The Ins and Out of Austism Spectrum Disorder

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Have you ever heard of the term ASD? What are your thoughts when you see a child misbehave in public? The two of these questions might be linked together. ASD is also known as Autism Spectrum Disorder which is a chronic disorder in the brain which affects the development of a child and the ability to function properly causing communication impairments, abnormal social relations with other people, anxiety and repetitive stereotypic movements. According to Rieffe et al., A well- known characteristic of children with autism is the lack of emotionally based contact with others.
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Children with autism fail to apply strategic manifestation of emotions. For example, in comparison to the non-autistic, their facial expressions are less expressive or inappropriate for the situation, they make fewer gestures that express an emotional state (195).
Currently, there is no known medical assessment that can diagnose ASD definitely. Instead, various screenings over a period of time are necessary to determine if the child is at high risk for an autism diagnosis.

The determination for ASD is not a short process but leads to multiple evaluations involving a speech-language pathologist, child psychologist, and developmental pediatrician. These evaluations are not only helpful in diagnosing the child with ASD but they are also essential in guiding parents in the right direction to help determine what type of intervention is applicable for the child. According to Lin, In December 2009, the Centers for Disease Control and Prevention estimated that 1 in 110 children are affected by autism spectrum disorder in the United States (17).
Studies have determined that autism is not caused by one gene, but rather lead by the interaction of multiple genetic regions and environmental exposure. Parents have expressed their concerns about the MMR (measles, mumps, and rubella) vaccines being that some children who displayed signs of developmental regression had the MMR vaccination preceding the onset of decline. However, numerous studies have reported no proof of the involvement of the MMR vaccinations in autism.
During early language deficits newborns between the ages of 6 to 12 months display a variety of communicative behaviors. They start to show signs of babbling and non-verbal actions of simple gestures to express intent. However, many analysts have proven that children later diagnosed with ASD lack many of these communicative behaviors. In fact, speech delay is one of the most common referral for parents for further assessments in children who are later diagnosed with ASD. Lin states, in recent studies show that about 25% to 30% of children later diagnosed with autism appear to develop social and language skills normally followed by symptoms of regression. Parents may report that children made significantly less eye contact and slowly stopped gesturing and talking. Particularly, such regression typically occurs between 18 and 21 months of age (25).
Children with ASD often show minimal interest in play skills and relationship with their peers. Instead, prefer common items such as sticks, papers, rocks, and strings. But on the other hand, when they do show interest in playing with toys they often play with them in a non-functional manner. For example, when an autistic child is playing with a toy he or she will play in a repetitive manner with an object such as spinning the wheels of a toy car or lining up blocks. Children with ASD show fewer initiations with peers by displaying poor eye contact, less to no greetings, and lack of response to the approach of others. In school settings, if they do happen to be out climbing structures in the playground or playing in close proximity to their peers, they engage in solitary play. In general, when compared to developing children, autistic children often find themselves more comfortable engaging in self-stimulatory behaviors rather than social interaction with peers.
In a recent study done by the American Journal of Occupational Therapy on April of 2014, participants were recruited online through numerous autism organizations, including the Interactive Autism Network, an online research registry for caregivers of children with ASD in order to determine the structure of active participation among school-age children with ASD. Additionally, they examined the associations between dimensions of active participation and family demographics. The method they used was an exploratory factor analysis and multiple regression was used to examine the extent to which child characteristics and family demographic were connected to Home and Community Activities Scale (HCAS) dimensions. As a result, the findings have indications for how activities may be categorized for children with ASD and suggest that the frequency of specific activities is affected by child characteristics and maternal education (Little et al., 2014).
Although children with ASD usually appear physically normal and have good muscle control, they have unusual repetitive motions which are commonly known as self-stimulation, stereotypic movement disorder, and repetitive behaviors. Typical examples include, teeth grinding, nail-biting and rocking movements. These behaviors can be extreme and highly probable, or more indirect. Some autistic children may spend a lot of time repeatedly wiggling their toes or flapping their arms, while others can unexpectedly freeze in position. Many theories exist as to what function repetitive behavior serve and the reasons for its occurrence in autistic children, for children with the under-stimulated nervous system, it may provide needed nervous system arousal, releasing beta-endorphins. Which in return feels like a norming effect allowing the child to control a definite part of the world they perceive through their senses and is thus a soothing behavior.
The authors claim that this lifelong neuro-developmental disorder is affecting around 60 to 10,000 children under the age of 6 years old. A recent study done by the UK National Autism Plan for Children in 2003 examined the relationship between anxiety and repetitive disorders. 67 young people in the ASD (Autism Spectrum Disorder) group and 20 children in the WS (Williams Syndrome) group between the ages of 6 and 15 years old participated in the study where they were asked to complete a questionnaire. Tests indicated that the group with Autism Spectrum Disorder had reported a higher level of anxiety than those with Williams Syndrome (Rodgers et al.,2012).
In the past 70 years, music therapy research has explored the adequacy of music therapy in improving multiple areas of functioning affected by the symptoms of autism. One of the reasons why music has quickly become one useful tool to help autistic children is that it can stimulate both hemisphere of their brain, rather than just one. This means that a therapist can use an instrument or a song to support cognitive activity so that children can form relationships with others and self-awareness. Music encourages interaction with others and communicative behavior, which is something that autistic children have great difficulty with. For children with autism, this could be learning a new word from a song or better understanding of how to act in a social situation based on the messages a song expresses. According to Lagasse, a study was done by the American Psychiatric Association in 2014, to analyze the effects of music therapy. Seventeen children ages 6 to 9 who participated in a 50-minute group session during a period of 5 weeks. All sessions were designed to target social skills along with a video analysis used to evaluate changes in social behaviors. Results from this study provided evidence that music therapy group sessions may improve joint attention, and eye gaze towards other people. Although, improvements were found more research is needed to examine intervention efficacy through a larger trial (Lagasse, 2014).
Another key part of the autism treatment team is speech therapy. Once the child is diagnosed, the speech therapist evaluates the best ways to improve communication and enhance a child’s quality of life. Speech-language pathologist are therapists who specialize in treating speech disorder and language problems. Throughout therapy, the speech pathologist works closely with the school, family and other professionals. If a child with autism is non-verbal or has major problems with speech, the therapist may introduce some therapy techniques such as, using sounds to which a person is over or under sensitive to compress, and expand speech sounds as well as singing songs composed to match the stress, rhythm, and flow of sentences. According to Keilmann et al., in 2004 Folia Phoniatrica et Logopaedica did a research where they analyze 169 questionnaires of parents whose children had received speech therapy and 140 questionnaires of speech-language therapists concerning their satisfaction with the outcome of the intervention. As a result, they found that the majority of parents were very satisfied with the outcome of speech therapy, the professional knowledge of the speech-language therapists and the type of therapy (1).
Our perception of autism spectrum disorder has developed over time. Sixty years ago, the condition was nothing more than an unrecognized developmental delay mainly lumped with intellectual disabilities. Today is recognized as an independent neurologically based disorder of significance, a major public health issue, and a topic of much research. Researchers have struggled to find a cause for the disorder without great success. Despite the difficulties, numerous treatments and therapies have been developed to help children with autism spectrum disorder maximize their potential to learn and become socially fluent. No matter how strong their impairments may be, there is a cause of hope.

Gregg Thompson

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