ASD literature review
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kirsty3602 (student)
A literature review of Autism Abstract: As our understanding of autism increases, so definitions, diagnostic criteria and ideas on which approaches may be most useful, change. This, in turn, affects the research that is done. Recently, the term autistic spectrum disorder has been used to include other conditions and pervasive developmental disorders which have the same triad of impairments. It is likely that as interventions and support systems become more appropriate, the better the outcome for people with an asd will be. The literature for this paper came from a variety of sources including books, journal and websites. Introduction: What is Autism? “Autism is a pervasive developmental disorder. Its symptoms include differences and disabilities in many areas including social communication skills, fine and gross motor skills, and sometimes intellectual skills.” (Volkmar,Wiesner 2009) In 1943 Dr. Leo Kanner published a report on eleven of his patients at a Baltimore clinic. Entitled “Autistic Disturbances of Affective Contact.” (Kanner, 1943), this seminal paper became the base for all study on what came to be known as autism. It is a disorder characterized by deficits in three major areas of behaviour, social communicative and the display of repetitive or restricted behaviours. The paper lists the essential features as “the presence of markedly abnormal or impaired development in social interaction and communications and a markedly restricted repertoire of activities and interests” (American Psychiatric Association, 1994). The social problems include less eye contact, less attention to social-stimuli and difficulty in learning and using the social skills needed to function in society. The communication problem is due to a significant delay in language development seen in classic cases of autism. This varies on a case by case basis and if speech does develop it is often joined by echoalia, a simple
repeating of what's just been said by someone else. Lastly and perhaps most often identified with autism, are the repetitive or ritualistic behaviours that manifest. Behaviours such as wanting the same foods and clothes everyday, organizing things into lists and insisting on sameness, resisting any change in routine or schedule. All of these symptoms are the hallmarks of classic autism. In the early part of the last century autistic children were often misdiagnosed as being schizophrenic (Grinker, 2007). Four times as many males have the condition than females. While autism was once thought to be very rare 4 in 10,000, ...
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repeating of what's just been said by someone else. Lastly and perhaps most often identified with autism, are the repetitive or ritualistic behaviours that manifest. Behaviours such as wanting the same foods and clothes everyday, organizing things into lists and insisting on sameness, resisting any change in routine or schedule. All of these symptoms are the hallmarks of classic autism. In the early part of the last century autistic children were often misdiagnosed as being schizophrenic (Grinker, 2007). Four times as many males have the condition than females. While autism was once thought to be very rare 4 in 10,000, autism is now thought to be very common possibly 1 in 166 (Sicile Kira,2004). This is likely due to the fact that autism is now seen as a spectrum of disorders, from classic autism (sometimes called Kanner's autism) to Asperger's Syndrome to (PDDNOS) Pervasive Developmental Disorder Not Otherwise Specified. Autism is diagnosed based on behavioural symptoms and not with any objective biological means, a situation that would also bolster prevalence numbers. The cause is almost surely a mixture of biological and environmental factors with genetics playing a large role. In the 1960s, psychoanalyst Bruno Bettelheim portrayed autistic children as unreachable and blamed their condition on unaffectionate “refrigerator” mothers. Because children with autism often look perfectly normal physically it was thought that the condition was wholly psychogenic, or purely in the mind (BaronCohen,2008). Brain scanning technology has allowed science to probe the autistic brain and discover that there are many physical differences when compared to typical brains. Children with autism will have more grey and white brain matter as youngsters. Eventually, the grey matter will stop increasing but white matter will continue to increase, giving an autism patient more connective white tissue than “neurotypical” people through their lives. Often the amygdala and the hippocampus of the autistic patient are smaller than average. This may play a role in some of the social deficits seen later in an autistic child's life. Recently, there has been a scare concerning child vaccination and whether vaccines could play a role in autism. Spurred on by one faulty study, the idea that vaccines can cause autism has no evidence behind it and is now seen as biologically implausible (Paul, 2009). Very few people with severe to moderate autism live independently, but some are very successful (Howlin, Goode, Hutton & Rutter, 2004). Temple Grandin, an autism advocate and author who doubles as a doctor of animal science at Colorado State University. Peter Tork of the Monkees rock and roll band has Asperger's Syndrome. But unfortunately, stories like those above are few and far between. There remains no cure for autism. New treatment techniques and early intervention strategies give hope for the future, but the prognosis for a patient with autism is mixed. Sometimes a child can “recover” or lose their diagnosis, but this is rare and in most cases due to a faulty initial diagnosis. If one acquires speech and has an IQ above 50 their chances for the future improve drastically, but below those figures resides a life of dependence. Autism is a devastating and debilitating condition that continues to perplex the fields of medicine, neurology and psychology. Now that it has been established that people with ASDs, including people with Asperger's syndrome, and the cause being biological in origin there still remains one question, what can we do to improve the situation? Within the autistic spectrum, there is a range of educational needs which requires different forms of provision and intervention. Some of these children will require support and resources additional to those usually provided within the school, but others will not. Early intervention in autism has been shown to improve cognitive skills and to affect progress in cognitive levels reached (Itzchak, Lahat, Burgin & Zachor, 2008) so the earlier in a child's life one looks for treatment and aids the better the future situation will be. Jessica was statemented from an early age so we could put a lot of interventions into place for her with. She had a whole team of multi-agency who worked with school to promote Jessica’s development. These included speech therapists, incontinence nurse and a physiotherapist to name just a few. Another of those interventions was “Social Stories” she has one made for almost every new situation she will face in school. Social Stories are a tool for teaching social skills to children with autism and related disabilities. Social stories provide an individual with accurate information about those situations that he may find difficult or confusing. The situation is described in detail and focus is given to a few key points: the important social cues, the events and reactions the individual might expect to occur in the situation, the actions and reactions that might be expected of them, and why. The goal of the story is to increase the individual’s understanding of, make them more comfortable in, and possibly suggest some appropriate responses for the situation in question. Conclusion: Science has little to say about the individual case. Autism is so variable and individuals with an asd so different, that a particular child may benefit from a particular approach at a particular time. Teaching is more of an art than a technology and an inspired and dedicated teacher (whether this is a professional or a parent) can often succeed against the odds, with whatever approach he or she believes in. But by recognizing and studying this aspect of cognitive development the research community have provided a guide for treatments, understanding for families and people with autism and a direction forward for future research. Hopefully, someday, research of this kind can lead to the detection of the root cause of ASDs. References: American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders – Text Revision (4th ed.). Washington, DC: Author. BaronCohen,S. (2008). The Facts: Autism & Asperger Syndrome. Oxford University Press Grinker, R. (2007). Unstrange Minds: Remapping the World of Autism. Basic Books. Howlin P, Goode S, Hutton J & Rutter M (2004). Adult outcomes for children with autism. Journal of Child Psychology & Psychiatry 45(2), p. 212–29. Kanner, Leo. (1943). Autistic Disturbances of Affective Contact. Nervous Child, 2(3), p. 217-250 Itzchak, E.B., Lahat, E., Burgin, R. & Zachor, A.D. (2008). Cognitive, behaviour and intervention outcomes in young children with autism. Research in Developmental Disabilities, 29, p. 447-458 Paul, R. (2009). Parents Ask: Am I Risking Autism if I Vaccinate my Child? Journal of Autism and Developmental Disorders, Sicile Kira,C. (2004). Autism Spectrum Disorders: The Complete Guide to Understanding Autism, Asperger's Syndrome, Pervasive Developmental Disorder, and other ASDs. The Berkeley Publishing Group. Volkmar, F Wiesner, L.A (2009) A Practical Guide to Autism: What Every Parent, Family Member, and Teacher needs to know. John Wiley and Sons. New Jersey. p.1-4 http://www.autism.org.uk/ accessed on 21/11/11 http://www.bbc.co.uk/health/physical_health/conditions/autism1.shtml accessed on 18/11/11 http://www.polyxo.com/socialstories/ accessed on 2/12/11 Page |