Autism

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g Head IDENTIFICATION AND CHARACTERISTICS OF AUTISM

Identification of the Background and Characteristics of the Pervasive Developmental Disorder Autism

Joe Eader

Evangel University

Help with essay on Autism

Identification of the Background and Characteristics of the Pervasive Developmental Disorder Autism

Autism is an interesting research field because pervasive disorders are very difficult to treat. In addition, autism is extremely problematic and contains a wide range of behaviors including deficits in language, perceptual, and motor development (Carson, Butcher &, Mineka, 000, 565). Personally, I have never observed or confronted an autistic child or adult. However, I have spoken with many friends, peers, or family members that have experienced autistic people. These family members or peers have told me their various stories of frustration, discouragement, and depression with the developmental disorder. In addition, advertisements such as commercials on TV with Doug Flutie are powerful and spark interest and curiosities about autism. Because autism is tough to treat and creates many problematic behaviors, I almost feel compelled to pay special respect and attention to this disorder. After all, TV commercials are overly expensive, hard to make, time consuming, and typically are only made by either big corporations or important foundations. These types of people have spent a lot of time and energy into making people aware of autism. As a result, finding ways to treat and better understand autism is costly and time consuming. This proves that autism is an important area to be emphasized and studied.

Autism is a pervasive developmental disorder (PDD), a group of disabling conditions that are among the most difficult to treat. In addition, autism is one of the most frequent and most puzzling and disabling of the pervasive developmental disorders (Carson et al., 565). Although the views on autism have varied in the past, there is general information that we know about the disorder. Information on autism can be identified, described, and better recognized through the DSM-IV description and criteria of autism, the history of autism, and through current trends in the diagnosis and treatment of autism.

The Diagnostic and Statistical Manual of Mental Disorders (DSM- IV) describes autism through diagnostic features

The essential features of Autistic Disorder are the presence of markedly abnormal or impaired development in social interaction and communication and a markedly restricted repertoire of activity and interests. Manifestations of the disorder vary greatly depending on the development level and chronological age of the individual. Autistic Disorder is sometimes referred to as early infantile autism, childhood autism, or Kanner's autism. (American Psychiatric Association, 14, 66)

The impairment in social interaction is gross and sustained. In addition, there may be "marked impairment in the use of multiple nonverbal behaviors (e.g., eye-to-eye gaze, facial expression, body postures, and gestures) to regulate social interaction and communication" (American Psychiatric Association, 14, 66). Also, there may be "failure to develop peer relationships appropriate to developmental level that may take different forms at different ages. For example, younger individuals could have little or no interest in friendship but lack understanding of the conventions of social interaction" (American Psychiatric Association, 66). Furthermore, there may be a "lack of spontaneous seeking to share enjoyment, interests, or achievements with other people" (American Psychiatric Association, 66). An example of this would be not showing or pointing out things that they find interesting or exciting.

The impairment in communication is described and marked by sustained affects in both verbal and nonverbal skills (American Psychiatric Association, 14, 66). For example, there may be a "delay in, or lack of, the development of spoken language" (American Psychiatric Association, 14, 66). Also, when the individual does speak, there may be "marked impairment in the ability to initiate or sustain a conversation with others, or a repetitive use of language or idiosyncratic language" (American Psychiatric Association, 66). Often, when speech develops the pitch, intonation, rate, rhythm, or stress may be abnormal. An example of this would be if the speech is monotonous and contains a question-like rise in pitch at the end of each sentence. Repetition is also fairly prevalent when describing Autistic Disorder. The autistic child may repeat certain jingles or commercials from on television that he/she likes or finds interest in (American Psychiatric Association, 66).

Individuals with Autistic Disorder also tend to have "restricted, repetitive, and stereotyped patterns of behavior, interests, and activities" (American Psychiatric Association, 14, 67). In addition, there may be an encompassing "preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus" (American Psychiatric Association, 67). Individuals with autistic disorder display a range of interests and are typically preoccupied with one narrow interest . In addition, they may insist on sameness and show resistance to or distress over trivial changes . Other abnormalities may include strange postures (walking on tiptoe, odd hand movements and abnormal body postures) (American Psychiatric Association, 67).

The Diagnostic and Statistical Manual of Mental Disorders criteria for .00 Autistic Disorder is as follows

(I) A total of six (or more) items from (A), (B), and (C), with at least two from (A), and one each from (B) and (C)

(A) qualitative impairment in social interaction, as manifested by at least two of the following

1. marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction

. failure to develop peer relationships appropriate to developmental level

. a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people, (e.g., by a lack of showing, bringing, or pointing out objects of interest to other people)

4. lack of social or emotional reciprocity ( note in the description, it gives the following as examples not actively participating in simple social play or games, preferring solitary activities, or involving others in activities only as tools or mechanical aids )

(B) qualitative impairments in communication as manifested by at least one of the following

1. delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)

. in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others

. stereotyped and repetitive use of language or idiosyncratic language

4. lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level

(C) restricted repetitive and stereotyped patterns of behavior, interests and activities, as manifested by at least two of the following

1. encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus

. apparently inflexible adherence to specific, nonfunctional routines or rituals

. stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)

4. persistent preoccupation with parts of objects

(II) Delays or abnormal functioning in at least one of the following areas, with onset prior to age years

(A) social interaction

(B) language as used in social communication

(C) symbolic or imaginative play

(III) The disturbance is not better accounted for by Retts Disorder or Childhood Disintegrative Disorder

Other typical characteristics of autism are "affect isolation, unrelated ness to others, twiddling behavior, inconsistent developmental continuity, self-destructive behavior, temper tantrums-anxiety, apparent confusion, and orderliness" (Webster, Konstantareas, Oxman &, Mack, 180, 6-8). All of which are described in similar terms through the DSM-IV.

Historically, researchers and professionals overtime have changed their viewpoints and understandings of autism. As a result, the definitions, characteristics, and approaches to the treatment of autism have all been reviewed (Olley, 1, ). "Today, the term autism is usually associated with the syndrome described by Kanner, but its use began much earlier in psychiatry. Bleur (111/150) used the term to describe a withdrawal into fantasy in schizophrenia" (Olley, ). However, Kanner's (14) use of the word autism reflected his emphasis on the social deficits of the disorder, but were still confused with a syndrome of schizophrenia by some(Olley, ). Although the term autism was introduced in this century, it has been present for many generations. There are reports documented long before Kanner and Bleur that show the observation and study of the origin of children with very deviant social and language development. Early on, characteristics, such as avoiding the gaze of others and showing no recognition of parent's absence were observed in autism (Olley, ). Later on, researchers and observers began to label this deficit as withdrawal. For his time, Kanner was accurate with many of his observations on the symptoms of autism. Unlike Bleur, Schizophrenia is differentiated from autism in Kanner's studies. Kanner described autism as being "'from the start anxiously and tensely impervious to people'" (Olley, 4). In addition, Kanner saw people with autism living in a world, which they have been "total strangers from the beginning. …[and] also pointed out the isolated play, unusual language traits, insistence on ritual behavior, and resistance to change. " (Olley, 4).

Historically, Kanner was wrong about some of the aspects of autism, but was overall quite accurate. Early optimism of children with autism "concluded that the children had 'intelligent physiognomies' and that their faces showed 'serious-mindedness'" (Olley, 1, 4). This is where the myth of the autistic child as a "latent genius" has endured and caused great distress for family members and teachers (Olley, 4). During this time, some people believed that autistic children were prodigies who could not associate with the more common world. However, more recent research has consistently found about 80% of people with autism to function in the mentally retarded range of intellectual development and the other 0% show social language, and other learning problems that seriously impair their adaptive behavior (Olley, 4). Consequently, the optimistic suggestion that autistic children are geniuses is unfounded and baseless through research.

Another past misconception was that parent behavior caused the autistic condition. Although characteristics of autism are present from the beginning of life, Kanner also observed mainly that the parents in his sample to be from upper middle-class backgrounds and to have a cold manner in dealing with their autistic child (Olley, 1, 5). As a result of Kanner's observation, Bettleheim (167) picked up this theme and built a theory of nature of autism in which the emotional coldness of parents, especially mothers, was the central cause. Later, Rimland (18) summarized Bettleheim's view that "'autistic children had been mistreated by their mothers… thus giving the children feeling s of hopelessness, despair, and apathy and leading them to withdraw from contact with reality'" (Olley, 5). According to more recent and better research, this would be considered a past scientific view. Past scientific and "medical literature on the childhood psychoses [has been] confusing and contradictory in numerous respects" (Davids, 174, 17). "Some books and articles are written from the psychogenic point of view, as though it were quite well-established that faulty mother-child relations were the sole cause, or at least a major contributing cause, of psychosis in childhood" (Davids, 17). A good example of this view would be what Bettelheim theorized. Other writers "concern themselves with biological approaches, and pay scant, if any, attention to the convictions of the psychogenecists" (Davids, 17).

On the other hand, "Rimland and other writers of the 160s played an important role in changing the prevailing psychoanalytic view of autism that had been popularized by Bettleheim" (Olley, 5). Rimland later on found no evidence for the "psychogenic or psychologically based approach", which opened the door for the burgeoning biomedical research of today (Olley, 5). As a result of Rimlands findings, the departure of the psychoanalytical approach led to rapid growth of research based on other viewpoints including behavioral, cognitive-developmental, and the biomedical views (Olley, 5). Beginning in the 160s, researchers applied psychological research from the laboratory to the learning of children with autism (Olley, 1, 5). In the past, behavioral reinforcement and punishment techniques have seemed to show some effectiveness with simple practical skills. Early studies on the effects of rewards and punishments have led to a much broader emphasis on teaching practical skills for the autistic community and throughout their lifespan and today "the integration of basic behavioral research and treatment programs in many settings has led to substantial knowledge and improved services" (Olley, 1, 5).

The cognitive-developmental view on autism seems to focus on the basic deficits in cognitive processing. This includes such mental processes as language, social, and related learning (Olley, 1, 5). These have been the basis for another past and contemporary approach to autism. However, some writers, such as "Rutter (18) have identified cognitive deficits in language, abstraction, and sequencing as the primary deficit in autism" (Olley, 5-6). Although the cognitive-developmental view may differ depending upon the researcher, in general, it remains a contemporary view on autism. In addition, it helps professionals understand the deficits in abstractions that autistic children typically have particularly those pertaining to social behavior (Olley, 6).

Recent medical research has contributed to our knowledge of autism. It has increased our knowledge of the organic basis of autism through the neuroanatomical, neurochemical, and genetic abnormalities that autism presents (Olley, 1, 6). Historically, these have not been emphasize, but with the advances in technology the biomedical view it has been made available. Another area that has recently been advanced is in the medicines that can treat at least some of the symptoms of autism (Olley, 6). These are far better understood now than they were even a few years ago. Recent biomedical studies of autism have included autopsied brains of people with autism. Scientists and researchers have found abnormalities in the limbic system and the cerebellum (Olley, 6). These are areas that are linked to memory and emotion. Overall, the growth of medical research on autism has been dramatic and recent. Although experts may disagree on the specifics, the medical view has given essential knowledge about autism.

Historically, another area that has been in major disagreement is diagnosis. Although today autism diagnosis has been significantly clarified, at one time "confusion existed involving the differentiation of one type of childhood psychotic from the others" (Davids, 174, 17). For example, the terms "childhood schizophrenia, psychotic child, autistic child, and child with infantile autism [were] used so often interchangeably" (Davids, 17). As a result, many researchers would often enter this field with serious interest only to find the information from sources muddled and confusing (Davids, 17). Often, scientific progresses in the field of autism were impeded severely by this chaotic situation.

Current trends of the diagnostic criteria for autism have relatively remained the same since 14. This was the year that the most recent version of the Diagnostic and Statistical Manual of Mental Disorders was published. Although there are still controversies over some research, no apparent changes seem expected to be made for on the next version of the DSM. Diagnosing autism is an overall hard-hitting task for professionals. The multiple "definitions of the syndrome lead to disparity in the way the diagnosis is applied. This may be further compounded because an autistic child may exhibit a majority of but not all of the symptoms" (Johnson & Koegel, 18, 4). The consequence of this is that it contributes to a low reliability rate among professionals diagnosing the same child as autistic. Because of the low reliability rate, a solid behavioral assessment is emphasized to help define children who may have autism.

Currently, treatments for autistic children are available, but the remedies do not seem to be as effective as they are in many other disorders. Not too long ago, many autistic children were deemed "'unable to profit from an educational program'" (Erikson, 187, 600). In return, this left parents of autistic children few resources, which meant they were left to cope on their own. At this point institutionalization was the only alternative offered. This is when the education and treatment of handicapped children and adults became a national concern. "In 10, the Individuals with Disabilities Education Act (IDEA) added autism as a new category of disability. The law's recognition of autism as a distinct disability constituted an important step forward in meeting the needs of children with autism" (Katsiyannis & Reid, 1, 8). As result, currently, states are required to develop classroom and personnel training standards, and educators. Today, parents can expect that existing expertise and knowledge on autism will be used as a basis for working with their children. Unfortunately, despite a considerable body of research on techniques that are demonstrably effective for autistic children, there is a persistent reliance on controversial treatments. Because autism is so hard to treat, many of the methods of treatment are still considered "implausible and empirically unsupported" (Katsiyannis & Reid, 7).

Many of the treatment methods are unsupported because of uncertainty. Autism can be an implacable foe. This is because the contours of autism are shadowy; it takes on different shapes wit different children and within the same child at different ages. Up to this point, "[t]here is no standard treatment for autism" (Cohen, 18, 84). Instead, "there is a history of supposed 'breakthroughs' or 'miraculous treatments' that turn out not to be miraculous and help only a small proportion of autistic children" (Cohen, 84-85). At the present time most forms of treatment for autism are probably best thought of a s facilitative (Cohen, 85). They may pave the way for "improved functioning" (Cohen, 85) but do not eliminate the core features of autism. The only treatments that seem to be supported are "'alternative treatments'" (Cohen, 85) like auditory integration training, which may be facilitative for some children. Other treatments that are being viewed as possibilities include megavitamin therapy, dietary treatment, and sensory integration therapy (Cohen, 85). However, nothing seems more promising than educational treatment for young autistic children. There is "virtually no disagreement about the value of early educational intervention" (Cohen, 87). "Over twenty years of data collected by federally funded educational projects for children with developmental disabilities point to this conclusion, as do several programs specifically designed for autistic children.

In conclusion, autism is a battle for professionals, family, and teachers. There seems to be a reciprocating effect between diagnoses and treatment of autism. Throughout the research there seems to be a general idea that the more accurate and reliable we become in properly diagnosing autism, the more chance there is that we will find better and more effective methods to facilitate and treat autism. Another conclusion that I have come to is that there will never be a total recovery from autism unless divinely healed by our Lord. The word recovery is to imply promise and normalcy. Basically, recovery states that a child will become normal. Although autistic children have the ability through treatment to improve, to an extent, the degree of their behavior, it seems that autism will always be seen as a lifelong disorder. Although, with the technological advancements of medical capabilities, someday it may be possible that scientist can isolate the biological hurdles involving autism and produce prevention methods. For example, already there is research being done to see whether there is a correlation between immunization or booster shots and increasing occurrence of autism. Early research has shown that there is no evidence or association found between the measles-mumps-rubella (MMR) immunization and increasing occurrence of autism (Henderson, 001, 1). What I feel is most important from my research is that autism is finally receiving an appropriate level of attention. Research is expensive and time consuming. After such an expended time of dormancy it is great to know that finally newer research, findings, and knowledge are beginning to sprout about Autistic Disorder.

References

American Psychiatric Association (14). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC American Psychiatric Association.

Carson, R. C., Butcher, J. N., & Mineka, S. (000). Abnormal Psychology and Modern Life (11th ed.). Needham Heights, MA Allyn & Bacon.

Cohen, S. (18). Targeting Autism. Los Angeles University of California Press.

Davids, A. (174). Child personalityand psychopathology Current topics. New York Wiley-Interscience.

Erikson, J. (187). Public policy Themes and emerging issues. In D. J. Cohen, A. M. Donnellan, & R. Paul (Eds.), Handbook of autism and pervasive developmental disorders (pp. 5-614). Silver Spring, MD Wiley-Interscience.

Henderson, C. W. (001, /1/001). No association between MMR Immunization and increasing occurrence of autism. Vaccine Weekly, 0/1/001, 1-17.

Johnson, J. & Koegel, R. L. (18). Behavioral assessment and curriculum development. In R. L. Koegel, A. Rincover, & A. L. Egel (Eds.), Educating and understanding autistic children (pp. 1-). Boston College-Hill.

Katsiyannis, A. & Reid, R. (1, Summer ). Autism and section 504 Rights and responsibilities.. Focus on Autism & Other Developmental Disabilities, 14(), 7-1.

Olley, J. G. (1). Autism Historical overview, definition, and characteristics. In D. E. Berkell (Ed.), Autism Identification, education, and treatment (pp. -0). Hillsdale, NJ Lawerence Erlbaum Associates.

Webster, C. D., Konstantareas, M. M., Oxman, J. & Mack, J. E. (180). Autism New directions in research and education. Elmsford, New York Pergamon Press.

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