The Individuals Disabilities Education Act (IDEA) is a federal law that requires the state to provide free public education for those children with disabilities. Most children with autism are covered under this act. Some children with Aspergers or pervasive developmental disorders that are high functioning will receive services through section 504, which is the rehabilitation act of 1973.
One of the first pieces of advice given to parents or caregivers would be to obtain an assessment from a professional who has expertise in autism. Law states this has to be completed within 50 days. One of the advantages of a private expert is that parents are given the opportunity of free services from their child’s educational agency. These include school health services and social work services in schools. Parents are entitled to these by law. An assessment can be requested from the local education agency (LEA) free of charge. However this may lead to misdiagnosis of their child due to the lack of expertise on autism.
Once an autistic child qualifies for special education there are a number of different educational procedures that can be offered. ‘Applied Behaviour Analysis’, other wise known as Discrete Trial Instruction (DTI) and Treatment and Education of Autistic and Related Communication Handicapped Children (TEACCH) are the two main strategies. Some schools may only provide one strategy, although this may not be effective as an autistic child may respond more to one strategy than another, or they may prefer a combination of strategies. Children with autism can improve their hand skills, speech and sensory problems through occupational therapy.
ABA usually occurs at home or in special pre-schools. It believes that speech, academic skills and life skills can be taught on scientific procedures. This analysis assumes that children are more likely to repeat responses or behaviour if they are reinforced and less likely to repeat them if they are not rewarded. In time the reinforcement will become smaller until the child can learn without rewards. DTI is a form of ABA. This is used to help teach eye contact, fine motor skills, language and self-help. The children are taught skills in small tasks at first and then build up to the more complicated ones.
TEACCH is not as intense as ABA in the pre-school years. In the classroom it is usually structured with separate areas for separate tasks. It agrees with visual aids. This is potency for children with autism. They use pictures and/or words to help structure their day. Pictures are a useful source for those children who do not have verbal skills. However a strong weakness of this theory is that it does not stress social interaction and verbal communication. Dr Stanley is a child psychiatrist who has written about strategies for children with developmental problems. His approach is floor time that involves a parent or a caregiver following a child’s lead so that they are able to understand the concept of interaction and communication. This approach works best for the child if it is combined with ABA.
Publishing good practice guides for example consistent classroom schedules and routines, will provide quiet time for the children, use visual props, be patient with the children and allow them time to respond, will keep a good communication level between home and school.
The Research and Innovation to Improve Services Results for Children with Disabilities is a Florida programme that addresses social and behavioural problems in children with ASD. The project is successful due to examining of experimental analysis procedures of structural strategies. It identifies variables that will aid in the child’s social and behavioural development in a natural setting. The outcome of the project is the packaged curriculum called “ Social Skills Assessment and Intervention Curriculum”. These give the children and care givers the opportunity to examine the consequences and setting events related with social skills for children with ASD.
A child’s green paper ‘every child matters’ was introduced on the 8th September by the priminister. The paper was set about to improve the outcome for children and their families. There are four main aspects to the paper: Early intervention and effective protection, supporting parents and carers, accountability and integration, locally, regionally and nationally and workforce reform.
The National Autistic Society (NAS). Founded in 1962, by a group of parents. It provides services for adults and children with autism. The NAS works to follow up the green paper in the identification of autism and support to people with autism. A particular comment of the green paper is ‘mental illness’. It recommends the government assemble a group of agencies together to work in the field of poor mental health. This should include the National Autistic Society. With a collaborative approach issues will be approached and appropriate action will be taken. The paper states it is primarily important to look at those with mental illness that have been undiagnosed or unsupported.
Recently there has been concern relating the measles, mumps and rubella (MMR) vaccine with autism. Only 84% of children had been immunised by the NHS between 2001-2003 against measles, mumps and rubella which is a fall of over 3% since 2000-2001 and 8% lower than the peak coverage of 92% between 1995-1996.
It has been suggested that the MMR vaccine caused a certain type of autism known as variant autism. This is where the child becomes increasingly worse over time and will probably suffer bowel disorders. However the Royal Free hospital found no link between the jab and autism. The British Medical Journal looked at 500 children born with autism between 1979 and 1998. The proportion of children with developmental problems or bowel disorders did not change over this period. The MMR vaccine was introduced in 1988. This indicates that if there was a link between autism and MMR then there would have been an increase in autism cases. Professor Brent Taylor from the Royal Free stated there is “no relation whatsoever between MMR and autism and a huge amount of good evidence that there’s no relation.” Latest figures show that in the UK the MMR jab is still at a rate of 84.2%. The recommended rate is 95%. This is due to parents worrying about the risks of the link between the jab and autism.
Jackie Fletcher is a member of Jabs, a support group for parents who believe their child has been affected by the vaccine. She states “We have a huge body of children 1,600, believed to have been affected by the MMR and they have not been investigated.” Judith Barnard from the National Autistic Society which meets the needs of individuals with Autistic Spectrum Disorders (ASD’s) replied to Jackie Fletcher’s statement with “The experts themselves came to the conclusion that they couldn’t exclude the possibility of a susceptible sub-group that could be affected by the MMR.”.
The National Information Centre for Children and Youth with Disabilities said that children with autism “may seem unresponsive or over responsive to sensory stimuli”. It is common that some children do not enjoy gentle physical contact but enjoy rough contact. A weakness of this theory is that it can be expensive, as activities have to be provided for the child’s learning of their senses. However it sometimes may be covered through insurance or by schools early intervention. Due to these children finding it difficult to empathise, it could result in bullying due to aspects such as being the last person to get the point of a joke.
The causes of autism are not fully understood. Twenty five percent of sufferers are associated with brain damage and fifty percent have other handicaps from physical illnesses. There are physical and psychological indicator signs to diagnose autism. These include early feeding difficulties e.g. problem with chewing. They may be unable to interpret facial expressions and sounds of speech, e.g. there may be no babbling by 12 months of age or no single word by 18 months. They may have temper tantrums and sleeplessness. If the autism is recognised at an early stage there is a good prognosis of normal development. Tranquillising drugs, music and special schooling related to the child’s ability can help treat it. Brian.J., Martin.D.M. (1989) Child Care & Health for Nursery Nurses. Stanley Thornes Ltd. London. (Pp.204)
In conclusion autism is a wide spectrum disorder. One child can be very different from another in relation to their social skills, language development e.t.c. There are many different perspectives, all of which have an interesting insight in autism. There are different treatments available such as special schooling, alongside projects such as RASP for support. In the present day autism is becoming more widely recognised and therefore children have the opportunity to reach their full potential, hopefully to the point of “norm” in society.
Genetic factors play a part in most autistic people. In single siblings the rate of autism is 2-6% which is a higher increase than population rates.
Wakefield AJ. Investigated into a series of children with chronic enterocolitis and regressive developmental disorder.
Wakefield AJ, Murch SH, Anthony A, Linnell J, Casson DM, Malik M, Berelowitz M, Dhillon AP, Thomson MA, Harvey P, Valentine A, Davies SE, Walker-Smith JA.
Lancet 1998 Feb 28; 351(9103): 637-41. 12 children with a mean age of 6 years were taken to a paediatric gastroenterology unit with a history of normal development followed by loss of language, diarrhoea and abdominal pain. The children under went gastroenterological, neurological and developmental assessment. The parents associated behavioural symptoms with measles, mumps and rubella vaccination in 8 of the 12 children. One of the behavioural disorders was autism in which 9 out of 12 children had.
‘Theory of mind’ is a new idea in the field of autism. Simon Baron-Cohen gave this idea much attention in his book Mindblindness, Cambridge, Mass: The MIT Press 1995. Theory of mind has the idea that autistic children are unable to understand other people’s ideas, thoughts, emotions and attitudes. There has been task set to test this theory with both autistic children and those with mental retardation. The theory of mind only seems to occur to those with autism. Those with Aspergers syndrome also have the problem of theory of mind, however not to such a great extent as those with autism.
Simon Baron-Cohen believes there are differences in the male and female brain and this may explain certain conditions such as autism. He believes the female brain is mainly wired for empathy, the male brain for Systemising. This is called the E-S theory. Empathising is the insight to recognise other people’s thoughts and feelings. Systemising is where you are able to explore a system efficiently e.g. a math’s equation. This theory suggests there are three brain types, the male brain (s), female brain (e) and the balanced brain (b). The balanced brain is where a person has a balance of empathy and systemising in their brain. Your sex can not tell which type of brain you have i.e. you may not necessarily have a female brain if you are female. As well as biology we also know that society and culture play a part in determining whether you have a male brain or a female brain. Children with autism tend to be extreme in the male brain. Journal of Autism and Developmental Disorders 33 (5): 509-517, October 2003 They have trouble empathising but are very good with systemising. There are two main sub-groups of autism. These are Asperger syndrome and classic autism. Both find it difficult in developing social relationships, communication and they both tend to have a fixed obsession with a routine. There are differences between the two; children with classic autism could have an IQ of any range. Children with Asperger syndrome have at least an average or above average IQ. One child in every 200 is diagnosed with having autistic conditions. Males are far more likely to be diagnosed than females. The E-S theory describes the autistic obsessive behaviour as focus on systematic interest on objects. The obsession can range from a time length of a few weeks to a few years.
Thursday April 17, 2003 The Guardian
A therapist that is trying to teach imitation will use a command such as “clap your hands” while the therapist claps her hands. The child will then be expected to clap their hand. If the child is successful they will be rewarded; if they are not successful the therapist will say “no”, then pause and repeat the procedure. Dr. O. Ivar Lovaas, a pioneering researcher in psychology published a study in 1987 that showed 19 preschoolers involved in full time behavioural impediment on that of 40 hours a week achieved “normal functioning”.
References
Brian.J., Martin.D.M. (1989) Child Care & Health for Nursery Nurses. Stanley Thornes Ltd. London. (Pp.204)
Charlotte Moore, Wednesday 14, 2003, The Guardian
G.C.Davenport. (1994) An Introduction to Child Development, second edition. Collins Educational. London. (Pp.170-171).
Journal of Autism and Developmental Disorders 33 (5): 509-517, October 2003
Simon Baron-Cohen, Thursday April 17, 2003 The Guardian
Wakefield AJ, Murch SH, Anthony A, Linnell J, Casson DM, Malik M, Berelowitz M, Dhillon AP, Thomson MA, Harvey P, Valentine A, Davies SE, Walker-Smith JA.
Lancet 1998 Feb 28; 351(9103): 637-41. 12
