Effectiveness of Therapeutic Interventions to Autism - Essay Example

? Effectiveness of Therapeutic Interventions to Autism Introduction Autism can be defined as impairment in growth of brain and central nervous system characterized by impaired social interactions, disorders of verbal and non- verbal communications and stereotyped behaviors which in some cases can be repetitive and/or restricted. The disorder of brain is always characterized with brain malfunctions which affects concentration, memory, emotions and learning abilities and other physical effects such as motor disorders as the individual grows (Compton, 2010). Autism symptoms can be seen as early as when a child is three years old but for proper parenting, it should be noticed in the first three months of age as it is a development condition which in most cases reflects child’s non-responsiveness to the physical and social order (Harris, Rendall & Nashat, 2011) of the environment he/she is in. These may include non- response to the normally expected facial movements, the toddler does not respond to cuddling, the somatic movement when the parent points at something, the toddler does not smile back when smiled at and many more. Medically autism has no exact known cause but it is genetically based in that the changes of nucleotide sequence of the individual as a result of DNA impairment, and rare combination of common genetic variants (Fitzgerald, 2011) are believed to be the major contributors. With three other recognized disorders in the spectrum, together with Asperger Syndrome and Pervasive Developmental Disorder, they have the following signs and symptoms which can be noticed at different stages of growth and development. As children get older, signs and symptoms of autism become diverse; depending with the environment and childcare or nurturing, but the basic ones revolve around impaired social skills with other children, speech and language difficulties, non- verbal communication disorders and inflexible behaviors (Riba & Ravindranath, 2010). For instance, at 12 months of age the child should respond to voices of a name and produce some bubbly sounds trying to mention something that she/he hears in normal occasions, and back or forth gestures such as showing, reaching and/or pointing at something. This would later change with time as at 16 months the child should be having some spoken words or phrases and at 24 months the child should cognitively differentiate common phrases without imitation and repetition (Cook & Bassetti, 2011). At this tender age, these are direct signs that the child is developing autism disorders which in later stages of development are more physical and can be noticed at glance (Thackery & Harris, 2008). For instance, when the child has communication and speech difficulties such as speaking in abnormal voice or tone; repeating same words over and over, difficulty in expressing needs and desires, referring to him/herself in a third party format and cognitively not understanding basic concepts of talking and speech exchange, are symptoms of the condition. Non-verbally, a normal child should pick up on subtle cues and explicitly use body language, factors that necessitate “give and take” aspects of social interactions. Children with autism disorders will in most cases avoid eye contact, use of facial expressions that do not match with what he/she is saying, makes a few gestures while communicating (Tallerman & Gibson, 2012)and traits of unusual response to smells, sights, textures and sounds and abnormal postures with clumsiness and eccentric movements. On behavior flexibility, a normal child should have flexible and responsive behaviors which can be restricted with time and space, little obsession in their daily activities and/or cognitively reflective interests that change with time and environment(Hart, 2011). Children with autism behave exactly opposite in that they follow a rigid routine for instance the same route to school or to shop, they are preoccupied with narrow topics of interests, have difficulties in maneuvering to changes in environment or their normal routine, repeat the same kind of activities over and over again and they over- concentration on a single part of an object or process for a long time (Benaron, 2009). Therapeutic Interventions to Autism Therapies in biological and medicine context mean processes which can be gradual or sequential designed to heal and cure or attempted remediation to a health problem in curbing deterioration. Autism therapies are designed and objected to lessen deficits and abnormal behaviors associated with the disorder in order to improve on the functional independence of affected individuals and quality of life especially in cases where brain underdevelopment is involved. As a development disorder, it should be noted that a child can suffer from one disorder to the other with time and environment and early intervention is paramount to assist reverse the situation and enable normal development of that child (Maiese, 2011). Therapeutic interventions involve treatments which are tailored to the child’s needs such as medical management and educational interventions or involve psychosocial therapies such as intensive and sustained education programs and behavior therapy. Theories and studies have suggested mitigation and intervention approaches which despite methodological problems that inconclusively prevent efficiency, can be applied solely or combined to reverse the condition and/ or mitigate deterioration. Educational interventions on the other hand have been effective to school going children on global functioning and intellectual performance though neuropsychological disparity in reports shows a variation of what is recommended and what is actually given (Han & Poppel, 2011). In addition, medical approaches of treatment have proved fruitful in some instances where psychoactive drugs and anticonvulsants have been applied while further studies suggests alternative approaches due to side effects of medical approaches. This paper will evaluate therapeutic interventions by analyzing their rationale and applications and later investigate the effectiveness of these interventions in mitigating the disorder in different ages and recommend where necessary. In addition, it will seek to draw empirical support in quality-of-life contexts by validating intervention’s applications and relevance to real life; ascertain the overall cost to the affected and society at large, evaluate alternative therapies and interventions and effectiveness of scientific and conservative/ subjective approaches. Relationship based Interventions These are models designed to help children reach and improve early developmental milestones such as development of interests in real world phenomenon, intentionality and reflective aspects of actions and aspects of intimacy or cordial relationships. It is family based program that draws relevance on the belief that development of dynamic intelligence; take different perspectives, process information simultaneously, cope with change and ability to think flexibly, is the key to improving quality of life children with autism (Landreth & Bratton, 2006). This kind of therapeutic intervention is based on the fact that relationships at different stages of growth and development play a major role in influencing the outcomes of individual’s perception of the past, current and the future. The objective of this intervention is to help children create a stronger bond with people and later be transformed into the environment and other unseen social and cultural phenomenon in the society (Jordan, 2009). Effectiveness of Relationship Therapy Relationship development therapy is believed to have much impact in reversing and counter attacking autism in toddlers, school going children and adults in later stages of development. As a developmental therapy it seeks to highlight the core precepts of understanding child’s sensory differences, follow child’s leads and use these leads to encourage him/her climb up the developmental ladder (Louis, 2012). It is based on the principle idea that principal shortfalls of autism are as a result of sensory variations which in turn affect individual’s motor planning abilities, relations and communication with others. The principle study approach is applied in this intervention in that the child under study is evaluated on the basis of different relationship within his/her environment with time and variations of the response recorded. It is a simple and effective model in that with the family as the basic source of knowledge and adaptation to children, primary data can be collected from other siblings or from parents which necessitates the course of action (Lipchik, 2009). For instance, information on early development of a child, his/her medical history and the external influences coupled with his/her response can be analyzed by simply asking the parent or a near source. One of the methods to ascertain the effectiveness of the relationship therapy is the floor time evaluation in which playful facilitation redirects the child with the therapists. This will help the child to become more social and avoid repetitive clumsiness and develop symbolic activities. The process of evaluation is taken regularly and consistently throughout the study based on the fact that children will feel more secure expressing their feelings to a stranger but in presence of a relative, which with the interactive skills by therapist the child will open up his/her problems. Rationale of Relationship Therapy Relationship therapy works on the rationale that in development stages children need to feel secure and look up to the closest individuals as a source of motivation and confidence in their undertakings. A child who is suffering from autism needs assistance from individuals who can understand him/her, and effective strategies need to be applied for effective reversal and mitigation. One strategy used in this intervention is regulation and interest in the world such that measures are taken to fine tune the environment that the child is in to ensure that he/she is calm and feeling well enough to attend to anyone or attempt any activity of choice (Mark-Smith, 2011). This is based on the fact that freeing one’s conscious while approaching someone or attempting something is motivational and reflective such that he/she can express feelings in a regulated manner which is more adaptive to the environment. Another strategy is that of engagement and Relating in that the child is given a chance to relate to the environment and develop special relationship with caregiver or someone he/she can freely relate with. As part of cognitive development, this will help the child in creating a difference between inanimate objects from people which in the long run will improve the social relations aspects of a child with autism (Cotugno, 2009). A two-way intentional communication technique is also used in this therapy where simple back and forth interactions between the child and care taker takes place. At this point the child is introduced to physical wave’s movement such as pointing of some pictures or object; physical sensory stimulation such as tickling, and anticipatory play (Proulx, 2009). This is designed to stimulate reflex action of the nervous system but in a coordinated manner whereby the care giver/ therapist monitors the response with concentration on magnitude and variation of these responses. Another strategy in this intervention is the social problem solving whereby the care giver is supposed to introduce a problem to the child and device physical or channels of response by the child. For instance, the caretaker can disturb the child to make the child uncomfortable then whenever he/she starts to cry the caretaker can use gestures or interaction to help him stop crying. Also the caretaker can babble to indicate the need of joy, pleasure or facial expressions that indicate annoyance to the child to ascertain how the child responds, which is the use of pre-language skills to show intentions (Taylor, 2008). Alternatively the caretaker can use the technique of symbolic play whereby words, pictures or symbols are used to communicate ideas, thoughts or intentions. The rationale behind this technique is to ascertain the cognitive response by the child in relation to the physical objects that the child can see. This will be important in monitoring the deviation of what the child wants from what he/she needs and the results in form of communicative response and adaptation to the physical body reactions/ responses (Hall, 2006). Bridging ideas is another technique used in this approach in that therapist seeks to incorporate new ideas to the child in a bid to help develop logic, emotional thinking, reasoning and instilling sense of reality to the child. The rationale behind this stage of the intervention is that having introduced the child to communication, social problem solving and relations; it is prudent to help the child understand the realities involved in phenomenon to allow free transformation and unrestricted or flexibility in behavior change (Guimon, 2008). Relationship based interventions is a stage modeled approach with which its successful stages dictates the progress to another and in case one stage fails or is not efficient, the subsequent stages may not be fully successful though this can be pegged on the environment and the extent of relationships in the child’s process of growth and development. One challenge that presents itself with this model is its linear concentration with cases of infants, toddlers and children withholding the fact that unrecognized autism is evident in adulthood, and as a developmental disorder, the intervention should incorporate treatments or mitigation procedures past the children age. Occupation Therapy This is an intervention designed to combine various treatments so as to develop, help recover and/ or maintain daily living or working skills for people with development, physical or mental disorders. Autism as a development disorder sets in such that the intervention seeks to help recover the disorder by assisting the affected individuals through centering on their objectives (Thew, 2011) that is, the intervention is client- based through tasks modification or teaching new skills to help the client adapt better to his/ her objective. Effectiveness of Occupation Therapy Autism as a developmental disorder can develop at different stages of growth and to some extent at work place due to pressures at job place and thus we cannot rule out adulthood stage in the analysis. Occupation serves in many cases as the source of livelihood and it is given priority in daily undertaking of any individual such that failure or underperformance in the area of specialization has long term effects on health and development (Townsend, Stanton & C.A.O.T, 2008). Therapy’s focus on measures to increase productivity and performance in these areas serves as the best and basic relevance to clients with autism much more by devising ways to increase participation. For instance, by teaching new skills of adapting to ever changing occupation environment goes further into helping an individual accommodate pressure and tension in that he/she can find alternative channels of solving a problem. In addition, by modifying tasks to help fit the environment would help the child or the client cognitively devise new approaches or perspectives of looking at the problem (Ross, 2009). This would help improve the non-verbal communication between the client and the phenomenon in that the mental concentration or the adaptation of the client to the specific task would reflect the same reaction to the external world and by devising new approach would help flexibility and behavior change. Rationale of Occupation Therapy Occupation therapy works with infants, toddlers, children, youths and families in specific settings in a bid to help them develop mutual skills that help them in their occupations. The techniques used in this therapy are behind the rationale that children and youth require special kills which include psychosocial needs that help them participate in meaningful life events (Christiansen, Baum & Bass-Haugen, 2005). Analyzing occupations include promoting processes that enhance normal growth and development, education and social skills, feeding and playing with an aim of enhancing holistic development. The major techniques involved in this intervention include promoting wellness programs in schools to prevent obesity and facilitating hand- writing programs to school going children. The rationale behind these techniques is that self-realization and appreciation boosts self-esteem, a deficiency in children and youth with autism, and by this, therapists promote confidence, instill reality, emotional thinking and reasoning (Randomski, Latham & C.A.T, 2008). This goes further in helping the affected individuals to adapt to new environment such as school with ease as these programs are more engaging as a group than individualistic, giving flexibility of adaptation and cognitive development (Mariani & Levin, 2007). In addition, by promoting functional skills for living in children with developmental disabilities and providing individualized treatments for sensory difficulties goes further in addressing psychosocial needs of a child or youths and teaching effective coping strategies. Another technique in occupation therapy is health and wellness which is based on the rationale that autism as a developmental disorder can be a product of physical and mental health disorders. The connection in this is that autism will be gradually manifested to individual who have either poor physical or mental health (Hoeger, 2012). For instance, poor physical health would lead to poor mental health which is associated with poor cognition, temperament, poor reasoning and decision making and repetitive or compulsive behaviors. By enhancing factors that improve quality of life and reduction of health care disparities help address the cases of autism in that they promote mental functioning of an individual who in turn improve physical processes and attitudinal approaches in one’s occupation. Prevention of disease and injuries and secondary conditions will go further in promoting wellbeing of those with chronic or persistent autism as a form of psychological relief (Svirko & Hawton, 2007). The rationale behind this intervention is to combine psychosocial functions with those of the environment to help reverse the condition. For instance, schedule maintenance and routine building will go an extra mile in addressing coping strategies for people with these disorders; childcare, community access and participation, leisure pursuits and money management will help in social skills development which in the long run will promote the reversing procedures. Occupation therapy approaches seeks to give guidance to family members and use of creative media as a therapeutic activity; comprehensive home jobs evaluations with appropriate recommendations, performance skills assessments and treatments evaluation and adaptive equipment recommendations and usage. Autism as a developmental disorder will be affected by inefficiency in any of this within the workplace or at home since occupation varies with time and space and to reverse conditions that come with these malfunctions (Engel, MacKinnon & A.O.T.A), effective strategies within the occupation approach need to be addressed. Effectiveness of occupation therapy can be assessed using generic models such as person environment performance model, occupation therapy intervention process model, functional group performance model and functional information processing model; presented in a graphs or chats to represent the impacts of the approach in reversing autism. Scientific approaches of data collection, recording and analysis assist in data validation though as a psychological measure it is difficult to have concrete figure due to inability of numerical evaluation of behavior. Conclusion A strong argument can be made for relationship based interventions and occupation therapy in that they develop mechanisms of reversing autism at ages of detection and critically analyzes the procedural applications. Applying scientific means to evaluate therapies will be functional in the analysis of the observed and recorded outcomes but for the effectiveness of therapy in contextual application, the subjective options of how the intervention has taken place gives primary data and information of the intervention. 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