What is Autism?

This week, I wanted to share 2 videos that I found on You Tube.  The first one outlines the basic features in identifying Autism, and the other one highlights some treatment modalities for children with Autism.  Although both are generally good videos, I must warn you that they express the opinion of the makers of the video, and do not necessarily reflect my professional opinion on all their points.

What is autism?  This question can be better understood in the context of the basic understanding that each person has five (5) aspects within him/herself.  These five aspects are the:  physical, intellectual/cognitive, emotional, social, and spiritual aspects.  As all these aspects overlap with each other and often intertwine, we started developing in each of the different aspects form the time we were conceived, and we continue to do so for the rest of our lives. 

Particularly in the first few years of life, development in these areas is crucial because many basic building blocks for later learning and being happen at this time.  And development in these basic areas is often sequential and fairly predictable.  Autism is one of the conditions where significant developmental delays in these aspects are observed. 

Autism is a condition where children do not develop in ways that are expected.  Essentially, there are three major areas of development that impact on the five (5) aspects of a person mentioned earlier.  These include the following: 

• Communication – Youngsters with Autism do not learn language at the time children are expected to learn it.  Because of this, many are suspected to have hearing impairments when they are young, but this suspicion is promptly disproved by appropriate hearing tests.  When they start speaking, their use of language is often unusual, even nonsensical.  For instance, they often repeat phrases incoherently, have a monotone when they are speaking, and say made-up words that do not exist. 
• Social interaction – Children with Autism have difficulty understanding and engaging in many everyday social interactions that many of us take for granted.  For starters, they often have difficulty establishing and maintaining eye contact.  As such, they have difficulty deciphering social cues and reacting appropriately to the situation. 
• Stereotypic interests and behaviors – Before age 3, children are expected to be able to play with objects in the way they are intended to be used.  They are also able to use their imagination to pretend-play (e.g., using a play telephone to simulate a conversation with another person; using a toy car to run a race with another toy car).  Children with autism often do not use things in ways that the things were intended to be used.  Instead, they typically enjoy watching spinning things and lining up objects repeatedly.  They also tend to be focused on a specific area of interest and hardly veer away from this (e.g., memorizing road maps or flags of countries).  They are rather inflexible, even rigid, in their area of interest and ways of conducting themselves. 

 

Currently, Autism is understood to be: 

• Biologically-based – It appears to have a genetic and neurologic (in the brain) component, although these are not yet fully understood.   
• Lifelong – As it is not a disease but a condition, it cannot be cured.  It is something a person has for the rest of his/her life. 
• A developmental disability – Signs of patterns of delay in development can be observed in the first few years of life, and these delays impact on later development of the person.    
• A spectrum disorder – Autism can be seen across any intellectual level (from the intellectually challenged to the very gifted), and the severity of impairment in language and social interaction is vast.  The development of different children as they get older also varies greatly from one individual to another. 

When Autism is diagnosed by a qualified professional (including, but not limited to any of the following:  Neurologist, Psychiatrist, Developmental Pediatrician, Neuropsychologist or a Clinical Psychologist), parents are often recommended to bring the child for various interventions.  It is important to note the goals of these intervention centers on minimizing the problems of autism and maximizing independence and quality of life.  The child and his/her family are also often helped to cope with the condition in more effective ways. 

Despite progress in the various modalities of treatment, many services in the Philippines are available only in the urbanized areas.  Many of the services required by children with Autism are also private with very limited government funding.  As such, a majority of our countrymen who have this condition are unable to access services they need.

The most effective interventions for children with Autism have been found to have three basic features.  First, they emphasize early intervention (the earlier, the better) and involve the parents and main caregiver.  Many exercises done in intervention sessions need to be reinforced at home, where the child spends most of his/her time.  Second, they are oriented to the particular developmental stage where the child is currently functioning.  Interventions need to have a clear underlying comprehension of developmental stages so that mastery of current skills is reinforced and subsequent incremental development is prompted and rehearsed.  Third, these methods are echoed in the educational techniques used for special needs populations.   

On the part of many parents, the diagnosis of Autism can be both a confirmation of a gut instinct and a devastating blow to their dreams and aspirations for their child.  They have to go through a long process of understanding their child and their role as parents of these children. 

In the years I have been working with such parents and their children, I noticed that the children who make very good progress in the goals of treatment over the years have parents with certain characteristics and habits.  I believe these practices often boil down to the following: 

• Openness – They are open to the reality of the situation, and wholeheartedly deal with their own reactions. 
• Motivation – They are motivated to learn about their child and his/her condition.  They read up, engage various professionals, join support groups, and ask relevant questions.  They apply what they have learned in understanding the specifics of their child and become a true expert when it comes to their child’s special needs.  This brings about a clear understanding of the goals they have for their child, and they engage professionals with this in mind. 
• Delay of Gratification – They realize that their child’s development will be gradual and incremental, and there are no quick fixes.  So, they learn to be happy with the small progress their child is making.  They persist in fostering the hope of achieving the goals of treatment, at least to some extent. 
• Administrative Skills – They manage the needs of the family within the context of the special needs of their child with Autism.  Similarly, they also facilitate the healthy collaboration among the various professionals working with their child. 

Having a child with Autism is both challenging and rewarding.  It is also a gift that we have to learn to appreciate over time, and I know many parents who, after many difficult years of taking care of their child with Autism, tell me that this is an experience they will never ever regret having gone through.