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There has been a dramatic increase in the number of children being diagnosed with autistic disorder in the last two to three decades. According to the most recent surveys by CDC, prevalence of autism in the US has been found to be as high as 1 in 250, which is a marked increase from the 1970s, when the prevalence rate was about 1 in 2,500. This increase can be attributed to medical professionals’ greater awareness , better diagnostic methods, and some unknown environmental factors (Kabot, Masi & Segal, 2003). Autism is a part of Autism Spectrum Disorder, which also includes Asperger’s Syndrome and Pervasive Developmental Disorder. These are a group of genetic neuro-developmental disorders which are highly inheritable (Boyd & Bee, 2011). This paper researches various aspects of autism, including recent information on causes, symptoms and treatment, and its effect on child development.
According to Fuentes (2007), “Autism is a persistent developmental disorder, which is characterized by impairments in communication and social interaction, restricted, repetitive and stereotype patterns of behavior, interests and activities” (p. 1). Autism is a disorder of the central nervous system, but the defining characteristics and causative factors that connect behavioral changes to brain dysfunction are still under conflict. Autism can be explained in three different contexts, all of which are interdependent. It is a neurological disorder caused by brain dysfunction and a psychological disorder in which there is impairment of cognitive, behavioral and emotional development. It is also a relationship disorder where an individual fails to socialize normally. Experts define autism as a spectrum disorder in which different children exhibit a wide combination of symptoms while sharing a core deficiency of social and communication impairment (Fuentes, 2007).
The etiology of autism is not clear and experts differ in their opinions. Most cases of autism are idiopathic, with no known causes of dysfunction (like injury) in the brain (Bernier & Gerdts, 2010). However, studies support a genetic etiology for autism in an individual, as the risk increases with positive family history. If one of a pair of twins has autism, in 70% to 90% cases, the other twin will have it too. About 10% cases of autism coexist with known genetic disorders, like the fragile-X syndrome and tuberous sclerosis. The MMR vaccine and the presence of thimerosal (a preservative) in some other vaccines have also been said to cause autism in children, though these are only hypotheses and firm scientific evidence is yet to be found. Evidence points towards interaction of various environmental factors and genetic predisposition in individuals to trigger these developmental disorders. Autism affects males more frequently than females, with a sex ratio of approximately 4:1 (Boyd & Bee, 2011).
Symptoms of autism manifest themselves within three years of age. Autistic children characteristically exhibit symptoms of social withdrawal and failure to develop normal communication skills. Autism impairs the ability of a child to understand words (spoken and written) and language. They may misinterpret words, have difficulty understanding body language and may not understand emotions and feelings at all. Any kind of social interaction is difficult and confusing for autistic children. Therefore, they are generally withdrawn and isolated in a world of their own (Fuentes, 2007).
Impaired communication skills and social interaction produce certain behavior patterns typical to autistic children. These include abnormal or delayed speech patterns. In some cases, an autistic child never learns speech. He or she plays alone and engages in repetitive and obsessive forms of play. Autistic children cannot tolerate change and go to extreme lengths to resist it. When the environment around them changes, they may express confusion and frustration by throwing a tantrum. Autistic children can be extremely sensitive to certain sounds, smells, tastes, colors or textures. They may display an obsessive interest in certain objects, activities, places or people and engage in repetitive stereotypical behavior like spinning, rocking, toe walking, and hand-flapping etc. There is also a tendency towards self-injurious behavior, like head banging. Autistic children often avoid eye contact, may show extreme physical activity or passivity, and exhibit uneven motor skills (Fuentes, 2007).
Most children with autism also exhibit serious problems with feeding and digestion. There are frequent infections, acid reflux, chronic vomiting, and bloody diarrhea There is associated mental retardation in about 75- 80% of the cases, and about one-third of the cases develop epilepsy-like seizures in childhood or adolescence (Bernier & Gerdts, 2010).
Symptoms of autism generally appear for the first time between 12 to 18 months of age, but the average age of diagnosis is 3 to 5 years. It may be diagnosed by a clinical psychologist or a physician. Diagnosis of autism requires combined efforts of people from many different disciplines including a pediatrician, a psychologist and a speech and language pathologist (SLP). The psychologist assesses behavior and developmental level of a child and the SLP analyzes communicative behavior and speech. Medical assessment rules out any other probable causes for these symptoms and relates the results of assessment to the medical history of the child. Diagnosis is based on direct observation and information from parents about social, communicative and repetitive behavior (Bernier & Gerdts, 2010).
There are many options for treating autistic children. The recommended treatment approach is early and intensive behavioral intervention to target the core symptoms. This kind of approach is known as Applied Behavior Analysis (ABA), and it has shown excellent results in improving autistic children. ABA techniques and principles develop useful basic and advanced skills in autistic children and bring about a positive and meaningful change of behavior. Basic skills include looking and listening while advanced skills include skills like reading and conversation. Use of principles of learning, such as positive reinforcement, improves communication and social skills, learning, reasoning, and adaptability (Bernier & Gerdts, 2010).
Behavioral symptoms can also be controlled with medication. Drugs, for example, risperidone can be used to lessen aggressive and explosive behavior. Anti epileptic medicines, for example, valproate, are prescribed for children having associated seizures. These medicines can also control aggressive behavior (Fuentes, 2007).
Effect on Child Development
Presence of autism deprives a child of basic cognitive, social and emotional skills. The inability to make eye contact, form and maintain relationships, as well as perceive feelings of others, and accompanying mental retardation impair many aspects of development in a child, such as personality, temperament and emergence of emotional expression (Boyd & Bee, 2011)
Since children with autism display repetitive and stereotypical behavior which is not perceived as ‘normal’ by others, they are generally neglected or rejected in their peer group. As a result of rejection by peers, a child may become either withdrawn or aggressive. A withdrawn and rejected child gives up attempts at any social interaction and, as a result, may often feel lonely. A rejected child who becomes aggressive expresses strong feelings through disruptive and uncooperative behavior. Studies indicate that peer rejection in elementary school can have lasting effect on a child and can cause emotional disturbance or behavior problems in adolescence and adulthood. A rejected child may always have negative expectation from a relationship, even in adulthood, which would be a barrier to making friends and forming healthy relationships (Boyd & Bee, 2011)
All children have unique temperaments which determine their moods, reaction to new things, rate of activity and social interaction etc. A child may be easy, difficult or slow-to-warm-up. Difficult children are less predictable, more irritable, cry more and are more likely to be criticized or punished by parents. As autistic children show atypical behavior and may get aggressive or throw a tantrum for no apparent reason, they are also categorized as troublesome and likely to be punished by teachers and parents, till such time that their condition is diagnosed. Criticism and punishment may have further negative impact on this child. Although temperament is inborn in infants, it is also shaped and molded by a child’s relationships and experiences. The inability to understand emotions and form loving relationships with parents puts autistic children at a disadvantage during this phase of personality development. (Boyd & Bee, 2011)
Emotional expression in humans is an important part of personality and is present even in new born infants. However, in children with autism, perception and expression of emotional expression are impaired, which, if left untreated by behavior modification, can cause hindrance in living a normal life. Untreated autistic adults are often unsociable and prone to aggression or anger. They have difficulty in completing their education, holding jobs and making friends which leads to anxiety, frustration and depression (Boyd & Bee, 2011).
Despite extensive research, the exact cause of autism remains a mystery. Man is a social animal and the ability to form loving and lasting relationships is one of the things that define human beings. Autism impairs the ability of affected individuals to do that, hence putting them at a serious disadvantage in living a fruitful life. Although behavioral intervention at an early age does help in overcoming many difficulties, more extensive research is needed to help fully understand the etiology of the disease and take adequate measures to prevent it.