Concepts and Symptoms
The conceptualization of Autism Spectrum Disorder (ASD) has gone through some switches since Kanner first took the term autism in 1943 in order to accommodate new discoveries on the cause and development of the disorder. The current consensus view on ASD is that people with ASD usually show social and language communication skills deficits as well as Restricted and Repetitive Behaviors (RRBs), and this disorder could be observed at an early age (Smith, Schaefer-Whitby, & Mrla, 2016).
Formerly, ASD was identified as Pervasive Developmental Disorders (PDD). At present, there are two wildly recognized diagnosing tools including the International Classification of Disease, Eleventh Revision (ICD-11) created by the World Health Organization (WHO) and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) published by the American Psychiatric Association (APA). This article mostly refers to DSM-5.
ASD is usually diagnosed by a person’s behavioral and developmental features. However, it is difficult to make an accurate diagnose especially for those children who have very limited verbal skills and cognitive abilities (Maye, Kiss, & Carter, 2017). One of the most significant adjustments in DSM-5 would be the consolidation of different subtypes of disorders, for example, Asperger Syndrome (AS), into ASD. This supports that the typical characteristics of children with autism are different from simply having low cognitive levels, but they have abnormal mental and emotional modes of mindset as well as defects in verbal and/or nonverbal communication to different degrees (Lord & Bishop, 2015).
In fact, many children with autism have shown extraordinary abilities, such as realistic painting, musical feelings, and performances, very good long-term memory, doing math in their heads, but they might have to suffer from extremely simple verbal communication throughout their lives and their verbal expressions tend to be obviously different than others (Robins, et al., 2011). Therefore, the author believes that the monotonous, strange behaviors and social alienation of autistic children may be directly related to abnormal mental patterns.
Diagnosis
Social Communication
DSM-5 identified three major indicators of social communication defects of people with ASD: deficits in social reciprocity, nonverbal communication impairment, and inability in maintaining a healthy relationship. Furthermore, DSM-5 provided the severity rating structure of ASD that helps to summarize the observations and contributes to a more reliable diagnose. Early diagnosis is a prerequisite for intervention.
However, children with autism have great difficulties in dealing with changes in situations or affairs, which makes it hard to come to a conclusion (Murdick & Gartin, 2016). Screening tools of ASD suitable for infants and young children include Checklist for Autism in Toddlers (CHAT), Screening Test for Two-year-old Children with Autism Tool for Autism in Two-years-olds (STAT), and Pervasive Developmental Disorder Screening Test (PDDST), etc. (Robins, et al., 2011). Among them, CHAT is an effective tool that has undergone the most rigorous research and verification and is proved suitable for young children.
Restricted and Repetitive Behaviors (RRBs)
DSM-5 identified four major indicators of social communication defects of people with ASD: stereotyped or repetitive movements, insistence on sameness, circumscribed interests, and sensory responsivity. Studies have found that the incidence of RRB is higher in children with lower language skills, ASD and Typically Developing (TD) (Harrop, et al., 2014). In addition, context blindness may indeed cause sensory problems. There is a connection between hypersensitivity and contextual information processing. The context is essential for regulating sensory input and can have both promoting and inhibiting effects (Vermeulen, 2015). Children with autism will show some typical behavioral characteristics from infancy. For example, normal babies have obvious preferences for interpersonal interaction. And infants with autism rarely show interest in the faces of others. Children with autism disorder tend to have a partial eclipse or have a strong personal preference for how to give them food, (for example, they have to put food in a specific cup, or cannot accept different foods to touch each other when placing the foods, etc.), their physical development may be affected as well.
In addition to the characteristics mentioned above, certain supplementary features of ASD should also be taken into consideration. First of all, there are three distinctiveness of ASD, including 1) the onset of autism appears multidimensionally and it could be extended to a long period of time; 2) the typical level of ASD does not usually increase; 3) the characteristics of ASD varies across individuals and show divergent patterns. Another important fact about ASD is that certain co-occurring conditions are commonly observed even though they are not part of the diagnostic criteria. Such as 1) language and/or intellectual impairment; 2) genetic factor, medical condition, or environmental situation; 3) neurological issues, catatonia, or other mental or behavioral disorder symptoms.
Treatment and Intervention
The intervention program of ASD focuses on social skills teaching including social skills teaching, including behavioral interaction, communication interaction and language teaching, social skills interaction, and interaction to promote emotional and intellectual growth (Cihak & Smith, 2016). Behavioral interaction could effectively increase the formation of aimed behaviors for children with autism and systematically reduce problem behaviors. For instance, Antecedent-Based Interventions (ABI) and Positive Reinforcement helps to increase children’s cognitive ability. Social skills interaction could be divided into skills-based interventions and cognition-based interventions. Social interaction training is one of the focus of the intervention of the former (Cihak & Smith, 2016). However, this method has little response because it requires adults as the medium and ignores the nature of children’s social interaction. As a result, Peer-Mediated Intervention (PMI) is regarded potentially effective and has a greater impact on establishing better social skills of children with ASD. Visual Support and Social Narratives are also common cognitive intervention strategies. At present, there is no single intervention plan, such as treatment or drug therapy, that can “cure” ASD. Using a variety of techniques to conduct early comprehensive interventions on ASD might have better results.
Summary
Autism is a developmental delay that impairs a person’s communication and social skills. Some people are severely affected and they have little or no language skills and may have abnormal body movements or muscle twitches. Some people are only mildly influenced and have appropriate language skills for their age. Most people with autism have shown shortcomings when it comes to
interpret social cues such as gestures and facial expressions of others and have trouble responding appropriately.
Due to the uniqueness of ASD, there are currently no laboratory tests that can diagnose autism. But because language delays or verbal communication issues are the key characteristics of ASD, developmental evaluation, especially in speaking, language, and communication is an important part of diagnosing autism.
Drugs cannot “cure” autism. But when children’s behavioral or mental problems interfere with their learning progress or social development, medications might be used. Children with autism may also have to receive medications due to other physical conditions, such as seizure. Developmental and behavioral therapeutic education is the major method of treatment of children with ASD. Developmental therapeutic education focuses on physical movement, visual support, and language skills. The focus of behavioral therapy education is to change certain special behaviors that hinder education or development.
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