Introduction
Autism is a name given to a developmental
disorder in children whereby their communication and interactions are
impaired, and though many are able to stay in the mainstream of society,
there are others who lead very restricted lives. Males are four times
more likely to have autism than females, and out of every thousand
children, at least 3-6 are likely to be autistic. Autism is limiting and
restrictive, often preventing autistic children and their families from
leading normal lives.
Autism can be by birth or manifest itself
within the first two and a half years of a child's life. It is believed
to be due to some prenatal abnormalities the causes of which have not
yet been found. The physical appearance of the child is normal, but
behavior is different and communication and interaction rather puzzling.
Many are able to speak normally, and this makes recognition of other
symptoms all the more difficult. The condition prevents most children
from having normal educative learning though some can work towards
joining mainstream educational activities.
Typically autistic
children are self-absorbed, uncommunicative and cannot participate in
creative activities. They are impaired in several areas of development.
Autism is one of the 5 neurological disorders that fall under the
category of Pervasive Developmental Disorders, and also the most common.
There are no racial ethnic or economic boundaries for autism, the
causes of which are yet unknown. It can afflict any child from any
background, anywhere, and remains a lifelong problem.
Problems Created by Autistics
Autistic
children do not misbehave intentionally as is often the case with
normal children. Some external factors trigger specific actions.
- It is difficult for them to sit for long periods of time.
- They take everything literally;
- Matters that do not interest them will not hold their attention at all.
- They do not make eye contact and leave the other person wondering whether they have been heard and understood.
- They are aloof and unsocial.
- Many perform repetitive tasks, and strange actions like hand
flapping, blinking, biting, head-banging, fiddling with things, and
certain spontaneous movements.
- They sometimes lack the ability to understand emotions but can
display anger and reveal their displeasure in violent ways. While many
are able to express themselves with repetitive coaching, those who
cannot talk resort to physical expression of their unhappiness.
- They are likely to develop some obsessive interests.
- Some are less sensitive to pain and can end up hurting themselves badly without realizing it.
- On the other hand they are hyper sensitive to touch, taste, hearing and smell.
These traits become difficult to handle especially for those who
spend the maximum time with them. Parents find themselves constantly
watching over them and trying to protect them outdoors. Caution cannot
be forfeited at any cost with an autistic child. This can become a major
encumbrance for the parent and attendant.
Causes of Autism
The
exact cause or set of causes that lead to autism are unknown. It is a
question that torments parents of autistic children who often tend to
blame themselves for the neurological disorder that leads to this
condition. Extensive research has led to multiple theories being
presented about what leads to autism, though each has its set of critics
trying to refute them.
- One set of scientists believes that certain vaccines given to the
child especially, MMR (Mumps-Measles-Rubella) cause intestinal problems,
which can lead to autism.
- Some believe the culprit to be thimersol contained in certain vaccines.
- The genetic cause of autism is widely accepted, as it is possible
that autism has some genetic root, running in some families more than
others. However, autism is not caused by a single gene, but is rather a
consequence of several genetic differences as well as some form of
environmental "insult".
- Some researchers are exploring the differences in a typical brain
and autistic brain and are convinced that the autistic brain is wired
in a different manner, besides being larger in size.
Research is
continuing and it is clear that autism cannot be attributed to a single
cause, but is perhaps the outcome of a combination of unfavorable
factors like food allergies, environmental toxins leading to adverse
reactions in the child's body, and immune deficiencies.
How To Identify Autism
Autistic
children appear normal in appearance and the first signs can manifest
themselves around twelve months, but they become very conspicuous by the
time the child is three years old. Many seem to have impaired speech,
never look in the eye, exhibit strange behavior and movements, not wish
to play with others, seem engrossed in one particular thing or activity.
It is not unusual for parents to shake off these early signs as those
of an introvert or late learner. But pointers to an autistic condition
include:
- The child does not point to things and objects at twelve months
- He child does not pick up even one word by 18 months
- He cannot make two word sentences at age two
- He does not respond to his own name
- He stays away from people and peers
- He does not make eye contact
- He may not laugh and smile and may not seem to hear
- He constantly flaps arms, bites, bangs his head
- He is unable to shift focus from one object to another
Parents
are the first to notice some or most of these signs and must take
immediate advice to be able to help the child and in case remedial
measures can be taken in borderline cases, the sooner the better.
Educating an Autistic Child
The
toughest part for parents is coming to terms with the autistic
condition of their child. Once they are able to accept it, they become
anxious to educate the child to make him acceptable in the mainstream of
society. This is the toughest part as their symptoms manifest
themselves all the time.
- They are different from other students, as they cannot relate to
people and emotions, have some difficulty in comprehending what hey are
being told.
- They are unable to identify differences in tone and speech, gauge facial expressions, or relate to reactions of peers.
- It becomes important for the teacher of autistic children to know about their condition.
- If the child is in a special school with others like himself, he
will benefit from specially created learning modules, which include
visual schedules that autistic children find easier to follow.
- Working in pairs is immensely beneficial as well.
- In case the child studies in a regular school, his teacher needs
to know about his condition so that she can make the extra effort that
may be required to explain certain things to him.
- In many schools an additional aide is provided to the teacher to help such children.
- Autistic children resent being forced to do certain things, and
would rather make choices as it gives them a sense of control.
- It is better to encourage interests that they seem to prefer, for
instance, many have a flair for cooking. This can become a vocation in
later years.
Treatment for Autism
Treating autism is not
easy as no prescribed, standardized line of treatment has yet been
found, despite millions of dollars being spent on research in this
field. The only generalization that can be made is linked to helpful
therapies like:
- Applied Behavior Analysis
- Occupational Therapy
- Physical Therapy
- Speech Language Therapy
However, before the child can be started on any of these, the following steps need to be followed:
- An early diagnosis of autism an immediate intervention and
treatment is imperative for the child. Parents must not ignore unusual
behavioral traits that the child may exhibit in the second year of his
life.
- The first step is to find good physicians and specialists who can guide parents about what is best for the child.
- Most treatment has to be behavioral and parents have to ensure that the child is not pressurized.
- This can be done by giving him clear instructions that are easy for him to follow.
- He must be prompted encouragingly to perform certain tasks, and praise and applause for actions well done.
- Parents must make a distinction between good and bad and gradually
increase the complexity of instructions to encourage him to do better.
Parents need instruction in behavioral techniques to accomplish this.
- Self help techniques have to be taught to the children so that they can eventually become independent.
- However, there are various types of autism, and each child has
specific needs. His treatment also has to be custom made for his
requirements.
Treatment with medication is only for symptoms like
seizures, extreme mood swings; sleep difficulty, tantrums or injurious
behavior patterns. One set of doctors fell that additional diet
supplements like minerals and vitamins may be helpful, and also secretin
infusion, but none of these treat the underlying condition.
At
present, Risperidone is the only drug that has been approved for
treating children in the 5-16 age group for aggression and irritability
due to autism. Finally, the present treatment prescribed by medical
specialists includes a gluten-free and casein-free diet. Gluten is
contained in wheat, barley and rye, and casein in milk and dairy
products.
Improving Autism Communication
Communication and
social interaction are the biggest problems associated with autism. The
autistic child struggles in the fields of language and being able to
express him. Communication is crucial as it helps the child understand
people around him, comprehend environment cues, follow directions and
instructions, perform organizational tasks and also express himself.
Communication is much more complicated than mere speech, requiring
multiple skills like attention, absorbing information, interpreting that
information and finally formulating an appropriate response.
A
lot of research is being done in this field, and some drugs have been
developed that improve communication behavior and increasing attention
spans. Mineral and vitamin supplements, psychotherapy and medication
related to it have all been tried, but there is no documented evidence
of significant improvements.
Autistic children understand better
when information is provided to them verbally as well as visually.
Studies conducted on children who were instructed verbally and with sign
language, revealed that they responded with greater vocalization,
mastered signs and used them appropriately, and were able to communicate
better with their peers. Visual tools include body movements, use of
pictures, objects and environment cues. Step-by-step instructions are
also important. Autistic children relate best to models, objects, signs
and boards explaining the verbal communication.
While no
standardized treatment has yet been developed to improve communication
abilities of autistic children, some amount of success has been achieved
by studying individual requirements. Treatments first necessitate an
in-depth analysis of needs and then seeking therapy from speech-language
pathologists, from occupational and physical therapists to modify
unacceptable social behavior.
Another research reveals that
participation of the father in teaching the child showed a marked
improvement in the child's ability to communicate. This was especially
true in verbal communications with the child's usage of vocabulary
revealing a 50% increase.
Structured behavior modification
programs like Applied Behavior Analysis are beneficial for some, while
others benefit from informal coaching in a familiar home environment.
Music therapy and sensory integration therapy attempt to enhance the
child's ability to respond to information using his sense organs. Social
stories narrated to children time and again have also helped many
improve their social skills.
Yet another specialist has found that
early intervention with peer directed interaction helps autistic
children communicate better. Less adult directed communication and
greater participation from trained peers in an informal, natural setting
helped in maximizing the results of communication improvement.
The
Pivotal Response Treatment (PRT) has been rated as one of the best
innovative treatments for handling communication issues of autistic
children. Based on 20 years of research by Robert and Lynn Koegel, this
has helped advance children's communication abilities, foster
friendships and social interactions and improves school performance
besides controlling disruptive behavior. PRT works with every child's
natural motivation promotes functional learning and helps him develop
skills that can be used in the world outside. Rote learning is
discouraged and the child's cognitive abilities are enhanced. Prompting
him to respond gives him the impetus to do so.
Treatments have to
be personalized but starting sooner will yield far better results than
delays in taking action by the parents.
How to get Autistic Children accepted by other Children
Autistic
children do have communication and behavioral issues which are often
unacceptable to others. They are therefore the target of criticism, made
fun of, teased, ignored and neglected. But all autistic children are
not retarded and with help and support can become part of mainstream
society. The role of the parent and the teacher becomes important in
gaining social acceptance for their child. They need support not pity,
sympathy and a bit of care. It is important for the school to reinforce
its commitment to these children and explaining to others how they can
reach out to these special children. They need to be told that autism
does not explain the whole character of the child-it is only one aspect
and the child in question is blessed with other far more acceptable
traits. He can think too, get hurt and upset and he struggles with
things he cannot do. Acute hearing, sight and smell compensate for his
language limitations. Children can be made to see the good in the child,
what he can do and with that focus, help him. Often if one child comes
forward to help the special child, others follow suit and the result is
that he gains friends from whom he is able to learn much more than
parental training.
How do I help in Emotional Circumstances
Children
with autism are often highly emotional, getting hurt and upset about
small things. Unfortunately, it takes them longer to overcome them and
it is challenging for parents to help him cope. In an emotional state,
the child first needs to be calmed, and this can be accomplished by
helping him take a few deep breaths. This must be practiced with him
before and becomes useful during stressful times. It is best to remove
him from the scene where he has got upset and talking gently in a manner
that he comprehends, is helpful. The child needs encouragement,
reinforcement of affection and loving reassurance. If the child can
talk, hearing him out also helps. Many of them are overly sensitive to
others' emotions, seeing another child cry, makes them cry as well. They
need to be taught that another person's feelings must not be mixed up
with their own.
A few steps that can help the child include, first
understanding his emotional needs, speaking in a language that he
understands, he must also get the facts correct, and not have any false
notions. It is important to look for warning signs that reveal an
emotionally disturbed state like facial expression, nervous tics, speech
variations, sweating, avoidance and irritability. Social stories
narrated to children may help them feel they are not alone in feeling in
a particular manner, and others are like them too. The bottom line is
keeping the child calm and secure.
The Child's Future
A
child being diagnosed as autistic is one of the worst nightmares for any
parent. The first thoughts after the why's and how's is the anxiety
about his future. His future is largely determined by the type of autism
he has, and his intelligence level, which may assist him to practice
some vocation and even be gainfully occupied. Many are able to lead near
normal lives and become responsible, independent individuals. Others
with more serious problems may never be able to lead a normal life and
be independent. In such cases the future of the child is largely
determined by the parents, how they plan for times ahead. They need to
make the child functional and ensure that adequate resources are put
aside to sustain him. Researchers believe that parents need to be
responsible for providing them with a social world in which they can
build meaningful relationships. Those alone can sustain them, despite
the fact that the child may never go to work, earn, and do other adult
things. Special education can help him do better than lack of any
education. It may suffice to have him occupied and happy rather than
stressed and agitated, provided for and having someone.
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