Children with Autism Aged from18 Months to 4 Years Old - Literature review Example

Title Author Institution Affiliation Autism Autism is a health problem that affects people all around the globe. It has no discrimination on the basis of nationality, social status or ethnic background. This is a problem that demands for the attention of the whole world both at the national and international levels in order to better the lives of the people and families continually suffering the effects of this serious disorder. Autism is a developmental problem that persist in life and its affects the relationship of a person with the surrounding environment and interactions with people around. Fundamentally, it is a neuro developmental disorder that is exhibited through abnormal social interactions, communication and repetitive and restricted behaviour. In children, signs of autism appear within the initial 2 years. The signs show gradual development although in some children, normal growth may be witnessed before the child experiences a relapse. In many countries around the world, researchers are struggling to pull manufacturers, doctors and educators to work on the development of curricula, therapies and evices required to support and guide children affected by autism. It is not easy to determine the rates of prevalence of autism in various countries. This paper presents a literature review about children with Autism aged from 18 months- 4 years old. Autism, Its causes, diagnosis and Treatment According to Marchant, Hussain & Hall (2006, p. 230) autism is the impairment in social relationships, language and rigidity and lack of flexibility in thought processes. Autism results from both environmental and genetic causes working in combination. Certain cases of autism are caused by the infection of the baby when still in the mother’s womb. Infections may be caused by the use of cocaine and alcohol as well as other causes such as rubella. Wong (2007) found that researchers propose other environmentally related causes, but these are still controversial. An example is the hypotheses of vaccination which has since been rejected. A contrary view is given by Ratajczak (2011) who proposes a genetic cause to autism. Autism interferes with the processing of information within the brain cells. To help children with autism get social and communication skills as well as the ability to care for themselves, Twoy, Connolly, & Novak, (2007) found that there is need for early behavioural and speech interventions. There is no effective cure for autism, but cases of children recovering from this disorder have been reported. Many children affected by autism may not be able to live on their own when they reach adulthood although a few may become independent. A study by Marchant, Hussain & Hall, (2006) revealed that there is much variability is autism as a disorder. It appears for the first time when the child is still an infant. Autism affected people may display impairments in certain aspects, but may also be normal in others or even show superiority in other areas. Overt symptoms appear slowly by the age of 2 or 3 years and they persist in childhood although in most cases they are muted. Most authors agree that the condition is not distinguishable by a single symptom. For example, Ratajczak, (2011) and Lee et al (2008) cite impaired communication and impairment in the child’s social interaction with others among other symptoms as some of the most reliable symptoms. Diagnosis and treatment Diagnosis of autism disorders is done on the basis of behaviour and not on cause and mechanism. Several instruments are available for diagnostic purposes. According to Wong (2007) two of them are very useful on researching about autism. They include the Autism Diagnostic Observation Schedule and the autism Diagnostic Interview Revised. The Childhood Autism Rating Scale is applied in clinical practice to gauge the degree of autism severity based on observing children. In some cases the use of the Diagnostic Interview for social and communication disorders is used. Using physical examination as well as the history of development of the child, a paediatrician may undertake an examination of the child (Marchant, Hussain & Hall 2006). If necessary, evaluation and diagnosis are done with assistance from specialists. They do observation and assessment of communication, cognitive, family and other factrs by use of standardized tools and consider any related medical conditions. In the process of diagnosis, a pedriatric pneuropsychologist helps in the assessment of behaviour and cognitive skills so as to assist in diagnosis and suggest educational remedies. It may also help to perform a differential diagnosis which may put into consideration the intellectual disability of the child, problems with hearing and a particular impairment in communication (Ratajczak, 2011). However, Merchant et al (2006) found that the diagnosis of autism presents more complexity than the suggested distribution of those specific characteristics. Cohen (1997) adds that degrees of impairment displayed by children with autism exhibit very broad variations. Autism adds to the complexity of diagnosing the coexisting psychiatric disorders including depression. Autism can at times be diagnosed by the time a child is 14 months although it may happen more successfully in the first three years of age. For instance, a child 12 months old may meet diagnostic criteria but the chances of proceeding may be lower than those of a three year old meets the same criteria. The Struggles of Autistic Children (i) Sluggish Social development Social deficits create a distinction between autism and other related disorders. Children suffering from autism display social impairments and they fail to have intuition about other people. Unusual development in the social aspect clearly shows in early childhood (Bayat, 2007). They may not look at others or smile often and they their response to their own names is limited. Toddlers with autism show a striking difference from social norms. For instance they show less eye contact and they take turns less often. They also cannot make use of simple movements, for example pointing at objects as a way of self expression. A study by Altiere & Von Kluge (2009) revealed that children between the age of three and five years have a lesser likelihood of displaying social understanding, showing spontaneous approaches to others, displaying response and imitation of emotions, taking part in verbal communication and taking turns at tasks with other children. These children have no obvious attachments to the people that give them primary care. Research shows that children with high levels of autism are prone to loneliness of a higher frequency and intensity than other children without autism. This is in contrary to the prevalent belief that children suffering from autism prefer to spend time alone (Lee, Harrington, Louie & Newhoffer, 2008). Affected children have difficulties marinating friends. Researchers have produced anecdotal reports about violence and aggression in children with autism, but only few systematic studies on the same exist. Altiere & Von Kluge, (2009) found that there is scarce statistical evidence suggesting that autistic children with intellectual disability display tantrums, aggression and destruction of property. (ii) Communication and behaviour Approximately 30 to 50 percent of children with autism lack the ability to develop sufficient natural speech to satisfy their communication needs for each day (Bayat 2007). There may be differences in communication which begin in the first year. Such differences include a delay in the beginning of babbling, abnormal gestures, highly reduced responsiveness, and strange vocal patterns that the caregiver may not be able to synchronize. Mancil, Boyd & Bedersem (2009) found that in year two and three, children with symptoms of autism show low frequency and less diversity in babbling, combining words, and they show gestures that they don’t often integrate with words. The children rarely make requests or share their experiences and they often repeat the words spoken by others. For them to develop functional speech there is need for joint attention (Ratajczak, 2011). These children often have problems with imaginative play and with the development of symbols into understandable language. Autistic children are dangerous to themselves and others when left unattended. For example, they may attack other children or display self destructive activities such as skin-picking, banging or hitting their own heads, biting their hands and poking their eyes. No particular self injurious behaviour can be linked specifically with autism but in cases of autism, there is a high occurrence pattern and intensity of these abnormal behaviours. According to Cohen (1997), autistic children may display symptoms that are not related to the diagnosis, but these symptoms still have a negative effect on the child or family members. A small percentage of autistic children may display rare abilities such as splinter skills. Most of children with autism display abnormal eating behaviour and therefore this occurrence was used in the past as a diagnostic indicator. The biggest problem with eating is selectivity. However, studies show that in some cases there may be eating rituals, gastro-intestinal problems and rejection of food all together (Gray 2002, Bayat 2007). However, there is no published reliable data to prove that autism compounds the problem of gastro-intestinal complications in children. As some studies on this topic show that autism is accompanied by gastro-intestinal problems, other researchers have contrary findings and therefore, the relationship between autism and gastrointestinal problems is not clear. Challenges Faced by Parents of Children with Autism Since the task of parenting an autistic child is massive, parents need allot of social support to help them cope with the condition. Unfortunately, parents fail to enlist social support due to the abnormal behaviours of their children (Mancil, Boyd & Bedersem 2009). The society is so intolerant and the parents also feel judged by the society for failing in their role of parenthood hence their lack of desire to engage in activities away from home. Parents of children with autism have many challenges. Children with autism are normal in their looks and therefore, the society expects them to behave well (Gray 2002). There are four issues that make giving care to children with autism a difficult task. These include the unpredictable and damaging behaviours of the child, the desire for routine for sameness in children, problems with relating to the child’s way of processing sensory stimuli and problems in development of communication and the absence of emotional bonding. The behavior of a child who has autism can result in much anxiety, stress and distress for his parents. A number of authors agree that stress is a common problem for parents with autistic children. For example Mancil, Boyd, & Bedersem, (2009), and Gray (2002) all agree to this. Researchers of familial stress have shown that parents of children with autism have high stress levels than those of children with other disorders related to development (Mancil, Boyd, & Bedersem, 2009). However, a different study by Bayat (2007) shows contrary findings. He reveals that autistic children with superior qualities may not be a source of elevated stress levels to their parents because their superior qualities are advantageous in one way or another. When the members of the extended family and friends cannot tolerate the behaviours of a child, the parents have feelings of incompetency and self condemnation for not being effective parents. In a certain study about parents of children with autism, Mancil, Boyd, and Bedsem (2009) also discovered that parents preferred to isolate themselves than face people to explain or account for the unacceptable behaviour of their children. From his study, Gray (2002) states that grandparents and other members of the extended family criticized the behaviour of affected children and blamed parents for poor parenting. When children display temper tantrums, parents feel judged for failing to train them the right way (Cohen 2007). Some parents find it hard to carry their children with them to places outside the home because of embarrassment. They fear that the children may display humiliating behaviour. Fathers also face the same problem because it is hard to keep apologizing to people for the child’s behaviour. According to Stillman (2005), parents find it hard to understand whether the behaviour of their children results from autism. They often feel stigmatized as a result of the behaviour of their children. Parents rely on social support to help them cope with the conditions of their children. Therefore, losing that support due to unusual behaviour in their children makes the whole parenting role very difficult. Altiere & Von Kluge, (2009) noted that parents can be alienated by friends and fail to get invitations to social events whenever their children show symptoms of autism. A child with autism has a 70 percent lesser likelihood of attending church with family members compared to other normal children (Lee, Harrington, Louie, & Newshaffer, 2008). Conclusion In conclusion, it is evident from the literature reviewed that autism is prevalent in children below the age of four years and that little can be done to avoid it. It is known all over the world, and most of the cases occur among boys than girls. The existence of autism in the life of a child may be the result of a combination of both environmental and genetic factors. Children with autism suffer from slow development of social skills and difficulties in communication. Other symptoms include aggressive behaviour that may be violent, disturbing and self destructive. The news that a child has been diagnosed with autism can alter the lives of people in the family. It may change the identity of the parents, affect their social lives, limit their movements and alter important decisions about their careers, the behaviour of the children, and demand for routine in children, inability of children to process sensory stimuli, communication problems and failure to bond emotionally. Therefore, parents need to have strong social support from friends and relatives to help them cope with the stress related with bringing up the affected children. The parents also need training on how to handle their autistic children and apply various coping strategies especially those applicable to their situations. References Altiere, M. & Von Kluge, S. (2009). Family functioning and coping behaviors in parent’s of children with autism. Journal of Children and Family Studies, 18, 83-92. Bayat, M. (2007). Evidence of resilience in families of children with autism. Journal of Intellectual Disability Research, 51(9), 702-714. Cohen, D.J., (1997). Handbook of Autism and Pervasive Developmental Disorders. 2nd Edn., John Wiley and Sons, New York. Gray, D. (2002). Ten years on: a longitudinal study of families of children with autism. Journal of Intellectual and Developmental Disability, 27(3), 215-222. Lee, L., Harrington, R.A., Louie, B.B. & Newhoffer, C.J. (2008). Children with autism: Quality of life and parental concerns. Journal of Autism and Developmental Disorders, 38, 1147-1160. Mancil, G. R., Boyd, B.A. & Bedersem, P. (2009). Parental stress and autism: are there useful coping strategies? Education and Training in Developmental Disabilities, 44(4), 523-537. Marchant, P., A. Hussain and K. Hall, (2006). Autistic spectrum disorders and Asian children. Br. J. Educ. Stud., 54: 230-244. Ratajczak H. (2011). Theoretical aspects of autism: Causes—A review. Journal of Immunotoxicology, 8(1): 68–79. Stillman, W. (2005). Everything parent’s guide to children with Asperger’s syndrome. Avon, MS: F&W Publications. Twoy, R., Connolly, P.M. & Novak, J.M. (2007). Coping strategies used by parents of children with autism. Journal of the American Academy of Nurse Practitioners, 19, 25-260. Wong, V.C.N., (2007). Epidemiological study of autism spectrum disorder in China. J. Child Neurol., 23: 67-72. Read More

Using physical examination as well as the history of development of the child, a paediatrician may undertake an examination of the child (Marchant, Hussain & Hall 2006). If necessary, evaluation and diagnosis are done with assistance from specialists. They do observation and assessment of communication, cognitive, family and other factrs by use of standardized tools and consider any related medical conditions. In the process of diagnosis, a pedriatric pneuropsychologist helps in the assessment of behaviour and cognitive skills so as to assist in diagnosis and suggest educational remedies.

It may also help to perform a differential diagnosis which may put into consideration the intellectual disability of the child, problems with hearing and a particular impairment in communication (Ratajczak, 2011). However, Merchant et al (2006) found that the diagnosis of autism presents more complexity than the suggested distribution of those specific characteristics. Cohen (1997) adds that degrees of impairment displayed by children with autism exhibit very broad variations. Autism adds to the complexity of diagnosing the coexisting psychiatric disorders including depression.

Autism can at times be diagnosed by the time a child is 14 months although it may happen more successfully in the first three years of age. For instance, a child 12 months old may meet diagnostic criteria but the chances of proceeding may be lower than those of a three year old meets the same criteria. The Struggles of Autistic Children (i) Sluggish Social development Social deficits create a distinction between autism and other related disorders. Children suffering from autism display social impairments and they fail to have intuition about other people.

Unusual development in the social aspect clearly shows in early childhood (Bayat, 2007). They may not look at others or smile often and they their response to their own names is limited. Toddlers with autism show a striking difference from social norms. For instance they show less eye contact and they take turns less often. They also cannot make use of simple movements, for example pointing at objects as a way of self expression. A study by Altiere & Von Kluge (2009) revealed that children between the age of three and five years have a lesser likelihood of displaying social understanding, showing spontaneous approaches to others, displaying response and imitation of emotions, taking part in verbal communication and taking turns at tasks with other children.

These children have no obvious attachments to the people that give them primary care. Research shows that children with high levels of autism are prone to loneliness of a higher frequency and intensity than other children without autism. This is in contrary to the prevalent belief that children suffering from autism prefer to spend time alone (Lee, Harrington, Louie & Newhoffer, 2008). Affected children have difficulties marinating friends. Researchers have produced anecdotal reports about violence and aggression in children with autism, but only few systematic studies on the same exist.

Altiere & Von Kluge, (2009) found that there is scarce statistical evidence suggesting that autistic children with intellectual disability display tantrums, aggression and destruction of property. (ii) Communication and behaviour Approximately 30 to 50 percent of children with autism lack the ability to develop sufficient natural speech to satisfy their communication needs for each day (Bayat 2007). There may be differences in communication which begin in the first year. Such differences include a delay in the beginning of babbling, abnormal gestures, highly reduced responsiveness, and strange vocal patterns that the caregiver may not be able to synchronize.

Mancil, Boyd & Bedersem (2009) found that in year two and three, children with symptoms of autism show low frequency and less diversity in babbling, combining words, and they show gestures that they don’t often integrate with words.

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