume, pitch, stress, rate, rhythm and intonation * Impairment in ability to initiate or sustain a conversation with others despite adequate speech * Stereotyped body movements: hand flicking, twisting, spinning, head banging, complex whole body movements * Persistent preoccupation with parts of objects * Marked distress with changes in trivial aspects of environment such as a vase being moved from its usual spot * Unreasonable insistence on following routines in precise detail * Markedly restricted range of interests and a preoccupation with one narrow interest * Onset during infancy or childhood (11)
There is no known specific cause for Autism, though there are several theories, the most recent being biological and neurological differences in the brain. There may be a genetic basis to the disorder, as many individuals with autism have family members with other related disabilities, however there is at the time no known gene directly linked to autism. There are associated medical conditions in those with Autism, including fragile-x syndrome, tuberous sclerosis, neurofibromatosis, and hypothyroidism. (15) Previous theories included "bad parenting", specifically on the part of the mothers, known as "refrigerator moms" because of the perception that autism was caused by mothers who were "cold" and "uncaring" for their children, as well as autism due to the MMR vaccination. (1,6) There is also the hypothesis that the toxic environment around us has caused damage to the immune systems and developing brains of children with autistic syndromes. (11) While there is no cure for autism, it has been proven that early intervention is quite effective.
Research on Autism remains continuous, as no one really knows the cause(s), and because there are so many variants of the disorder. One such place of research is the NIMH (National Institutes of Mental Health). They use non-invasive brain imaging techniques, such as MRI and fMRI, to aid in understanding the neurological basis for emotional and intellectual deficits seen in individuals with autism. One drawback of this,however, is that we have little data on normal brain functioning, so how can we possibly compare accurately? (8)
There is also work on setting up a "brain bank" which allows for the examination of brain tissue from individuals with autism ho have passed away. With access to this brain tissue, they can examine abnormal activity of genes with in cells, and from this can identify the underlying neuropathology of autism. (8)
Due to ethical reasons, humans can not be used to conduct certain experiments, although the use of monkeys has proved useful as their brains are similar to those of humans. (8)
Research has also found that individuals with autism are often co-morbid for severe psychopathologies (including OCD,MR,and mood and anxiety disorders). (8) There are also drug treatments used for individuals with autism, including risperidone, and treatment with intravenous gamma globulin (IVGG), a product of human plasma that has been used to treat immunodeficiency since 1952. (11) There is currently controversy over whether or not the use of secretin (a naturally occurring polypeptide hormone secreted by the small intestine as part of the digestive process) is effective. There has also been talk of use of Mthylcobalamin (an active form of vitamin b-12) to facilitate repair of damaged nerve tissue. (11) Several other therapies used have been music therapy, physical therapy, TEACCH, vision therapy, dietary interventions, and behavioral treatments (teaching autistic "appropriate" behaviors). (1)
There are several organizations which provide research, support, access, information on treatment for individuals with autism, as well as their families. Several websites contain various links to other sites which focus on research, support groups, therapies, general information etc. (2,3,4,5,9,10,13,14) Autism can be a stressful situation for any family, as there is no "cure", no "right" treatment, and even no clear cut cause. However, many autistics go on to lead fully functional lives, such as in the case of Dr. Temple Grandin, an autistic with incredible capabilities. (16)
WWW Sources1) The Autism Society of America
17) Autistic Savants
09/30/2005, from a Reader on the Web
I worked with a boy called David who suffered from extreme autism, knowing little about his condition and having little to no guidence or infomation i found rather like i had been thrown in at the deep end. Through pure experience which had to develop over the time which i spent with him i gradually became more aware of struggle autistic children have to cope with. I found David a very loving child, who was gentle and loved recieving "cuddle" as he called them< (one of the few words he could speak) I only wish that i had researched more infomation while i was caring for him, that way i could have understood his condition and behaviour more. As a result of the rewarding experience with David, i am now consideing working with another special needs school while i am free from college.
Hi, I am the mother of a 9 y/o boy ( Noah) who was diagnosed with autism 1 week after his second birthday. He is now in regular ed 3rd grade 60% of his day. He receieves special ed resource, 60 minutes of speech therapy a week and has just transfered to consult for occupational therapy. He is doing amazingly well with academics, however, he does still have a significant social delay( around 5-6 y/o developmentally)as well as quite a few perseverative behaviors. He also has a sensitivity to loud or high pitched noises. Most importantly though he is a very happy and loving boy who is my sunshine everyday. He loves to please others ,is easliy redirected and is a favorite amongst the staff at school. He is a cubscout and enjoys reading. I wanted to share with you about my son so you understand why your paper and your obvious passion for the subject touched my heart. I am so glad that there are people out there like you continuing their education in these types of disorders. Great job and Good luck. Amy Bors
I am actually working with a child who is PDD giving him individual assistance in school environment.He is very sweet but challenging, due to the change in his routines by his teacher and school rules. I will love some tips from you on how to prevent his trantrums and or help him to overcome them, so far I am doing my best but he is going to the quiete room more often.Winter is really an issue, following the school rules and the diverse of teachers that dayli talk to him in a different way and expectations I am actually sad today thinking that I am not helping him enough but really it`s not really up to me alone we are a team and we know what he needs and when so what are we doing wrong or what can we do right please help, I am willing to folow directions, this is my 9 year working with Autism(PDD) thanks again Maria Hutchings
The most important thing for parents to know is early intervention.The earliest signs of odd behavior should be keep noted with your pediatrician.Keep a file on your childs developement.Read as much about child developement as possible.The more a parent knows about what to expect from thier children at certain ages.The easier to detect an issue.Write everything done it will help in diagnosis.Get a second opinion.Parents also need support from family.Most of all both parents need to be on the same page when handling a child with disabilities.Each child is unique.God love them all ... Melissa Baker, 27 June 2006
I am currently working with a 5 year old that has been diagonised with autism. He attached himself to me last year when in 4 year old program at our school. Now I am working as his aide. It is really hard at times to know where to turn or how to handle the agression and the lack of social skills, but we are trying to work through things one step at a time. This article has helped me to realize some of the other problems that I may well be facing. Thanks for the information ... Christine Stephens, 14 September 2006
I have a three year boy, who was recently labelled as autistic, by his doctor to get the funding in place to help him. and help us to deal with it. He has some of the tendencies of autism. We are looking for any answers to some questions we may have, or if there are some parents out there of autistic that may have some answers ... Amber Sutherland, 31 January 2007
This is not a comment, I just wanted to find out information about school settings for autistic children. What is the law in regards to placing autistic children (severe) with regular children in a pre-k class? I do not know about such legislation. What action can I take? Please let me know. Thank you very much ... Jacqueline Elias, 21 June 2007