Autism
History & Prevalence
Autistic Disorder, otherwise known as Autism, is one of three developmental
disabilities making up the Autism Spectrum Disorder (ASD). Autistic Disorder is
the most commonly known type of ASD, the others are Asperger Syndrome and
Pervasive Development Disorder- Not Otherwise Specified (NDD-NOS) (Autism
Spectrum Disorder Fact Sheet, CDC, 2012). In an interview with
Dianne Hardisty, Temple Grandin, one of the most famous autistic women, said:
There is a spectrum. At one end are severely disabled
children, who have contributing medical problems, such as epilepsy. At the
other end are the quirky, nerdy, brilliant ones who go on to invent the light
bulb or computer systems. The Silicon Valley is filled with these people. There
are uneven skills. You build on them (Hardisty, 2011).
Autism is a complex brain disorder that
affects many areas of child development. Early
intervention in children with Autism Spectrum Disorder is very important. Thirty-eight
percent of children with Autism Spectrum Disorder have an intellectual
disability, an IQ test score less than or equal to 70 or have had a doctor or
psychologist document intellectual disability on his/her record (ADDM, 2012,
p.6).
In the mid 1990s the prevalence rate of Autism
was 1 in 3,000 children. New reports from the Center
for Disease Control report that currently 1 out of every 88 children in the
United States has an Autism Spectrum Disorder (ADDM, 2012, p.1). The prevalence of
this spectrum of disorders makes it the fastest growing developmental
disability in the United States (Sansosti, 2009, p.170). Boys are impacted significantly
more often than girls; according to the “Community Report” from the Autism and
Developmental Disabilities Monitoring (ADDM) Network 2012, funded by the Center
for Disease Control, male children are five times more likely to have Autism
than females (ADDM, 2012, p.6). One in every fifty-four boys is identified as
having an Autism Spectrum Disorder versus the one in every two-hundred and
fifty two girls who are identified (p.6). The number of children identified with Autism
Spectrum Disorders varies greatly from state to state ranging from 1 in 210 in
Alabama to 1 in 47 children in Utah (Center for Disease Control and Prevention,
2012).
Between 1993 and 2006, the number of
children receiving services for Autism increased 1,342%, according to the U.S
Department of Education (Sansosti, 2009, p.170).
Research
Based Instructional Practices
According to Cosmas U. Nwokeafor (2009), a
professor at Bowie State University, in his paper “Conundrum of Autism: A
Review of Its Causes and Significant Impact on the Education of a School Age
Child”, children with Autism lack a few basic skills that are necessary for
learning (Nwokeafor, 2009, p.9). Nwokeafor states that children with Autism
lack imitation skills and joint attention skills, both of which are essential
to the learning process (p.9). For this reason, educating children with Autism
poses challenges to schools, educators and parents. Some children with Autism
have above average intelligence while others have below average intelligence,
therefore not all instructional practices work for all autistic children.
There is currently no cure for Autism,
however, research has shown that early diagnosis along with intensive early
intervention can significantly improve the social and academic skills of
children with Autism (Nwokeafor, 2009, p. 2). In addition, stimulating children
with Autism may cause new neural connections to form. There are many different
types of early intervention, this is because every child with Autism is
different and responds differently to each type of intervention. Unfortunately,
not all children respond to early intervention.
Intensive Speech therapy is a very common
early intervention strategy because there is a very small window of opportunity
for a child to learn language; many autistic children are nonverbal and others
can develop language early on and then lose it. Some other forms of intervention
are: social skills training, a form of group therapy with other children;
cognitive behavioral therapy, a form of therapy that helps children to manage
their emotions; medications for other conditions such as anxiety and
depression; occupational and physical therapy to help children with poor motor
coordination; and parent training and support which teaches parents behavioral
techniques that can be implemented at home.
For many adults with Autism, their lives would be completely different had
their parents not found them early intervention services. Some may never have
learned to use language at all. Others may have never made lasting
relationships with others, due to their poor social skills and behavioral
problems. For example, former pro-football quarterback Dan Marino has an
autistic son; the family found early intervention services that worked for him
and he went from being completely non-verbal to being mainstreamed in many of
his classes in school. When he speaks, you would never know that he was ever
diagnosed with Autism as a child.
Another intervention, Social Stories, is often used to teach social behavior to children with Autism
Spectrum Disorders. Social Stories are personalized short stories to help
children with Autism interpret and understand challenging or confusing social
situations (Sansosti, 2009, p.171). The objective of Social Stories is to
demonstrate social situations in which a child with Autism may have a hard time
recognizing relevant social cues or expected behaviors and to comprehend the
consequences of various actions (p.171). This intervention helps autistic
children to understand socially appropriate ways to deal with common situations
that they are likely to find themselves in at some point in the future.
IDEA
To be diagnosed with Autism, a child must
have documented features in three areas: impairments in social interaction,
stereotypical behavior and onset before age three (Vaughn et al, 2007, p.145).
The child must have six or more of the following: impairments in social
interactions such as poor eye contact, lack of responsiveness, or inability to
form relationships, echolalia or repeating exactly what has been heard, robotic
speech, use of gibberish or made up words. The child must also exhibit
stereotypical behavior such as body rocking, hand flapping, finger movements,
or fascination with objects or their parts. These characteristics must have
begun before age three. The child must
not meet the criteria for Rett syndrome or child disintegrative disorder
(p.145).
The Individuals with Disabilities
Education Act (1997) defines Autism as:
A
developmental disability significantly affecting verbal and nonverbal
communication and social interaction, generally evident before age 3, that
adversely affects a child’s performance. Other characteristics often associated
with Autism are engagement in repetitive activities and stereotyped movements,
resistance to environmental change or change in daily routines, and unusual
responses to sensory experiences. The term does not apply if a child’s
educational performance is adversely affected primarily because the child has a
serious emotional disturbance (Vaughn et al, 2007, 146).
Characteristics
of Autism
Autism is a complex disorder. Every child
with Autism is different - the symptoms and severity of one autistic child may
be very different than those of another. They may have mental retardation or
savant characteristics (Vaughn et al., 2007, 145). In the case of mildly affected children, Autism
may go undetected; Autism may also be hard to detect if it is overshadowed by other handicaps (Nwokeafor, 2009, p.4). Some of the
early signs of Autism include rarely making eye contact and being non-verbal,
for example not crying or babbling as a baby, and the majority of autistic
children have a delay in understanding and using language. Typically, children
with Autism are characterized by three distinct behaviors: difficulties with
social interaction, problems with verbal and non-verbal communication and
repetitive behaviors or narrow interests (p.5).
Social characteristics of a child with Autism
include little to no eye contacts, autistic leading, in which the autistic
child takes the hand of an adult or peer and puts it onto, or in the direction
of, something they want, and unawareness of social situations. Many children
with Autism exhibit very little verbal communication, and some don’t communicate
verbally at all. They also use repetitive language, are echolalic, immediately
repeating the words or sounds of another person, or use robotic speech.
Children with Autism have inflexible routines and motor repetitions such as
finger flapping and body rocking.
Possible
Causes of Autism
No one has all the answers when it comes to Autism; this is probably why the
symbol for Autism awareness is a puzzle piece, because we are still trying to
fit the pieces together. Most scientists studying Autism Spectrum Disorders
believe that there is more than on cause of Autism (ADDM, 2012, p.38). Research
shows that: both genetic and non-genetic factors play a role; children who have
a sibling or parent with an ASD or are born to older parents are at a higher
risk; ASDs occur more often among children with certain genetic disorders or
chromosomal conditions; 10% of children with ASDs have also been identified as
having Down syndrome, fragile X syndrome, tuberous sclerosis, or another
genetic or chromosomal disorder; the prescription drugs valproic acid and
thalidomide, when taken during pregnancy, have been linked to ASDs; also,,
children born with low birth weight or born prematurely are at a greater risk
(p.38).
Some people believe that an exposure to
pesticides can cause Autism. Many people believe that the mercury in childhood
vaccines can cause Autism; however, if vaccines were in fact, the cause, the
incidence of Autism should have declined after 1999, when the dangerous
ingredients were taken out of vaccines. Some doctors believe that diet can help
to improve Autism by detoxifying the body of metals; there is no evidence,
however, to prove that this detoxification works.
Bernard Rimland, Ph.D., the former
Director of the Autism Research Institute in San
Diego, California, believes that “Autism is not a disease with a specific
cause, but rather a syndrome with a combination of abnormal behavioral
characteristics (Alternative Therapies, p.540). Metabolic disorders have been
linked to some cases of Autism. Defects in the breakdown of peptides, or simple
proteins, during digestion, have been found in autistic children through an
increased level of urinary peptides (p.540).
Another possible cause of Autism is
fetal alcohol syndrome, as found by a Canadian study. The study found that one
in fifty-four children with fetal alcohol syndrome also had Autism (Alternative
Therapies, p.540). Other studies have linked brain stem defects, such as
significantly decreased brain stem size, to Autism (p.540).
Maybe the most controversial idea for the
cause of Autism has been infant vaccines. Both parents of autistic children and
some scientists believe that the mercury in the preservative, thimerosal, used
in many childhood vaccines in the United States is the cause of Autism (Gorski,
2007, p.23). Many people made the connection between infant vaccines and Autism
because characteristics of Autism typically present themselves between age one
and three, the same time period in which children receive the majority of their
vaccines (p.24). Many people, such as David Gorski (2007), the author of “Mercury in Vaccines as a
Cause of Autism and Autism Spectrum Disorders (ASDs): A failed hypothesis”
believe that the correlation between the time at which the characteristics of
autism present themselves and the age at which children receive vaccines is
merely coincidental.
Many activists insist that the preservative
thimerosal, containing mercury, is the cause of most cases of Autism, however, in
1999 the American Academy of Pediatrics and the U.S. Public Health Service, as
a precaution, recommended that the preservative containing mercury be
immediately removed from infant vaccines (Gorski, 2007, p.24). Therefore, by
March, 2001, all vaccines recommended for infants were available with little to
no thimerosal. The last batch of vaccines containing thimerosal expired in 2002
and, since the expiration, no childhood vaccine, besides the flu vaccine,
contained more than trace amounts of the preservative (p.24).
Through their Study to Explore Early
Development (SEED), the Center for Disease Control is actively searching for
the possible causes of Autism Spectrum Disorders. This is the largest study in
the United States seeking to identify risk factors for ASDs (ADDM, 2012, p.38).
No one knows why the incidence of Autism
has increased so drastically in the last few years; however, there is reason to
believe that increased awareness of Autism and its characteristics have
increased the number of children being diagnosed, rather than the rate at which
children are developing the disorder (Gorski, 2007, p.24).
Challenges and Advantages
of Inclusion
There has been an increased tendency to
place students with Autism in general education classrooms, if at all possible
(Sansosti, 2009, p.170). According
to Rita Jordan (2008), author of “Autism spectrum disorders: a challenge and a
model for inclusion in education”, education in it of itself can be a
successful treatment for Autism Spectrum Disorders, especially when taught by
high-quality teachers (Jordan, 2008, p.11). She emphasizes the fact that
education envelops so many things that are not always thought of – it is the
way children are “taught the values, understanding, knowledge and skills that
will enable their full participation in their community” (p.11).
Inclusion helps autistic children to develop
better social skills through interacting with their peers. Autistic children
can gain from collaboration and teamwork with their peers in a mainstream
classroom (Jordan, 2008, p.12). Some autistic children are severely
intellectually disabled which would make inclusion very difficult and be a
disservice to the child, however with specialist support in the classroom such
as a special education in-class support teacher or a paraprofessional, the
student can benefit from inclusion in the general education classroom.
Specialist support in the classroom can make education of an autistic child
possible in a non-segregated setting (p.12).
References
Asperger Syndrome Fact Sheet: National
Institute of Neurological Disorders and Stroke (NINDS). (n.d.). National
Institute of Neurological Disorders and Stroke (NINDS). Retrieved April 2,
2012, from http://www.ninds.nih.gov/disorders/asperger/detail_asperger.htm
Gorski, D. (2007). Mercury in vaccines as a
cause of autism and Autism Spectrum Disorders (ASDs): A failed hypothesis. The
Scientific Review of Alternative Medicine, 11, 23-27. Retrieved
April 9, 2012, from the EBSCOhost database.
Sansosti, F. (2009). Teaching Social
Behavior to Children with Autism Spectrum Disorders Using Social Stories:
Implications for School-Based Practice. Best of JSLP-ABA- Consolidated
Volume 4, 2009, 4, 170-177. Retrieved March 26, 2012, from the
Articles Plus database.
Smith, M. (n.d.). Autism Symptoms &
Early Signs: What to Look for in Babies, Toddlers & Children. Helpguide
helps you help yourself to better mental and emotional health. Retrieved
April 2, 2012, from
http://www.helpguide.org/mental/autism_signs_symptoms.htm#early
Vaughn, S., Bos, C. S., & Schumm, J. S.
(2007). Teaching students who are exceptional, diverse, and at risk in the
general education classroom (4th ed.). Boston: Pearson Allyn & Bacon.
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