POSITIVE PARENTING
By CHEONG SAU KUAN
Forty years ago, this developmental disorder was rarely heard of. However, we now live in a world where one child in 150 is diagnosed with autism.
AUTISM is a life-long developmental disability that commonly presents in early childhood. It has varying degrees of severity. Though milder forms of autism are easier to manage, it should not be viewed lightly as it can severely affect both the child as well as his family members. In fact, autism can be so debilitating that it was considered no different than schizophrenia until it was separately regarded as a developmental disorder in 1971.
More worrisome, however, is the fact that there has been an increase in the number of cases of autism in recent times, both locally and globally. According to the National Autism Society of Malaysia (NASOM), there has been a 30% increase in the organisation’s intake of individual’s with autism for the past three years. Globally, as many as one in 150 children are diagnosed with autism.
Having said that, it is important for parents to learn how to identify the symptoms of autism as early intervention can do wonders to improve the lives of individuals with autism.
Triad of impairments
Most children who have or who do develop autism typically do not look any different from other children. However, children with autism are distinctive through their behaviours, which may seem puzzling and disturbing to observers.
Due to the large spectrum of behaviours that people with autism may exhibit, it is difficult to generalise certain behaviour characteristics of autism, but the problems tend to fall into three key areas generally known as the “triad of impairments.”
Impairment in social interaction – This is the most striking abnormality common to all individuals with autism. This may be observed early in the child’s life where he may exhibit little or no social inclination. As an infant, he may demand very little attention and is usually unresponsive. For example, he is less likely to respond to his name and may fail to recognise and memorise faces of people who should be familiar to him.
As he grows up, he may also show impaired non-verbal behaviour (e.g. little or no eye contact), fail to develop relationships and understand people and lack the ability to share enjoyment or interests.
Furthermore, children with autism tend to ignore other people and seem very content to be by themselves, whether at play or otherwise.
Impaired communication skills – About 30% of children with autism fail to develop spoken language, while in others, language development is delayed and/or abnormal. They may babble, scream or constantly echo what other people say (echolalia). They also tend to experience difficulties with vocabulary, syntax, and comprehension. Conversations are characterised by irrelevant details and constant shift in topics.
Essentially, they are unable to engage in the usual give-and-take of conversations.
Restrictive and repetitive behaviours – People with autism develop a wide variety of odd behaviours that are often described as restricted, repetitive, and stereotyped. They may exhibit dangerously high levels of tantrums and aggression, self-injurious behaviours (such as head-banging, hand-biting, hair-pulling), repetitive behaviours, and rituals in daily routines.
Conversely, some might feel disturbed when there is change in their daily routines.
Some people with autism may develop an unusual preoccupation with certain objects or things. For example, they may compulsively collect certain items or become obsessed with numbers or arranging things.
The course of autism is as unpredictable as its symptoms. Some children may start to present with behaviours characteristic of autism since birth. Other children may develop normally for a while and stop at a certain developmental milestone, while some may regress and display qualitatively different development. For example, the child may stop gazing at others or responding to his own name where he previously had.
The autism controversy
The underlying cause of autism has been the subject of much speculation – from biological origins that blame genetic factors and neurological abnormalities to environmental origins, which blames toxins, and prenatal conditions in the womb.
Perhaps the most controversial claim of is that common childhood vaccines, such as the measles, mumps, and rubella (MMR) vaccine cause the development of autism.
This vaccine-autism controversy, arising from a single research paper published in 1998, which linked intestinal inflammation caused by the MMR vaccine to autism, has since gathered much unnecessary attention despite its lack of scientific support. In fact, in 1998, 10 of the 13 original authors of the paper published a formal retraction of their paper, acknowledging that their data was not strong enough to support the conclusion that was made.
On the other hand, there is an abundance of research refuting the link between autism and MMR vaccine, which is acknowledged by various organisations like the Centers for Disease Control and Prevention (CDC), World Health Organisation (WHO), American Academy of Paediatrics (AAP), and Malaysian Paediatric Association (MPA).
Similarly, paediatricians and scientists alike advocate that vaccines do more good than purported harm. Besides eradicating potentially fatal diseases, they ensure that our children get to live happy and healthy childhoods.
Help is available
There is no cure for autism. However, thanks to the advances made in treatment, an autism diagnosis today does not necessarily have negative connotations. Behavioural and educational interventions can vastly improve the quality of lives of individuals with autism, which will enable them to function to the best of their abilities.
It is also important to note that the age at which treatment or intervention takes place will have a direct impact on the individual’s life. The earlier the child is treated, the better the outcome of treatment.
Among the many treatments for autism, perhaps the most effective and commonly used treatment in Malaysia is Applied Behaviour Analysis (ABA). In ABA, individuals are taught a vast range of skills that enable them to manage problem behaviours such as self-injurious, aggressive, and disruptive behaviours, as well as to learn useful skills that will enable them to adapt effectively in settings that they will live, study, and work. For example, they will be taught skills that will enable them to communicate, develop relationships, learn at school, and play.
Research has indicated that ABA is as an effective intervention programme for individuals with autism. Many children who receive this treatment has shown significant improvements in tests of their cognitive, communication, and adaptive skills.
The improvements are even more significant when they begin receiving the treatment at an earlier age.
To learn more about autism and the intervention programmes, you can contact the following centres:
National Autism Society of Malaysia (NASOM), tel/fax: 03-40223744, email: ; Autism Link Malaysia, email: ; Early Autism Project Malaysia Sdn. Bhd, tel: 013-3190301, fax: 03-2282 0423, email: ; The Association of Resource and Education for Autistic Children (Lions REACh), tel: 04-6564357, email: .
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