Autism in the Spectrum of Pervasive Developmental Disorders - Research Paper Example

?Running Head: Autism Autism Outline i. ii. Introduction iii. Symptoms of autism iv. Tests for autistic children v. Treatment of autism A. Applied Behavioral Analysis (ABA) B. TEACCH C. Medication D. Diet vi. Conclusion Abstract There are many children in the world who seem to have a problem with learning, communicating with others and other peculiarities that make them seem “abnormal”. A wide range of disorders can be the cause of this behavior in many children and are classified under Pervasive developmental disorders (PDD) (Caronna, Milunsky, & Tager-Flusberg, 2008). There are many disorders that fall within this category, each with its own unique set of manifestations on the child. However, there are commonalities in this spectrum that include impairments or delays in the cognitive development of children, abnormal social behaviors and impairment or delays in communication. The disorders include Asperger’s syndrome, childhood disintegrative disorder (CDD), pervasive developmental disorder not otherwise specified (PDDNOS), Rett’s syndrome and Autism. These disorders can be recognized during infancy and any time before the child reaches 3 years of age. The common symptoms of PDD include: unusual and repetitive behavior, problems with social interactions as well as problem with language. The child may also manifest an unusual response to loud noises and bright lights (Shah, Dalton & Boris, 2007). Although these symptoms are common in all the disorders, their severity and variability differ from individual to individual. There are a variety of remedies that can be administered in order to reduce the symptoms and attempt to manage the disorders. This paper is aimed at the extensive discussion of Autism, in the spectrum of PDD. The possible causes, characteristics, management and treatment of the disorder will be discussed below. Introduction Autism is a disorder that is characterized by repetitive behavior that is restricted. Its manifestation is in impaired social interactions of affected children and also impaired communication. The effect of this disorder is in the brain where there is an alteration of the way that synapses and their respective nerve cells connect and organize. How this happens is not yet fully understood by the researchers in Autism. The disorder is largely genetic and there is ongoing research into whether there is a mutation that leads to one having autistic genes or there is just an unexplained confluence of genetic material that is possessive of autistic genetic material (Abrahams and Geschwind, 2008). In many cases, autism is associated with birth defects but again, there is inconclusive evidence as to whether this is actually the case. Many people purport that the disorder is caused by the environmental agents that are brought about by human activity. Some of the causes that are thought of include diet, body’s inability to utilize certain components like vitamins and minerals, changes in the digestive tract changes, sensitivity to vaccines, and mercury poisoning. There is a vaccine that has been developed aiming at reducing the prevalence of autism in children under the age of 3. Worldwide, surveys have shown that 1 to 2 children per every 1,000 are affected by the disorder. This is in sharp contrast to the prevalence rate in the US where 9 in every 1,000 children are diagnosed with the disorder. Additionally, autism is common 3-4 times more in boys than in girls. However, there has been an increased number in the reported cases of autism since the 80’s. This fact does not necessarily point to an increased number in the people affected but rather an improvement in the manner of detection of the disorder. Parents whose children have the disorder usually start noticing the symptoms when the child is about 2 years old (Arndt, Stodgell and Rodier, 2005). From then, depending on the child, the symptoms may develop slowly or may become severe at that stage in development. Whichever, the case, there are a number of early interventions that can be applicable in the management of the disorder from that initial stage. There is no known cure for the disorder although there have been reported cases where individuals have actually recovered from it. In general, many people with autism do not live to be independent into adulthood although the interventions applied help them to improve the overall quality of their lives. With increased cases of autism being reported, many parents are skeptical that the vaccines given to their infants could be the causes of autism. Although this is a very active area of research, there has been no conclusive evidence to support this assertion and hence, the American Academy of Pediatrics and the Institute of Medicine encourage parents to continue vaccinating their children as the consequences of absconding on these vaccines could be dire for their children. Symptoms of autism As discussed above, the manifestation of autism in children usually starts when they are between 18 months and 2 years of age. The most common symptom is that the children usually have difficulties in pretend play, a common feature of children in that age. Additionally, they do not interact well with others and also do not seem to have the capacity to communicate as other children in the same age bracket do. The problem with language does not necessarily have to occur when the child is 2. In fact, a child may develop naturally until a certain point where regression is witnessed. Skills that had been gained are lost and the child seems to deteriorate rapidly. This type of autism is commonly referred to as regressive autism (Levy, Mandell & Schultz, 2009). In order to tell whether a child has autism, one has to check whether their common senses of touch, taste, sight, hearing and smell are overly sensitive. Whether they react negatively whenever their routines are suddenly changed, whether the child seems to have a strong attachment to an inanimate object and whether there is a repetition of a particular body movement. The child will usually become distressed once something offends him/her that would not normally distress a normal child. As an example, children with autism may refuse to wear certain items of clothing regarding them as “itchy” where a normal person cannot feel the itchiness. Symptoms in children with autism may vary in severity depending on very many variables including the type of autism and its initial effect on the child. In many cases, children with the disorder do not sustain a social conversation with others for any given period of time. Many children, unless those with regressive autism, develop the language skills fairly slowly and mostly employ gestures rather than spoken words. Other children have no notion of self, and will usually refer to the third or second person whenever they are referring to themselves. More often than not, an autistic child will not adjust his/her gaze to look at the object or event that other people are looking at and seems to be oblivious of the object or of the occurrence. In the same action, the child will not point to the object that he/she wants others to turn their attention to. When such a child is set in front of a television or a radio, he/she tends to repeat what commercials say over and over again. The child also gets fascinated with nonsense rhyming and will keep at it for a long time, tirelessly. Autistic children have many peculiarities when interacting with others. Mostly, they do not make any friends and spend all of their time alone. This means that such a child does not have an interest in interactive games as the others do and always prefers to play alone. The child will also tend to treat others like objects and seem incapable of being empathetic. Furthermore, most autistic children tend to be withdrawn and will neither meet eye contacts nor will they respond to smiles that are directed at them. In responding to stimuli, an autistic child will either have heightened or low sensory manifestations. For example, during normal conversations between other people, the child may hold his/ her ears as if the noise is too loud. On the contrary, some autistic children may look startled by loud noises while some may seem oblivious of the noise. This diverse reactions are manifested in all the senses and more so in touch. Many autistic children find physical contact too overwhelming or over stimulating and are usually visibly distressed whenever a person touches them. Some of the children seem to have developed a resistance to pain and do not respond normally when hurt. In other cases, autistic children tend to continuously rub on surfaces, suck on their fingers and lick other objects. During play, the autistic child will not appear eager to imitate the actions of the others and will mostly resign to a solitary place to avoid the company of the others. The imagination of an autistic child does not seem to be as prolific as that of the other children as he/she will not partake in any kind of pretend or imaginary play. Autistic children are very dramatic and tend to throw tantrums at very trivial things. Since they are oversensitive to things, almost everything causes them to act up. Additionally, the behavior of such a child seems to border on repetition. He/she will get stuck on a single topic or on a single task and will not stop until after a very long time. This child will not concentrate on anything anyone tells him/her since his/her attention span is very small. This is because those children with autism tend to have very narrow interests. If for example, one says something that the child disagrees with, a shoulder shrug may be repeated for a long time even after the topic has changed. This is because even though such children have a knack for repetition, they are also very overactive hence manifest singular behavior without seeming to tire. The opposite is also true that even when a grave thing has been done to another child with autism, his/her condition might cause hi/her to be very passive and seem un-offended or uninterested in the action against him/her. Tests for autistic children When a parent realizes that his/her child has not reached the various milestones that other children do in the course of development, he/she should take the child for examination by a pediatrician or by a doctor if the concern of the parents is still persistent. The language milestones that children should achieve start when they are 12 months old until they attain 2 years where they can communicate effectively. In the beginning, the child should be able to babble. At the same time, the child should be able to do basic gestures like pointing or waving. When he/she is 16 months old, he/she should be able to pronounce single words and that should progress to two-word phrases at 24 months. While all these may be noticed in a child, it is not enough to assume that the child is automatically not autistic (Newschaffer, Croen & Daniels et al., 2007). This is because children with regressive autism do develop normally until a certain point from where they start regressing. There is a Checklist for Autism Toddlers (CHAT) that entails blood tests, hearing evaluations and screens for other symptoms that are associated with autism. Another tool is the Autism Screening Questionnaire. However, the eventual diagnosis of autism can only be made by a qualified professional. The Diagnostic and Statistical Manual IV is what is referred to when attempting to make a diagnosis for autism as there is no biological test developed to conclusively detect autism (Dover & Le Couteur, 2007). There is an avalanche of tools that are employed in order to determine the health of the physical and nervous systems so as to rule out autism. They include Childhood Autism rating Scale (CARS), Pervasive Developmental Disorders Screening Test - Stage 3, Autism Diagnostic Observation Schedule (ADOS), Gilliam Autism Rating Scale and Autism Diagnostic Interview - Revised (ADI-R). The wide range of tests is important to assess all the symptoms of autism including the examination of the genes and also metabolic testing. The former is aimed at looking for any abnormalities that may be in the child’s chromosomes. Treatment of autism There is always an advantage attached to the early detection of any disease or disorder. In the same spirit, the early detection of autism is very vital in its management. The programs that are developed for children are highly individualized and usually focus on the particular interests of the child. Teams of professionals or a specialist are charged with the development and design of the programs that are aimed at assisting those with autism. There is the inclusion of Applied Behavior Analysis (ABA), special medication, occupational therapy, physical therapy and language therapy (Johnson & Myers, 2007). In addition, the child may require vision and sensory therapy depending on the condition. A combination of these therapies is usually more effective in contrast to just the application of one. Applied Behavioral Analysis (ABA) This entails one-on-one teaching with a view of imparting specific skills into the child with autism. It is very effective for younger children and is aimed in making them develop functional skills so that they are normal members of the community they live in. Although this method has been touted as being highly effective, it has the disadvantage of being very expensive as it employs the services of a behavioral psychologist who undertakes the program in the home setting of the child. The expensive nature of this program is because it is not supported by the state and is a private initiative of the parent towards the child. TEACCH The abbreviation above stands for Treatment and Education of Autistic and Related Communication Handicapped Children. The program is aimed at making children adapt to the environment by organizing it using visual cues and pictures. The major point of departure of TEACCH form ABA is that the former does not expect the child to develop typically with the treatment. The program was undertaken as a statewide initiative in North Carolina. Medication The medication that is administered to individuals with autism is not aimed at curing the disease but rather suppressing the symptoms that are associated with the condition. Among the emotional problems and behaviors that the medication is aimed to contain are: difficulty in sleeping, anxiety, impulsiveness, irritability, aggression, outburst, mood swings, attention deficits, hyperactivity, tantrums and extreme and uncontrollable compulsions. Specific medicines include risperidone, approved to contain irritability in children between 5 and 16 years old. Additionally, there are medications meant to stabilize moods, SSRI’s, divalproex sodium and stimulants like methylphenidate (Burgess & Gutstein, 2007). Diet There has been a research in the diet that is fit for children with autism. Interestingly, autistic children tend to respond to foods that are both casein and gluten free. Casein is mostly found in all dairy products including milk whereas gluten is found in barley, rye and wheat. When deciding what diet to give an autistic child, it is prudent to seek the counsel of either a gastroenterologist or a registered dietitian. Conclusion Autism is a very serious disorder as it affects the normal functioning in children and persists into their adulthood. Traditionally, there were very many myths that were associated with the disorder. However, presently, with extensive research in the disorder, some of the myths have been dispelled but some have persisted. No conclusive research has shown the causes of the disease although many people speculate many metals and foods to be the cause as it is with cancer. The only thing that is known for sure is that the disorder is transmitted in genes. However, not even that is conclusive as researchers speculate that either a mutation or a confluence of autistic genetic material occurs. The disorder is witnessed in children below the age of 3 and is characterized by impaired social interactions, impaired communication and repetitive behavior. Although there are many disorders that fall within the autism spectrum, each has its own characteristics apart from the common ones. Children that suffer from the disorder are likely to be withdrawn and antisocial. A wide range of indicators of autism have been discussed above. Autism does not have a known cure. However, the disorder is managed using different methods that are aimed at improving the quality of life of the autistic individual. Several therapies can be applied simultaneously to try and promote the normal functioning of affected individuals. Although medication is administered, its aim is to suppress the symptoms of autism rather than to cure the disease. Additionally some diets have been thought to be disagreeable with the disorder but the decision should be that of a qualified professional rather than that of the child or layman. In conclusion, it is prudent to state that although the disorder is difficult to manage and live with, there is need to appreciate the fact that the conditions have improved much and cannot be compared to the ones that existed some years back (Bertoglio & Hendren, 2009). With the appropriate therapy, some symptoms of the disorder can be suppressed and thus the life of the individual is considerably improved. References Abrahams, B.S. and Geschwind, D.H. (2008). Advances in autism genetics: on the threshold of a new neurobiology. Nat Rev Genet 9(5):341–55. Arndt, T.L., Stodgell, C.J. and Rodier, P.M. (2005). The teratology of autism. Int J Dev Neurosci 23(2–3):189–99. Bertoglio, K. & Hendren, R.L. (2009). New developments in autism. Psychiatr Clin North Am 32:1-14. [PubMed] Burgess, A.F. & Gutstein, S.E. (2007). Quality of life for people with autism: raising the standard for evaluating successful outcomes. Child Adolescent Mental Health 12(2):80–6 Caronna, E.B., Milunsky, J.M. & Tager-Flusberg, H. (2008). Autism spectrum disorders: clinical and research frontiers. Arch Dis Child 93(6):518–23. Dover, C.J., & Le Couteur, A. (2007). How to diagnose autism. Arch Dis Child.92:540-545. [PubMed] Johnson, C.P., & Myers, S.M. (2007). 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