AUTISM Autism is a puzzling disorder because it is difficult to understand the behaviors of autistic people and because the world is as confusing for them as it is to us. Thus we have to learn to live with one another because it seems to be becoming more common among us.Autism affects more boys than girls. Ratio 4:1
There are Five Pervasive Developmental Disorders (PDDs)
Childhood Disintegrative Disorder (CDD)
Rett’s Disorder (RD)
Autistic Disorder (AD)
Pervasive Developmental Disorder – Not Otherwise Specified (PDD-NOS)
Asperger’s Syndrome (AS) – high functioning autism
Although the word “autism” was first used publicly by the Swiss psychiatrist Eugen Bleuler around year 1911, criteria for the syndrome did not exist until Leo Kanner laid them down around 1943. Autism appears to have existed throughout recorded history. It occurs in all ethnic and social groups. Knowledge of autism has improved greatly over the years in some countries, although there is no known cure. It means “SELF”.
It is still not known what causes autism but recent research, is pointing increasingly in the direction of its being a difference in brain structure, especially in the amygdale, from what is considered normal. Genes might also be involved. Brain abnormalities may result from genetic (hereditary) or environmental (e.g., exposure to toxins) factors, metabolic disorders (e.g., serotonin deficiency), viral infections (e.g., German measles), or complications during pregnancy and delivery.
It is definitely not caused by poor parenting as was once believed.
Autism is effectively a developmental disability. An autistic person will have significant difficulties in several areas of his/her development. The areas most affected are communication, social interaction and behavior. This developmental disability may have a particular pattern called autism, or there may be varying amounts of disability in other areas of development which result in patterns called Asperger’s syndrome or Pervasive Developmental Disorder – Not Otherwise Specified (PDD – NOS). This whole area of autistic developmental disabilities is referred to as “autism spectrum disorders”. People with these disorders are affected differently, but all require specialized assistance and support.The best way to help a person with an autistic disorder is to understand how the following three areas of difficulty affect their view of the world.
· COMMUNICATON: Autism affects the ability of a person to understand the meaning and purpose of body language and the spoken and written word. Words can be misunderstood, interpreted literally or not understood at all. Other people’s feelings and emotions can also be difficult to understand.
· SOCIAL INTERACTION: Social interaction is an essential part of life for most people. For autistic people, being sociable is difficult, scary and very confusing. Some appear to withdraw and become isolated; others try very hard to be sociable but never seem to get it right. People with autism can find friendships difficult.
· BEHAVIOUR: Impairments in Communication and Social Interaction produce a range of behaviors that have become linked with autism spectrum disorders. These may include:Some early infant behaviors can clue parents in to potential problems before a formal test or a pediatrician (child doctor) visit might. Please note that seeing any or several of these does not necessarily indicate autism, but once you detect a pattern of the behaviors below to consult a developmental specialist.
Around 6 months to 12 months:
- Not babbling much
- Not making eye contact with parents during interaction – Not smiling when parents smile (parents shouldn’t have to touch the baby to elicit a smile)
- Not participating in vocal turn-taking (where the baby makes a sound, you imitate child; child then makes the sound again, and so on.)
- Not responding to peek-a-boo on a regular basis
Around 6 months to 36 months:
- Speech – absent, delayed or showing abnormal patterns, no attempts to speak
- Cannot feel pain, no emotions to pain, high trash-hold of pain
- No pointing, waving or grasping – No response when called by name; indifference to others
- Obsessions -intensive interest with favorite topics, objects, places, people or activities.
- Insistence on sameness – routines bring some order to the autistic person’s confusion – a change of routine can be very difficult to cope with.
- Repetitive Body movements – such as rocking, hand-flapping, tip toeing
- Behavior that may cause self injury (such as hand biting). head-banging, hand-biting, wrist-biting and excessive self-rubbing and scratching. Behaviors often associated with seizure activity include: headbanging, slapping ears and/or head, hand-biting, chin hitting, scratching face or arms, and, in some cases, knee-to-face contact
- Fixations on a single object or clothes. For clothing, child might insist on wearing the same clothes the whole day, the whole week, the whole month, etc.
- A strong resistance to changes in routine. They might get upset if the gate is not closed properly, the chair is off by one centimeter off normal position, your shirt is not buttoned, your dress is not pressed, etc.
- Sensory sensitivities – to certain sounds, colors, tastes, smells, textures. – Oversensitivity to certain textures, smells or sounds – Loss of any language skills – Play – isolated, repetitive, unimaginative, destructive, obsess in stacking things up, lining things like a train, spinning things, using anything like drums
- Tantrums – can be a way of expressing extreme confusion and/or frustration, screaming, banging head or other types of self mutilation / destruction, jumping – Problems sleeping, likes dark places
- Don’t like noise or certain sounds
There is no cure for autism, and there is as yet no standard of care. But while scientists search for biological and environmental factors that may predispose a person to the disorder, a few treatments have made a difference for some children.
One of the most widely used programs is Applied Behavior Analysis, which focuses on reducing specific problem behavior such as aggression and self-injury while also teaching new skills and showing children diagnosed with autism how to handle changes in their environment. (Another reason why an individual may engage in head banging is to reduce pain such as pain from a middle ear infection or a migraine headache (de Lissovoy, 1963; Gualtieri, 1989). There is growing evidence that pain associated with gastrointestinal problems, such as acid reflux and gas, may be associated with self-injury. In addition, some autistic individuals report that certain sounds, such as a baby crying or a vacuum cleaner, can cause pain. In all of these instances, self-injury may release beta-endorphins which would dampen the pain.)
The Picture Exchange Communication System (PECS) – The exchange of a picture to communicate
This system was developed to help people with autism and developmental disabilities who are nonverbal or have limited verbal communication. PECS may also be used in conjunction with a voice output communication device. The Picture Exchange Communication System (PECS) when introduced and practiced rigorously is proving very useful to develop communication, particularly in children with autistic spectrum disorders. The basis of the whole thing is that when a child reaches for something they really, really want, something they love, then the thing they love in picture or photo is introduced in between the child and their “reached-for” desired object or activity. When the child then gives the adult the picture, the adult immediately gives them the thing (or activity) they want. This exchange can take place very quickly, when children are not physically disabled. The process works up from very simple requests to use of complex sentences (in pictures and/or words) but is always based on the exchange principle. The exchange process is a lot easier to describe than to do correctly! The PECS system is a behaviorist – using rewards to reinforce desired behaviors, aim of errorless learning, formal techniques for extinguishing errors, etc – and hightly structured. Each step in the instructional process is broken down into about 6 highly detailed stages. As well as being a behaviorist instructional approach, PECS is also a specialized form of augmentative & alternative communication AAC. Functional communication is emphasized and prioritized, rather than ‘language’ or curricular targets. There are no prerequisites to entry to this method of communication instruction (e.g. picture recognition and symbolic understanding are not required before the start – they are expected to develop throughout the process). All modes of communication are accepted, speech attempts must not be insisted upon (but improved oral speech often occurs, with PECS). PECS is often used alongside the TEACCH approach; it is not an ‘either/or’ scenario.
Medication is often used to deal with a specific behavior, like self-injurious tendencies or aggression. Reducing such behavior may allow the person with autism to focus on other things, like learning. Doctors have had success prescribing drugs typically used for obsessive-compulsive disorder, schizophrenia and attention-deficit hyperactivity disorder. (Naltrexone and naloxone)
This kind of treatment helps children develop daily living skills, fine and gross motor development, and sensory integration.
Praises, Encouraging comments
Try to praise, encourage the child instead of showing face of disbelieve when child takes the wrong item or say the wrong thing. Use positive words to encourage confidence in timid child! Praises should come in different forms: example, “good job, well done, excellent, you are so smart, I like that, genius, so brainy”, etc. Encouragement can also come as a physical tap on body parts, example, tap the child on the shoulder, on the head, on the hand, etc. You can also use food or toy rewards to motivate the child. Remember to use the things that the child likes very much, (if appropriate). Try to change the reward so that the child doesn’t get sick of it.
This can help some people with autism overcome communication and language barriers.
There is growing interest in the link between autism and gastrointestinal (GI) ailments. Eliminating certain foods from the diet can help some children. Easing the pain and discomfort of food sensitivities that many autistic kids have can free them up to focus on other things. Starting child on a restricted diet, such as a gluten/casein-free diet, or removing specific foods to which their child showed signs of an allergic reaction. (People with autism are often intolerant of gluten, a protein in four types of cereal, and casein, a protein found in animals’ milk.) Gluten and gluten-like proteins are found in wheat and other grains, including oats, rye, barley, Turkish’s bulgur, durum, Egypt’s kamut and spelt, and foods made from those grains. They are also found in food starches, semolina, couscous, malt, some vinegars, soy sauce, flavorings, artificial colors and hydrolyzed vegetable proteins. Casein is a protein found in milk and products containing milk, such as cheese, butter, yogurt, ice cream, whey and even some brands of margarine. It also may be added to non-milk products such as soy cheese and hot dogs in the form of caseinate.
Classical music, sound of the sea waves, sound of water, chants, soothing music have been shown to encourage improvement in the way the brain processes input for some kids with an autism spectrum disorder.
These vary widely, but are most effective when tailored to the needs of the individual. Most are aimed at helping children overcome problem behaviors.
CONCLUSION Autistic adolescents and adults are people you might encounter every day but not know it. There are many things you might think about them, but often they are not true. Some of them may appear selfish, self-absorbed, crazy or egotistical because autistic people do not respond adequately when someone says something, or because autistic people talk on and on about one subject with little regard to the rest of the conversation. Some of them might appear like loners, or eccentric loners. Some of them might appear as the opposite, people who try hard to be social but don’t know how. Autistic people come from all different backgrounds, and have all different appearances. There are the high-functioning, low-functioning, anything in between, and any combination of functioning levels. Different people might classify autistics as different functioning levels depending on when and where they see them. Some of them wouldn’t appear different at all until you got to know them. They may have been lower-functioning, or higher-functioning, or the same level of functioning, as children. Their skills might fluctuate dramatically. They present their autism in as many ways as there are autistic people, and have as many opinions about it. They may have high-paying jobs, or low-paying jobs, or no jobs at all. The thing they all have in common is that they are autistic. They may not always appear like the child that so many people have heard of, who rocks and bangs his head on the wall and does not make eye contact and is completely mute and will never speak and lives in an institution. They may not appear like the “Rainman” savant who does complex calculations in his head but is otherwise autistic. They may not be Einstein or the Silicon Valley computer programmer stereotype. They may look like these things sometimes but not others. But they are autistic. They share some of the same difficulties and the same advantages in being autistic. They have differences, yes — everyone does — but they do have that in common. The next time you think of autistic children, remember that children grow up. The next time you think of someone who you get furious with because they just “don’t get” something simple even though they can do some things that are complicated, remember them. The next time you see someone walking down the street flapping their hands in front of their face and making odd noises, remember them. They may not be autistic, but you never know. Autistic children grow up, into autistic adolescents and autistic adults. They do not appear always the same as autistic children, though they may have a lot in common with them that may or may not be visible to someone unfamiliar with autism.
We should learn to be more compassionate to them and their families, rather than just stare at them or criticize them for being being brought up badly, because they are not!! Every parent would want the best for their children, but because we do not know much about them, we are not able to help them much. REMEMBER, THEY DON’T WANT TO BE BORN THIS WAY.
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