The Various Facets of Autism Spectrum Disorder

The Various Facets of Autism Spectrum Disorder: Implications on Children
Lamin Dainkeh
St. Mary’s College of Maryland
Abstract
Autism has become an area increasing area of interest to medical professionals, educational institutions, child developmental researchers, and parents. The increase in prevalence is attributed to various reasons such as increase in awareness of children identified with autism, expanding in diagnostic criteria and diagnostic substitution. The purpose of this literature review is to provide a comprehensive review of autism, provide symptoms of this disorder, explore possible causes and risk factors, methods of treatment and therapy such as Applied Behavior Analysis (ABA).

The Various Facets of Autism Spectrum Disorder: It Implications on Children Learning
Recently, Autism Spectrum Disorder has able area of research among medical field professionals and researchers. Research into
Numerous studies have suggested that the number of children diagnosed with ASD has increased dramatically in the past decades (Kogan et al., 2009; Simonoff et al.,2008; Ehlers ; Gillberg,1993). In 2007, the prevalence estimate rate was 110 per 10,000 (Kogan et al., 2009). The increase in prevalence was attributed to increase awareness of children identified with autism, expanding in diagnostic criteria, and diagnostic substitution (Fombonne, 2008; Keen ; Ward, 2004). According to the Center for Disease Control and Prevention (CDC), 1.5 children were identified with ASD. In 2009, 637,000 children in the United States were diagnosed with ASD (Kogan et al., 2009). ASD was four times more prevalent in boys than girls; Caucasian children are more likely to be diagnosed with this disorder than African Americans and Hispanics (Kogan et al., 2009).
In the United States, 175, 000 children under 15 years of age are diagnosed with Autism (Filipek et al., 1990; Filipek et al., 2000). According to a survey of 1, 300 families in the United Kingdom, showed that the average age of diagnosis was 6 years old (Howlin ; Moore, 1999). Most children are not diagnosed until they are 2 to 3 years of age (Filipek et al., 2000). Researchers have noted that early intervention during preschools years improve outcomes of children diagnosed with autism (Howlin ; Moore, 1999). Filipek et al (2000) stated that early interventions provided time for educational planning, family support, management of stress, and establishing appropriate medical care and treatments.
The Childhood Autism Scale (CARS) was developed in 1966 by Eric Shopler, Robert Reichier, and Barbara Rochen Reiner (Schopler, Reichler, DeVellis, ; Daly, 1980). This questionnaire was used to examine and score children who exhibited autistic behaviors. These behaviors are observed by an Applied Behavior Analysis (ABA), and reported by teachers, family members, and parents (Schopler et al., 1980). Based on the assessment of ABA, they will access the influences an intervention has on changing autistic behaviors (Simpson, 2001). The behavior analyst was responsible for collecting data, meeting parents, school staff, and various members of the home to analyze and develop programs that will help children with autism (Simpson, 2001).

These programs are individualized based on the needs of the child, and every child with autism has a completely different program (Simpson, 2001; Schopler et al. 1980). The purpose of this literature review is to provide a comprehensive review of autism, such as possible causes and treatments, identifications; learning and teaching implications. The structure of this literature review is as follows. First, we define autism. Second, we discuss the symptoms associated with ASD. Third, we will discuss the various causes of ASD. Next, we will discuss Applied Behavior Analysis (ABA) to provide a theoretical prospective of ASD and various treatment options.
Followed by impacts of autism on children learning and the various types of treatment. Next, we evaluate the evidence relating to ABA and whether it is an effective treatment. Followed by various policies that impact children with autism. Finally, we address gaps in literature, limitations in research and future research directions.
Review of Literature
Defining Autism
Autism is defined as a neurodevelopmental disorder characterized by impairment in communication, socialization, and repetition of activities and interest (Ingram, Takahashi, ; Miles, 2007; Kogan et al., 2009; Lord et al., 2000). The phrase spectrum disorder refers to a wide range of symptoms, skills, and levels of disabilities that affect daily functioning (Fombonne, 2002; Keen ; Ward, 2000; Partland, Reichow, ; Volkmar, 2002). The manifestation of this disorder is presented in the early onset of childhood development and has associations with language daily, mental retardation and epilepsy (Fombonne, 2002; Field, 2007). Filipek et al. (2000) noted that individuals have to meet the criteria listed on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in order to be diagnosed with autism. According to the DSM-5, ASD is placed in the category of Pervasive Developmental Disorder (PDD). Currently. there are five disorders included under PDD (Filipek et al., 1990). These disorders are autistic disorder (classic autism), Asperger’s disorder (Asperger’s syndrome), pervasive developmental disorder (PDD-NOS), Rett’s disorder (Rett’s syndrome), and childhood disintegrative disorder (Filipek et al., 1990, Filipek et al., 2000).

Symptoms of Autism Spectrum Disorder
According to the CDC, symptoms among individuals diagnosed with ASD varies from one person to the other, but these symptoms involve three criteria’s. These involve social impairment, communication difficulties, and repetitive and stereotyped behaviors (Fombonne, 2002) Individuals diagnosed with autism find it difficult to involve in everyday social interactions (Kogan et al., 2009; Kim, Szatmari, Bryson, Streiner & Wilson, 2000). Kim et al. (2000) stated that limitations in social interactions may present various obstacles for individuals with ASD, such as making eye contact, listening to others, recognizing emotions, picking up social cues, and reading people’s emotions. In addition, ASD individuals respond differently or inappropriately when others show feelings of distress, sadness, affection, or anger (Kamps, Leonard, Vernon, Dugan, ; Delquadri, 1992; Kim et al., 2000). Various studies have shown that children who suffer from ASD develop language comprehension slower than others, repeated words that they hear from others, and their sentences structure does not make sense to others (Simpson, 2001; Fombonne, 2002).
Causes of Autism Spectrum Disorder
The causes of ASD are still unknown, but various studies have suggested that maternal factors may have an impact on this disorder (e.g. Bolton et al., 1997; Juul-Dam et al., 2001). A study by Lyall, Pauls, Spigelman, Ascherio, and Santangelo (2011) hypothesized that early maternal life factors associated with hormone levels may be correlated with having a ASD child.

In their study, they focused on maternal early factors, and the whether or not hormonal and reproductive changes impact the chances of having a child with ASD (Lyall et al., 2011). Their sample included prospective cohort of 116,608 females aged 25-42. These prospects were recruited in 1989 through a biennial mailed questionnaire. Also, they collected information about the age of their menstrual cycle, characteristics of their menstrual cycle during adolescence, and their use of any contraceptives or birth control. Furthermore, they asked about their body mass index (BMI) prior to given birth and their body shape (Lyall et al., 2011). They found that women with a history of pregnancy complications were significantly more likely to have a child diagnosed with ASD than women with uncomplicated pregnancies.
Numerous studies have examined the influence of parental, prenatal, and perinatal; the impact it has on having a child with ASD. Parental is characterized by the period before the child was born. Prenatal is characteristics of the parents. Perinatal is characterized by the period after delivery (Zhang et al., 2010). In a study conducted by Zhang et al. (2010), the researchers examined three factors which are parental, prenatal, and perinatal, and their association with ASD. The sample population included a cohort of 190 Han children with and without autism to examine prenatal and perinatal risk factors. They examined numerous parental risk factors such as parental ages at delivery, occupation, education, marriage of close relative, personality, family medical history, and ethnicity (Zhang et al., 2010).
On the other hand, the prenatal risk factors that were examined included alcohol consumption, maternal characteristics, behaviors during pregnancy, emotional state, and medication history. Some of the perinatal factor included newborn complication, infants gestational age at birth, abnormal skin conditions, and birth weight. Zhang et al. (2010) found that emotional state during pregnancy was significantly associated with autism. Out of the risk factors studied, seven conditions during gestation increased the chance of having a child with autism. Also, the factors that showed the strongest relationship were emotional state, acute medical conditions, maternal unhappiness, and second-hand smoke exposure (Zhang et al., 2010). Based on their results, Zhang et al. (2010) concluded that the following. First, perinatal risk factors were significantly associated with autism. Second, advanced paternal age at delivery were significantly associated with autism.
Autism is a difficult disorder to cure. Currently, there are no single therapy or method that could cure an individual with autism. However, there are various therapies and treatments that have been proven to be effective in treating individuals with this disorder. Furthermore, most therapies and treatments used a combination of different therapies and methods to improve various life skills. The two common approaches used to improve various life skills are Applied Behavior Analysis (ABA) therapy and
that the individual is deficient in. Some of the most common approaches of autism are
Applied Behavior Analysis
Various methods have been developed to help children with ASD. One of commonly used method is Applied Behavior Analysis (ABA). ABA is an intensive behavior therapy that is initiated as soon the child is diagnosed with autism, usually around the ages of 2 to 3 years old (Filipek et al., 2000). ABA therapy was developed by Dr. Ivar Lovass based on the principal of operant therapy and conditioning (Field, 2017; Filipek et al., 2000). Lovass (1987) stated that by using association learning and operant condition, behavioral responses of children with ASD can be modified by positive and negative reinforcement. In his study, Lovass reported that 47% of children in the experimental group achieved normal intellectual educational functioning (Lovass, 1987). However