Literature Review on Autism Wilfredo Garcia

Table of Contents Abstract 3 Autism 4 Videogames and young people with Developmental disorders 10 Funding of Applied Behavior Analysis 11 Executive function in individuals with sub threshold Autism traits 12 Conclusion 14 References 15

Abstract
The increasing number of individuals with Learning Disabilities (LD) and psychiatric disorders presents a key challenge to their assessment and treatment in mental health services. Children and young people with LD are more likely to experience mental health than the general population (Allington-Smith, 2006). There is a close relationship between autism spectrum disorder and learning disability. Epidemiological studies suggest that autism is more frequent in people with LD, nearly 40% of people with LD also have autism on the other hand, and nearly 70% of people with autism also have LD (La Mafa, 2004). The strong association between autism and LD (Bradley, 2004) also associates an increased risk of mental health problems. It is suggested that adults with LD and autism spectrum disorder (ASD) may experience symptoms of anxiety at a greater level than the general population; however, this requires more conclusive evidence in relation to the prevalence of anxiety disorders in adults with LD and autism.

Autism Autism is a complex developmental disability that typically appears during the first three years of life. This is the result of a neurological disorder that affects the functioning of the brain. Autism is four more times prevalent in boys than girls. Autism shows no racial, ethnic or social boundaries. Family income, lifestyle and educational levels do not affect the chance of autism's occurrence. Autism and its associated behaviors have been estimated to occur in as many and one in 500 individuals. In this essay, I will discuss the signs and symptoms of autism, types of autism, the diagnosis of autism and studies done on autism. Autism affects the normal development of the brain in the areas of social interaction and communication skills. Children and adults with autism have difficulties in verbal and non-verbal communication, social interactions and leisure or play activities. This disorder makes it hard for them to relate to the outside world. It is hard for them to communicate with others. Aggressive and/or self-injurious behavior may be present in some cases. They may exhibit repeated body movement, such as hand flapping or rocking, unusual responses to people or attachments to objects and resistance to changes in routines. They possibly will experience sensitivities in the five senses of sight, hearing, touch, taste and smell. Children will be within the pervasive development until the ages of 24-30 months, when parents may notice delays in language, play or social interaction. If any of these symptoms occur by themselves, which would not result in a diagnosis of autism. Autism is a combination of several developmental challenges. There are many symptoms of autism. They include: extreme difficulty in learning language, inappropriate response to people, avoiding eye contact, resisting being picked up or cuddled, uncooperative play with other children, extreme hyperactivity and many others. There are five major areas in children highly affected by autism. They are communication, social interaction, sensory impairment, play and behavior. Every person with autism has a unique personality and combination of characteristics. Some autistic people mildly affected may exhibit only slight delays in language and communication and greater challenges with social interactions. The abilities of an autistic child may fluctuate from day to day due to difficulties in processing, concentration or anxiety. They may show evidence of learning one day, but not the next. Learning can be affected by external stimuli and anxiety. They may have average or above average verbal, memory or spatial skills but find it difficult to be imaginative or join in activities with others. Individuals with more severe challenges may require intensive support to manage basic tasks and needs of day to day living. Contrary to popular belief, many individuals with autism make eye contact, show affection, smile, and laugh and demonstrate a variety of other emotions, although in varying degrees. Like others, they respond to environment with both negative and positive ways. Autism may affect their range of responses and make it more difficult to control how their bodies and minds react. Sometimes motor, visual, and/or processing problems make it difficult to maintain eye contact with others. Some autistic people use peripheral vision rather than looking directly at others.
Sometimes the closeness or touch of others may be painful, resulting in withdrawal.
Several related disorders are grouped under "Persuasive Developmental Disorder" or PDD- a general category of disorders, which are characterized by severe and persuasive impairment in several areas of development. A PDD is diagnosed when a specified number of characteristics are present. Diagnostic evaluations are based on the presence of specified behaviors indicated by observation and through parent consultation, and should be made by a highly trained team. Thus, when professionals or parents are referring to different types of autism, often they are distinguishing autism from one of the other persuasive developmental disorders. Individuals who fall under the PDD category exhibit commonalities in communication and social deficits, but differ in severity. The five different diagnoses are: Autistic Disorder, Asperger's Disorder, Persuasive Developmental Disorder, Rett's Disorder and Childhood Disintegrative Disorder.
Autistic Disorder includes impairments in social interaction, communication and imaginative play prior to age three. An autistic child will also have stereotyped behaviors, interests and activities. Asperger's Disorder is characterized by social impairments in social interactions and the presence of restricted interests and activities with no clinically significant general delay in language, and testing in a range of average intelligence. A Persuasive Developmental Disorder-Not otherwise specified (commonly referred to as atypical autism) a diagnosis may be made when a child does not meet the criteria for a specific diagnosis, but there is a severe and persuasive impairment in specified behaviors. Rett's Disorder is a progressive disorder, which has occurred only in girls. It includes a period of normal development and then a loss of previously acquired skills, loss of purposeful use of the hands replaced with repetitive hand movements beginning at the ages of one to four years. Childhood Disintegrative Disorder is characterized by normal development for at least the first two years, showing significant loss of previously acquired skills. Researchers have devoted a considerable time and energy into finding the answer to what causes autism. Medical researchers have explored numerous explanations for the various forms of autism. Although a specific cause is not known, current research links autism to biological or neurological differences in the brain. In many families, there appears to be a pattern of autism or related disabilities. This suggests that there is a genetic basis to the disorder. But there has been no gene linked directly to autism. The genetic basis is believed by researchers to be highly complex, probably involving several genes in combination.
Autism is not a mental illness. Children with autism are not unruly kids who choose not to behave. Autism is not cause by bad parenting. These are just some of the several theories that are false about the cause of autism. They have been proven false. Furthermore, no known psychological factors in the development of the child have been shown to cause autism.
An accurate diagnosis must be based on observation of the individual's communication, developmental levels and behavior. Because many of the behaviors associated with autism are shared by other disorders, various medical tests may be ordered to rule out or identify other possible causes of the symptoms being exhibited. Because the characteristics of autism vary so much, a child should be evaluated by a multidisciplinary team which may include a neurologist, developmental pediatrician, and psychologist, learning consultant, speech/language therapist or another knowledgeable professional about autism. In some cases, well-meaning professionals have misdiagnosed autism. Difficulties in the recognition and acknowledgement of autism can lead to a lack of services to meet the needs of individuals with autism. A brief observation of in a single setting cannot present a true picture of an individual's abilities and behaviors. Parental input and developmental history are very important components of making an accurate diagnosis. At first observation, some autistic people may appear to have a mental retardation, a behavior disorder, and problems with hearing or even odd and eccentric behavior. These conditions can co-occur and complicate matters further. It is important to distinguish autism from other conditions, since an accurate diagnosis and early identification can provide the basis for building an appropriate and effective educational treatment program. Very sensitive imaging studies have shown two areas in the brain that are primarily affected: the cerebellum and the limbic system. Currently the cornerstones of treating autism are special education, family support and counseling, behavioral therapy and treatment for any other symptoms that might make symptoms worse, such as medications to treat seizures. A lot of excitement has been generated by recent reports that symptoms of autism dramatically improved in a few children who received Secretin. Secretin is a hormone normally produced by the body. Its main function is to help with digestion. It is actually a peptide produced in the gut. Secretin is sometimes given by vein to children with serious intestinal problems as a diagnostic test. In 1998, three autistic children who were being tested with secretin to evaluate intestinal disorders were observed to have dramatic reductions in their autistic symptoms"”starting to talk, being more alert and maintaining good eye contact. Their parents and pediatricians were amazed. Soon, reports started appearing that a miracle drug had been found to treat autism. In a series of 100 autistic children treated with secretin, half of their families reported improvements in sleep, digestive problems and behavior. In another series of 200 autistic children, only about 10% had dramatic improvements. It was not clear whether the improvements were due to the hormone or to the other therapies being used. It's still a mystery why secretin might help. It is known that the brain has receptors for a lot of different hormones, including some that have their biggest effects on other organs. For example, another intestinal hormone, called vasoactive intestinal peptide has many receptors throughout the brain. It appears that secretin might bind to brain receptors too. Right now it's not clear which brain cells bind to secretin, why they do or exactly what the hormone does once it is there. Researchers have also found that a diet low in amino acid tryptophan made some symptoms worse in 11 autistic adults. After the special diet, patients were more likely to display typical autism behaviors, including pacing, rocking back and forth, and hitting themselves. Their inability to interact socially did not change, but they became more anxious and unhappy. Tryptophan is an amino acid found in protein; the body converts it into serotonin, which regulates mood and behavior. Previous research suggested that a defect in serotonin production might contribute to autism. A second study by the same researchers adds weight to this theory. Autistic adults who took fluvoxamine (Luvox), a drug that boosts brain serotonin levels, were less aggressive and better able to communicate and interact that patients given dummy pills. The 12-week drug treatment also improved some patient's lives. Two people moved out of group homes to supervised apartments. One person was able to keep a full-time job. Although the study involved only 30 adults, the researchers say the results warrant trials in children and adolescents. Drugs currently used to treat autism have limited effectiveness. Understanding of autism has grown tremendously since Dr. Leo Kunner first described it in 1943. Some of the earlier searches for cures now seem unrealistic in terms of today's understanding of brain-based disorders. To cure means, "To restore health, soundness or normality"; in the medical sense, there is not cure for the differences in the brain, which result in autism. However, better understanding of the disorder has led to the development of better coping mechanisms and strategies for the various manifestations of the disability. Some of these symptoms may lessen as the child ages; others may disappear altogether. With appropriate intervention, many of the associated behaviors can be positively changed, even to the point in some cases, that a child or adult may appear to the untrained person to no longer have autism. The majority of children and adults will, however, continue to exhibit some manifestations of autism in some degree throughout their entire lives. Over one half million people in the United States have autism or some form of pervasive developmental disorder. Its prevalence rate makes autism one of the most common developmental disabilities. Yet most of the public, including many professionals in the medical, educational and vocational fields, are still unaware of how autism affects people and how they can effectively work with individuals with autism. Researchers try every day to cure autism. Maybe one day, we will have a cure and these people will not have to live everyday of their lives with their disability.

Videogames and young people with developmental disorders People with developmental disorder are attracted to videos games for many reason; people with Autism Spectrum Disorder (ASD) like games because they escape to a different world. They react differently to the sensory stimulus the video games offer them. Video games offer the opportunity to people with ASD to be in their world, do not have to worry about socialization and offer the structure they need. Main reason for this it is link with the dopamine release in the system while they play video games. Dopamine is a neurotransmitter “is known to be closely associated with reward-seeking behavior” (Durkin, 2010). This study concluded that people with ASD can meet the demands of the executive functions that the video games require. The video games help the people with ASD in the socialization category. The reason for this is because it stimulates the discussion with other people. For example is an ASD teen is at school and hear some other teens talking about a game he or she played, it will make more attractive for the ASD teen to socialize and talk to the other kids. It also let the child to share and exchange information of the game or games he or she played before. Unfortunately there are not enough studies to further prove this theory and hypothesis. This study reveals interesting facts. Often we hear professionals talking about how bad video games are for the kids and youth. But now I read an article that tells me that perhaps the relationship between video games and people with developmental disorders, needs to be more study it. I do believe video games help the ASD children; it stimulates the coordination in their brain and further develops their sensory system. It offers an escape to their world, but at the same time helps them to talk to other children with the same preference of certain game. Further investigation needs to be done, in order to formulate a true basis and gear the technology to help developmental disorder patients. Funding of Applied Behavior Analysis services: current status and growing opportunities Applied Behavior Analysis (ABA) intents to control and predicts the human behavior. In recent years the ABA services have increased with patients with autism. The procedure has shown effectiveness with ASD; especially if the intervention begins as early as possible, recommended age is less than 4 years old (Harvey, Harvey, Kenkel & Russo, 2010). The treatment is effective; however the services are not offer easily for these patients. Some states have limited resources, but the big hit is with private insurance. Private insurance do not include this therapy in their benefits. In fact some insurance do not cover any treatment of anything related with autism. Some states are taking this developmental disorder seriously, thanks to Autism Speaks; more than 14 states now have laws who require health insurance to offer treatment to patients with autism. A movement from the Blue Cross Blue Shield, Michigan State, has introduce a special insurance just for ASD treatments; this will help caregivers to have the resources they need to help their kid, teen or adult who suffer from ASD. As right now only Tricare, insurance for military personnel, covers the ABA with a cap of $3,000 per month. This offers a great relief to parents with autistic son or daughter. More funding and development tools need to be in place to develop the services and promote the studies of ABA. Autism is a developmental disorder and it last a lifespan. Patients with Autism need the help and tools to function correctly in society. Some of them never will. ABA interventions on early age will help autistic patient to have a better chance in their future. ABA will help them to change certain behavior and learn new skills. ABA will change the way ASD kids will socialize and see the world. I agree that we need to promote the ABA therapies; if this helps to alleviate the problems why not study it? ASD is a lifespan disability, it will never go away, and any help we can give to the patient to live better I believe it needs to be done. The federal and states government, need to come together and design health insurance just for developmental disorders. Not only ASD but for others like it. Executive function in individuals with sub threshold autism traits Autism spectrum disorder affects the social and communication skills, it also drives the patient to behave in repetitive behavior; it also limited the patient on choices of interest. This studies the relation between individuals with traits of autism with problems with executive controls. This study used 1,847 students who completed a self-report screening and they were also students of introduction to psychology. What the study shows is that there is a link of the traits present in patients and the difficulties with executive controls. This is not only for ASD students but also the ones who self-reported ADHD. The study had an interesting fact, that the trait of autism can be there but is not enough to do a formal diagnosed. A family with multiple siblings and more than one, are diagnosed with autism is a pretty good chance that the other sibling reflect some of the autistic traits. What is the importance of this study? It is important to know because if there are multiple diagnosed is a pretty good chance that all kids will have the ASD; some not at the same extend but some of the traits. If more studies are done and the results are the same, which is an indication that we need to be giving the child with the traits the therapy need it to avoid any problems with executable controls in the future. Another important outcome is that if we can study the ASD trait individuals we might get closer to understand the ASD. There is very little known of ASD and if we can advance the knowledge of it by studying it at a minimum impact to a human being, then it is worth it. It is very important when a sibling gets diagnosed with ASD, to actually do a test to all siblings. And this is to determine if the traits are there or not. Conclusion As reviewing the journals, I had a better understanding of the autism spectrum disorder. This condition is for a lifespan; there is no cure but there are methods to help someone with the condition. Even though some techniques are beneficial to these patients there is little support from the government. In fact the insurance companies know this and they limit the sessions and or therapy a person or child with ASD can get. The federal government needs to ally with the states and come with a common ground and offer the services need it for autistic kids, teens and adults. I do not know what is prepare in my future but something is for certain I will support the support for the ABA programs and therapies. If with ABA we can offer a better life to people with ASD, then it is worth it. I am not here to make money, but to give someone else a better quality of life. This courses and literature paper have shown me that there are people who need help and it is up to us to help them. A career in psychology is what I am convince I need to do. I want to offer a better chance to someone else. Make a better society, after all the kids of today are the future leaders of this country.

References Bradley, E., Bolton, P., (2006). Episodic psychiatric disorder in teenagers with learning disabilities with and without Autism. The British Journal of Psychiatry, Vol. 189, 361-366
Christ, S. E. & Kanne, S. M., & Reiersen, A. M. (2010). Executive Function in Individuals with Sub threshold Autism Traits. Neuropsychology, 24, 590-598.
De Bildt, A. & Sytema, S. & Kraijer, D., & Minderaa, R. (2005). Prevalence of pervasive developmental disorders in children and adolescents with mental retardation. Journal of Child Psychology and Psychiatry, 46, 275-286
Durkin, K. (2010). Videogames and Young People with Developmental Disorders. Review of General Psychology, 14, 122-140.
Harvey, A. C. & Harvey, M. T. & Kenkel, M. B., & Russo, D. C. (2010). Funding of Applied Behavior Analysis Services: Current Status and Growing Opportunities. Psychological Services, 7, 202-212.
Hill, J. & Furniss, F. (2006). Patterns of emotional and behavioral disturbance associated with autistic traits in young people with severe intellectual disabilities and challenging behaviors Research in Developmental Disabilities, 27, 517-528 Hunt, R. (2004). Fundamentals of Cognitive Psychology. New York (NY): McGraw-Hill Higher Education Publishers.
Kim, J. A. & Szatmari, P. & Bryson, S. E. & Streiner, D. L., & Wilson, F. J. (2000). The Prevalence of Anxiety and Mood Problems among Children with Autism and Asperger Syndrome Autism, 4, 117-132
La Malfa, G., Lassi, S., Bertelli, M., Salvini, R., & Placidi, G. F. (2004). Autism and intellectual disability: a study of prevalence on a sample of the Italian population. Journal of Intellectual Disability Research, 48, 262-267 O’Brien, G., Pearson, J. (2004). Autism and Learning Disability. Autism, Vol. 8, No. 2 125-140
Waller, N., & Furniss, F. (2004). Relationship between anxiety and autistic behavior in persons with severs Learning disabilities. Journal of Intellectual Disabilities Research 48, 320 Wilson, A., Jahoda, A., Stalker, K. & Carirney, A. (2005). What’s happening? How young people with learning disabilities and their family careers understand anxiety and depression. The foundation for people with LD. P 37-61