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Autism Spectrum Disorder - Marwa Al- Mauly

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INTRODUCTION

Every parent has hopes and dreams for their children and all parents want their kids to

be the best and even though no one is ever perfect, they would still try to make them

perfect, But all this may be shattered once this little boy or girl gets diagnosed with

one of the most alarming disorders in the world of childhood disorders which is not

only a serious disability; but is also a bewildering one this disorder is called Autism.
  1. A. Title:

Autism Spectrum Disorder
  1. B. Why Autism?

there were six childhood psychological disorders other then autism that any person would find very interesting to do a research about, but autism is found to be one of the most dangerous and confusing childhood disorder any parent can find also learning a bit about autism in Oman made it very important to talk and explain this disorder to Omani parents and the Omani community as a whole.
  1. C. Purpose:

To spread awareness on the Autistic Spectrum Disorder in Oman and this will have a great and positive impact on the treatment of the Omani children that were diagnosed with Autism.
  1. D. Objectives:
  • To give the reader a clear and detailed information on the Autistic Spectrum Disorder.
  • To spread awareness on the Autistic Spectrum Disorder to the Omani people in specific.
  1. E. Limits and Difficulties:
  • The time given before the dead-line was not enough.
  • References like books, articles, etc... Related to the subject were very limited.
  1. F. Methodology:

The methods used to complete this report included reading from different sources including: Books, Magazines, and Web sites also visiting The Muscat Autism Center was very helpful.

Autism Spectrum Disorder

The Root of the word "Autism:

The word Autism comes or drives from the Greek word "Auto" which means self, and the adjective word "Autistic" literally means alone.

In the world of psychology and psychiatry autism or Autistic Spectrum Disorder is defined as:
  1. A life-long brain disorder that is normally diagnosed in early childhood.
  2. A disorder that causes kids to experience the world differently from the way most other kids do.
  3. A complex developmental disability that typically appears during the first three years of life and affects a person's ability to communicate and interact with others.

The history of Autism:

The word "Autism" was first used in 1943 by a psychiatric and physician called Leo Kanner who wrote a paper on "Autistic Disturbance of Attitude contact " for a journal called: nervous child" which does not exist anymore, Dr. Leo wrote that article after conducting a research on 11 children of ages between two to eight years old who had similar symptoms which included difficulties communicating with others, difficulties interacting with others, and having unusual interests. Before the publication of that article children with the previous symptoms were labeled as "schizophrenic". (Kocgel & Lazebnik)

Types of Autism

There are many types of autism some are known while others are not known, but there are 5 main types that most researchers agree with, which are:

1) Classic Autism:

This type can be recognized before the age of 3 years, but can be diagnosed later in life. Children diagnosed with classic autism show lack of eye to eye contact, lack of affection or emotional contact with others, difficulty to socialize and interact with others, intense wish for sameness in routine, and develop language late or not at all.

Children diagnosed with Classic autism also show high levels of Visio -spatial skills* but major difficulties in other areas.

2) Autism Spectrum Disorder (ASD) which  includes:

A)    Aspergers Syndrome:

Is a form of autism in which speech development and IQ are normal, but in which social disabilities can be compounded by depression and mental health problems [1]. This syndrome is a higher functioning disorder than classic autism and can range from mild to saver. A child diagnosed with Aspergers Syndrome can exhibit a number of characteristics, show deficiencies in social skills and have difficulties with transition or change ( they compulsively stick to rituals and any changes in their routine can upset them), they also find it difficult to read body language and to determine the proper body space.

Some of the kids that were diagnosed with Aspergers Syndrome have shown reduced sensitivity to pain & an increased sensitivity to bright light and loud noises.

*Visual Spatial Learners have a very wide imagination, that helps them make a whole movie just by reading something, that is because they can draw a picture in their mind about anything they read or hear.

B)  Rett Syndrome or Rex Syndrome:

This is a neurological & developmental disorder that is marked by poor head growth. Some doctors claim that Rett or Rex Syndrome is not a part of autism spectrum disorder, the reason behind this claim is that Rett or Rex Syndrome is a disorder that mostly occurs in females whereas autism affects mostly males.

Children suffering from this syndrome show loss of muscle tone, diminished eye contact, and crawling or walking problems, they also stop using their hands and often develop stereotyped hand movements such as: wringing, clapping, or patting their hands. Kids diagnosed with Rett or Rex Syndrome loses the ability to perform motor skills.

C) Childhood Disintegrative Disorder (CDD):

This disorder occurs a little late in the child's life, first the child seems perfectly normal then by the age of 2-4 years they start to regress, where they stop socializing with people, loss potty-training skills, stop playing, and stop making friends. The difference between autism and CDD is the long period of normal development below age 2. (Bock & Stauth, 1999)

D) Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS):

A child that exhibits some but not all of the classic autism symptoms is said to have PDD-NOS.

Children with PDD-NOS either do not fully meet the criteria of symptoms used to diagnose any of the four specific types of autism or do not have the degree of impairment described in any of the above four specific types.

Causes of Autism

Until this very day no one knows what the exact cause of autism is the only thing that is clear is that autism affects 1 of 150 kids.

The brain contains over 100 billion nerve cells called neurons. Each neuron may have hundreds or thousands of connections that carry massages to other nerve cells in the brain and body. The connections and the chemical messengers (called neurotransmitters) let the neurons that help you see, move, remember, and work together as they should, but for some reason some of the cells and connections in the brain of a kid with autism –especially those that affect communication, emotion, and senses- don't develop properly or get damaged. Scientists are still trying to understand how and why this happens [1].

Is lack of a mother's affection a cause for autism?

While the definite causes of autism is not yet found or clear, it is clear that there is no any connection between bad parenting or having a cold mother and the development of autism.

At first Dr. Leo Kanner, the psychiatrist who first described autism as a unique condition in 1943, believed that it was caused by cold, unloving mothers. Bruno Bettelheim, a renowned professor of child development supported this misinterpretation of autism. Their promotion of the idea that unloving mothers caused their children's autism created a generation of parents who carried the tremendous burden of guilt for their children's disability.

In the 1960s and 70s, Dr. Bernard Remand, the father of a son with autism, who later founded the Autism Society of America and the Autism Research Institute, helped the medical community understand that autism is not caused by cold parents but rather is a biological disorder.

The diagnosis of Autism

There are no any biological tests that can be done to detect if a child is suffering from autism or not, the diagnosis of autism depends solely on observation and also educational and psychological testing.

An autism-specific screening tool, such as the Modified Checklist of Autism in Toddlers (MCHAT) should be used. The MCHAT is a list of simple questions about the child. The answers determine whether he or she should be referred to a specialist, usually a Developmental Pediatrician, a Neurologist, a Psychiatrist or a Psychologist, for further evaluation.

What do doctors do?

Often, specialists work together as a team to figure out what is wrong. The team might include a pediatrician, a pediatric neurologist, a pediatric develop- mentalist, a child psychiatrist, a child psychologist, speech and language therapists, and others. The team members study how the child plays, learns, communicates, and behaves. The team listens carefully to what parents have noticed, too. Using the information they have gathered doctors can decide whether a child has autism or not.

DSM-IV criteria for a diagnosis of Autism:
  1. A total of six (or more) items from heading (A), (B), and (C), with at least two from (A), and one each from (B) and (C):

    (A) Qualitative impairment in social interaction, as manifested by at least two of the following:

    • Marked impairments in the use of multiple nonverbal behaviors such as eye-to- eye gaze, facial expression, body posture, and gestures to regulate social interaction.
    • Failure to develop peer relationships appropriate to developmental level.
    • A lack of spontaneous seeking to share enjoyment, interests, or achievements with other people, (e.g., by a lack of showing, bringing, or pointing out objects of interest to other people).
    • A lack of social or emotional reciprocity.

    (B) Qualitative impairments in communication as manifested by at least one of the following:

    • Delay in or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime).
    • In individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others.
    • Stereotyped and repetitive use of language or idiosyncratic language.
    • Lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level.

    (C) Restricted repetitive and stereotyped patterns of behavior, interests and activities, as manifested by at least two of the following:

    • Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus.
    • Apparently inflexible adherence to specific, nonfunctional routines or rituals.
    • Stereotyped and repetitive motor mannerisms (e.g. Hand or finger flapping or twisting, or complex whole-body movements).
    • Persistent preoccupation with parts of objects.

    II. Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years:

    (A) Social interaction.
    (B) Language is used in social communication.
    (C) Symbolic or imaginative play.

    III. The disturbance is not better accounted for by Rett's Disorder or Childhood Disintegrative Disorder.[1]

[1] (diagnostic and statistical manual of mental disorders , fourth edition)

Treatments used to cure clients diagnosed with Autism

There is no cure for autism but there are treatments that will help reduce the intense of the disorder and help the child and the family cope with the disorder.

Treatment for autism is a very intensive, comprehensive undertaking that involves the child's entire family and a team of professionals. Some programs may take place in the child's home with professionals and trained therapists and may include Parent Training for the child under supervision of a professional. Some programs are delivered in a specialized center, classroom or preschool.

There are many therapies and treatments for autism here are some of the most common ones [1] :
  • Applied Behavior Analysis (ABA)
  • Pivotal Response Therapy (PRT)
  • Verbal therapy
  • Floor time
  • Relationship Development Intervention

[1] (http://www.autismspeaks.org/treatment/floortime.php)

Autism in Oman

As mention in the beginning of the report the main objective from this report is to spread introduce the "Autism Spectrum Disorder" to the Omani people, because after a field research that was made in Oman on children suffering from autism the number 4000,200,1, and 0 was the result of this research.

What does 4000, 200, 1, and 0 stand for?

4000 = number cases of autism in Oman.

200 = number of cases diagnosed in Oman.

1 = number of child psychiatry clinic in Oman.

0 = the future number of undiagnosed cases of autism in Oman.

After reading and understanding the above number it is belived that no more words or discussion is need accept:

"There is a problem you are the solution. There is a dream, you make it real"

Dr. Yahya Al-Farsi

Conclusion

Autism Spectrum Disorder is a very scary developmental disorder that deserves special attention, and having as much knowledge about this disorder makes it easier to notice it and diagnosing it earlier and this will help lower the risk of it becoming a sever and un-curable disorder.
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