Autism is a psychological and/or mental disorder that has been under study for several years now. Scientists, pharmaceutical companies, and physicians are working hand in hand to find out more about this disorder and discover possible treatments that will help the recognized autistic people and their families.
To diagnose whether a person is autistic or not, a series of tests and observations need to be done. Physicians normally use a questionnaire or other screening instrument to gather information about a child’s development and behavior. The questionnaire should be answered by the parents or guardians who are most often with the suspected child. Some screening instruments rely solely on parent observations; others rely on a combination of parent and doctor observations. If screening instruments indicate the possibility of autism, doctors will ask for a more comprehensive evaluation (Autism Fact Sheet, 2008).
As of today, statistics related to autism are not yet verified. However, a report from the U.S. Centers for Disease Control and Prevention (CDC) has suggested that autism and other related disorders are very common disorders nowadays (contrary to what others have hoped for) and that there is an increasing rate of the illness or an increased ability to diagnose the illness. More so, it has been revealed that autism has been affecting the boys (3 to 4 times) more than the girls. Sociological factors like family income, education, and even lifestyle do not, in any way, affect the risk of autism (Muhle and Trentacoste, 2004).
History of Autism
It was in 1911 when autism first came into view. Eugen Bleuler, a known Swiss Psychiatrist, coined the term autism, however, the term is first applied to adult schizophrenia. Several decades after, in 1943, a physician, named Leo Kanner, from Johns Hopkins University was able to give a full description of autism or people with autistic behaviors. His discovery and research were based on “11 children that he observed between 1938 and 1943. What he studied were children who had withdrawal from human contact as early as age 1”. The initial discovery of Dr. Kanner led to more verification and research in the succeeding years (History of Autism, 2005).
It is worth noting that during the 1940s through the ’60s the medical community felt that children who had autism were schizophrenic. This lack of understanding of the disorder leads many parents to believe that they were at fault. It was only during the ’60s when people began to fully grasp and understand autism and more precisely identify autism symptoms and treatments (History of Autism, 2005).
Classification of Autism
There are three types of autism as described by psychology-related studies. These include classical autism, high functioning autism, and Asperger syndrome (Debbaudt, 2004).
People who are to be suffering from classical autism are those with evident physical disabilities and communication or speech difficulty. They are those who are diagnosed to be highly sensitive to sound light and another sensory stimulus. They sometimes adopt odd or peculiar behavior which is heightened when they are subjected to stress. Other observable attributes of people who are believed to be classically autistic are (Debbaudt, 2004):
- Repetitious body movements like hand flapping, hitting or hurting him/herself, headbanging, rocking, etc.
- Tendency to wander alone even in a new surrounding
- Wanting to be naked or unsuitably clothed because textures may sometimes be uncomfortable for them
- Having nuisance behaviors especially when in various public places such as shops, grocery stores, parks, churches, etc. they may sometimes rearrange objects, turn the lights on and off, open and close the doors, play with water, climb onto dangerous and high places, push others, stare at objects or lights, peer into windows, appear nervous and agitated.
Classically autistic people are also prone to become violent, particularly if reacting to extremely stressful situations. Institutionalized people may become unmanageable in a situation of extreme stress, particularly when there is an absence of suitably trained staff. Because of such bizarre behaviors many classically autistic people have been subjected to police searches or inquiries. It is so unfortunate that they are often become the suspects for drug abuse or mental illness as they may seem crazy, or potentially violent (Debbaudt, 2004).
The second classification of autism (the high functioning autistic) is said to be more prominent in older people. As high functioning autistics, they will soon develop some communication and social skills as they grow older. These abilities will now help them cope with the world even without the assistance of their parents (who are already may be too old to assist them at this stage). With communication and social skills, high functioning autistics can now hold jobs and live on their own. However, it may be observable that they still have the same symptoms that a person with classic autism suffers from. As a situation becomes more stressful, a person with high functioning autism may have increased difficulty in expressing themselves and making sense of the situation (Debbaudt, 2004).
Other characteristics that high functioning autistics seem to have include:
- Inability to maintain eye contact
- Preference to being alone
- Having difficulty in expressing needs because of their inability to understand gestures or another form of non-verbal communications
- Insistence on sameness
- Inappropriate answer to sound or other sensory input
- No real fear of dangers
- Being insensitivity to pain
- Unbalanced physical skills
- Unsuitable laughing or giggling
- Inappropriate attachment to objects or items
- The continued fascination with water, lights, and reflection
The last type of autism is now known as Asperger syndrome. It was found out that people with Asperger syndrome possess a large vocabulary and little language disability in producing speech. However, a person what is common from the other types of autism is that people with Asperger syndrome still have difficulty understanding social cues, non-literal figures of speech, gestures, facial expressions, and subtle sarcasm. They are often susceptible to bullying and manipulation by peers and can be eager to please when given attention (Debbaudt, 2004).
A young person with autism or Asperger Syndrome may get into trouble without even realizing they have committed an offense. Offenses such as making threatening statements; personal, telephone, or internet stalking; inappropriate sexual advances; accomplice crimes with false friends; and making physical outbursts at school, would certainly strike most of society as offenses that demand some sort of punishment.
This assumption, though valid at face value, does not take into account the particular issues that challenge the individual with autism or Asperger syndrome (Debbaudt, 2004). Problems with sensory overload, poor social awareness, semantic misunderstandings, inability to deal with changes in routine or structure, and little to no understanding of non-verbal communications make more appropriate responses to society very difficult for someone with autism or Asperger syndrome. For example, what appears as anti-social behavior to the ‘regular’ world, is often simply the manifestation of the ASD person’s social misunderstandings. While most would see too many phone calls in the middle of the night as aberrant phone stalking, the person with autism or Asperger syndrome might well view the situation as one friend wanting to talk to another, no matter the time or frequency of calls. And a physical outburst at school might well be related to the person’s sensory dysfunction or inability to deal with interruptions in the daily routine. So, while the individual with autism or Asperger syndrome might have committed the offense in question, the intent might well have been anything other than to do harm (Debbaudt, 2004).
Based on several combined types of research, autism or coined as Autism Spectrum Disorder) is a neurological disorder that is permanent or for the whole lifetime although the symptoms become very prominent during the age of 3-5. it is said to affect one’s ability to learn, communicate and socialize. They also have problems with the most basic sensory organs like the sense of hearing, sight, smell, touch, and taste. Because of this, they have the tendency to have other interconnected problems including social problems, language disorders, eating & stomach disorders, and seizures. People who are autistic do not even look like they have any abnormality or disorder although, with deeper observation, they will seem “out-of-sync” with the world (Debbaudt, 2004).
The very first question that comes to the minds of the parents when they have an autistic member of the family or when they fear having one is the cause that results in autism. After numerous deliberations and through researches, it was revealed that autism is very much linked to that abnormality in the biological and chemical makeup of the brain, but it is still undiscovered what the possible causes of such abnormalities could be (Muhle and Trentacoste, 2004)
What is definite is the fact genetic make-up is a very important aspect of autism. In fact, based on studies, “identical twins are much more likely than fraternal twins or siblings to both have autism”. In the same manner, the relatives of autistic children are also more prone to having language abnormalities and vice versa (Muhle and Trentacoste, 2004). Muhle and Trentacoste (2004) further disclosed that ‘chromosomal abnormalities and other neurological problems are also more common in families with autism.’
There are more and other relative causes to autism but these are yet to be proven. Some researchers believe that changes in the digestive tract can cause autism. Some reveal that diet is a big factor that contributes to this kind of neurological disorder. Still, others believe that there is some chemical that may be involved in autistic tendencies such as mercury poisoning, vaccine sensitivity of the child or of the mother or even the body’s inefficient use of vitamins and minerals (Muhle and Trentacoste, 2004).
Emotional Characteristics of autistic children
It is common knowledge that autistic children require special attention for their special needs. Needless to say, this special attention must not only come from the autistic person’s house but also to another environment like the schools where the autistic child frequents.
The policymakers of any state have been trying to provide all the best possible assistance to people with special attention and need requirements. Specialized types of the educational institution with trained teachers are stationed in most cities so as to accommodate children and adults with recognized special needs. In the same manner, teachers are trained for and provided with the materials to facilitate the specialized instructional materials and classroom management skills in order to facilitate the needed instructional methods. Needless to say, special time, attention, and intensive interaction are given to both children and adults with special needs when it comes to learning.
In schools, students who have been diagnosed as autistic have not undergone any series of tests to really evaluate the psychological impacts brought by such a disorder. People behind the diagnosis – such as the physicians, parents, and even the teachers – are all very concerned that having such special needs provides negative effects to the psychological state of the individual himself (Durrant, Cunningham, and Voelker, 1990).
Based on thorough research, self-esteem is the first thing that is affected once a person is diagnosed and announced as autistics. King and Daniel (1996) revealed that low self-esteem is connected with emotional, behavioral, and academic performance in school-aged children. A similar study conducted by Durrant, Cunningham, and Voelker (1990) has proven that an increased risk of low self-esteem is found in students with evident special learning needs.
Inside the family circle, when a child is diagnosed as autistic, the family members have the tendency to treat the child differently. He would either be treated very special in a way that he will be receiving all the special attention from the parents or he will be treated the exact opposite wherein he will be regarded as the “black sheep” or the “unwanted” child. But whatever the treatment is (positive or negative) the result is the same, the child will eventually show great signs of lowered self-esteem (Gresham & MacMillan, 1997).
In school, the child faces the same problem. The special treatment he will be receiving from his peers and teachers will significantly reduce his self-confidence. As a result, social interactions both inside and outside the classroom is also negatively perceived (Saborie, 1994).
When the child’s self-confidence has been reduced the impact will be evident until he grows as an adult man. Needless to say, the performance of the child in school, inside the home, and even when interacting with other kids in the community will not be really successful for he will always be bombarded by negative thoughts to and from the people around him. In the same manner, adults who have been labeled with autism disorder will also perform negatively even when at work or when inside their own house.
Range of Autistic Emotional Development
Children since birth live with their parents. Their immediate environment is with their parents in a place they call home. Children, even those with autism disorders, have gained confidence, trust, and love for their parents and treat their family and home as their comfort zone. The biological and physiological needs of the children, as well as, their proximity with their parents allow the latter to share many experiences that influence and shape the development of the children. Because of this, parents are considered as the prime carers and educators of their children as well as the major providers of special, love, care, and attention that is normally given to autistic people (Braun, 1992).
Professionals in early childhood work, on the other hand, have gained formal education and training about children and their development. They have been exposed to caring for children of varying ages, different behaviors, and schemes or learning patterns, and different orientations, beliefs, cultures, and social statuses.
Parents’ in-depth and intimate relationship and detailed knowledge of the experiences of their children and professionals’ formal and technical know-how of child care and development should converge and be utilized at the optimum level in terms of children’s learning. Working with parents has proven to be effective especially in ensuring that the child is given maximum opportunity to develop his/her schemas at home and in school, whether learning is structured or unstructured and the setting is formal or informal.
There are several ways to work with parents during early childhood care and education. Dorit Braun in Contemporary Issues in Early Years discussed that parents’ rooms can be set up where parents can meet and chat with each other, parents can serve as helpers on trips, and parenting groups to support parents can be established. Furthermore, Margy Whalley (2001) discussed how the Pen Green Centre encourages participation among the parents. The Pen Green Centre for below 5s in Corby, a multidisciplinary service financed by Northamptonshire County Council, employs different engagement models in working with parents in their children’s learning. Parents can join a research group where parents meet and discuss with the nursery workers their children’s development. During meetings, parents can take a look at their children’s work which the nursery worker or staff can photograph or videotaped. Parents can then discuss the works of their children and even air sentiments and concerns about their children.
This is also a good opportunity for parents to seek advice from other parents regarding the behavior of their children. Parents who have encountered similar problems previously might suggest ways on how to resolve the concern or might provide a sensible explanation to the issue. Moreover, parents can keep diaries of their children’s behavior and activities at home. Home video materials showing their children in action are also proven effective especially in discussing their children’s development. These video materials can be shown during family sessions where parents can see them. Parents are particularly proud of their children’s progress and would be happy to show it to other parents as well. Home/nursery books including photos of children in the nursery is also another way of relating with parents. Nursery workers can add captions to explain what the picture is all about. Parents may then be asked to observe and validate if the same behaviors are displayed by the children at home. Parents can write their feedbacks on the nursery book or on a separate sheet of evaluation paper which will then be given to the staff. Nursery workers can use these sets of information in matching the behavior shown by the children while they are in school.
Here is the story of Angela and how she was involved in her child’s development. Angela, 35, took her daughter Bianca, 3 years old and found to be autistic, in a local nursery near their place. At home, she noticed that Bianca likes to wrap things up. Bianca would wrap a ball with paper. She would wrap the handles of the door, even the feet of their chairs with papers and tapes. She also likes to draw lipsticks around her face and on her dolls’ faces. Angela would become mad at times because Bianca would use her lipsticks and even wrap her things with paper. She has difficulty cleaning the place where Bianca had stuck papers and tapes on them. The nursery staff encouraged Angela to participate in a family session about schemas. From the session, Angela learned that Bianca has an envelopment schema. Bianca’s learning patterns are manifested in her desire to cover herself or the objects around her. Angela found the session on schemas enlightening and it became less stressful for her to understand Angela’s behavior.
To further develop Bianca’s envelopment schema, Angela has designated a recreation spot for Bianca where she placed the papers, tapes, and Bianca’s dolls and toys. She also bought fancy lipsticks for Bianca’s dolls. In the process, Angela has noticed that Bianca has developed a sense of creativity in wrapping things up. Bianca likes to include designs in papers before wrapping them with tapes. She has made parcels of wrapped objects into different sizes and shapes. To encourage Bianca, Angela bought coloring pens, colored papers, and an art book where different shapes and designs are displayed. Angela videotaped Bianca while Bianca was absorbed in coloring her papers and designing them into different shapes and sizes before wrapping things. Bianca’s video was shown in one of the weekly family sessions in the nursery. Parents were amazed at Angela’s work and commented that Angela is exhibiting her own learning style. The staff validated that in the nursery, Bianca would pick up colorful things like plastics and papers and would use them to cover small things in the playground such as balls and stones. Because of this feedback and findings, the nursery made sure that there are provisions available to help improve Bianca’s schema. The staff bought additional colorful papers and tapes for Bianca. They also show different shapes, sizes, and even the color wheel to the children in the nursery.
Liaising with parents is also very important especially if children are introduced to nursery schools. Because children’s immediate environment is their home and they have been accustomed to their parents’ presence every day, it is important that children are prepared to learn outside the home in the care of people other than their parents. The transition should be done smoothly so as not to give traumatic experiences to the children. Nursery workers and staff should communicate with parents about the setup of their children in the nursery, what the activities are, and the number of children that their children will interact with. If parents understood the situation thoroughly, they can better explain the changes to their children and can set proper expectations for them. Autistic children should feel the confidence and support that they feel from their parents with the nursery workers and staff.
Relating with parents can be very rewarding and helpful. However, this task requires a lot of effort and deep understanding on the part of the staff or nursery workers. Parents who do not get involved can be attributed to reasons which are very personal and complex. These include parents who work two to three jobs, parents who have jobs far away from home or from their family, parents who have jobs that require the family to move places or transfer locations from time to time, family pressures like caring for a sick family member, parents with a learning disability, and families in violent houses (Colette Tait, 1992). Nursery workers and staff can still have informal chats with these families if they refuse to be deeply involved.
Other difficulties that can also be encountered in liaising with parents are the reluctance of parents to speak with the teachers or in joining family groups or sessions. Some parents exhibit low self-confidence and refuse to participate in any form of activity to discuss their children’s development. Parents may find it uncomfortable to write diaries and letters or videotaped their children at home or while playing outdoor. These skill issues can further be attributed to the parents’ personal experience in school and the way they see themselves as being capable to carry out the tasks. Nursery staff and workers should be able to establish a level of trust with the parents to encourage them to participate. Training sessions and groups can be formed with a friendly environment approach which can make parents feel that they can share experiences and insights without being judged and criticized. Nursery staff and workers can also explain to parents who have low self-esteem due to skill issues that the content of the output is what is being evaluated and not entirely the way the material was written and structured.
Parents who are just compelled to participate for the sake of participating may harbor ill feelings toward the nursery worker or staff and even to the idea of taking responsibility for the development of their children. This may happen if the nursery or staff did not understand the value of the parents and how much impact they have in the process. Nursery workers or staff may just impose activities because they might think that they know better. This can be avoided if they have open communication with the parents, by understanding the role of the parents, and by establishing partnership and coordination in ensuring that the children learn and develop.
Supporting emotional development autistic children
The importance of relating with parents is clearly seen in the impact of involvement on parents’ lives and the outcomes of involving parents in their child development. Margy Whalley in the book Involving Parents in their Children’s Learning has cited that parents feel valued because their ideas and opinions matter. They are able to establish friendship among each other and can extend support when needed. Parents become more confident because they gain support in parenting and ideas and information about child-rearing. Parents learn to understand why their children act the way that they do and how they can support their children at home.
Parents’ confidence affects the way they care for their children. Their confidence is exuded in the way they explain things to their children and the manners in which they support their learning. In effect, their children also gain confidence because they feel the support of their parents in the activities that they do and they are more knowledgeable of the things which surround them. Parents who are deeply involved in their children’s work are also set as good examples. If their children see that they are keeping diaries of their children’s activities and their children see that it is a good experience for them, their children will be more encouraged in their writing and in engaging with activities that will enhance their literacy.
It is also important for workers to involve parents because they learn more things about the children. Some experiences crucial to the development of the children might have taken place at home or with their parents, experiences that are not familiar with the workers or staff. Parents can explain things to them in an attempt to gain a better understanding of their children’s behavior. Workers can also use the insight provided by parents in planning the curriculum for the children. They can re-evaluate the approaches that they are currently using to see if they target the autistic children’s needs for development.
People with complex needs, such are those who are diagnosed as autistic, are considered special in a way that they have special needs that should be provided through equally special means. Children with learning disabilities are found to have special learning needs. This is the very reason why effectively teaching children with complex needs lies in the hands of the teachers themselves.
Teachers play a very important role in the development of every student, much more if the students have special needs. Because of this, it is indeed a very important attribute for every teacher to know, not only the basics of teaching, not only the knowledge or information they are to provide with their students but also the very process of effective teaching.
There are a number of types of interventions that have been facilitated to children with gifted learning needs. All these interventions are aimed at improving the social and communications skills of children who are diagnosed as autistic.
One of the approaches that were used is the naturalistic method of teaching. This style of teaching uses specialized techniques such as “milieu teaching, incidental teaching, the mand-model procedure, naturalistic time delay, and activity-based intervention” (Bailey & Wolery, 1992). The naturalistic method comprises of two elements: the use of environmental structuring tactics and the use of instructional tactics matching the child’s interest and attention. The first element will require some things that are usually present in the child’s environment. Some examples are allowing the child to make choices, letting him organize his own toys, placing his items out of his own reach, and making him forget some items or events.
The second element – the use of instructional tactics – will require response or feedback to and from the child with special learning ability. An example of this is a teacher trying to get the attention of the child by sharing stories that talk about his favorite toy. Once the child’s attention is glued to the teacher or to the activity of storytelling, then the teacher can provide feedback or encouragement and support to the child to further promote his social interactions with others. However, on this approach, the teachers must see to it that they are careful and not actually forcing the children to interact. Instead, the teachers just need to motivate the children with gifted learning abilities and allow them to choose their own materials, activities, situations, and peers within an activity (Brown and Odom, 1995).
It has been revealed that children with recognized learning disabilities are benefiting if intensive interactions are facilitated with them. In school curriculums, students with complex needs are found to be performing very well on their reading, comprehension, and even writing subjects. On the more advanced level, students’ performances on the subjects of mathematics, sciences, and language subjects also tend to be significantly better if they have intensive interaction with the teachers and with other students (Bailey & Wolery, 1992).
There have been several theories concerning language acquisition (Allington, 2002). The continuum of learning is one specific concept endorsed by most theorists where it involves predictable and sequential stages of language development. This concept talks about the language learner’s progress from knowing nothing of the language to a competent one who soon resembles a native speaker. They identified distinct stages of language development or acquisition, which is especially required for people with recognized autistic behaviors, are the following (Allington, 2002):
- Stage I: The Silent/Receptive or Preproduction Stage: At this stage, students may not be able to speak though they can respond using different strategies like pointing to an object, picture, or person; performing an act that involves gestures and bodily movements; or simply responding “yes” or “no” answers – this is a period called the “silent period.” Teachers at this point should however not force the students to speak until they are ready to do so. Learners can also have obtained up to 500 “receptive” words, which they can understand, but may not be comfortable using, and can understand new words that are made comprehensible to them. This stage can usually last from 10 hours until 6 months (Allington, 2002)
- Stage II: The Early Production Stage: Usually developing close to 1,000 receptive/active words that they can understand and use, this stage can last an additional six months after the initial stage. Students during this stage students can usually speak one- or two-word phrases, and can demonstrate comprehension of new material by giving short answers than a simple yes/no, either/or, or who/what/where questions (Allington, 2002)
- Stage III: The Speech Emergence Stage: Capable of lasting up to another year, students at this stage have usually developed approximately 3,000 words and they can at the same time use short phrases and simple sentences to communicate. They begin to use dialogues and are able to ask simple questions such as “Can I go to the restroom?” They are, furthermore, able to answer simple questions. Though with grammatical errors, students at this stage may produce longer sentences (Allington, 2002).
- Stage IV: The Intermediate Language Proficiency Stage: At this stage, students begin to make complex statements, state opinions, ask for clarification, share their thoughts, and speak at greater length after having developed close to 6,000 words they can understand and use appropriately. Intermediate proficiency may still take up to another year after speech emergence (Allington, 2002).
- Stage V: The Advanced Language Proficiency Stage: Gaining advanced proficiency can typically take from five to seven years.
By this stage, students have developed some specialized content-area vocabulary and can participate fully in grade-level classroom activities if given occasional extra support. Students can speak English using grammar and vocabulary comparable to that of same-age native speakers (Allington, 2002).
Children with an autistic spectrum disorder have been described with both hypoactivity and hyperactivity. The hyperactivity seen in children with autism may be part of a pattern of hyper arousal behaviors, such as hyperactivity, hyper viligance, stereotyped body movements and even self-stimulation. The distractibility and poor attention span of some of these children often compound their already serious educational problems. Methylphenidate, a commonly used drug to improve attention span, has been used in autism, other choices include clonidine and naltrexone.
Clonidine is increasingly being used to treat attention deficit/hyperactivity disorders. There are several studies of clonidine performed in patients with autism; A related study reported that clonidine was effective in reducing hyperactivity, hyperviligance and improving social relationships. However possible side effects; drowsiness and sedation, were noted (Professor Gillberg, 2002)
But through series of studies conducted, it has been revealed that, still, the best remedy to treat autism is therapy although this does not totally eliminate autistic tendencies. Medical therapies can only improve the clinical dysfunctions of autism in particular children. These medical therapies of the autistic syndrome fall into three categories. First, wherever possible, is the ideal therapy of actually treating the basic disease process itself which is causing the symptoms of autism – targeting the specific place in the metabolic pathway, etc. A second approach to medical therapy involves treatment of symptom complexes not specific to, but found within, the autistic syndrome – such as treatment of sleep disorders or hyperactivity. These are the symptomatic treatments. Finally there are the non-specific therapies that attempt to treat the core symptoms of the overall syndrome that we call autism, when it is not further defined. In the non– specific therapies, although the drugs are classified by a particular mode of action, it needs to be noted that the full impact of each drug on the brain usually involves other metabolic pathways and is often far from being well understood (Professor Gillberg, 2002).
Therapy for symptom complexes within patients who fit the criteria of an autistic syndrome; although these behaviors are not unique to autism some of them may be a worrying part of the clinical management of the person with autism.
Love, attention and care as well as education are to be embraced by all. Everybody is entitled to benefit from the result attained through education regardless of the capacity of the person, regardless of how he or she would like to be educated.
People who have been assessed as autistic should not be deprived from the taste of reality. A normal setting of home and education is most helpful on his condition. The condition might be of many limitations, expenses to be incurred, insufficient facilities, need for special attention, and yet a consideration should also be given because those people deserve fair treatment.
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