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Autistic Spectrum Disorder (ASD) - Essay Example

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This paper aims to provide a critical examination of the characteristics and causal theories of ASD and the challenges this raises for mainstream educational settings, and how these challenges can be addressed to promote educational outcomes for cases of autism…
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Autistic Spectrum Disorder (ASD)
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?Autistic Spectrum Disorder (ASD) Introduction Autistic Spectrum Disorder (ASD) is a group of lifetime neurodevelopmental conditions with commencement in babyhood and are characterized by impairments in three major areas namely social interaction, communication and repetitive patterns of behaviour; these lifelong neurodevelopmental disorders include autism, Asperger Syndrome, in addition to, Pervasive Developmental Disorder, not otherwise specified (Whitelaw et al 2007 p.752). Autism, also referred to as ‘infantile autism’ is a behavioural syndrome and currently it is defined as a pervasive developmental disorder that manifests before 3 years of age in infants through social damage, verbal and non-verbal communication difficulties, stereotyped and repetitive behaviours (Celani 2003, p.141). Cases of infantile autism or developmental disorders have been rampant with a prevalence of about 116.1 per 10000 as reported in recent findings by Gillian Baird and colleagues, which is much higher than it was thought in previous studies (Lancet 2006, p.179), thus leading to a universal interest in autism (Kanner 1943 p.2003). In relation to this study, other studies in the UK and Sweden have also found that nearly 60% of pervasive developmental disorders as a whole was a typical autism while a half of the of these disorders was a non-specified subtype, a DSM-IV equivalent of atypical autism. This paper aims to provide a critical examination of the characteristics and causal theories of ASD and the challenges this raises for mainstream educational settings, and how these challenges can be addressed to promote educational outcomes for cases of autism. Causal theories The etiology of ASD is not well understood today but the current genetic basis for ASD has been motivated from observations that the rates of recurrence of ASD in siblings of individuals affected are considerably higher than that in the general population. In addition to that, twin studies have also revealed that concordance rates are about 60% and 90% for monozygotic twins but only about 0-10% for dizygotic twins (Whitelaw et al 2007, p.752); a specific cause for ASD can be identified in very isolated cases such as Fragile X syndrome, Chromosome disorders, tuberous sclerosis, and inborn errors of metabolism. The clear-cut linkage between ASD in these instances notwithstanding, the causes of ASD remain unclear in higher than 90% of all instances, but in the current studies, a lot of focus is directed to proving the genetic linkages by identifying the specific genes allied to autism. Meanwhile, in the absence of concrete genetic evidence for autism, documented empirical data concerning autism cases provides a basis for the estimation of recurrence risk, which has been found to be about 5% when only one child in a family is affected but considerably higher than that to about 25% when more than one child is affected. Rate of recurrence risk is also determined by sex of the foetus because a male foetus has been found to be about 3-4 times more likely to develop autism than a female foetus; in this respect, the recurrence risk in accordance to sex is about 2% for a female foetus but close to 8% for a male foetus. In understanding the etiology of ASD, professionals in the field of medicine have proposed several theoretic frameworks; for instance, Gerrad and Rugg 2009 propose the development of a standardized framework for analysing autistic characteristics to facilitate the identification of subgroups and the location of biological markers for genetic variation (Gerrad and Rugg 2009, p.1449). The two also support the neuroconstructivist model that contends that peripheral sensual defects interrupt compilation of complex skills, influence synapto-genesis, synaptic pruning and myelination, and manifests themselves as autistic conducts. Of all the cognitive-developmental disorders, autism is perhaps the most clearly genetically determined and by combining universal rates of autism and sibling recurrence, there emerges a simple genetic model that categorizes families into two main groups, high-risk and low risk families (Zhao et al 2007, p.12831). Sporadic autism in low risk families is caused by spontaneous mutation with high penetrance in males while in high-risk families it is mostly from female offspring carrier of a new causative mutation that is dominantly transmitted to their offspring. There are at least two distinct genetic mechanisms for acquiring autism, firstly, autism can be acquired through de novo mutation in simplex families, and secondly, through inheritance in multiplex families. Zhao et al 2007 further suggest that a considerable proportion of sporadic autism is caused by denovo mutation, deletions, and duplications, in addition to, other genomic rearrangements or point mutations in the germ line of one parent that can result in the loss or gain of function to a large number of target genes. According to this study, denovo mutation is prevalent in over 10% of children with sporadic autism more often than in normal children or in children from multiplex families; although other types of denovo mutations do occur in sporadic autism, deletions are the most common types of denovo mutation witnessed. Deletions are more likely to cause a loss of function, a condition described as haploinsufficiency and there are many examples of haploinsufficiency affecting neurological development, behaviour, and cognition. Besides autism, all other genetic disorders that reduce fecundity yet recur in the population with an incidence related to the age of parents at conception are caused by spontaneous mutation; these include severe developmental and neuropsychiatric disorders among others, in addition, morbid obesity, and serious mood and cognitive infirmities. Other studies have also estimated the potential that between 24%-37% of cases of autism are etiologically linked to established biological pathology (Celani 2003 p.142); however, this proposition to interpret the association between biological damage and autistic behaviour has been subject to a number of technical challenges. However, there are repercussions, which can potentially influence the behavioural development of children, for instance, pathologies present in the prenatal period include hematic perfusion deficit during pregnancy, non-optimum gestation conditions. Similarly, the presence of rubella in the mother, and congenital infection from cytomegalovirus or toxoplasmosis could lead to alterations in the neuronal structures of the brainstem thus influencing the behavioural development of children accordingly. In addition, according to recent findings by researchers at the Harvard School of Public Health (HSPH), early-life contact to pollution, comprising diesel particulatesand others could potentially lead to a higher threat of Autistic Spectrum Disorders (Sifferlin, 2013). Learning problems Autistic Spectrum Disorder presents many challenges to the affected children because they experience myriad difficulties that inhibit acquisition of educational outcomes, and these require mitigating interventions on the part of the stake holders involved in the education of autistic children. Overall, autistic children have trouble in education mainly in the areas of communication skills and social interaction; both adults and children present difficulties in verbal and non-verbal communication, social interactions, and leisure or play activities (Lal and Shahane 2011 p.169). However, since ASD represents a spectrum disorder, each individual is equally affected differently at varying degrees (Bennet et al 2013 p.14); essential human behaviours such as social interaction and feelings imagination among others are inhibited in autistic children but levels may vary between individuals. In addition to that, children with autism may present with difficulties in correctly identifying stimuli, and this is manifests through their abnormal responses to sensory stimuli such as touch, sounds, and sights. The ability to process sensory information is a very essential part of daily human function because individuals’ understanding of life as a whole is derived from their sensory experiences (Kern et al 2006, p.1). Individual differences in registered sensory experiences inevitably results to variations in sensory processing as well, hence, the lack of homogeneity in the experiences and interpretations of the world. According to Dunn’s Model of Sensory Processing that examines the influence of sensory processing in daily life, the way a person responds to sensory events is a function of both their sensory threshold that could be either low or high, and their responding strategy that could be either passive or active. It has been observed that children with autism demonstrate deficits in social functioning and social cognition in addition to overlapping deficits in specific theory of mind tasks (Toal et al 2009, p.423); in this respect, children with autism may experience baseline deficits in understanding the mental states of others (Antonia and Hamilton 2009, p.881). Largely, autistic children present with impairment in verbal and nonverbal communication, which is ideally part of the core feature of infantile autism-the intense disorder in understanding and adjusting to the social environment regardless of the levels in IQ tests (S Baron-Cohen et al 1985 p.37). In this case, autistic children have been found to insist on sameness by treating both people and objects in their environment the same and are unable to disengage their brains from a focal point (Hughes and Russell 1993, p.507). In relation to this, autism influences children’s perception of the world and this considerably affects how children learn from their experiences from the world accordingly. In this regard, insofar as education for autistic children is concerned, educational outcomes cannot be realized through normal instructional modes or programs developed for the normal children without autism because the functional ability of these two groups of children is highly varied. However, in line with the universal goals of education for all, education for ASD children remains as essential as education for normal children and must be provided regardless of the challenges faced by autistic children in educational setups. Challenges in education Educationists all over the world have described education as one of the fundamental factors of human development because it enriches people’s understandings of both themselves and their surroundings alike, and improves quality of life leading to multifaceted social benefits for both the individuals and society (Lal and Shahane 2011, p.169). In addition to that, education also leads to increased productivity and creativity in individuals besides promoting entrepreneurship and technological advances, thus underscoring the need for an investment in education. In this regard, the ultimate goal of education is to help people become responsible and independent individuals who contribute positively to their communities; education for children with special needs aims to maximize their potential and helping them become well-adjusted individuals in life. However, the above-mentioned problems allied to the education of autistic children presents a number of challenges in the educational settings, which must be addressed to promote education of the affected group. Generally, the myriad problems experienced by autistic children in education presents challenges in the education settings in form of teaching criteria/methods, content and structure of the curriculum, instructional resources, teaching programs, in addition to, goals of education and learning environment, among other things. In this regard, all these elements must be varied accordingly in relation to the peculiar needs of the autistic children that varies considerably from those of normal children or children without autism, to promote educational outcomes for autistic children. Educationists continually face the daunting challenge of helping autistic children to acquire knowledge and abilities that enhance personal independence and socially acceptable behaviour in view of the major learning difficulties experienced by these children. Whereas normal children children may acquire much behaviour without direct teaching, children with autism need to be taught different behaviours in order to present with independence and responsible behaviour in the community. For instance, autistic children may rote learn how to count but may not be able to name things they interact with daily and as they grow old, they may be able to operate electronic equipment but fail to dress appropriately. In this respect, educational goals for autistic children are varied to encompass language, social and adaptive goals that are not found in the standard curriculum offered to neurotypical children in normal education settings. Educational programs for autistic children must be thoroughly structured to address the children’s specific needs; for instance, autistic children have trouble with abstract, language-based, theoretical responsibilities that involve sequencing and organization. In this regard, typical teaching methods such as verbal explanation and modelling among others are inevitably rendered ineffective due to the constrained social communication and limited imitative behaviours in the children (Lal and Shahane 2011, p.170). In effect, educational settings for autistic children must be varied considerably from the traditional education settings for neurotypical children, to address the various challenges presented by these children and to promote acquisition of educational outcomes for the group. Meanwhile, the traditional education settings are constrained in all aspects in relation to their abilities to provide optimum environmental conditions that facilitate learning of autistic children. Educational interventions Several interventions can be applied in the education of autistic children to promote educational outcomes for these children; Treatment and Education of Autistic and related Communication handicapped Children (TEACCH) is a program designed to provide the structure and predictability that autistic children require to function successfully (Lal and Shahane 2011, p.170). As an evidence-based service, TEACCH is a training and research program for individuals with ASD regardless of age and skill levels, and their families; this approach focuses on the development of programs around the skills, interests and needs of the autistic children. This approach provides an essential framework for understanding autism, making strategic adaptations, and selection of intervention strategies that focus on autistic children’s skills, interests, and needs. Assistance in understanding, consideration of individual differences, on-going assessment, and parental collaboration are essential principles of the TEACCH program, which if incorporated to the letter can yield positive outcomes for the instruction of autistic children (Lal and Shahane 2011, p.172). Another influential approach to the instruction of autistic children is known as structured teaching, the action of building or constructing and arranging things in a definite pattern of organization. Structured teaching provides for the inclusion of a multifaceted approach to teaching that combines a variety of teaching methods such as visual support strategies, Picture Exchange Communication System (PECS), sensory integration strategies and discrete trials, among other methods (Lal and Shahane 2011, p.172). Based on the understanding of the unique features of autistic children, structured teaching describes the learning environment for autistic children rather than the ‘where’ or ‘what’ of the learning process; in that case, the structured teaching approach is a system for organizing environments, developing appropriate activities, and supporting autistic children to understand tasks. Theoretically, the structured teaching approach addresses behavioural deficits by establishing appropriate and meaningful environments that reduce anxiety, stress, and frustration that autistic children may experience in learning. Studies have shown that autistic children respond positively to structured educational programs, especially those that follow the behavioural line and are applied by in one or small group meetings. For instance, tasks that are visual in nature and rely more on the integration of the eyes and hands, spatial, or motor capacities are easily understood and enjoyed by autistic children. In that case, all tasks formulated for autistic children, including those that are verbal and conceptual in nature, need to be structured in such a way that both what is expected and how to achieve it is clear to the children through visual characters to enable learning. Besides the clinical interventions in the education of autistic children, there are other approaches that are followed in some parts around the world such as parent-managed programs, also known as workshop-model programs, from the type of consultancy service offered (Bibby et al 2002, p.84). However, due to the lack of adequate information regarding these parent-managed intervention programs, it is largely unclear whether these programs can yield the same success witnessed by clinic-based programs in the education of autistic children. Conclusion Autistic Spectrum Disorder (ASD) represents a group of neurodevelopmental disorders that manifest in infants less than 3 years of age and lasts for a lifetime; autistic children present with impairments in social interaction, communication and repetitive patterns of behaviour. Cases of infantile autism are prevalent in the world today with males being overrepresented with a rate of sibling recurrence risk that is nearly 4 to 5 times higher than females in families. The etiological foundation of autism is highly elusive to clinicians in the world, but the genetic explanation prevalent in current research is attributable to the observations that the rate of recurrence of autism in the siblings of autistic individuals is much higher than the rate of recurrence in the general population. However, there is evidence of a deliberate move towards the formulation of a general theoretical framework for understanding autistic behavior in the large body of research that has been dedicated to this subject. One of the most influential theoretic models in existence insofar as autism is concerned, the neuroconstructivist model, posits that compilation of complex skills, synapto-genesis, synaptic pruning and myelination are disrupted by peripheral sensory abnormalities. In the educational settings, autistic children mainly struggle with communication and social interaction problems, with difficulties particularly in both verbal and non-verbal communication, in addition to the ability to interact with peers in leisure or play activities. Autistic children present a myriad of challenges to educational settings because unlike neurotypical children, autistic children require special interventions that may not be readily available in the traditional educational settings. Nevertheless, special interventions through educational programs such as TEACCH and structured teaching address most of the challenges presented by autistic children in educational settings, leading to positive educational outcomes in this group. References Antonia F. and Hamilton C., 2009. Research review: Goals, intentions and mental states: challenges for theories of autism. Journal of Child Psychology and Psychiatry 50:8, pp 881–892. Baron-Cohen S et al., 1985. Does the autistic child have a “theory of the mind”. Journal of cognition, 21, pp.37-46. Bennet et al., 2013. Theory of Mind, Language and Adaptive Functioning in ASD: A Neuroconstructivist Perspective. Journal of the Canadian Academy of Child & Adolescent Psychiatry, 22:1, pp 13-19. Bibby P et al., 2002. Progress and outcomes for children with autism receiving parent-managed intensive interventions. Research in Developmental Disabilities 2: 81-104. Celani, G., 2003. Comorbidity Between Autistic Syndrome and Biological Pathologies: Which Implications for the Understanding of the Etiology? Journal of Developmental and Physical Disabilities, Vol. 15, No. 2. Gerrard, S. and Rugg, G., 2009. Sensory Impairments and Autism: A Re-Examination of Causal Modelling. Journal of Autism and Development Disorders 39:1449–1463. Hughes, C. and Russell, J., 1993. Autistic Children’s Difficulty with Mental Disengagement from an Object: Its Implications for Theories of Autism. Developmental Psychology, vol 29, no 3, 498-510. Kanner L., 1943. Autistic disturbances of affective contact. Nervous Child 2:217-50. Kern, J.K., et al., 2006., Examining sensory quadrants in autism, Research in Autism Spectrum Disorders, pp 1-9. Lal, R. and Shahane, A., 2011. TEACCH Intervention for Autism, Autism Spectrum Disorders. Department of Special Education, SNDT Women’s University, Mumbai. Lancet., n.d. Disorders of the autism spectrum. Thelancet.com. Vol 368, pp.179-181. Sifferlin, A., 2013. Prenatal exposure to pollution raises risk of autism in kids. Cable News Network [Online] Available at: http://edition.cnn.com/2013/06/19/health/prenatal-pollution-autism [Accessed 23 June 2013] Toal et al., 2009. Psychosis and autism: Magnetic resonance imaging study of brain anatomy. The British Journal of Psychiatry 194, 418–425. Whitelaw C et al., 2007. Recurrence risk in Autism Spectrum Disorder: A study of parental knowledge. Journal of Paediatrics and Child Health 43 pp.752–754. Zhao et al., 2007. A unified genetic theory for sporadic and inherited autism. PNAS; vol. 104 no. 31. 12831–12836. Read More
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