Autism Spectrum disorder is a developmental disorder that appears in the early years of life usually in the fort three years. The word “spectrum”, in the disorder means that it can have different degrees of severity, which means that symptoms may be dissimilar among the individuals with the same disorder. These individuals are not good at social interactions and communication. They may have obsessive behavior meaning they may repeat one thing over and over again. Autism has been redefined over the years as more research has been done on the subject bringing in new facts and understanding. Autism affects sixty children in every ten thousand children, so research must be conducted to understand the reasons behind this disorder. This paper will explore autism in detail and discuss different aspects of it extensively.
In 1911, Eugene Bleuler a German psychiatrist coined the term autism. According to him, autism was childish thinking that some individuals had to avoid their realities. This definition of autism was widely used in Britain throughout the 1920s up until the 1950s. However, this definition was challenged by child psychologists in the 1960s as it invalidated the experiences of children that had the disorder. The definition was reformed to accurately depict the disorder and ironically, this new definition was the exact opposite of Bleuler’s definition of autism. The new definition of autism defined it as a complete absence of imagination and lack of fantasy. This led to increased research in this field in pursuit of understanding the disorder in depth. The reason the definition was changed was due to a shift in the psychiatric reasoning and diagnosis that led to the observation of multiple cases and collecting pieces of evidence from them rather than relying on individual cases. The other reason for the change was the parents’ demands for better psychiatric facilities for their children (Evans, 2013).
Individuals experiencing autism may avoid eye contact with others and have a different body language as compared to other people. They may not be facially expressive and lack imagination thus avoiding participation in games that require imagination. They may repeat and obsess over one sound or gesture. They may focus on a few interests. They are also indifferent to extreme temperatures. Although; having these symptoms may not always mean that the person has autism these are some symptoms that autistic individuals have shown.
The diagnosis of autism heavily depends upon the observation of the clinician, medical history, and different questionnaires to determine whether or not the patient has autism. This disorder is not genetic and there are no biological markers so it cannot be diagnosed through blood tests or samples. There are some screening tests conducted to determine if a child may have autism these tests are as follows:
- Modified Checklist for Autism in Toddlers: This is a twenty-question test that is devised for children of ages between sixteen months and thirty months. It is also known as M-Chat and is used as an early detection test. This test is a reliable tool in the early diagnosis of autism (Kleinman et al., 2008).
- The Ages and Stages Questionnaire (ASQ): This questionnaire has different sections that focus on different ages to identify any developmental challenges a child may be facing. This questionnaire is used by healthcare providers and even educators to better understand children’s needs and adapt their teaching techniques according to their needs. It is easy to use and helps in identifying different signs of autism (Agarwal et al., 2020).
- Screening Tool for Autism in Toddlers and Young Children (STAT): This screening tool has twelve sections that focus on observing the toddlers’ way of playing, communicating with others, and imitating different activities. This teat was developed so that early signs of autism could be detected (Kobak et al., 2011).
- Parents’ Evaluation of Developmental Status (PEDS): This screening test takes interviews of the parents and asks them different questions that may help in determining whether the child has autism or not. This test is helpful as parents’ insight can be a very useful factor in giving a proper diagnosis (Theeranate & Chuengchitraks, 2005).
The pediatricians advise the parents to get these screening tests for their toddlers so that the possibility of autism can be either ruled out or detected early. There are some cases in which individuals with autism reach adulthood before being diagnosed but these cases are rare, usually, children receive their diagnosis before reaching the age of eight.
Before 1980, not a lot was known about autism and many cases may have been misdiagnosed as other disorders that may have been autism cases. At that time the cases of autism were one out of two-thousand children but after 1980, more effort was put into the research of this disorder and due to this the rate of cases increased significantly. The US Federal Centers for Disease Control released a report in the March of 2020 which reported that the cases of autism have risen to one child out of every fifty-four children. Cases of autism that have been recorded are higher in boys as compared to girls but it does not mean that it is a gender-specific disorder. It affects children of all genders, races, and ethnicities. The reason that there have been increased cases of autism is due to the ever-changing interpretation of the disorder. Symptoms that were previously associated with other disorders now fall under autism disorder. Autism has developed rapidly from its initial definition of infantile hallucinations to a developmental disorder. The vast amount of variation in symptoms is also a contributing factor in increased cases of Autism (Fombonne, 2003).
In most cases, this disorder cannot be fully cured and remain with a child for their entire life, however; some treatments and exercises can help in reducing the core symptoms. In other cases, it can severely affect the quality of life of these children making them completely dependent on their families. If the presence of autism is detected early in children then these treatments can help tremendously in reducing the symptoms significantly. The advancement in the research of autism has led to better outcomes that have allowed the children to attend typical schools which have helped them in enhancing their communication skills and play. Intelligence quotient (IQ) of these children a huge part in determining as it can help in their early development, communication skills, and social integration. However; the biggest hurdle that autistic individuals face in their adulthood is developing a working career. Efforts are being placed into creating a training program that will help them seamlessly become a part of the workforce so that they may sustain themselves (Posar & Visconti, 2019).
Comorbidities mean when an individual develops more than one disorder. In cases of autism having comorbidities is common and can include; depression, anxiety, metabolic disorders, gastrointestinal disorders, sleep disorder, and immune function disorders. These comorbidities can be difficult to identify as these can be hidden behind the symptoms of autism. However; if identified and diagnosed properly then the quality of life for autistic individuals can be improved significantly. The adults show the symptoms of seizures and the prevalence of this disorder has been seen in approximately thirty-five percent of these adults. Fourteen percent of children have reported suffering from seizures and this usually starts around late childhood and early adolescence. If the patient shows epileptic movements then it can be difficult to diagnose those movements from seizures. There is also a high prevalence of sleep disorders among these children and almost eighty percent of cases have shown the presence of sleep disorders. The different sleep disorders reported by these children include; sleep-related breathing and movement disorder, parasomnias, circadian rhythm sleep disorder, etc. These disorder in turn also affect their daytime activities.
The gastrointestinal disorder has also been observed in these cases with abdominal pain, constipation, diarrhea, and vomiting being the pervasive symptoms. Physicians face difficulty in recognizing whether the disorder is a byproduct of autism or a separate problem. If the symptoms are self-inflicted like consistent tapping on the chest, pressing down on the abdomen, or any other self-injuring behavior then the disorder is due to autism but this is difficult to determine as many patients are not vocal and do tell about their symptoms. Metabolic disorders are rare in autism but there have been cases of it, however; the percentage is estimated to be 2.5 percent. The cases that have shown the symptoms of this disorder were treatable but it is always advised to keep an eye out for it. It has been observed that when autistic children reach adolescence then their behavior may worsen. This is due to hormonal dysfunction due to changes in the body. Comorbidities are prevalent in autism and the reason that these are difficult to diagnose is due to the non-verbal nature of the patient as they may effectively communicate their symptoms to their physician. This non-communication along with many symptoms of autism that mimic the symptoms of these comorbidities can make the diagnosis difficult (Bauman, 2010).
The MMR Vaccine Scandal
In 1998, an article was published in “Lancet”, by Andrew Wakefield and his colleagues which claimed that the MMR vaccines used for measles, rubella, and mumps, could cause autism in children. This article got a lot of attention due to which the people refused to get their children vaccinated for the fear of them developing autism. This led the scientific community to put in the research to debunk this article which was ill-researched in the first place. The connection between the MMR vaccine and autism was refuted, however; parents had already made up their minds about the vaccine and refused to believe the facts. Wakefield was ordered to publish a retraction of his statement but the damage had already been done. It was later discovered that were financial interests involved which led to such a baseless article. Lawyers that were fighting a lawsuit against vaccine companies had funded Wakefield to publish this article to strengthen their case. Wakefield was charged with an ethical violation as he had conducted an invasive investigation without the consent of the organization and had also committed fraud. His medical license was also revoked leaving him unable to practice in the future. This fraud was covered extensively by the British Medical Journal and a lot of time and money was spent in the refutation of this fraud (Rao & Andrade, 2011). The damage of this research fraud has prevailed even today as many parents believe that vaccines cause autism. The anti-vaccine movement has been becoming larger every day and people with autism have been experiencing prejudice from the anti-vaccine parents.
Prejudice against Autism
The people that have autism find it difficult to secure a job not due to their lack of capabilities but due to the prejudice against them. It has been recorded that only twenty-four percent of autistic individuals can secure a job but those are still low-level jobs and proper high-paying jobs. The behavioral and social challenges that they may face during the job interview may be the biggest hurdles they face when applying for the jobs. It has also been observed that the attitude of the potential employer changes when they learn that the individual has autism. These individuals are also perceived negatively by their superiors and peers (Taylor, 2018).
Recommendations and Conclusion
The autism research has significantly expanded over the years but there are still some areas that need work. There is a much-needed training program required to train organizations so that they may help autistic individuals in securing jobs. People with autism have a hard time becoming a part of a functioning society but the inflexibility of the future employers is also a big hurdle in them getting a job. More improvements should be made to the early identification and intervention models. All educators at typical schools should be trained to deal with autistic students so that they can help those in developing relevant social skills. There is a lot of work being done in the early years of autistic children but not much is being done for them as they reach adulthood. There should be more research done in this area so that they can be trained to become functioning adults in society. People should be educated about autism so that the prejudice against autistic people can be reduced. Autism is not caused by vaccines and can happen to any child, instead of making their life difficult awareness should be developed so that they can receive relevant and timely help. Lack of awareness can be equally harmful to people with autism as discrimination (Damiano et al., 2014).
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