Introduction
It is important to kick off the discussion by giving an insight as to what autism means. In a nutshell, autism is a spectrum disorder, what this essentially means is that it affects people in varied ways and a continuum of severity or developmental impairment. Individuals on the autism spectrum exhibit symptoms that are unique, and abilities and challenges that are distinct. The knowledge of the autism spectrum by parents with children suffering from autism is critical for the understanding of the children and in the provision of the necessary interventions. Furthermore, this will help the parents to acquaint themselves with the meaning of the various autism terms which ease the communication with the child’s treatment team. This essay essentially focuses on the clinical perspective of autism and Asperger’s syndrome, discusses the issues raised by researchers and clinicians, highlights the insights derived from the personal perceptions with individuals with the disability and parental counts and concludes by explaining autism spectrum disorder.
Summary of the clinical perspective
The clinical perspective on autism shows that autism is not a single disorder but rather a spectrum of disorders that are closely related to the main symptoms that are shared. Each individual on the autistic spectrum portrays some degree of difficulty to some extend with; social interaction, communication, restricted repetitive activities, and interests. However, the extent of autistic affection varies from one affected individual to the other. This depends mostly on the levels of development and the chronological age of autistic victims. For instance, two children with the same diagnosis may be very distinct when it comes to their behavior and abilities (Volkmar, 2000).
The autism spectrum disorders are explained by many clinicians as being included among conditions exhibited in childhood. These clinicians refer to them as Pervasive Developmental Disorders (PDD). Besides autism, Autism Spectrum also contains Asperger’s Syndrome and Pervasive Developmental Disorder (Volkmar, 2000). Childhood disorders and Rett Syndromes are other developmental disorders that are not prevalent. They are not included in Autism Spectrum Disorder because they are independent medical conditions rare genetic diseases. The level of influence of autism disorder on patients varies considerably. Clinicians consider classic autism to be the severest among autism spectrum disorders. It is depicted in the patient’s mental retardation which might be mild and profound. Autistic patients’ also exhibit slowed or retarded cognitive development skills in addition. Notably, persons with autism are in most cases hyperactive, with a short attention span. In addition to this, they tend to be aggressive and often inflict injuries on themselves. Temper tantrums are a common phenomenon usually aroused by simple alteration of the routine. Children who have autistic disorders display odd responses to sensory stimuli and exhibit abnormality in eating habits, for instance, limiting their diet to only a few foods. Last but not least they have an abnormality with mood. The mildest among autism spectrum disorders is Asperger’s syndrome. While, pervasive developmental disorder, better known as typical autism, falls in between the above two. According to surveys conducted, only a small percentage of people have classic autism. A significantly larger majority falls on the milder side of the spectrum (Volkmar, 2000).
According to clinicians, signs, and symptoms of autism spectrum disorders in both children and adults are exhibited in the form of disability in; social interactions, communication, and restricted activities and interests (Volkmar, 2000). However, there is a significant variance in terms of the acuteness of symptoms, how they are combined, and the patterns of behavior by an affected person. Notably, many autism spectrum disorders share many common symptoms and therefore making it difficult to distinguish one from the other especially during the early stages (Simpson, 2004). At this point of the discussion, it is important to analyze in detail the signs and symptoms of autism spectrum disorders as mentioned above.
Issues raised by researchers and clinicians
Autistic persons with disabilities in social interaction usually experience gross and sustained impairment (Simpson, 2004). This hampers their social interaction and therefore making many children on the autistic spectrum live in their world and be detached from others. The detachment can be seen early when an autistic child is still a baby when he does not respond to cuddling or even fails to look at her mother when feeding. In addition, there may be impairment even in the use of multiple nonverbal behaviors such as eye contact, facial expression, body posture and gesture to, lack of interest in other people, prefers to be alone, lacks empathy, resistance to being touched, and resistance to being touched and. As a result of this, the autistic person may have difficulty in developing peer relationships (Volkmar, 2000).
The inability of autistic patients to communicate, on the other hand, impacts the verbal and nonverbal skills and is also sustained (Simpson, 2004). The patients may also experience slowed development of speech, and in extreme cases, the speech does not develop. Even when the spoken language is developed, an autistic person may not be able to initiate or sustain a conversation with others and in some cases end up with an abnormal pitch, intonation, and rhythm. A person on the autistic spectrum disorder may also tend to finish every sentence as if asking a question, give a response to a question by repeating it instead of answering it, and even use echolalia. In addition, people with this condition have a problem communicating their needs and desires and often use language correctly (Volkmar, 2000).
According to Volkmar: “the restricted repetitive activities and interests’ impairment by individuals with autistic disorder usually keep them preoccupied with one or more patterns and therefore making them insist on sameness, rigid, and more often obsessive in their pattern of behavior, activities, and interests” (Volkmar). All the above-discussed features manifest themselves before the age of three and are portrayed henceforth as; preoccupation with one topic of interest, having special attachment to unusual objects, following a schedule that cannot be altered and resistant to change s in the schedule of events or a change in their environment, and generally displaying repetitive body movements such as hand flapping, twirling or rocking.
According to clinicians, Asperger’s syndrome is the least severe disorder among the autism spectrum disorders (Simpson, 2004). Children with Asperger’s syndrome do experience delayed development of language in contrast to those suffering from autism. Unlike autistic children, children with Asperger’s Syndrome have good spoken skills and language that is well developed. The children on this part of the spectrum also exhibit normal to high intelligence. Nevertheless, effective communication and socialization of these children with others are not effective (Volkmar, 2000). Mentioned below are the signs and symptoms of Asperger’s syndrome; Children with this disorder tend to show an obsession with a specific topic, they carry out lengthy one-sided conversations, they are not able to read expressions and other peoples reactions, they have abnormal eye contact, gestures and facial, speak in overly formal and high pitched voices, they also exhibit repetitive routines and schedules, last but not least, sensitivity to pain, light, and sound. Asperger’s syndrome children tend to be preoccupied rigidly with a particular interest or subject. For instance, it is often a common occurrence for a person with Asperger’s syndrome to find himself memorizing facts and collecting information related to his obsession (Simpson, 2004). However, apart from social interactions, Asperger’s syndrome victims do not experience retarded development in areas such as; cognitive, vital self-help skills, and adaptive behavior (Volkmar, 2000). Furthermore, mental retardation is rare, and if present it is usually mild. People with Asperger’s syndrome also have very strong verbal ability although they face a weakness when it comes to nonverbal communication. This is depicted in motor clumsiness which is usually present though mild. An Asperger’s syndrome is a continuous and lifelong disorder (Simpson, 2004).
Embarking on the issues raised by researchers and clinicians, it is apparent that, there has been a major controversy surrounding researchers and clinicians on the issue of continuity or the lack of it in the severe psychiatric disorder of childhood with adult psychoses. According to British psychiatrist Maudsley, children could exhibit levels of insanity just like adults. On the same breadth, Kraepelin extended the concept of schizophrenia initially termed dementia praecox to children. The research by Porter emphasized the utilization of childhood schizophrenia definitions that were more stringent. His research had a general assumption of child and adult psychosis continuity that was fundamental. Porter based continuity as a presumption largely on the enormity of these conditions. The research attached less appreciation of factors of development that are significant in the understanding of reality by children. The Autistic syndrome description by Kanner was surrounded by the confusion and controversy contributed by these issues (Volkmar, 2000).
Primarily, Kanner’s definition of autism was based on clinical and behavioral descriptions, investigated by empirical research. His research is a diagnostic category that is unique because it has lasted longer than other diagnostic research referring to similar children. Many other research labels were based on theories such as psychoanalytic theory, and have now faded into disuse. The empirical research has been altered by some aspects of Kanner’s autism syndrome. However, others have remained similar, assisted by subsequent research. Parts of Kanner’s autism description that is still utilized include: human relatedness inadequacy at the beginning of life; disordered language; and emphasis on the repetitive behaviors, with upsets interruptions occur on such behaviors or routines. These parts of the definition are still considered as the primary features of autism. However, subsequent researches have modified other aspects of Kanner’s definition of autism. This includes single underlying disease process, peak skills, and mental retardation, autism compared with childhood schizophrenia, parent psychogenesis, and socioeconomics status (Simpson, 2004).
Autism syndrome represented a unitary, psychogenic disease process as believed by Kanner. This representation was interpreted widely as to mean that the child’s symptoms were caused by parental pathology. However, autism disorder primarily comes about as a result of various brain abnormalities from the prenatal and perinatal periods (Volkmar, 2000).
Kanner’s autism was rather too broad and encompassed schizophrenia, a common condition at the time. Unfortunately, many researchers and clinicians of the time did not question the assumption put forth by Kenner on the severe psychiatric disturbance in children. Due to this, there was confusion on the part of the researchers like Bender who assumed that there was continuity on the psychotic conditions considerable typical adult forms of schizophrenia. Studies carried out later in the 1970s by Rutter and Kolvin resolved the controversial issue of autism schizophrenia by suggesting clear differences between the two conditions. The suggested difference was in terms, of course, family history and clinical features. Due to their suggestions, much of the early work on autism become hard to interpret. It was proved a decade later that, Kanner’s assumption that, autism was not linked to any medical condition was misconstrued. This can be shown by the fact that many children portray signs s a dysfunctional central nervous system that tends to bring about seizures. Moreover, Kenner’s assumption of there being a normal intellectual potential among children with autism proved to be correct (Volkmar, 2000).
Clinicians and researchers found out that, a larger majority of the children with autism were actually in the mentally retarded range according to the IQ. However, recent studies undertaken depict that, a large number of autistic children are not mentally retarded as compared to the autistic samples conducted 30 to 40 years ago. Some clinicians and researchers of the time, for instance, Battlhaim, attributed the parent-child relationship or inadequate child care as a cause of autism. They did so due to Kanner’s observations on the high level of parental achievement and unusual parent-child interactions. However, controlled studies were conducted later on and proved that parents to the child with autism did not show high degrees of psychopathology nor did they have any deficits in infant caregiving. Further controlled studies indicate that autism can affect children of all social classes. Well, researchers and clinicians have also raised some issues with the relationship between autism and Asperger’s disorder; however, substantive studies are yet to be done (Simpson, 2004).
Insights derived from the personal perceptions of individuals with the disability and parental count
This essay also delves into the insights that are derived from the personal perception of the individuals with a disability and parental counts. Notably, any disability poses a serious challenge both to the afflicted and to his family. Autism just like any disability is difficult to cope with. Earlier on, parents of Individuals with autism disorder always perceived their children as being treated differently by society because of their condition. This was evident in learning institutions where students with autistic disorders were not admitted because of their condition and an evident lack of appropriate education for them. Furthermore, parents of autistic children perceived themselves as taking up bigger and challenging roles than those undertaken by parents with normal kids. In addition, the presence of an autistic child inhibited the family’s social life because many parents were embarrassed, ashamed, and not in a position to explain their child’s disability when asked. In addition, many parents perceived themselves as the primary cause of the disability in their child and often blamed themselves. Luckily, this trend of perception has been reversed significantly to the extent that, many parents if not all now perceive themselves as their children’s co-therapist and as their children’s developmental agent and special advocate. Furthermore, today there is an increased awareness about autism disorder and therefore a change in the social attitudes towards the parents of an autistic child. It is this change in attitude that has fostered humane and better treatment of autistic people of all ages in their homes schools and communities. Ordinarily, people with autistic disorders are mentally handicapped and this impairment hampers their perception. Therefore they may not notice if they are treated differently by others (Volkmar, 2000).
Conclusion
To conclude this discussion it is important to give a deep insight as to really what autism spectrum disorder is. Volkmar (2000) argues that Autism disorder is classified as a developmental disorder that is pervasive because the symptoms “pervade and affect virtually every area of activity and development”. Children and youth identified to exhibit pervasive developmental disorder “are characterized by severe and pervasive impairment in several areas of development: reciprocal social skills, communication skills or the presence of stereotype behavior, interest and activities” (American Psychiatric Association, 2000). Commonly, children with autism display these behavioral patterns in the first few years of life are importantly exact of a child’s developmental level or mental age (Volkmar, 2000).
Autism spectrum disorder affects significantly the usual development of the brain especially in areas of social interaction and communication skills (Volkmar, 2000). Individuals suffering from autism generally experience problems in verbal and non-verbal communication, social interactions, and play activities (American Psychiatric Association, 2000). These individuals find it hard to relate and communicate effectively with others. The affected people also exhibit aggressive or self-injurious behavior in some cases. According to Simpson (2004), individuals affected by autism may show repeated body movements such as the flapping of hands and rocking, unusual responses to people or attachment to objects, and resistance to changes in routines. Children suffering from this disorder may also exhibit sensibilities in the five senses of sight, hearing, touch, smell, and taste (Simpson, 2004).
Volkmar (2000) explains that all individuals who have a disability in terms of interacting socially, communicating repetitively and stereotypically, and has restricted interests and activities before the 36 months of age, are diagnosed with autistic disorder. These patients have IQs that fall in the range of moderate to severe mental retardation. Social interaction impairment of autistic children are characterized by features such as substantial impairment in the application of nonverbal behaviors including facial expression, eye to eye contact, social interaction gestures, and body posture; incapacity of patients to establish appropriate peer relationships developmentally; the inability of patients to seek opportunities to interact spontaneously with other people, for instance, lack interest in terms of objects identification; and they exhibit poor social or emotional reciprocity. Simpson explained that “Communication impairments among autistic children are characterized by features such as; delay in the development of spoken language or complete lack of spoken language development, stereotyped and repetitive use of language, and lack of varied social imitative play that is developmentally appropriate and spontaneous” (Simpson, 2004). The patterns of behavior, activities, and interests that are repetitive and restricted stereotyped are characterized by; individuals having rigid adherence to routines that are nonfunctional, their motor movements, for instance, finger flapping are stereotyped and repetitive, and they are preoccupied persistently with objects and components (Simpson, 2004).
Reference list
- American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders. Washington DC: American Psychiatric Association.
- Simpson, R., Griswold, D., & De Boer-Ott. (2004). Autism Spectrum Disorder. Corwin Press.
- Volkmar, F. (2000). Autism and Pervasive Developmental Disorders. New York: Cambridge University Press.