Autism Late Diagnoses - Research Proposal Example

? Autism Late Diagnoses Presented by Presented to Introduction Background to the study There are range medical and psychological problems that affect children of all ages. In most cases, some of these are not so severe that they do not require any specialized medical attention as any mild approach to their treatment can guarantee their solutions and ensure that the children continue to live very normal lives throughout their developmental stages (quote). However, not some of this can be said for cases of Autism Spectrum Disorder (ASD) in children. As identified by the National Institute of Neurological Disorders and Stroke (2013), “Autism spectrum disorder (ASD) is a range of complex neurodevelopment disorders, characterized by social impairments, communication difficulties, and restricted, repetitive, and stereotyped patterns of behaviour.” This means that ASD ranges in level of severity and the most common severe form of it has been identified to be Autistic disorder or classical ASD (quote). As a spectrum, it means that the earlier ASD is diagnosed, the better the chances of ensuring that the risk or rate of growth of severity does not increase to certain undesirable levels. However, there continues to be records and reports of late diagnoses of ASD in most children. In relation to the Waldorf approach to developmental stages in children, one would say that if ASD was diagnosed as early as the first stage, it would give medical experts so much hope and room for improving the lives of affected children, especially in terms of their academics. Purpose of the study Based on the background to the study presented above, the researcher seeks to set out a research work that has a purpose of identifying the developmental stages from the perspective of Waldorf approach and link this to Autism Spectrum Disorder late diagnoses. In essence, the researcher is setting out the proposed study to ensure that there is a comparative analysis between each of the three stages that Waldorf identifies, and how if ASD is diagnosed at each of these stages, could constitute late diagnoses or otherwise. What is more, the study shall be concerned with knowing what the impact of late diagnoses in relation to the developmental stages could be on children who are diagnosed with ASD. This purpose is made with the rationale that as much as autism may be a serious health and psychological problem for children, it should not be the basis for which children should suffer or be left behind in any sense in terms of their normal development as people. This is particularly so when it comes to the academic life of the children. Unfortunately though, the chances of achieving this goal reduces significantly if diagnosis is not made as early enough as possible. While looking at the issue of late diagnosis, the impact of different cultural perspectives will be linked to any possible causes. Aim and objectives To achieve the purpose of the study, an aim has been set for the study, which has further been broken down into specific objectives to signify the specific activities and tasks the researcher should be involved in to achieve the aim. The aim is given as finding the relationship between the developmental stages and autism spectrum disorder late diagnosis. The specific objectives to bring about this aim are given as follows. 1. To determine how the developmental stages as given by Waldorf are perceived by different cultures in terms of religious cultures, moderate cultures and liberal cultures 2. To underscore how the perception of developmental stages according to cultural differences help in avoiding or promoting late diagnoses of ASD. 3. To ascertain how children diagnosed with late with ASD can be helped to live healthy integrated lifestyles. Significance of the study Should the aims and objectives set above be achieved, there are a number of benefits that will be derived. In the first place, an understanding on the effect of cultural differences on ASD would help in finding a common perspective grounds for the issue of developmental stages in children and how this impacts on ASD (quote). This way, the possibility that some children are going to suffer as a result of cultural differentiations in the way that the developmental stages are opined is going to be a thing of the past. It is expected for this significance to be achieved findings of the study that would point to the need for using a curriculum based intervention to streamline the cultural perspectives will be taken in good faith and fully implemented. Secondly, this is going to be an academic record that will identify the gaps that exists in various works of literature on the relationship between developmental stages and ASD. This means that all future researchers can use this work as a reference point for undertaking further research, aimed at improving the lives of children diagnosed with ASD. Finally, an understanding of the risk involved in late diagnosis and the attendant solutions that may be given to these will ensure that the practice of late diagnosis is eradicated and where it exists, there will be change-based interventions to ensure that the children integrate easily into society. Research questions The conduct of the proposed study shall be guided by the scope of the research questions set below. This means that the data collection process of the researcher must not go behind the identification of answers or solutions to these questions. 1. In what ways are the developmental stages given by Waldorf perceived by different cultures in terms of religious cultures, moderate cultures and liberal cultures? 2. How does the perception of developmental stages according to cultural differences help in avoiding or promoting late diagnoses of ASD? 3. How can children diagnosed with late with ASD be helped to live healthy integrated lifestyles? Background literature Background to the Waldorf developmental stages Waldorf focused his study on children and young people developmental stages. These stages assist in understanding the nature of children as they grow from the time of birth to adulthood (Oldfield 2001). Waldorf argued that a child is an empty vessel whereby knowledge must be filled as it grows. He came up with three childhood conceptual developmental stages that encourage healthy child development (Raphael 2007). Depending on the age of the individual, the focus and nature of assessment vary. Generally, an assessment at a younger age is more focused on diagnosis, whilst, at the later stages, the focus is on measuring their skills. Stage 1 (0-7 years) This stage contains three developmental stages of birth. From birth to three years referred to sensory-motor skills stage, three to five years referred to imagination stage and five to seven years where a child gets an idea of playing. The stage between 0 to 7 years is a stage of will where a child involves in constant movement and learns through repeating and imitating other people. This period lasts until the first milk teeth are lost. The following stage is essential to a child growth and development because it learns to walk, speak and learn through other people. Parents and other child caring parties should give such children an opportunity to imitate what others do and say. At early childhood and pre-school age, diagnosis often occurs with presenting problems that parents observe from their children. The baby is at the most absorptive age and more open to external influences. In addition, managing to stand upright, speak and think within a period of three years becomes a great achievement. Imitation forms a special characteristic of children at this stage because the young person mimics everything in his or her environment that includes sounds of speech, gestures of people, attitudes, and values of parents and peers (Zonneveld 2007). Stage 2 (7-14 years) This stage lasts up to the onset of puberty that occurs between the ages of 13 and 15 years. In the end of the first stage of childhood development various changes occur. Teachers of Waldorf Education term this stage as the most prominent because physical changes take place starting with the loss of milk teeth. Biologists argue that a person takes seven years from birth for the transformation of every inherited cell in the body. At this stage, the emotion of a child begins to mature and a child enters the “feelings world”. The child becomes wholly herself or himself for the first time. In addition, a child enters into a new life of imagination and becomes ready for formal learning. Parents should handle children at this stage with special care and provide them with more advices because there is a higher probability of a child engaging in unwanted practices (Mitchell 2003). Stage three (14-21 years) At this stage, the child has attained puberty and begins making his or her own decisions. A child can now truly analyse the world and come up with critical opinions. This is the stage of adolescence with the following features. Psyche represented by a healthy, vulnerable sensitivity, valuable idealism, and unfolding, insecure sense of self. Psyche requires a lot of protection because the young people become more energetic and more sexually active. In addition, boys become more defensive and unwilling to negotiate with their elders. Teachers and parents have a hard task taming children of this stage into acceptable behaviours in the society (Oldfield 2001; 55-61). Cultural perceptions on developmental stages Child developmental stages education plays a significant role in shaping the life of a young person. Many cultural perceptions have been present related to the quality of education and care offered to children by their teachers and parents during these developmental stages. According to Lee and Johnson (2007), early childhood educators have not been attentive enough to the influence of culture in children’s development. Health disparities are usually caused by individual behaviors, attitudes, health care systems, and cultural values in a given society. Knowing one’s social status assists an individual in determining the social category. Social status is categorized into 19 classes depending on the country of origin or resident areas. From the classifications given, the Mexican American culture is falls under the immigrant’s category (Smith 2012). Looking at the cultural psychological perspective, culture forms the most significant system in every human development. Waldorf’s developmental stages are perceived differently by different cultures in terms of religious cultures, moderate cultures and liberal cultures. Culture represents all aspects of human adaptation according to the set of values, beliefs, and norms that a certain group of people have in common. Culture consists of language, food, ideas, customs, and social roles (U.S. Department of Health and Human Services 2000). Different communities have varying cultures that aim at preparing a child religiously. Waldorf childhood developmental stages are perceived by some religions as not fully providing a child with the necessary religious background. Waldorf education honours all cultures, but some communities still believe some important features of culture have been left out. On the other hand, Waldorf teachings provide a chance for a child to avoid some common childhood disabilities like autism. The impact of cultural perceptions on late diagnosis of ASD Late identification of the disorder may accompany greater risks and lead to more permanent detrimental effects for the individual. According to Gabovitch and Wiseman (2005), this is often the case as paediatricians, who have the most number of routine contacts with children prior to school age, fail to recognise early signs of the disorder. Whilst autism has no cure, interventions that are intensive, well-defined and timely can significantly improve the prospect of children who are challenged emotionally, socially, and cognitively (Gabovitch & Wiseman 2005). Autism impend verbal communication, effective social interaction, and appropriate behavior in a child and can be recognized from the age of three years (American Psychiatric Association 2000). The autism diagnosis and treatment decisions made by families are totally influenced by cultural backgrounds. The individual perspectives of culture and the way in which societies perceive culture determines their willingness to follow Waldorf’s teachings on child development. Communities that have negative perception on Waldorf’s childhood developmental stages face lack awareness of common disabilities in children like autism. Most parents contribute to the behavioural characteristics found in children because they fail to teach them to differentiate between the good and evil. Herbert and Koulouglioti (2010) argue that parental beliefs about culture cause them a lot because they ignore the nature of child development as they focus more of their cultural beliefs. Late diagnosis of autism is associated with cultural believes of some communities. Early intervention with appropriate treatments is the most effective way that can assist people with autism learns skills capable of increasing their quality of live. However, some people ignore these aspects claiming that their culture does not allow this or the other thing. Most families fail to teach their children to associate and share with their peers within the society as this increases chances of early autism diagnosis. On the other hand, majority of families teach their children to be self-directed learners who are independent of other people. Moreover, tradition perceptions on Waldorf teachings affect treatment recommendations for ASD. For instance, African American culture requires that a person must seek recommendations from family, friends, or religious leaders before seeking any professional assistance. Such believes lead to late autism diagnosis because traditional doctors might fail to detect some issues that can be easily seen using the professional technology. White American culture on the other hand allows for the interception of both the traditional treatments and professional treatments concurrently (Sue & Sue 2008). Religion also holds some positive and negative perceptions on Waldorf’s developmental stages. Religions across cultural groups assist families socially and emotionally and play a significant role in coping with common childhood disabilities. Some communities conduct counselling services to their people in order to ensure they give their children the necessary guidance on how to show acceptable behaviour in the society. On the other hand, religious cultures also ignore professional treatments and call upon their followers to take their sick to people of God for prayers. Such believes causes late autism diagnosis (Dyches et al 2004). Research design The proposed study is a qualitative research, which shall be conducted following the ethnographic research design. Reeves (2011) has explained that “ethnography is the study of social interactions, behaviours, and perceptions that occur within groups, teams, organizations, and communities.” In relation to the research problem, this research design can be said to be rightly selected in ensuring that there is a critical studying of social interactions, behaviours and perceptions that has to do with cultural perspectives on the developmental stages of children. Whiles investigating these variables qualitatively, there will be the notion of doing so to bring about an understanding of another independent phenomenon, which is late diagnosis of ASD in these children. The use of ethnographic research is going to affect several aspects and components of the study, including the way in which data is going to be collected. Commonly, researchers go about ethnography with the aim of critically understanding the impact of certain views and actions of people as prevails for their locations (quote). But to ensure the universality of the ethnographic data that will be collected, the researcher shall collect data from as many as six (6) different countries scattered across the West and the East. Based on the findings from the different locations, there shall be a generalization of the relationship between developmental stages and late diagnosis of ASD using a common data generalization model. Population and sample The population of the study refers to all people from whom there is a level of possibility that the researcher is going to collect data from. With this in mind, the population of the study is said to come from six main countries, three from the East, and three of Eastern and Western Europe. The countries are China, India, Phillipines, Russia, Poland, and United Kingdom. From each country, it is estimated that there will be a very large number of children who fall within the developmental stages of Waldorf who for one reason or the other suffer from ASD. Due to how large the researcher expects the population to be, there shall be a sample size to minimise the number of respondents from whom data shall be collected from directly. The researcher is convinced that if the number of respondents and for that matter the sample size is smaller, it would enhance the proper collection and handling of data (quote). This is because the researcher can easily assign sufficient time to the peculiarity of each member in the sample size. This notwithstanding, the sample size will be large enough to ensure that there is a better representation of the population that makes generalisation of findings possible. The sample size is therefore estimated to contain a total of thirty (30) respondents, five of who will be drawn from each of the identified countries. Sampling technique Sampling entails getting a small group from the big group or population of the study. The area chosen for the study has a population of approximately 5000 and out of these; a sample of 10 children in each of 5 villages will be selected. Stratified sampling will be used. The population will be divided into different strata or categories (Begi, 2009). There will be four different categories and then from the four simple random sampling will be done to get one school per category. The parents and guardians of selected population will also respond to the questionnaire designed for the teachers. The selected population form 10% of the total population of people in the targeted area. According to Begi (2009), a useful sample should be large enough to allow generalization and should be above 10% of the total population. This study will utilize the mixed method design. According to Ragin, Nagel and White (2004), a mixed design is a combination of methods. It is a method that combines both the quantitative and qualitative data. This is the best design for this research. The quantitative method is objective and the researcher records down findings of the research as they are while on the other hand, in the qualitative method, the researcher interprets the quantitative data and generalizes it to a large group because of the limited number of participants studied. Samples in the range of 100-200 are rarely brought into question based size. Data collection procedure According to Fraenkel and Wallen (2000), data collection procedure is a process of preparing and collecting data aimed at obtaining information. Data will be collected by use of a set of questionnaires to be answered by the parents of the affected children. In addition, a survey will be conducted to healthcare centers to come up with cases of autism reported in the targeted population. A review of the related literature will be done using books, reports and journals in order to ensure the collected data is acceptable. References BEGI, N. (2009). Research, Monitoring and Evaluation. Blesmo Research. DYCHES, T. T., et al. (2004). “Multicultural issues in autism”. Journal of Autism and Developmental Disorders, 34, 211-222 FRAENKEL, F. D., & WALLEN, N. M. (2000). Sampling. A handbook on Education Research. New Kemit publishers. MITCHELL, D. (2003). Child development and pedagogical issues. Fair Oaks, Calif.: AWSNA Publications. NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE. (2013). Autism Fact Sheet. Retrieved from: http://www.ninds.nih.gov/disorders/autism/detail_autism.htm OLDFIELD, L. (2001). Free to learn: Introducing Steiner Waldorf Early Childhood Education. Gloucestershire, England: Hawthorn. RAGIN, C., NAGEL, J. & WHITE, P. (2004). Workshop on Scientific Foundations of Qualitative Research. Washington: National Science REEVES, S. (2008). “Qualitative research methodologies: ethnography”. BMJ, 2(3): 333-337 SHAE, V. & MESIBOV, G. B. ( 2009). “Age-related issues in the assessment of autism spectrum disorder. In S. Goldstein, J.A. Nagleiri and S. Ozonoff, eds”. Assessment of autism spectrum disorders. New York, NY: The Guilford Press Smith, G. D. (2012). Journal of Clinical Nursing. 21(5-6). Blackwell Publishing Limited. P. 565 SUE, D. & SUE, D. (2008). Counseling the culturally diverse: Theory and practice (5th ed). Hoboken, NJ: John Wiley. U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. (2000). Healthy people: understanding and Improving Health. Second Edition. Washington, D.C. U.S Government Printing Office. ZONNEVELD, F. (2005). Waldorf Alphabet Book. Great Barrington, USA: Bell Pond. Read More