Category: Autism Spectrum Disorder

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Autism Spectrum Disorder

Art and Music Therapies for Individuals with Autism Spectrum Disorder

Autism Spectrum Disorder (ASD) is classified as a neurological and developmental condition characterized by behavioral difficulties in areas of social interaction and communication. Individuals with ASD may display patterns of repetitive behaviors or restricted interests which can conflict with their proficiency to use verbal or non-verbal gestures, interpret their own and others’ emotions, or adjust to new environments and scenarios (American Psychiatric Association, 2021). As a result, individuals with ASD may be hindered from successfully communicating their thoughts and wishes to others. Children and adults with ASD experience different degrees of impairment with respect to the severity, number, or presentation of their symptoms. Early intervention, focused on different forms of training and therapy, have been shown to improve functionality of social and speech skills which can help individuals to better understand social situations. While most individuals with ASD opt for common forms of intervention such as applied behavior analysis and occupational and speech therapy, non-traditional programs such as art and music therapy have been seen to be very effective in increasing social adaptation and communication skills (Centers for Disease Control and Prevention, 2019). 

Art therapy is emerging as a new tool to successfully mitigate some symptoms of ASD by promoting a stimulating outlet to help individuals use artwork and media to explore their emotions while developing self-awareness skills to better acclimate to new surroundings (The Carmen B. Pingree Autism Center of Learning, 2021). Art therapy is a creative process which is facilitated by an art therapist who is a licensed, master-level clinician with expertise on how to integrate sensory and symbolic art modes into improvement of cognitive and emotional function (American Art Therapy Association, 2017). As individuals with ASD may experience difficulty expressing themselves verbally, art therapy provides a non-verbal outlet where one may develop and enhance their ability to express themselves in a less restrictive environment. As art therapy tends to be individualized, one may choose what materials, mediums, and colors they want to use to form their own visual work. In this manner, those with ASD are able to integrate abstract thinking and their emotions into their art to reveal their perspective and creative expression. Art therapists can cater their exercises to seeing which materials are most preferable or popular to their patient so they can be most comfortable in their own learning environment (Van Lith et al., 2017, p. 78-84). The preference in choosing different materials can help individuals with ASD increase their tolerance to experience new stimuli. Art strategies, such as sand art or playdough sculptures, are forms of different sensory materials which can help individuals to be more desensitized to new textures and smells. While participating in this creative play, individuals can be more comfortable with various stimuli which will inevitably improve their interaction to similar situations in their daily life. Here, art therapy is able to enhance visual and spatial skills in individuals to allow them greater behavioral regulation (The Carmen B. Pingree Autism Center of Learning, 2021).      

Similar to art therapy, music therapy is an intervention, facilitated by an accredited therapist, that focuses on instrument play, musical improvisation, and various musical activities to foster social and communicative skills. Music therapy helps to provide a predictable structure to sessions that may help to better accommodate individuals with ASD for their learning environment. Because of heavy sensory engagement, music based therapy sessions can help one to be accustomed to different social environments and increase the likelihood of positive engagement in daily activities. Additionally, music therapies can often be presented in group activities which can encourage individuals with ASD to collaborate with others and increase their interaction. As ASD may make it difficult for individuals to understand others’ expressions and emotions, these group activities can help their social skills and communication (American Music Therapy Association, 2015).

Through efforts to expand therapy and intervention practices, one can see how there are options for individuals with ASD to learn new social and communicative skills in a manner most comfortable to them. Interventions such as art and music therapy provide innovative learning styles where an individual with ASD can foster abilities to be confident and secure in themselves in their own environment.   

 

References

American Art Therapy Association. (2017). Becoming an art therapist. https://arttherapy.org/becoming-art-therapist/

American Music Therapy Association. (2015). Fact sheet: music therapy and autism spectrum disorder (ASD). https://www.musictherapy.org/assets/1/7/Fact_Sheet_ASD_and_MT__8-26-15.pdf

American Psychiatric Association. (2021, August). What is autism spectrum disorder? https://www.psychiatry.org/patients-families/autism/what-is-autism-spectrum-disorder

The Carmen B. Pingree Autism Center of Learning. (2021, May 25). Art therapy activities for autism. https://carmenbpingree.com/blog/art-therapy-activities-for-autism/

Centers for Disease Control and Prevention. (2019, September 23). Treatment and Intervention Services for Autism Spectrum Disorder. https://www.cdc.gov/ncbddd/autism/treatment.html

Van Lith, T., Stallings, J. W., & Harris, C. E. (2017). Discovering good practice for art therapy with children who have autism spectrum disorder: The results of a small scale survey. The Arts in Psychotherapy, 54, 78-84. https://doi.org/10.1016/j.aip.2017.01.002

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Autism Spectrum Disorder Neurocognitive Disorders

Adjusting to Online Learning During the Pandemic for Students with Autism

As of spring 2020, school closures due to the coronavirus pandemic have affected at least 55.1 million students in both public and private schools across the U.S. (Map: Coronavirus and School Closures in 2019-2020). As schools started in the U.S. this fall, many students have engaged in fully remote learning. Life, for elementary school children used to having recess or college undergraduates used to in-person lectures, has completely shifted. While these adjustments have been difficult for all students in terms of education, they have been especially challenging for students who experience Autism Spectrum Disorder. 

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder related to brain development, and impacts an individual’s social and communication skills, as well as behavior (Autism spectrum disorder – Symptoms and causes). Repetitive behaviors, having trouble expressing needs using typical words or motions, having trouble adapting when a routine changes, having trouble relating to others, having trouble understanding other people’s feelings or talking about their own feelings, and avoiding eye contact are some of the symptoms that individuals with ASD may experience. Detection of ASD can occur as early as 18 months. Even though there is currently no cure for ASD, early intervention therapy can assist children with ASD in focusing, walking, talking, and interacting with others (What is Autism Spectrum Disorder?). 

General challenges that many students, parents, and educators have faced during remote learning throughout the pandemic include concerns about technological security, workplace environment, privacy, increasing feelings of isolation, and limitations in engagement throughout remote learning (Online learning concerns that shouldn’t be ignored). However, children and older students with ASD or other learning disabilities couple these concerns with other challenges as well. Specifically, students with ASD that may have trouble communicating in classrooms may find it more difficult to communicate virtually since social engagement is profoundly reduced via remote learning. Many of these students, especially younger children, have aides that assist them in social engagement and attentional issues in classroom environments, and they may not be able to have their aide support them in person with quarantine and social distancing measures in place. Students with ASD who received “related services” or school therapists and behaviorists that monitored and assisted them with behavioral difficulties may no longer receive them (Coronavirus: What happens to students with disabilities when schools close?). Additionally, many students with ASD often process information and learn differently from their peers. For instance, many students with ASD have trouble working independently, struggle with time management, are more likely to have difficulties in tasks  involving language and communication, and experience high levels of anxiety which may be worsened due to the stress of remote learning. Oftentimes, individuals with ASD associate specific tasks with locations, and thus may resist doing school work at home (Webster, 2020).  

Despite such challenges, there are some tips to help students with ASD adjust to remote learning. Some tips include creating a learning space to associate with school work and a routine that allows them to not become overwhelmed with the sudden changes happening. Children with ASD may have trouble engaging in independent tasks, something that has exponentially increased due to limited opportunity for social interaction in remote learning. Therefore, independent tasks such as completing homework may be challenging for students with ASD. However, research has demonstrated that creating a homework plan with clear communication between the parent and educator about which content should be prioritized as the main “takeaway” from lessons makes the individual task less anxiety inducing or overwhelming to the student, while being equally educational and effective. For instance, instead of writing an essay on the story or history of early settlers, students with ASD can use puppets to tell this history since they may have trouble thinking about what goes on in someone’s mind or relating to someone else’s story. Thus, this method would make the individualized tasks less overwhelming, more engaging, and helpful to the student in overcoming any hardships that may exist when it comes to understanding or relating to someone else (Webster, 2020). 

Additionally, there are some positives to remote learning that can benefit students with ASD. Technology can offer students with ASD the opportunity to learn a wide range of academic skills by presenting educational content in a way that better fits the students’ learning style, which is oftentimes visual learning. In particular, apps that are specifically designed to improve language and literacy skills for different learning styles can be of use to students with ASD who often learn and process information differently from their peers (Webster, 2020). The Learning App Guide to Autism and Education is a useful resource for parents, educators, and students with ASD because it contains reviews for learning apps categorized by skill areas and age groups.  For instance, Babnoor, the first Arabic language app, will launch in UAE to help children with ASD and other neurodevelopmental disorders by teaching children how to create sentences using symbols or images (Dawodi et al., 2020). Overall, online learning apps and platforms can be engaging through educational games or presenting learning styles for different types of learners, including students with ASD. 

Coming together and relying on different resources has been helping all students continue to make the best out of the education they receive everyday. Students with ASD may experience additional challenges relating to adjusting to remote learning, but there are many tips, resources, and positives to look forward to. At the end of the day, no one can stop students from learning. In the words of Albert Einstein, “Intellectual growth should commence at birth and cease only at death.”

 

References

Dawodi, A., Alzahrani, S., Almumtin, R., Alshyban, S., Alshabanah, M., Alrajhi, D., Alsmadi, M. and Almarashdeh, I., 2020. Developing and Implementing an Online Learning Platform for Children with Autism. International Journal of Scientific Research in Science and Technology, pp.176-188.

Webster, A.A., 2020. 5 tips to help parents navigate the unique needs of children with autism learning from home. The Conversation, 4, pp.1-5. 

Usatoday.com. 2020. [online] Available at: <https://www.usatoday.com/story/opinion/2020/03/21/coronavirus-what-happens-students-disabilities-when-schools-close-column/2867856001/> [Accessed 4 October 2020].

Strauss, V., 2020. Five Concerns About The Mass Rush To Online Learning That Shouldn’T Be Ignored.. [online] Washingtonpost.com. Available at: <https://www.washingtonpost.com/education/2020/03/30/five-concerns-about-mass-rush-online-learning-that-shouldnt-be-ignored/> [Accessed 4 October 2020]. 

Education Week. 2020. Map: Coronavirus And School Closures In 2019-2020. [online] Available at: <https://www.edweek.org/ew/section/multimedia/map-coronavirus-and-school-closures.html> [Accessed 4 October 2020].

Centers for Disease Control and Prevention. 2020. Basics About Autism Spectrum Disorder (ASD) | NCBDDD | CDC. [online] Available at: <https://www.cdc.gov/ncbddd/autism/facts.html> [Accessed 4 October 2020].

Mayo Clinic. 2020. Autism Spectrum Disorder – Symptoms And Causes. [online] Available at: <https://www.mayoclinic.org/diseases-conditions/autism-spectrum-disorder/symptoms-causes/syc-20352928> [Accessed 4 October 2020].

Cameron, J., 2020. Photo Of Child Sitting At Computer. [image] Available at: <https://www.pexels.com/photo/photo-of-child-sitting-by-the-table-while-looking-at-the-imac-4145153/> [Accessed 27 September 2020]. 

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Autism Spectrum Disorder

Measles: Once Eradicated, Back Again

Vaccination has remained controversial.

The scientific facts illustrate vaccines do not cause autism. In addition, it is inaccurate to think of autism as a single disorder. Autism is rather a spectrum of disorders characterized by different symptoms and their severity. So why do these controversies persist despite the United States Court of Federal Claims’ ruling on three cases that no evidence currently supports a correlation between vaccines and autism spectrum disorders? Individuals who choose to vaccinate, and not to vaccinate (read: anti-vaxxers) have both entered the debate with contention. This heated debate stems from anti-vaccine activists such as Andrew Wakefield; a physician barred from practicing medicine for allegations of scientific misconduct following a failure to replicate or confirm his findings of a correlation between the measles, mumps and rubella (MMR) vaccine and autism. In fact, the former practicing physician directed the anti-vaccine propaganda film Vaxxed: From Cover-Up to Catastrophe. Conspiracy theories interest me but after reviewing the research there comes a time to conclude these unsound controversies – especially when they risk harming others. This is one of those times.

Precautions taken to prevent debate from growing include removing thimerosal from vaccines administered to children. Anti-vaxxers have argued that thimerosal, a mercury-containing preservative, cause autism. Public health officials have dismissed these claims, stating there is a lack of evidence suggesting thimerosal is implicated in the development of autism, still thimerosal has been removed from vaccines in hope of persuading people to vaccinate their children. The heated debate continues along with an increase in reported frequency of measles, a disease once eradicated from America.

Measles is a highly infectious airborne disease spreading rapidly through simple interactions such as coughing or sneezing. Once contracted there is no cure, supportive care can however reduce mortality. America was declared free of circulating measles with approximately 900 recorded cases from 2001 to 2011. In 2014, the Centers for Disease Control (CDC) issued a statement suggesting endemic measles, rubella, and congenital rubella syndrome (CRS) has not returned to the United States apart from some reported cases of measles due to unvaccinated tourists infecting others around them.

In 2014, the anti-vaccination movement began to pick up again. By 2015, from January to April 159 cases of measles were reported by the CDC; 48% unvaccinated and 38% unsure whether they were vaccinated. Measles resulted in pneumonia and subsequently the death of one woman that year, the first fatality from measles in roughly a decade. In 2018, there were 273 reported cases of measles. Recently, from January to February an outbreak resulted in at least 58 confirmed incidents of measles in Clark County, Washington, where there is a higher rate of vaccination exemptions. In fact, 1 in 4 kindergartners have not received vaccinations. The Washington State governor has declared a state of emergency. The cause of the outbreak tied to parents electing not to vaccinate their children.

Outbreaks of measles are still occurring following its eradication from our country. While this may be a heated debate for some, it is life and death for others. Vaccine-preventable diseases still exist around the world and in America, despite their low prevalence. The only disease eradicated completely is currently smallpox. Polio, while close to eradication still exists. With the decision to not vaccinate increasing in number so will the incidence of vaccine-preventable disease. However, viruses move quicker than parents’ ability to decide: what started out as 10 or 50 infected people can become hundreds and thousands.

References

Aleccia, J. (2015, July 03). Undetected measles led to death of Clallam County woman in her 20s. Retrieved from https://www.seattletimes.com/seattle-news/health/undetected-measles-led-to-womans-death/

Ball, L. K., Ball, R., & Pratt, R. D. (2001). An assessment of thimerosal use in childhood vaccines. Pediatrics, 107(5), 1147-1154.

Clemmons, N. S., Gastanaduy, P. A., Fiebelkorn, A. P., Redd, S. B., & Wallace, G. S. (2015). Measles—United States, January 4–April 2, 2015. MMWR. Morbidity and mortality weekly report, 64(14), 373.

Fiebelkorn, A. P., Redd, S. B., Gastañaduy, P. A., Clemmons, N., Rota, P. A., Rota, J. S., … & Wallace, G. S. (2015). A comparison of postelimination measles epidemiology in the United States, 2009–2014 versus 2001–2008. Journal of the Pediatric Infectious Diseases Society, 6(1), 40-48.

Gastañaduy, P. A., Redd, S. B., Fiebelkorn, A. P., Rota, J. S., Rota, P. A., Bellini, W. J., … & Wallace, G. S. (2014). Measles—United States, January 1–May 23, 2014. MMWR. Morbidity and mortality weekly report, 63(22), 496.

Godlee, F., Smith, J., & Marcovitch, H. (2011). Wakefield’s article linking MMR vaccine and autism was fraudulent.

Johnson, K. (2019, February 8). The measles outbreak continues to be an emergency in Washington state. Retrieved from https://www.post-gazette.com/news/health/2019/02/07/outbreak-measles-cases-Clark-County-Washington-state-vaccination-emergency/stories/201902010163

Novella, S. (2016). The anti-vaccination movement. Skeptical Inquirer, 31, 26-31.

Offit, P. A., & Jew, R. K. (2003). Addressing parents’ concerns: do vaccines contain harmful preservatives, adjuvants, additives, or residuals?. Pediatrics, 112(6), 1394-1397.

Schuchat, A. (2015). Measles in our time: the US experience. Future virology, 10(7), 809-812.

Sudfeld, C. R., Navar, A. M., & Halsey, N. A. (2010). Effectiveness of measles vaccination and vitamin A treatment. International journal of epidemiology, 39(suppl_1), i48-i55.

Sugarman, S. D. (2007). Cases in vaccine court—legal battles over vaccines and autism. New England Journal of Medicine, 357(13), 1275-1277.

UNICEF. (1996). Vaccines bring 7 diseases under control. Retrieved from https://www.unicef.org/pon96/hevaccin.htm

Volkmar, F. R., State, M., & Klin, A. (2009). Autism and autism spectrum disorders: diagnostic issues for the coming decade. Journal of Child Psychology and Psychiatry, 50(1‐2), 108-115.

Wakefield, A. (2016). Vaxxed: from Cover‐Up to Catastrophe. Burbank, CA.: Cinema Libre Studio.

Woodard, T. (2019, January 10). Measles, still present after all these years! Retrieved from https://www.akpeds.com/pediatric-peeps/2019/1

Categories
Autism Spectrum Disorder

Drama Therapy – Skill Development in ASD

Individuals with Autism Spectrum Disorder (ASD) often have difficulties developing skills connected to the concept of Theory of Mind.  According to Psychology Today, Theory of Mind involves “understanding another person’s knowledge, beliefs, emotions, and intentions and using that understanding to navigate social situations.”  A creative strategy known as Drama therapy is used to help build these skills, which is supplemented with more traditional treatments in clinical settings such as Applied Behavioral Analysis.  MSR News Online describes the techniques seen in Drama therapy as “exercises commonly practiced in the theatre such as scene acting, improvisation, and physical acting.”  This outlet provides a fun atmosphere for individuals with ASD to develop skills in a fun environment with their peers.

Drama Therapy works to improve Theory of Mind in individuals with ASD by allowing them to take on the role of a character.  It encourages adolescents to get in the mind of fictitious characters within social interactions. This helps individuals develop skills in empathy and understand the feelings and behaviors of others through these theatrical transformations. As described in, “The Effects of Drama Therapy for Children with Autism Spectrum Disorders,” a study conducted as an honors thesis at Bowling Green State University by Katie O’Leary, “Children on the spectrum want social connections as well, and drama therapy helps a child learn how to relate to others by actually becoming another person through a character on stage (Bailey, 2010).”

In O’Leary’s study, she describes exactly how Theory of Mind skill can be achieved through drama therapy.  She states that “various social situations can be modeled and role-played giving the child a solid level of comfort and familiarity with the situation so that when social interaction is encountered in real life, the child can engage in a more normal manner.”  Drama Therapy works to prepare individuals for social interactions which they will ultimately encounter in their own lives.  Handling these social situations while working towards certain developmental steps in a fun and expressive way allows those with ASD to master these skills.  O’Leary asserts that the drama therapy improved their individuals’ skills for, “working with others, interacting and engaging with peers, learning parts for the performance, concentrating his physical body in games and exercises, and learning how to behave through a different character that each student was assigned as an actor.” The benefits obtained by drama therapy give these individuals more confidence in their social interactions outside of the theatre. Having more confidence will lead to a more fulfilling and successful social experience.

The benefits of drama therapy are not only limited to the acquisition of skills related to Theory of Mind. According to MSR News Online, individuals who participate in drama therapy experience, “increased self-confidence, improve self-esteem and pride in their accomplishments, improve recognition of emotions in others, improve identification and labeling of their own emotions, enjoy new leisure-time activity in a group where they can be successful, enjoy a new awareness of volume levels and beginning modulation of vocal levels, enjoy new skills for functioning as part of a group, enjoy new skills for following directions, improve the ability to interact with peers.”  The benefits of this type of therapy are invaluable for persons on the spectrum.  

References: 

MD, Dr. Charles Crutchfield III, et al. “Home.” MSR News Online, 24 Nov. 2017, spokesman-recorder.com/2017/11/24/drama-therapy-new-tool-help-autism/

O’Leary, Katie. “The Effects of Drama Therapy for Children with Autism Spectrum Disorders.” Scholarworks.bgsu.edu, 16 Dec. 2013, scholarworks.bgsu.edu/cgi/viewcontent.cgiarticle=1002&context=honorsprojects

Thompson, Brittany. “Theory of Mind: Understanding Others in a Social World.” Psychology Today, Sussex Publishers, 3 July 2017, www.psychologytoday.com/blog/socioemotionalsuccess/201707/theory-mind-understanding-others-in-social-world

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Autism Spectrum Disorder

Tablet Games: A Possible Future Diagnostic Technique for ASD

Diagnostic techniques for Autism Spectrum Disorder (ASD) often fall short of perfect because they rely on observation of behavioral and developmental progress by a physician (Screening and Diagnosis).  This subjectivity leads to a large population of undiagnosed individuals.  A study was recently conducted which aims to provide an effective supplemental tool in diagnosing and tracking the progress of therapy in ASD in children by Kołakowska, Landowska, Anzulewicz, and Sobota.  

Automatic Recognition of Therapy Progress Among Children with Autism studied the behavioral data of individual users while engaging in tablet games that monitored user activity through features such as touch screen sensors, accelerometer trackers, and a gyroscope that is able to record behavioral characteristics continuously. These features track the behavioral data of the user, which are incredibly accurate at predicting ASD in children at an early age, as well as track the progress of their therapy.  When the study was replicated, the authors found that this technique can be used to “identify children with autism with up to 93% accuracy.” Early diagnosis is crucial for the individual’s future development.  This research is important because it offers unique insights in the form of quantifiable data of behavioral characteristics of ASD, thereby eliminating some human error that may result in traditional diagnostic and progress checks alone.

Tablet games are useful for therapy progress because they focus on, “particular issues by teaching specific skills–e.g. expressing needs, learning certain behaviors, improving verbal communication, answering questions, interacting with other people in typical situations, recognizing and expressing emotions.” The detection of eye movement while engaging in a tablet game is a feature of this therapy.  The software records eye movements of the individual during gaming in order to capture the individual’s behaviors. Data collected from changes or lack thereof in eye movement can help the interpretation of other factors, such as motor deficiencies, making diagnosis more precise and evidence-based  The software can track motor deficiencies in individuals and record “the way a particular movement is prepared, in the velocity, acceleration, and jerks while specific types of arm movements are performed, or in different distributions of grip force over time”.  The data collected can then be used as a supplemental tool by the diagnostician.

Another advantage that tablet game platforms offer to diagnostic practices is that it provides data through a stress-free platform, not typically seen in traditional settings such as a questionnaire in a clinical interview. The DSM-5 illustrates the “insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior” often seen in individuals with ASD. Tablet games utilize this tendency through computer technology, which provides a “predictable framework” in which children with ASD are often comfortable with.  

 A unique aspect of the tablet game approach is that it provides a wealth of raw data that eliminates some human error seen in visual analysis of behavior alone. Though further research should be done to reassure the effectiveness of these tablet programs, experts should consider working this technique into their diagnostic practices in order to add evidence to their diagnosis and assure that they are being as accurate as possible.  

References:

Kołakowska, Agata, et al. “Automatic Recognition of Therapy Progress among Children with Autism.” Nature News, Nature Publishing Group, 24 Oct. 2017, www.nature.com/articles/s41598-017-14209-y

“Neurodevelopmental Disorders.” Neurodevelopmental Disorders | Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Association Publishing, 2013, dsm.psychiatryonline.org/doi/full/10.1176/appi.books.9780890425596.dsm01#x98808.2728600

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Autism Spectrum Disorder

Deficiencies in Detecting Autism Spectrum Disorder in Females

The diagnosis of Autism Spectrum Disorder (ASD) has a significant gender difference. According to “Linguistic camouflage” could complicate the diagnosis of Autism Spectrum Disorder in girls”, girls are about four times less likely than boys to be diagnosed with ASD.  A possible explanation for these large gender discrepancies could be due to differences in diagnostic techniques–not the lack of prevalence of the disorders in females.  According to  Gender and Autism, “Various studies, together with anecdotal evidence have come up with men/women ratios ranging from 2:1 to 16:1”.  Often times, girls can be diagnosed later in life or not at all. This results in less early intervention which is crucial for the development of those on the spectrum.  According to the Autism Spectrum Disorder Foundation, “Children who receive autism-appropriate education and support at key developmental stages are more likely to gain essential social skills and react better in society”. This results in an overwhelming amount of women and girls who are not receiving the support they need.  

Experts in the field have noted obvious differences among males and females on the spectrum. An article in National Public Radio (NPR), ‘Social Camouflage’ May Lead To Underdiagnosis Of Autism In Girls identifies that “Boys more likely to exhibit repetitive behaviors, fixated interests and being less likely to engage in social interactions. Girls tend to be more verbal and socially interactive, at least at younger ages.” This difference is certainly a contributor to the current diagnostic methods present in ASD. A recent study looked deeper into the cause of this trend and found that females with ASD are more likely to display behavior that has been termed “social camouflaging”.  

Social camouflage is characterized by modifying typical behaviors to blend in with peers (Morris, Schultz 2017). An example of “camouflaging” is well explained by The British Psychological Society, “if an autistic person maintains eye contact during a conversation because they have learned that this is socially appropriate, even though this clashes with how they really want to behave, this would be an example of camouflaging”.

Behaviors such as these contribute to diagnosticians lack of recognition of the disorder in females since they are more geared towards male ASD tendencies.  The development of innovative techniques could lead to equal diagnostic capabilities and early intervention to give them the same opportunities for wellness as those who do not display camouflaging behavior.

Gender and Autism point out that men tend to excel more in the general population in visuospatial activities, while females tend to excel in verbal skills.  They then conclude that due to this general tendency and the false perception of the male ASD stereotype, males are quicker to be diagnosed with ASD than females.  Therefore, “no direct analogy can be drawn between the poorer verbal skills of boys and the higher incidence of autism in men and boys”.  

Neuroimaging has been suggested by studies to aid in the diagnosis of ASD by detecting brain abnormalities which are typically present. These techniques are not designed to replace traditional behavioral assessment of ASD but are beneficial in supplementing them. According to “Neuroimaging-based methods for autism identification: a possible translational application?”, “Traditional neuroimaging analysis approaches were designed mainly to reveal brain abnormalities by statistically comparing data from two groups of subjects (usually affected subjects and a control group) either matched or controlled for possible confounding variables ”.  Though as of yet, the techniques have not made any move to a clinical setting due to its lack of recognition by American Academy of Neurology and Child Neurology Society as an effective diagnostic tool, researchers are continuing to study neuroimaging in order to assert their arguments.  In the future, neuroimaging may prove to assist clinician in the diagnosis of ASD and reduce diagnostic gender disparities by reducing subjectivity present in behavioral assessments which are under the influence of perceived stereotypes.

The expression of ASD in females needs to be better understood through more extensive research in order to prevent neglect. It is up to the psychological community to provide revisions in diagnostic techniques in order to identify females with ASD at an earlier age, so they do not continue to go through life without a diagnosis

References:

“Autism and gender.” The National Autistic Society, www.autism.org.uk/about/what-is/gender.aspx

“Early Intervention Makes a Huge Difference for Children with Autism.” Autism Spectrum Disorder Foundation, myasdf.org/site/media-center/articles/early-intervention-makes-a-huge-difference-for-autistic-children/

Hasselmann, Helge. “There’s such a thing as.” Research Digest, 3 Apr. 2017, https://digest.bps.org.uk/2017/02/24/theres-such-a-thing-as-autism-camouflaging-and-it-might-explain-why-some-people-are-diagnosed-so-late/

Julia Parish-Morris & Robert T. Schultz 2 Oct 2017. “”Linguistic camouflage” could complicate the diagnosis of Autism Spectrum Disorder in girls.” On Health, 2 Oct. 2017, blogs.biomedcentral.com/on-health/2017/10/02/linguistic-camo

Neighmond, Patti, and Jane Greenhalgh. “’Social Camouflage’ May Lead To Underdiagnosis Of Autism In Girls.” NPR, NPR, 31 July 2017, www.npr.org/sections/health-shots/2017/07/31/539123377/social-camouflage-may-lead-to-underdiagnosis-of-autism-in-girls

Retico, Alessandra, et al. “Neuroimaging-Based methods for autism identification: a possible translational application?” Functional Neurology, CIC Edizioni Internationali, 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC4370436/

Categories
Autism Spectrum Disorder

Person-First Language: The Right Way, Right?

As the importance of rhetoric remains a controversial topic today in political discourse, a split has risen in the Autism Spectrum Disorder (ASD) Community over the issue of person first language.  Person-First Language reaffirms the idea that those who are affected by disabilities are not defined by them, and have unique identities that are often overshadowed by the harmful language used to describe them.  Whether or not you have been exposed to this type of language may not have been obvious to you at the time. Have you ever heard or read references to someone on the spectrum as a “person with autism” as opposed to an “autistic person”, if so then you have experienced its implementation first hand.  

Person-first language advocates believe that the words we choose to use truly do have an impact on society’s attitude towards those with autism and their ultimate treatment.  This belief is further explored in the article “Put me first: The importance of person-first language” by Mary Tobin. Tobin states that , “Person-first language is a philosophy of putting individuals before their disability. As you will see, this is about more than just language; it goes deeper into our attitudes toward others and how those attitudes translate into action” (Tobin, 2011).  The goal of this language is to change the attitude of defining a person by their condition, into celebrating that person. While there is large support for the use of this type of language to describe individuals with ASD, there is a controversy that this line of thinking has the reverse of its intended effect.

Those opposed to person-first language prefer to be called an “autistic person” because they believe having ASD is a beautiful and unique aspect of their identity, and to change the semantics ultimately chalks up their identities to misfortune and devalues them. Others would argue that this type of language is actually harmful to the identities of those with ASD.  They believe that being “an autistic person” is inseparable from their person. To make a distinction is to reinforce that having ASD, creates an idea that they are somehow less than. This sentiment is explained by an article, “The Significance of Semantics: Person-First Language: Why It Matters” by Lydia Brown.  Brown states that “ when we say ‘person with autism,’ we say that it is unfortunate and an accident that a person is Autistic. We affirm that the person has value and worth, and that autism is entirely separate from what gives him or her value and worth. In fact, we are saying that autism is detrimental to value and worth as a person, which is why we separate the condition with the word ‘with’ or ‘has’” (Brown, 2011).  This side of the argument has the same goal as person-first language, yet it uses different logic which produces the opposite execution.        

Another point of view believes that our focus should not be on language, but the intention of the individual should be the focus of the conversation. This argument is voiced by a mother whose son has ASD.  She uses both kinds of language when talking about her son.  She describes her opinion in her article, “Has Autism” versus “Is Autistic”; A muddled debate”.  She states, “I’m far more interested in the substance of what someone says rather than getting hooked up on whether they used “autistic” or “has autism” (2011).  While she displays rejection to both sides of the argument, her main objective is to allow her son a positive experience with his identity and experiences with those around him.

After reading an overview of the central points of both arguments, where do you stand?  While I believe that rhetoric and semantics do have an impact on the world and its attitudes,  I do agree with the logic used by both sides of the debate.  Consider, that the most beneficial point of view to keep in mind could be the person you’re talking with. Ask them how they feel about the subject and what makes them comfortable.  In the end, isn’t the underlying theme of both arguments to keep the individual in mind?

References:

Brown, L. (2011, August 04). The Significance of Semantics: Person-First Language: Why It Matters. Retrieved October 01, 2017, from http://www.autistichoya.com/2011/08/significance-of-semantics-person-first.html

Tobin, M. (2011, May 23). Put me first: The importance of person-first language. Retrieved October 01, 2017, from http://www.ttacnews.vcu.edu/2011/05/put-me-first-the-importance-of-person-first-language/

“Has Autism” versus “Is Autistic”; A muddled debate. (2011, July 26). Retrieved October 01, 2017, from https://autismandoughtisms.wordpress.com/2011/07/25/has-autism-versus-is-autistic-a-muddled-debate/

White Alphabet Dice. (n.d.). Retrieved October 01, 2017, from https://www.pexels.com/photo/toys-letters-pay-play-48898/

Categories
Autism Spectrum Disorder

“Atypical”—Suggestions to Paint a More Comprehensive Picture of Autism Spectrum Disorder

The new Netflix Original—“Atypical” features Sam, a high school senior navigating love and life with Autism Spectrum Disorder.  Autism Spectrum Disorder (ASD) is characterized by, “deficits in social communication and social interaction” (American Psychiatric Association 2013).  It’s no surprise that it adds challenges to the already tricky landscape of a high school social life.  The series does a great job of asserting the point that Sam wants to experience relationships with others, he just might not know how to go about obtaining them. Netflix and Rabia Rashid, the creator and executive producer of the show, had the best of intentions in creating a protagonist with ASD.  Rashid conveys this in her interview with vulture.com when asked about her inspiration for creating a show with a protagonist on the spectrum.  “I was very aware that more people were being diagnosed with autism, and it was interesting to me that a whole generation of kids were growing up knowing that they were on the spectrum and wanting independence” (2017).  It is clear that she wanted to give a voice and representation to group of people who are marginalized in the media, unfortunately, the execution missed the mark in a few areas.  

The Mighty and The Huffington Post explores the show’s shortcomings by interviewing individuals living with Autism Spectrum disorder within their articles, “People in the Autism Community Review ‘Atypical’, Netflix’s Original Series About Autism” and “My Autistic Opinion: Atypical is a Stereotypical Representation of Autism”.  While the general consensus from those interviewed in the articles by The Mighty and The Huffington Post was approval for a number of the show’s qualities, they agreed it left some room for improvement.  As someone who does not experience Autism Spectrum disorder, my initial thoughts on the show were an overwhelming approval for what I thought was a championing voice for the community.  Although, after reading the opinions of people who are actually on the spectrum, I realize that “Atypical” is a far from perfect representation of ASD, despite good intentions.

A common criticism mentioned by several of the individuals was that Sam was a “caricature of autism” which perpetuated many of the harmful stereotypes of the disorder (Staff 2017).  One woman with ASD, Haley Moss, described her feelings on how these stereotypes might have a larger impact on public opinion in the article from The Mighty.  She states, “[the show] hurts us by falsely portraying us as creepy, insensitive, and just really awkward” ( Moss 2017).  Stereotypes in the media like these do truly have an impact on the perceptions of neurotypical people that may not be properly informed on the subject.  It is also very important to keep in mind that not everyone who experiences ASD faces the same challenges, so by using such broad stereotypes, it ultimately reduces the collective experience into a “caricature”.   As Moss points out, “Atypical” could have avoided mistakes like these if a person with Autism Spectrum Disorder was consulted during the production.  Another improvement that could have been implemented was the choice of an actor who has been diagnosed with Autism Spectrum Disorder (Staff, 2017). This decision would have allowed someone in the community to breathe more genuine and authentic qualities into Sam’s character in a nonstereotypical manner.

As with many real-life instances, Sam is often unfairly the source of humor in the show deriving from his perceived lack of insight on social cues and overall communication with others.    Moss is especially worried that the jokes in the show paint Sam as, “…inherently selfish and inconsiderate…” (Moss 2017).  This depiction is not representative of individuals on the spectrum in any way and may lead to further stigmatization.  “Atypical” may benefit the community by deriving humor elsewhere which does not capitalize on Sam’s attempt to connect with people.  This aspect of the show’s shortcomings are particularly harmful in that often times, people with ASD may have difficulty understanding others humor due to a deficit in comprehending social contexts (American Psychiatric Association 2013) .  Therefore, to use Sam as the source of humor in a show that attempts to humanize him is particularly ineffective and damaging.    

All of this is not to say that “Atypical” completely missed the mark.  It is so important to produce narratives surrounding Autism Spectrum Disorder because it is an important step in creating a more understanding atmosphere.  By showing the world this perspective it might inspire empathy and acceptance in others which might have otherwise gone ignored or right out scrutinized. “Atypical” is on the right track, the execution simply needs a few adjustments.

References:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders(5th ed.). Arlington, VA: American Psychiatric Publishing.

Fernandez, M. E. (2017, August 15). Atypical Creator Robia Rashid on Autism: ‘I Had to Do a Lot of Real Learning’. Retrieved September 24, 2017, from http://www.vulture.com/2017/08/atypical-showrunner-robia-rashid-interview.html

Moss, H. (2017, August 11). My Autistic Opinion: Atypical is a Stereotypical Representation of Autism. Retrieved September 17, 2017, from http://www.huffingtonpost.com/entry/my-autistic-opinion-atypical-is-a-stereotypical- representation_us_598e2e04e4b0ed1f464c0abd

Staff, T. M., Daughter, M. &., Savely, C., Reynolds, B., Flood, T., & Burgess, M. (2017, August 1). People in Autism Community Review ‘Atypical,’ Netflix’s Original Series About Autism. Retrieved September 17, 2017, from https://themighty.com/2017/08/atypical-autism-netflix-review/

 

Categories
Autism Spectrum Disorder

Now Boarding: How Airlines Are Accommodating Those with Autism

Air travel is arguably the most stressful form of travel. From crowded security checkpoints to the constant rotation of delays and cancellations, air travel can present unique challenges for any traveler. Such difficulties can be magnified for those with autism due to the sensory and communicative symptoms related to the disorder. While an airport environment can be incredibly overwhelming for a person with autism, airlines are beginning to recognize and respond to the needs of their travelers with neurological disorders.

The Arc, a Washington D.C. organization which assists those with developmental and intellectual disabilities, coordinates Wings for Autism, a program geared toward helping families of autistic children become familiar with airports and air travel. The program runs as a type of rehearsal; families come to the airport and participate in standard airline procedures such as going through security checks, waiting in the gate area and getting onto a plane. The program does not require any airline commitments or flight tickets.

The program offers the unique opportunity to foresee how a child with autism may react to air travel, giving the family a chance to adjust accordingly. Wings for Autism also serves as an educational tool for airlines. TSA employees are able to spend additional time with children with developmental disabilities and practice their interaction. At the events, TSA officers ask the families for insight on how to best accommodate the needs of children with autism or other intellectual and developmental disorders.

Since 2011, 44 airports have participated in the program, totaling more than 75 individual Wings for Autism events.

Sarah Bal, public relations director for The Arc, emphasized that the program’s primary goal is to acclimate children across the autism spectrum to the airport environment. This includes sounds, procedures, and the general commotion which often comes with air travel. According to Bal, the program has helped over 2,000 families since launching six years ago at the Charles River Center in Needham, Massachusetts (Netto, 2017).

Wings for Autism is an important and useful tool in assuring that air travel for those with autism is as painless as possible. In addition to such interactive programs, airlines are stepping up in other ways to assure comfort and convenience for their travelers dealing with neurological disorders.

In April 2016, Delta Air Lines unveiled a calming room at Hartsfield-Jackson Atlanta International Airport. The room, which was created to ease the airport experience for children with autism and other disorders, features a mini ball pit, tactile activity panel, and a bubbling water sculpture (Baskas, 2017).

A similar quiet room was recently opened at Myrtle Beach International Airport in South Carolina, and the first airport sensory room in Europe launched in March at Ireland’s Shannon Airport. The latter’s accommodations include color changing LED lights, a wheel projector, and an undulated wavy wall.

The combination of Wings for Autism and sensory rooms in airports allows families affected by autism to ease themselves into air travel. The stresses related to air travel are often unpredictable, but these airline accommodations allow the chance to best prepare and deal with the inconveniences that may arise during a trip. Businesses and establishments have a responsibility to accommodate all people to the best of their ability, including those with disabilities, and hopefully, more airlines and airports across the world continue to introduce new ways of assisting their customers.

References:

Baskas, H. (2017, April 12). Friendlier Skies: Airlines Are Making Travel Easier for People with Autism. Retrieved April 26, 2017, from http://www.nbcnews.com/business/travel/friendlier-skies-airlines-are-making-travel-easier-people-autism-n745711

Netto, J. (2017, April 19). Preparing to fly with kids with autism. Retrieved April 26, 2017, from http://www.cnn.com/2017/04/19/health/autism-kids-flying/

Categories
Autism Spectrum Disorder

Could Stem Cells Lead to an Autism Breakthrough?

Duke University recently conducted a first-of-its-kind study that sought to determine whether a transfusion of umbilical cord blood containing rare stem cells could help treat autism. The study included 25 children diagnosed with autism and the results were optimistic; two-thirds of the children, ranging from ages 2 to 6, reported improvements.

The safety trial began over a year and a half ago, which found that umbilical cord blood was not only safe, but 70% of the 25 participants had behavioral advances as described by their parents and tracked by the Duke researchers. The children traveled to Duke three times over the course of a year, and each visit included a series of evaluations including MRIs, EEGs, and autism assessments. The children received the umbilical cord blood infusion on the first visit. Each child received 1 to 2 billion cells, given through an IV in their arms or legs. The subsequent visits occurred six months and one year after the infusion.

Dr. Joanne Kurtzberg and Dr. Geraldine Dawson spearheaded the study. Kurtzberg, head of the Robertson Clinical and Translational Cell Therapy Program, and Dawson, director of the Duke Center for Autism and Brain Development, each saw the intense need for advancements in autism treatments.

Kurtzberg has been studying for years the effects of umbilical cord blood treatments on several disorders, including inherited metabolic disorders and cerebral palsy. In children with cerebral palsy who also exhibited autistic tendencies, their symptoms of autism improved with the treatments. The improvements among children with cerebral palsy gave Kurtzberg the idea to test cord blood specifically for autism.

While both doctors were encouraged by the results of the initial study, they cautioned that plenty of additional research is necessary in order to definitively state whether or not umbilical cord blood treatments improve autism symptoms. Dawson noted the study did not have a comparison group, which she stated is “very important in establishing whether a treatment is actually effective” (Drash & Sanjay, 2017).

Next up is a definitive trial — a double-blind, placebo-controlled trial involving 165 children with autism, ranging in age from 2 to 8. During this secondary phase, the children will receive either their initial umbilical cord blood infusion during their first visit to Duke, or a placebo. A battery of tests, including brain monitoring, will follow.

After six months, the children will receive a second infusion with whatever preparation they did not receive the first time. Known as a crossover trial, subjects receive both a treatment and the placebo, but in a different order. The order of the infusion is not known and researchers say it would be practically impossible to find participants if their parents knew that their children might not receive an infusion.

If this second phase of research shows that umbilical cord blood is effective in improving autism symptoms, primarily social behaviors, Dawson said the finding would be “game-changing”. Again, before any optimism can be confirmed, Kurtzberg reiterated, “we don’t want to mislead people and claim it’s working before we have definitive proof” (Drash & Sanjay, 2017).

And while such definitive proof is still up-in-the-air, these studies should, at the very least, spark hope for the future of autism research. When dealing with research concerning any disorder that lacks a known cause or cure, it is vital to remember that there may be several dead-ends before progress is actually made. Although the Duke study is extremely preliminary, it demonstrates the constant push for more knowledge surrounding autism spectrum disorder. It is this type of research that one day may uncover a breakthrough that could alter the lives of millions of people affected by autism.

References:

Drash, Wayne, and Sanjay Gupta, Dr. “Stem cells offer hope for autism.” CNN. Cable News Network, 05 Apr. 2017. Web. 09 Apr. 2017.