What is Autism? An Overview
Autism is a complex neurobiological disorder that typically lasts throughout a person’s lifetime. It is part of a group of disorders known as Autism Spectrum Disorders (ASD). Today, 1 in 166 individuals is diagnosed with autism, making it more common than pediatric cancer, diabetes, and AIDS combined. It occurs in all racial, ethnic, and social groups and is four times more likely to strike boys than girls. Autism impairs a person’s ability to communicate and relate to others. It is also associated with rigid routines and repetitive behaviors, such as obsessively arranging objects or following very specific routines. Symptoms can range from very mild to quite severe.
Autism was first identified in 1943 by Dr. Leo Kanner of Johns Hopkins Hospital. At the same time, a German scientist, Dr. Hans Asperger, described a milder form of the disorder that is now known as Asperger Syndrome. These two disorders are listed in the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders) as two of the five developmental disorders that fall under the Autism Spectrum Disorders. The others are Rett Syndrome, PDD-NOS (Pervasive Developmental Disorder), and Childhood Disintegrative Disorder. All of these disorders are characterized by varying degrees of impairment in communication skills and social abilities, and also by repetitive behaviors.
Parents are usually the first to notice unusual behaviors in their child or their child’s failure to reach appropriate developmental milestones. Some parents describe a child that seemed different from birth, while others describe a child who was developing normally and then lost skills. If you have concerns about your child’s development, don’t wait: speak to your pediatrician about getting your child screened for autism.
If your child is diagnosed with autism, early intervention is critical to gain maximum benefit from existing therapies. Research indicates, however, that early intervention in an appropriate educational setting for at least two years during the preschool years can result in significant improvements for many young children with Autism Spectrum Disorders. As soon as autism is diagnosed, early intervention instruction should begin.
Treatments for Autism
There is no single treatment protocol for all children with autism, but most individuals with ASD respond best to highly structured educational programs. Some of the most common interventions are Applied Behavior Analysis (ABA), Floortime Therapy, Speech Therapy, Occupational Therapy, Sensory Integration Therapy, Relationship Development Intervention, Verbal Behavior Intervention, and the school-based TEAACH method.
Applied Behavioral Analysis (ABA).
Behavior analysis is a natural science of behavior that was initially described by B.F. Skinner in the 1930’s. The principles and methods of behavior analysis have been applied effectively in many arenas. For example, methods that use the principle of positive reinforcement to strengthen a behavior by arranging for it to be followed by something of value have been used to develop a broad range of skills in learners with and without disabilities.
Since the early 1960’s, hundreds of behavior analysts have used positive reinforcement and other principles to build communication, play, social, academic, self-care, work, and community living skills and to reduce problem behaviors in learners with autism of all ages. Still others teach skills in the context of ongoing activities. All skills are broken down into small steps or components, and learners are provided many repeated opportunities to learn and practice skills in a variety of settings, with abundant positive reinforcement.
Regardless of the age of the student with autism, the goal of ABA intervention is to enable him or her to function as independently and successfully as possible in a variety of environments.
Developed by child psychiatrist Stanley Greenspan, Floortime is a treatment method and philosophy for interacting with autistic children. It is based on the premise that the child can increase and build a larger circle of interaction with an adult who meets the child at his current developmental level and who builds on the child’s particular strengths.
The goal in Floortime is to move the child through the six basic developmental milestones that must be mastered for emotional and intellectual growth. Greenspan describes the six rungs on the developmental ladder as: self regulation and interest in the world; intimacy or a special love for the world of human relations; two-way communication; complex communication; emotional ideas; and emotional thinking. The autistic child is challenged in moving naturally through these milestones as a result of sensory over- or under-reactions, processing difficulties, and/or poor control of physical responses.
In Floortime, the parent engages the child at a level the child currently enjoys, enters the child’s activities, and follows the child’s lead. The intervention is called Floortime because the parent gets down on the floor with the child to engage him at his level.
Occupational Therapy can benefit a person with autism by attempting to improve the quality of life for the individual. The aim is to maintain, improve, or introduce skills that allow an individual to participate as independently as possible in meaningful life activities. Coping skills, fine motor skills, play skills, self-help skills, and socialization are all targeted areas to be addressed.
Through occupational therapy methods, a person with autism can be aided both at home and within the school setting by teaching activities including dressing, feeding, toilet training, grooming, social skills, fine motor and visual skills that assist in writing and scissor use, gross motor coordination to help the individual ride a bike or walk properly, and visual perceptual skills needed for reading and writing.
Occupational therapy is usually part of a collaborative effort of medical and educational professionals, as well as parents and other family members. Through such collaboration, a person with autism can move towards the appropriate social, play and learning skills needed to function successfully in everyday life.
The communications problems of autistic kids vary to some degree and might depend on the intellectual and social advancement of the person. Some might be totally unable to speak whereas others have well-developed vocabularies and can talk at length on subjects that interest them. Any attempt at treatment must start with a specific evaluation of the kid’s language abilities by a skilled speech and language pathologist.
Some autistic children have little or no problem with the pronunciation of words; many have difficulty actually utilizing language. Even those children who have no articulation problems display difficulties in the practical use of language such as understanding what to say, the best ways to say it, and when to say it as well as how to interact socially with people. Many who speak frequently say things that have no content or info. Others repeat verbatim exactly what they have heard (echolalia) or repeat unimportant scripts they have memorized. Some autistic kids speak in a high-pitched voice or usage robotic sounding speech.
Two pre-skills for language development are joint attention and social initiation. Joint attention involves an eye look and referential gestures such as pointing, demonstrating to and giving. Children with autism lack social introduction such as questioning, make fewer utterance and cannot use language as a way of social initiation. Though no one treatment is found to successfully enhance communication, the very best treatment begins early during the preschool years, is individually customized, and involves parents together with specialists. The objective is to constantly improve useful communication. For some verbal communication is sensible, for others gestured communication or interaction through a sign system such as photo boards can be attempted. Periodic examinations should be made to discover the finest approaches and to reestablish goals for the particular child.
Relationship Development Intervention (RDI).
Based on the work of psychologist Steven Gutstein, (RDI) focuses on improving the long-term quality of life for all people on the spectrum. Dr’s Gutstein program is said to be based on substantial research study in typical development and translates research study findings into a methodical scientific technique.
1) Emotional Referencing: The capability to utilize a psychological feedback system to learn from the subjective experiences of others.
2) Social Coordination: The ability to observe and continually control one’s behavior to get involved in casual relationships involving partnership and exchange of feelings.
3) Declarative Language: Using language and non-verbal communication to express curiosity, invite others to interact, share understandings and feelings and collaborate your actions with others.
4) Flexible thinking: The capability to quickly adjust, alter strategies and change plans based upon changing circumstances.
5) Relational Information Processing: The ability to acquire significance based upon the bigger context. Resolving problems that have no “right-and-wrong” options.
6) Foresight and Hindsight: The ability to review past experiences and prepare for prospective future scenarios in a productive manner.
Dr Gutstein, who together with Dr. Rachelle Sheely, formed the Connections Center For Family and Personal Development based in Houston Texas in 1995, states,” We are tough families and specialists to think beyond achieving simple functionality as a valid result for people with autism; our referral point for success in the RDI program is lifestyle,” The objective is social enhancements as well as changes in flexible thinking, pragmatic interaction, innovative information processing and self- advancement. The program offers training workshops for parents as well as numerous books that offer step-by-step exercises constructing inspiration so that abilities will be made use of and generalized. The program is said to be able to be begun smoothly and implemented into regular, daily activities that enrich domesticity.
Spoken Behavior Intervention.
In the late 1950s and early 60’s when Dr. Ivar Lovaas was developing his ABA principles, Skinner released Verbal Behavior which detailed a practical analysis of language. He described that language might be grouped into a set of systems, with each operant serving a different function.
In a VB program the child is taught to ask for the cookie anyway he can( vocally, sign language, etc.) If the child can echo the word he will be inspired to do so to get the desired object. Critics of Lovaas say children are taught to label many words however often can not utilize them in practical or spontaneous ways. If you say to the child “I’m baking …” and the kid completes the sentence with “Cookies,” that’s an intraverbal fill-in.
Both ABA and VB use similar formats to deal with kids. It is said that VB efforts to capture a kid’s motivation to establish a connection between the value of a word and the word itself. Numerous therapists are now utilizing methods of VB to bridge some of the gaps seen in ABA.
Sensory Integration Therapy.
Sensory Integration is the procedure through which the brain organizes and interprets external stimuli such as motion, touch, smell, sight and noise. Autistic kids often exhibit symptoms of Sensory Integration Dysfunction (SID) making it hard for them to process info brought in through the senses. Children can have mild, moderate or severe SID deficits manifesting in either increased (hypersensitivity )or decreased (hyposensitivity) to touch, sound, movement, and so on. For instance, a hypersensitive child may prevent being affected whereas a hypersensitive kid will seek the stimulation of feeling objects and may enjoy remaining in tight places.
The goal of Sensory Integration Therapy is to facilitate the development of the worried system’s capability to procedure sensory input in a more typical method. When successful, it can improve interest, concentration, listening, understanding, balance, coordination and impulsivity control in some children.
A particular program will be prepared to offer sensory stimulation to the child, frequently in conjunction with purposeful muscle activities, to enhance how the brain processes and organizes sensory information. It is thought that SIT does not teach higher-level abilities, however, enhances the sensory processing capabilities, therefore, permitting the child to acquire them.
TEACCH (Training and Education of Autistic and Related Communication Handicapped Children) is an unique education program that is customized to the autistic kid’s individual needs based upon general standards. It goes back to the 1960’s when medical professionals Eric Schopler, R.J. Reichler and Ms Margaret Lansing were working with children with autism and built a means to get control of the teaching setup so that self-reliance might be promoted in the kids. Exactly what makes the TEACCH approach unique is that the focus is on the design of the physical, social and interacting environment. The environment is structured to accommodate the difficulties a kid with autism has while training them to perform in appropriate and proper methods.
Structure on the truth that autistic children are often visual learners, TEACCH brings visual clearness to the knowing process in order to build receptiveness, understanding, organization and independence. The kids work in an extremely structured environment which might consist of physical company of furnishings, clearly defined activity locations, picture-based schedules and work systems, and educational clarity. The kid is guided through a clear series of activities and hence aided to end up being more arranged.
It is thought that structure for autistic children supplies a strong base and framework for knowing. TEACCH does not particularly focus on social and interaction skills as totally as other treatments it can be used along with such therapies to make them more reliable.