Autism Essay, Research Paper
A relatively rare multifactorial disorder occurring in as many as 1 in 500 people, autism is still largely an enigma to many doctors and scientists (Johnson, Dorman, 1998). Until Leo Kanner’s use of the description autistic in 1948, schizophrenia was the general label given to patients with certain behavior patterns. Although autism and schizophrenia are widely seen as separate disorders today, there are still many conflicting classification issues which are distinguished largely with the help of the American Psychiatric Association’s Diagnostic and Statistical Manual of mental disorders, revision IV(DSM-IV). In the last five years research has shown that many people who engage in autistic behaviors have related but distinct disorders (Edelson, 1995). There is no known specific cause for autism, but over the years there has been a growing focus on biological etiology. Combinations of psychotherapeutic and medical treatments, as well as comprehensive educational treatment provide the best care and placement of both adults and children afflicted with autism. Adult psychotic disturbances were noted in the early twentieth-century classifications of mental disorders (Nelson, Israel, 1997). The descriptions and classifications of these disturbances, however, were confusing and controversial. Kraeplin set the basis for modern classification. He used the terms dementia, a belief that progressive deterioration occurred, and praecox, meaning the disorders began early. Later the term schizophrenia was applied by Bleuer. He argued that deterioration was not inevitable and that psychological factors played a role. As time went on many other different diagnostic terms were applied such as dementia infantilis, disintegrative psychoses, childhood schizophrenia, and childhood psychosis (Nelson, Israel, 1997). Schizophrenia became the most common generalizing term used until 1948 when Leo Kanner described his observation of early infantile autism. He was a pioneer in the field and his studies of eleven severely affected children set out the groundwork for the research that would occur over the next fifty years. Kanner gave descriptions of the children, emphasizing their inability to relate to other people and the world around them, a problem exhibited early in life. He quoted parents as referring to their disturbed children as, “self-sufficient,” “like in a shell,” “happiest when left alone,” and “acting as if people weren’t there” (Nelson, Israel, 1997). Kanner then described the isolation displayed by the children with the word autism, meaning an absorption in the self or subjective mental activity. The characteristics Kanner noted in his eleven cases were also observed in other studies and autism was then recognized by the major classifications systems as a distinct syndrome that accounted for many cases of early childhood disturbances. Eventually called Autistic Disorder, autism is recognized in the DSM-IV as a pervasive developmental disorder. This broad heading includes four diagnoses used to describe those who display some, but not all, of the autism characteristics (Johnson, Dorman, 1998). One of the problems with autism is that the diagnosis is based on subjective criteria and it is difficult to classify. The umbrella diagnosis is pervasive developmental disorder, which not only includes autism, but several other related disorders including, Asperger’s disorder, Rett’s disorder, Fragile X Syndrome, Landau-Kleffner Syndrome, William’s Syndrome, Angelman Syndrome, and Prader-Willi Syndrome (Tustin, 1992). Autism appears to be the end product of several different disorders which share similar social, language, and neurological abnormalities. There are no accurate medical tests for diagnosing autism. The only way a precise diagnoses is achieved through observation of a child’s behavioral, communicational and developmental levels. Because of autism’s multiple behavioral disorders, doctors often complete many tests to rule out other possible causes. Ideally, a child should be evaluated by several professionals, including a neurologist, psychologist, developmental pediatrician, speech/language therapist, and learning consultant (Hobson, 1993). The more accurate the diagnosis, the more effective the chosen treatment will be. The most cited statistic is that autism occurs in 1 out of 500 births (Johnson, Dorman, 1998). It is four times more likely to affect males than females, but this gender difference is not unique to autism, as many developmental disabilities have a greater male to female ratio. Autism is now considered to be the third most common developmental disability, more common than Downs Syndrome, yet professionals in educational, vocational, and medical fields are still unaware of specific causes and treatments (Johnson, Dorman, 1998). Many autistic infants are different from birth. Two common characteristics they may exhibit include, arching their back away from their parent to avoid physical contact and becoming limp in order to fail anticipating to be picked up. As infants they are often described as either passive or overly agitated babies. The passive baby makes little or no demands on its’ parents and is relatively quiet. The overly agitated baby refers to an infant who cries constantly and sometimes may rock or bang their head against the crib. In the first few years of life, some autistic toddlers may develop such abilities as talking, crawling, and walking much earlier than the average child, while others are considerably delayed. Approximately 1/3 of autistic children develop normally until 1 + to 3 years of age, then symptoms begin to show (Edelson, 1995). These children are referred to as having regressive autism. Some children participate in self-stimulatory behaviors, such as repetitive, non-goal directed behavior. The child may be overactive or very passive; throw frequent tantrums for no apparent reason, or participate in self-injurious behavior.Communication, both verbal and non-verbal are dysfunctional in autism. In normal children, even before speech develops hand gestures are used to communicate and develop in conjunction with speech. Autistic children show deficiencies in joint attention interactions involving gestures such as pointing and making eye contact with an object (Nelson, Israel, 1997). Similarly, simple gestures communicating “come here” or “be quiet,” as well as more complex gestures, which express feelings, are lacking. This has lead to studies question the autistic child’s perception of the human face. In one study control group, children sorted photographs based on facial expression such as happy and sad, while the autistic children sorted according to the types of hats people wore (Hobson, 1993). Another study performed by Hobson showed autistic having difficulty matching “bodily postures, sounds, and situations,” with pictures of facial expressions (Hobson, 1986).
Verbal communication also poses a problem with autism. Some children never speak or will only say words and simple phrases. About half do not develop useful speech (Nelson, Israel, 1997). A common speech development is called echolalia in which the child merely repeats other people’s words. Echolalia may serve a number of purposes, and in the least it demonstrates the child’s ability to match auditory input. Autistic children seem to register the imitation of their own actions by someone else. Perhaps stemming from echolalia is another common error found in autistic speech, pronoun reversal. A child will commonly refer to others as I, me, and refer to themselves as he, she, them, or you. This is either a result of failure to understand the usage of pronouns or the roles of speaker/listener (Tustin, 1992). Autistic individuals also suffer from sensory impairments in one or more of their senses. This impairment may involve the auditory, visual, tactile, taste, olfactory, proprioceptive senses (Edelson, 1995). These senses may result in the person experiencing interference such as ringing in the ears. As a result, it may be difficult for these individuals to process incoming sensory information properly. Sensory impairments may also make it difficult for the individual to withstand normal stimulation. Some autistic individuals may be tactilely defensive and avoid all forms of body contact. Others, however, have little or no tactile or pain sensitivity. Another example of sensory abnormalities is hypersensitive hearing. Approximately 40% of autistics experience discomfort when exposed to certain sounds or frequencies (Edelson, 1995). These individuals often cover their ears and throw tantrums after hearing certain sounds. One of the most fascinating cognitive phenomenons in psychology is the autistic savant. This refers to individuals with autism who have extraordinary skills not exhibited by most people. Historically, individuals with these exceptional skills were called ‘idiot savants,’ a French term meaning unlearned skill. The correct term, autistic savant, was implemented by Dr. Rimland in a 1978 article in Psychology Today. About 10 % of autistic individuals possess these skills. The most common forms involve mathematical calculations, exceptional memories, artistic and musical abilities. Some can multiply and divide large numbers in their head and can also calculate square roots of prime numbers in a matter of seconds. Some with memorization skills have the ability to memorize the US highway system or remembering all details about the Presidents. Other individuals have incredible artistic abilities. Richard Wawro, who was described in an issue of Reader’s Digest, is legally blind and draws in crayons. His works sell up to $10,000. Music is another common savant ability. Many performers with autism have perfect pitch and an exceptional memory for music. In some cases, a person can hear a classical piece once and play it back in its entirety (Tustin, 1992). The reason why some autistic individuals have savant abilities is not known. There are many theories, but there is no evidence to support any of them. One suspicion is that many autistic have a narrow or focused attention span. They have incredible concentration abilities and can focus their attention to a specific area of interest. Many researchers feel we can not truly understand memory and cognition until we can understand the autistic savant. Causes of autism have been linked to various forms of biological and neurological abnormalities in the brain. MRI (Magnetic Resonance Imaging) and PET (Position Emission Tomography) scans are often used to locate significant abnormalities in the cerebellum (Johnson, Dorman, 1998). No psychological factors have been shown to cause autism. It is not a mental illness (Tustin, 1992). One of the newest explorations in the research of causes of autism is that in the field of genetics. Autism is prevalent in both pairs of identical twins and quite rare in the cases of fraternal twins. Identical twins, coming from the same egg share 100 % of their genes, and fraternal twins share only 50%. A statewide survey of autism was conducted by UCLA in the 1980’s in Utah. The researchers identified 11 families where the father was diagnosed as having autism. There were a total of 44 offspring from these families, and 25 of the children were also diagnosed with autism (Edelson, 1995). The incident rate in these families is much higher than the general population, suggesting a genetic link to autism. Over the years, families have tried various types of treatments to reduce autistic behavior and to increase appropriate behaviors. There is no primary approach shown to be consistently effective. The most recognized treatment is behavior modification combined with various other therapies such as speech/language therapy, vision therapy, auditory training, medications and dietary interventions. Those with autism respond best to a highly structured program that is tailored to the individual (Johnson, Dorman, 1998). Aside from professionals, parents should remain an integral part of treatment. The most recent advances in medical treatment of autism lie in the administration of the neurotransmitter, secretin. Within five weeks of the secretin infusion, A dramatic improvement was noted in individual’s behavior. This was manifested by improved eye contact, alertness, and expansion of expressive language (Horvath, Stefanatos, Sokolski, Wachtel, Nabors, Tildon, 1998). All these traditional methods of treatment along with other non-traditional treatments are used in the quest to cure autism. The disorder is a very complex one and the needs of each person can vary greatly. After 50 years of research professionals are beginning to realize that the symptoms of autism are treatable and researchers are coming up with interventions which can make a significant difference.