Some questions about the Autism - Assignment Example

? of the Paper s Shelly may not have been entirely incorrect when she said that Jon’s shyness may be PDD. PDD or Pervasive Developmental disorder is an umbrella-like term for a family of personality disorders (Childhood disintegrative disorder, Asperger’s syndrome, autism, Rett’s syndrome and PDD-NOS) which are immensely complex in nature and affect the lives of an individual in a number of ways. The fact that the term “developmental” has been used to describe the disorder family means that children are either born with it or are born with the capability of developing it later. ”The study of autism is particularly associated with developmental issues because it is initially diagnosed early in childhood, continues to be evident throughout the life span, affects development in virtually all domains of functioning, and is typically (but not always) associated with delayed development” (Burack et al,2001) Causes of PDD (myth vs reality - what is scientifically known thus far) It is a myth that all PDD children are alike because there are certain classifications of PDD and the accurate condition can be understood only with the help of professionals. Some people tend to think that children affected with PDD do not have feelings and may be a danger to society but this is untrue because in most cases such children are more sensitive than normal children. Most researchers believe that autism is caused by faulty genes and can also be genetic in nature. PDD “does not appear to be a reflection of a single gene defect; rather, several genes may play a role in shaping the core and associated symptoms of this disorder. Moreover, autistic symptoms may be a final common pathway resulting from a variety of genetic and/or environmental factors (e.g., birth complications, exposure to toxins, etc.) affecting various brain systems (Hollander, 2003). Sometimes it is also believed that early rejection of the child by his/her parents causes PDD because the behavioral symptoms of a maltreated child are identical to those of an autistic child; however such theories have been nullified. PDD is detectable in children at a very early age. PDD individuals have difficulty in interacting, socializing and communicating. Other features include “the presence of a distinctive impairment in the nature and quality of social and communicative development (influenced by the specific biological and environmental circumstances of the individual)” (Zager, 2005). Since, Jon shows some of the possible PDD symptoms we should take the situation lightly and should not rule out its probability altogether because prevention is always better than cure. Rates PDD in the US According to a published review article of Fombonne (2009) in Pediatric research, the numbers of children affected by PDD in the US have risen. Epidemiologic surveys on PDD using a variety of methods were carried out by the United States Centers for Disease Control and Prevention with the help of researchers from John Hopkins Bloomberg School of Public health. According to the report published the estimation of prevalence of PDD also known as Autistic spectrum disorders “1 in 88 U.S. children overall, and 1 in 54 boys” ( CDC REPORT, 2012). The study also suggests that across all the American states it had been observed that boys were five times more likely to develop PDD than girls. The researchers suggest a national median age of 4 years 6 months for PDD diagnosis. Coleen Boyle, director of U.S. CDC’s National Center on Birth defects and Developmental Disabilities said that most PDD affected children do not receive any diagnosis until they are four years old. (CDC Report, 2012). The symptoms of PDD are often ignored and that is the main reason for late recognition and diagnosis in most children. However, psychiatrists suggest that parents should get their children assessed for PDD by health professionals in case they notice late development. Early assessments help in planning and implementing diagnosis. Assessment procedures There are several assessment procedures available today. The very first step is to get an initial assessment which will determine the presence of PDD. The initial assessment can be done by any mental health professional and is basically an interaction between the parents and the health professional where the nature, depth and severity of the problem are assessed. If the health professional feels that the child is a potential PDD individual he/she may refer the parents for a specialist assessment. Specialist assessments include tool and procedures that help the investigator gather more information about the type and possible diagnosis of the PDD. Specialist assessments are comprehensive in nature and may take a long time for to assess and reach a conclusion. Among the various procedure Special Autism Diagnostic interview –Revised (ADI-R) is the simplest one. It is basically a questionnaire for the parents, which is mostly done in the presence of the child so that the investigator has a chance to meet up with the child and understand the priorities and problems faced by the parents.”The interview focuses on caregiver descriptions of actual behavior as it has occurred in the subjects life” (Lord et al, 1994). Another assessment is the Autism Diagnostic Observational Schedule generic (ADOS-G) “is a semi structured assessment of social interaction, communication, play, and imaginative use of materials for individuals who may have autism or other pervasive developmental disorders” (Lord et al, 2000) Childhood Autism Rating Scale (CARS) is an assessment procedure in which investigators observe the behavior of the child throughout the day. Medical assessment today is also of great use since all forms of PDD are disorders of the brain.” 10% of children with autism have an associated identifiable neurological disease” (Szatmari, 1995) There are various other assessment procedures that assess the language, interaction, cognitive and non-verbal intelligence of the child. How is PDD officially defined by the DSM-IV? DSM IV has laid down certain criteria to identify PDD Like autism, PDD-NOS, Asperger’s syndrome, Rett’s syndrome and child disintegrative disorder. Firstly, impairment of social skills such as lack of use of non-verbal gestures like facial expression, eye-to-eye gaze, body posture etc or failure to develop interest in interaction with people or even lack of interest in seeking enjoyment have been laid down as possible criteria for PDD (Diagnostic and Statistical Manual of Mental Disorders ,2000). What is the value of early intervention? PDD has no permanent cure but it is possible to enhance the development and delay developmental problems of individuals with PDD. Over the years many researchers have developed treatments for children.” Interventions emphasizing social skills in children, usually from later preschool through school age and in adolescents and adults, have emerged as a major theme of the treatment literature in the past few years” (Volkmar et al,2004). Most of these interventions are behavioral, developmental and cognitive in nature. Studies conducted by Harris and Handleman (2000) compared development and mental growth of autistic children receiving intervention after four years of age to those children receiving intervention before reaching the age of four. The studies provided “empirical evidence that children who enter programs at younger ages make greater gains than those who enter programs at older ages” (Corsello, 2005). After early recognition, early intervention becomes really valuable. Infants and young children have flexible neural circuits which can be trained easily. The neural circuits of the brain are the foundation of learning and development and as time passes by the circuits become harder to change, therefore it is important to start the intervention as early as possible. Early positive experiences strengthen the brain and help in development of the child in terms of social and interaction skills which also lay the foundation for enhancement of cognitive development; hence there is a need of starting the intervention at a younger age. A study conducted by researchers at the University of Michigan (Serwach, 2004) on 200 autistic children at the age of two showed that almost all the children made progress and one-third made considerable progress with 5% of the children who had follow-ups at the age of 9 showed no symptoms of need of further diagnosis. Another very important reason for early intervention is that parents and relatives of children with have tremendous difficulty in understanding them and early intervention not only help the development of the children but also help parents understand them better and cope well with the situation. In fact early therapeutic interventions have bore positive results across the world, for example The Mifne method, which mainly focused on human bonding and utilized the concept of parental intervention was used in Israel to treat PDD children under the age of five (Alonim, 2004) and later, the follow-ups revealed that 73% of the children were fit enough to attend mainstream schools. Thus, the need of early intervention must not be overlooked. Give at least 4 major educational considerations to consider in working with a child with PDD Working with a child with PDD needs special attention and considerations on the part of the educator. “The education of children with autistic disorders was accepted as a public responsibility under the Education for All Handicapped Children Act of 1975 “(Educating Children with Autism, 2001). Direct Instruction is one educational consideration when education a PDD affected child. It involves the principle of Applied behavior analysis. The child should be taught functional skills and the progress monitored where positive behavior is rewarded and reinforced. “For many autistic and PDD children, a stronger channel is the visual one. Therefore, pairing auditory stimuli with visual stimuli helps information be received and stored differently” (Siegel, 1996), therefore visual instruction is yet another educational consideration. Using technology like computers may seem unconventional but is in fact really useful because the content is much easier to understand than the words of an instructor as they provide visual instructions as well. Behavioral consideration is one of the most important considerations when educating a PDD affected child because such children often show inappropriate behavior. Educator use Functional Behavior Assessment to understand the behavior and PBIS to eliminate bad behavior. Natural instruction settings are another thing to consider because the child learns more in an environment that he/she is comfortable in. Therefore, since Jon is only two years now and is showing probable symptoms of PDD we should get him assessed so that we can intervene at the earliest and help him develop much more naturally. REFERENCE Alonim, H. (2004). The Mifne Method — ISRAEL Early intervention in the treatment of autism/PDD: A therapeutic programme for the nuclear family and their child. Journal of Child and Adolescent Mental Health 2004,, 16(1), 39-43. American Psychiatric Association, & American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders: DSM-IV-TR. Washington, DC: American Psychiatric Association. Burack, J. A., & European Congress of Psychology. (2001). The development of autism: Perspectives from theory and research. Mahwah, N.J: L. Erlbaum. CDC releases new report on autism prevalence in US - 2012 - News Releases - News. (2012, March 30). Johns Hopkins Bloomberg School of Public Health. Retrieved March 12, 2013, from http://www.jhsph.edu/news/news-releases/2012/lee-autism-prevalence.html Corsello, C. (2005). Early Intervention in Autism. Infants & Young Children, 8(2), 74-85. Fombonne, E. (2009). Epidemiology of Pervasive Developmental Disorders. PEDIATRIC RESEARCH, 65(6), 591-597. Harris, S. L., & Handleman, J. S. (2000). Age and IQ at intake as predictors of placement for young children with autism: A four- to six-year follow-up. Journal of Autism and Developmental Disorders,, 30(2), 137-142. Hollander, E. (2003). Autism Spectrum Disorders. New York: Marcel Dekker. Lord, C., & Et al (2000). The Autism Diagnostic Observation Schedule–Generic: A Standard Measure of Social and Communication Deficits Associated with the Spectrum of Autism.Journal of Autism and Developmental Disorders, 30(3), 205-207. Lord, C. (1994). Autism Diagnostic Interview-Revised: A Revised Version of a Diagnostic Interview for Caregivers of individuals with Possible pervasive Developmental Disorders.Journal of Autism and Developmental disorders, 24(5), 1994. Serwach, J. (2004, June 21). Early intervention lessens impact of autism. March 11, 2013 | The University Record Online. Retrieved March 12, 2013, from http://www.ur.umich.edu/0304/Jun21_04/25.shtml Siegel, B. (1996). The world of the autistic child: Understanding and treating autistic spectrum disorders. New York: Oxford University Press. Szatmari, P. (1995). Identification and early intervention in pervasive developmental disorders.Recent Advances in Pediatrics, 13(9), 123-138. Volkmar, F. R., & Et al (2004). Autismand pervasive developmental disorders. Journal of Child Psychology and Psychiatry, 45(1), 135-170. Zager, D. (2005). Autism Spectrum Disorders: Identification, Education, and Treatment(3rd ed.). Mahwah, NJ: Lawrence Erlbaum Associates. Read More