The Diagnosis of and Prognosis for Autism - Essay Example

? ESSAY/REPORT BY Introduction The uniqueness of autism overshadows all other developmental orders. First, unlike a number of other developmental disorders such as mental retardation, deafness, blindness, and many others, autism does not have any apparent biological reason. Without a concrete evidence, the diagnosis of and prognosis for autism is full with doubt. This vagueness makes it very hard for parents to accept the child’s condition. Second, parents of children with autism are frequently deprived of various essential rewards for parenthood because the disorder is characterized by difficulties with social interaction, such as developing attachments and showing affection. It is because of these reasons that autism has been deemed as one of the most complex and difficult developmental disorders with which families might have to deal with and family members of such children are often perceived to experience negative psychological effects (Gupta & Singhal, 2005). Dealing with traumatic events that are outside one’s control is one of the biggest challenges of life. With no possibility of lessening or eradicating the causes of stress, such circumstances require tactics where one transforms the self to fit the situation. It is important to understand the ways in which families deal with such circumstances as these are essential to cognitive paradigms of stress and coping frequently applied to families of children with disorders. Interventions concentrating on parents’ coping mechanisms have revealed encouraging results. These treatments utilize concepts from stress and coping paradigms to enhance parent education in problem solving and decision-making, communicative abilities, ability to contact and make use of social networks, and coping mechanisms such as encouraging self-statements, self-praise and relaxation (Gupta & Singhal 2005). A number of factors effect families’ experience of having a young individual with certain mental, emotional or physical disability and it is significant to keep in mind the distinctive requirements of each family, when deciding on the type of support being provided. Various factors such as cultural values of the family, socio-economic status, level of the disability, and amount of social support, type of family structure, and geographic location are significant when formulating and applying effective treatment programmes. All or any of these factors can improve or restrict the success of a treatment and emphasize the need for individualization. Thus the amount and kind of programs should be according to the needs of the individual family unit (Gupta & Singhal 2005). Research suggests that the number of children being red-flagged with autism is increasing. This increase might be to some extent due to enhanced assessment techniques or better knowledge of autism and other developmental disorders and of behaviours of autistic children. This disturbing increase in the number of children evidently requires for added facilities to fulfil the needs of these children and their families (Barnard, et al. 2002). From the developmental systems perspective, children are members of numerous social networks. These networks are created and are implemented by socio-cultural beliefs. Vygotsky, in relation to people with developmental disorders, suggested that the various aspects of development are quite similar in people with mental retardation and other disorders. He deemed working together as vital for the growth of improved psychological processes, and highlighted the significance of children working together in different groups (Vygotsky, 1993). Active participation of parents in the treatment programmes is increasing in the contemporary world. This involvement of parents has proven to be successful in educating parents to teach a number of skills to their children, especially play and communication skills. Increasing participation of parents during this stage, by giving extra information and incorporating them in child’s education programme, not only develops the child’s abilities; it is also influential in strengthening their faith in their own abilities. The working together of families and educational institutions further strengthens the dominant role of parents in their children’s education and thus, offers excellent treatments for the children. According to this paradigm, when problems occur, the child and family attributes are imperative in crafting interventions and providing suggestions (Barnard, et al. 2002). Researchers have witnessed huge progress in children’s social skills, due to a collaborative approach. Families of autistic children are not only integrated in the treatment programs through parent training, but they are also thought to be important participants in their children’s special education group. This concept promotes the level of coordination among children, their families, educational and other institutions (Dunlop, MacKay & Knott 2003). Collaboration among parents and professionals sees the young person and the family in the wider environmental perspective. Parents might seek professional help from individuals who have the know-how in working with the children with disorders to determine the best possible treatment for their children. On the other hand, given that each child is a part of a wider family system, it is essential to think about the socio-cultural environment when evaluating the needs of individuals and their families and in designing successful treatment programmes. As a result, people or groups offering services must think about the specific needs of each family to give helpful support for families having disabled children (Whitaker 2002). Bringing up a child with autism offers unique challenges to families. Receiving a diagnosis of autism and taking up a lifetime responsibility of raising a child with autism is a painful experience for the families. It is essential to understand how families cope with issues of sorrow, loss, tension in marriage, stigma and humiliation in order to give psychosocial support to the families of children with autism (Gupta & Singhal 2005). Review of Literature Smith, Rowlandson and Bohane (2010) examined autistic spectrum disorder and attention deficit hyperactivity disorder in order to develop an inter-agency service for children and their families and schools. The research suggests that a variety of government programs promote increased shared working between agencies to guarantee that holistic and harmonized evaluation of need, and combined intervention is accessible to children and families. The research brought together method for evaluation and diagnosis of autistic spectrum problems and attention deficit hyperactivity disorder, and the synchronization of intervention among schools, families and the community. Sheffield Information Giving Network (2009) provided with a factsheet that included information regarding expert support for Pre-school children with special educational needs and disabilities. The article suggested that all those working with children with special educational needs and disabilities have the same opinion that the earlier children get the support they need the better the results for the family. All agencies working with young children recognize the need to work closely together to make sure that the services provided to families are well coordinated. Bellini, Peters, Benner and Hope (2007) studied social skills programs being taught in educational settings. A meta-analysis of 55 single-subject design studies was carried out to generate a few generalizations about successful treatments programs as they are at present being delivered in schools. Bellini et al. restate that there is only minimal indication that social skills training programs are successful for children in general, let alone for those for whom social deficit is the central characteristic. Myers and Johnson (2007) studied the management of children with autism spectrum disorder. The research suggests that paediatricians have a significant part not only in early detection and assessment of autism but also in constant management of these disorders. (The key objectives of interventions are to make the most of the child's functional independence and quality of life by overcoming the main autism features of spectrum autism, improving growth and learning, encouraging social interaction, lessening maladaptive behaviors, and training and supporting families. Schieve et al. (2007) investigated the relationship between looking after a child with autism and stress markers. The answers of parents or other informed individuals were brought together in the Aggravation in Parenting Scale. Parents of children having autism were contrasted with parents of children with special health care requirements consisting of emotional, developmental, or behavioural issues other than autism that required treatment and children with special health care needs without developmental problems; and children without special health care needs. The results of the study indicated that parents having autistic children were expected to have greater aggravation in contrast to the other parents under the study. The parents of children with autism and current special help requirements were expected to have greater aggravation as compared to the parents of the other groups in the research. Thus, looking after a young person with autism with current special service requirements appears to be related with distinctive stresses. Gupta and Singhal (2005) illustrate the amount of stress and coping techniques used by families having autistics children. Variations in the stressors perceived and coping techniques assumed by the different members of the family of an autistic child suggests that mothers have a greater effect as compared to fathers of their child’s autism. The authors further emphasize the importance of providing psychosocial support to the families of children with autism. Furthermore, the research suggests that it is extremely important for parents, educational institutions and the community to work together to achieve the desired outcomes. Barnard, Broach, Potter and Prior (2002) investigated autism in educational institutions. For this purpose, 373 completed surveys were studied from seven local education authorities (LEAs) in the United Kingdom. The results revealed that 1 in every 86 children have the need for special education that is relevant to autism. The results further revealed that 1 in every 152 children had received a proper diagnosis of an autism disorder. Thus, the results of the survey indicated that the number of children with autism spectrum disorders throughout the educational setting in Britain surpassed current occurrence rates which means that is that children having autism is far greater than the prevalent rate. Whitaker (2002) explored a program that offered support to the families of preschool autistic children in the United Kingdom. The researcher interviewed parents of the autistics children when they started full-time education and were not a part of the project anymore. The findings in relation the amount of contentment with the service given and parents’ reactions to the various aspects of the support revealed that the project proved to be quite useful. Parents predominantly appreciated the support to make sense of their child’s development and needs; useful techniques for enhancing language and participating in interactive play; and support to the nurseries and playgroups attended by their children. Gregor and Campbell (2001) investigated the thoughts of teachers in Scotland to the inclusion of autistic children into mainstream schools. This study gathered views of 23 expert and 49 mainstream teachers. Only a small number of mainstream teachers thought children with autism should be included in mainstream schools. A number of teachers showed concerns about influences on mainstream students but most were ready to take on more training. Expert teachers were more optimistic, although they accepted potential drawbacks for both factions of children and emphasized that the success of mixing depends on each child. Statement of Issue for the Critical Investigation The present research focuses on the family-professional relationships in primary schools which serve families with young children having behavioural problems, more specifically, autism disorder. The research emphasizes on the significance of primary schools support for families who have children with autism disorder. Methods A practitioner who works with young children in schools was used as a participant for the present research. A structured interview with the practitioner was conducted in order to collect data for the study. Interviews are generally used in studies that explore the relationships of families and children with disabilities with schools. There were two benefits of collecting data using an interview method. First, using individual interview to collect information on practitioner’s experi­ences offered comprehensive and detailed information (Bogdan & Biklen 2007). Second, the interview method permitted me and the participant to interact (Mitchell & Jolley 2001). Thus, one-on-one interview with the practitioner was useful in obtaining detailed informa­tion. The interview guide comprised of 7 open-ended questions. During the interview, I informed the practitioner to be specific and provide in-depth information. In order to conduct the interview written permission was granted by the tutor and the interviewee. Furthermore, permission was also obtained for the interview to be audio taped. Plan for Analysis A coding system was established to analyze the interview data. I studied the interview record and looked for common themes. Using the constant comparative method as described by Glaser and Strauss (1967), categorizes were established. If any of the information did not fit in any of the categories, new categories were made Ethics The adherence to ethics is extremely significant during research in order to up hold the integrity of the research being conducted. There were numerous ethical issues involved in the present research which were addressed accordingly. Firstly, written permission was requested from both the tutor and the interviewee to conduct the research. The interviewee was asked to sign a consent form which indicated that she was participating in the research on her own free will (Resnik 2010). As the interviewee has the right to know the aim of the research being conducted and the use of the results, therefore, the interviewee was clarified the purpose of the research along with the use of the results (Resnik 2010). The consent form also gave the interviewee the right to withdraw herself and/or the information provided anytime during or after the research. According to the Data Protection Act of 1998, the name of the participant along with the data collected was kept private and confidential so that the rights of the participant were not violated at any point during the research (Resnik 2010). Findings The participant of the study suggested that the relationship between family and professional in primary schools which serve families with young children having autism disorder was extremely significant. The interviewee emphasized on the importance of primary schools support for families who have children with autism disorder. Based upon the practitioner’s responses, five themes were developed for the purpose of analysis; autism and the school environment, school support for children having autism and their families, inter-agency collaboration for supporting children with autism and their families, types of support provided for children having autism and their families by the schools and recommendations to improve children with autism in schools. In order to determine, how the response related to each of the fields, careful analysis was carried out. If the response was related to the relationship between autism and overall school environment, it was categorized into autism and the school environment. If the response was related to importance of support of schools for autistic children, it was categorized into school support for children having autism and their families. Reponses related to different institutions working with autistic children and their families were categorized into inter-agency collaboration for supporting children with autism and their families. Responses related to various techniques used by schools was categorized into types of support provided for children having autism and their families by the schools, while responses in relation to different measures that can be taken to improve the functioning of autistic children were categorized into recommendations to improve children with autism in schools. Autism and the school environment The practitioner included in the study suggested that behavioural problems in children exhibit a stable pattern of aggressive, negative or troublesome behaviour towards oneself or towards the society. The interviewee suggested that child behaviour problems are sometimes due to behaviour disorders, many of which start during early childhood. Among these disorder is autism which is a permanent behaviour disorder that starts at a young age. Autism in children typically starts between the age of 1 year and three years. The practitioner reported that: Autism is a lasting behaviour disorder that starts in childhood. The warning signs include; compulsive behaviour, echolalia (recurring use of a word or phrase), impaired social relations, language disorders and ritualistic behaviour. Regarding autism and the school environment, the interviewee indicated that it was common for children with autism to be placed in special needs school rather than regular public schools by their parents. The reason behind this is that many of the instructors are trained to deal with students with autism. On the other hand, some parents feel that by placing children in mainstream classroom environment with other children will elicit positive behaviour and promote learning in an autistic child. The practitioner reported that: The idea behind placing children with autism is that the autistic students will learn both educational and social skills from non-autistic students. Furthermore, it will also help in avoiding separating the children with autism from other children. School support for children having autism and their families The respondent suggested that the school support for children having autism and their families was extremely significant. Similarly, it will reduce the amount of stress that the parents feel while looking after their autistic children/child. The practitioner during the interview reported that: School can work together with the parents to recognize their child’s autism, develop communication skills and implement practical approaches to deal with their child’s behaviour. Furthermore, school support for autistic children will also help relieve certain amount of stress from the parents. Inter-agency collaboration for supporting children with autism and their families Parents, schools and agencies have to increase mutual working relationships to maximize outcomes. The practitioner during the interview reported that: Parents and the community have to contribute in educational planning, goals and interventions. Shared goals and strategies among parents, schools and community are mainly helpful in areas such as communication, social skills and in dealing with challenging behaviour. Furthermore, schools work in partnership with agencies that specialize in behavioural disorders among children to improve their planning and strategies for children having autism. Types of support provided for children having autism and their families by the schools There are different types of supports provided by the schools for children having autism and their families. All public schools have to provide parents with Individualized Education Plans (IEP) that concentrate on the students’ current developmental level. Furthermore, schools can provide family members with information regarding autism from the professional literature in an organized and easy format which can facilitate them in applying various aspects of learning to education and management. The practitioner reported that: Nowadays schools provide specialized training programmes for teachers and school personnel to allow them to fulfil the needs of autistic children. Furthermore, schools appoint expert educational psychologists and special needs examiners who can offer guidance to schools on issues associated with children with behavioural problems such as autism. Similarly, they also support the families of such children by providing them information and management techniques that help them deal with their children in a better way. Recommendations to improve children with autism in schools Regarding the measures that need to be taken in order to improve the children with behavioural problems at school, the interviewee suggested that schools should work together with parents, the community and professionals dealing with such disorders. The interviewee suggested that: Family is the key player in the development and implementation of educational programs for children with autism; therefore, it is important for schools to work in collaboration with the family and other specialized institutions to better meet the needs of children facing behavioural disorders. Discussion The relationship between families and school is critical in supporting children with behavioural disorders (Epstein & Sanders, 2000; Henderson & Mapp, 2002). The findings of the study indicated that practitioner considered the collaboration of schools, family members and the community to enhance the functioning of children having autism or any other behavioural disorder both in school and the society in general. The practitioner in the study suggested that schools supported children with autism or other behavioural disorders and their families in a number ways and recommended certain measures to enhance the functioning of such children in the school environment. The results of the study are consistent with previous researches shows that early educational intervention encourages the long-term growth of communication and social skills (Sheffield Information Giving Network 2009). The results of the study further revealed that all autistics children are unique individuals and require careful consideration to decide on the most appropriate educational setting. Schools catering to students with special needs and homeschooling should offer complete control of the environment and total focus and course of treatment for the autistic child. According to the results, mainstream public schools also offer autistics children with an environment where they can interact with normal children and develop their social skills (Gregor & Campbell, 2001). In the study conducted by Gregor and Campbell (2001) only a few mainstream teachers thought that children with autism should be placed in mainstream schools. On the other hand, expert teachers were more encouraging, although they recognized potential difficulties for both groups of children and emphasized that the effectiveness of integration relies on the individual child (Gregor and Campbell 2001). In regards to the support for children having autism and their families, the results from the present study are consistent with existing literature, suggesting that schools take numerous measures to educate and help autistic children. The study, consistent with Gupta and Singhal (2005), indicate that school support for children having autism and their families is extremely significant. The reason behind this is that children with autism frequently come across numerous challenges during their school years (Gupta and Singhal 2005). The findings of the study suggest that by supporting the autistic children and their families, school personnel can play a critical role in helping the children succeed at school and the society in general (Gupta and Singhal 2005). Furthermore, school can work together with the parents to understand their child’s autism, enhance communication skills and implement practical strategies to manage their child’s behaviour. Inter-agency collaboration for supporting children with autism and their families is extremely significant in order to achieve the desired outcome. The results from the study revealed that constructive social behaviour of children with autism in situations where parents and school personnel work together to resolve behaviour related problems in the school and the society in general. It further states that an increasing number of agencies are working in collaboration to make certain that holistic and synchronized appraisal of need and joint intervention is offered to children and families (Smith, Rowlandson and Bohane 2010). Therefore, parents, schools and agencies that specialize in behavioural disorders among children need to working together to achieve the desired outcomes (Smith, Rowlandson and Bohane 2010). Thus, a shared move would improve learning for the child (Smith, Rowlandson and Bohane 2010). In regards to the different types of support mechanisms provided to children with autism and their families in schools, the results are again consistent with the existing literature. For this purpose, the present study along with Miller (2006) indicate that schools develop IEP (Individualized Education Plan) that assesses the child's specific needs throughout the year and design classroom activities accordingly along with special training programmes for teachers to deal with difficulties of autism. Most school with high quality autism programs also have other therapies available as well, such as occupational or speech therapy (Miller 2006). The results further reveal that, it is important for the schools to offer support to autistic children so that the pressures the families undergoes in rearing up an autistic child can be relieved. Similarly, schools need to employ specialist educational psychologists who offer guidance to educational institutions on issues relating to children with behavioural problems such as autism (Miller 2006). Similarly, the findings indicate that schools also provide family members with information regarding autism which can help them implement numerous aspects of learning to teaching and management. Most importantly, school personnel can provide family member with compassion, a listening ear, and basic problem solving either through individual sessions or group work (Schieve et al. 2007). Regarding the different measures that need to be undertaken in order to enhance the functioning of autistic children in school, it was found that schools need to work increase parent and community involvement while dealing with such disorders. Furthermore, arrangement of special educational programs, by schools, for the families of children having behavioural problems to inform them regarding various issues related to behavioural problems including autism was also considered important. Moreover, schools need to seek help from specialized institutions or individuals dealing with behavioural problems such as autism in children to better understand the related issues and plan the school and classroom strategies accordingly (Miller 2006). Conclusion In conclusion, autism being a life-long development disorder requires early intervention to promote the longer-term development of communication and social skills. The present study highlights the importance offering appropriate support to such children so they can develop and grow into successful human beings by schools. It further emphasizes the need for schools to provide different types of support to the family members of the autistic children as well so that they can understand the difficulties parents go through and help them cope with the disorder of their child most effectively. Furthermore, as parents are a key component in the development and growth of their children, therefore, it is extremely important that different parts of the community to work together to meet the needs of autistic children. Schools should collaborate both with the parents and the community to maximize outcomes. Thus, the most successful interventions are synchronized across the home, school and community and the evolvement of these interventions is a reaction to the need for a mutual approach with a special attention on family environment and quality of life issues. Bibliography Barnard, J, Broach, S, Potter, D, & Prior, A, 2002, ‘Autism in schools: crisis or challenge?’ The National Autistic Society report for Autism Awareness. Retrieved 2nd December, 2010, from http://www.governornet.co.uk///linkAttachments/autisminschools.pdf Bellini, S, Peters, JK, Benner, L, & Hopf, A, 2007, ‘A meta-analysis of school based social skills interventions for children with autism spectrum disorders’, Remedial and Special Education, vol. 28, no. 3, pp. 153-162. Bogdan, RC, & Biklen, SK. 2007, ‘Qualitative research for education: an introduction to theories and methods’ Allyn & Bacon, Boston. Dunlop, A, MacKay, T, & Knott, F, 2003, ‘Social interaction and understanding in autism supporting success in mainstream education for pupils with autistic spectrum disorders’. Retrieved 2nd December, 2010, from http://www.aare.edu.au/03pap/dun03189.pdf Epstein, JL, & Sanders, MG, 2000. ‘Connecting home, school, and community’, Kluwer, New York. Glaser, BG, & Strauss, A L, 1967, ‘The discovery of grounded theory: Strategies for qualitative research’, Aldine, Chicago Gregor, EMC, & Campbell, E, 2001, ‘The attitudes of teachers in Scotland to the integration of children with autism into mainstream schools’, Autism, vol. 5, no. 2, pp. 189-207. Gupta, A & Singhal, N, 2005, ‘Psychosocial support for families of children with autism’, Asia Pacific Disability Rehabilitation Journal, vol. 16, no. 2, pp. 62-83. Henderson, AT, & Mapp, KL, 2002, ‘A new wave of evidence: the impact of school, family, and community connections on student achievement’, Southwest Educational Development Laboratory, Austin, TX. Miller, G 2006, ‘Best schools for autistic children’, love to know. Retrieved 2nd December, 2010, from http://autism.lovetoknow.com/Best_Schools_for_Autistic_Children. Mitchell, M, & Jolley, J, 2001, ‘Research design explained’, Wadsworth, Stanford. Myers, SM, & Johnson, CP, 2007, ‘Management of children with autism’, Pediatrics, vol. 120, no. 5, pp. 1162-1182. Schieve, LA, Blumberg, SJ, Rice, C, Visser, SN, & Boyle, C, 2007, ‘The relationship between autism and parenting stress’, Pediatrics, vol. 119, Supplement February, 114-121. Sheffield Information Giving Network 2009, ‘Factsheet: specialist support for preschool children with special educational needs and disabilities’. Retrieved 2nd December, 2010, from http://www.sheffinfolink.org.uk/OneStopCMS/Core/ErrorHandler.aspx?ref=b50b89e8807c43098e2f0a483244d812&errormessage= Smith, C, Rowlandson, P, & Bohan, L, 2010, ‘Autistic spectrum disorder and attention deficit hyperactivity disorder: developing an inter-agency service for children and their families and schools’, Procedia – Social and Behavioural Sciences, vol. 5, pp. 648-654. Resnik, DB, 2010, ‘What is ethics in research and why is it important?’ NIEHS. Retrieved 2nd December, 2010, from http://www.niehs.nih.gov/research/resources/bioethics/whatis.cfm Vygotsky LS 1993, In: Rieber RW, Carton AS, eds. ‘The collected works of Vygotsky LS: Vol. 2’, The fundamentals of defectology, Plenum, New York. Whitaker, P 2002, ‘Supporting families of preschool children with autism: what parents want and what helps’, Autism, vol. 6, no. 4, pp. 411-426. Retrieved 2nd December, 2010, from http://aut.sagepub.com/content/6/4/411.abstract Read More