Learning Disability A positivist study to explore which behavioral and developmental interventions work best in addressing the needs of children with Autism Spectrum Disorder
Learning disability is a hindrance in way of an individual to learn and perceive routine activities and inability to read or write. Autism Spectrum Disorder (ASD) is a disease that leads to many disorders like being unable to communicate, less socialization power, repentant behavior, and learning disability. But fortunately autism disorder is a curable disease and there can be various interventions that help treatment of such disorder in children. Children are mainly suffered by ASD as it occurs even in infancy. This piece of research aims at indicating the causes, symptoms and characteristics of ASD and the interventions that can help children suffering from ASD to recover. The study also provides an insight on the role of parents, peers, teachers and siblings in treatment of a child and the training that can be provided to them to help the disable child. Review of previous researches indicated that ASD is spreading world wide irrespective of geological conditions and is affecting children of both genders. The research concluded that ASD is positively a curable disease and early diagnosis helps treating it. Development of interventions also supports the recovery of a child for autism disorder and helps the child to live a normal and healthy life.
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Introduction
The topic of research is “Learning Disability”: A positivist study to explore which behavioral and developmental interventions work best in addressing the needs of children with Autism Spectrum Disorder. The research is focused on finding the meaning of learning disability in children along with a disease called Autism Spectrum Disorder (ASD). The main focus of this study is to identify the characteristics of ASD, its symptoms, causes, treatments, and effects on life of the individual suffering from this disease. This paper is mainly focused on symptoms ASD in children of age from 1to 5 years.
The topic was chosen for research because ASD is a commonly experienced disability world wide and there must be awareness among people how to diagnose the presence of ASD in their children and how they can get them treated. The main objective of conducting this research was to view all the symptoms, causes and treatments of ASD along with providing interventions that may help in curing this disease. Although some interventions are identified in this research but still there may be some other ways too to treat this disease. Moreover it is also identified in the interventions that parents, peers, adults and teachers have a vital role in treating children suffering from ASD. Early diagnosis also has importance in helping the children come out of this disability.
Literature Review
Learning disability is an ailment suffered by a person which includes some disorders that makes it difficult for a person to learn (Bradley 2002). Disorders experienced by the person make it difficult to learn in typical systematic manner and such disorders are caused usually by an unknown factor. Wende (1998) defined leaning disabilities as a group of biologically disturbances in development that considerably weaken school performance of children. Such disorders hinder the growth of a child and create problems in performing well at school.
There are always some specific symptoms that indicate that a child is suffering from learning disability but these symptoms may vary from child to child depending on genetic pattern and biological differences. Silver & Hagin (1964) found that disorders caused due to learning disability significantly affect a narrow range of academic and performance outcomes. Learning disability may occur in along with other disabling conditions, but they are not the main reason to such issues like mental retardation, behavioral trouble, lack of opportunities to learn, or primary sensory discrepancy. Kirby (2009) pointed out that an individual may face disorders like reading/ writing problem or inability to do mathematics. Simultaneously this further leads the way to increase in disorders. A child may also experience non-verbal learning disability or disorder of speaking and listening.
One of the major reasons for prevalence of learning disability is Autism Spectrum Disorder (ASD) which is a psychological disease. Dunlap &Kay (1994) defined autism as a developmental disability that affects a person’s ability to communicate, understand language, play, and interact with others. It is a behavioral syndrome, which implies that it is based on prototype behaviors that a person exhibits. Autism is not an illness but a neurological disability that is presumed to be present from birth and is always apparent before the age of three. The specific causes of autism are unknown but still it affects the functioning of brain. Dunlap &Kay (1994) also found that it is widely assumed that there are most likely multiple causes of autism each of which may be obvious in different forms or subtypes of the disease.
Powers (2008, p.28) says that individuals with ASD vary widely in ability and personality and can exhibit severe mental retardation or be extremely gifted in their intellectual and academic accomplishments. Powers also stated that some people with autism appear lethargic and slow to respond, but others are very active and seem to interact constantly with preferred aspects of their environment. So there are different behaviors that can be experienced by a person suffering from autism.
Doja & Roberts (2006) found in a research that autism is prevailing about 1-2 per 1,000 people worldwide; however in United States it is approximately 9 per 1,000 individuals. Newschaffer et al, (2007) identified that the number of people diagnosed with autism has increased dramatically since the 1980s. Bryson et al, (1988) indicated a prevalence of 10 per 10,000 individuals in Canada, and Webb et al. (1997) reported a prevalence of 9.2 per 10,000 populations in a Welsh district, a change from the 3.3 per 10,000 of 10 years earlier. In an elegant study of prevalence in Northern Finland, autism was seen in 12.2 of 10,000 individuals, a reported increase from the 4.75 individuals from only nine years earlier (Kielinen et al, 2000). While the causes of this substantial increase in the prevalence of autism are unknown or not properly addressed the consequences are far reaching (Wing & Potter, 2002). But partly due to changes in diagnostic practice; the question of whether actual prevalence has increased is still vague.
Epidemiological reports suggest that the number of children diagnosed with autism and autism spectrum disorders continues to rise (Bryson et al 1999). Due to increasing rate of autism, it has recently been considered an epidemic (Burton, 2002; Fombonne, 2003; Yeargin-Allsopp, Rice & Karapurkar, 2003). The existing services are generally insufficient to cope with this alarming increase in cases of autism, coupled with the intense and ongoing support needs of the children and families
Myers & Johnson (2007) pointed out that parents usually notice signs in the first two years of their child’s life and recognize that their child is suffering from autism. Although there is no known cure, early behavioral or cognitive intervention can help autistic children gain self-care, social, and communication skills. The signs usually develop gradually, but some autistic children first develop more normally and then regress (Stefanatos, 2008). Howlin et al. (2004) stated that not many children with autism live independently after reaching adulthood, though some become successful. Silverman (2008) indicated that acceptance of autism as a difference not as a disorder has developed an autistic accepted culture.
Autism is distinguished not by a single symptom, but by a characteristic chord of symptoms like impairments in social interaction; impairments in communication; and restricted interests and repetitive behavior (Filipek et al, 1999). In addition to these core features Eagle (2006) identified some other behavior problems like anxiety, depression, sleeping and eating disturbances, attention issues, temper tantrums, and aggression or self-injury. Sacks (1995) pointed out that individuals with autism have social impairments and lack the insight about others. Unusual social development becomes apparent early in childhood. Autistic infants show less attention to social stimuli, smile and look at others less often, and respond less to their own name (Volkmar, 2005).
In a research, Burgess& Gutstein (2007) found that children with high-functioning autism suffer from more powerful and frequent loneliness compared to non-autistic peers, despite the common belief that children with autism prefer to be alone. Making and maintaining friendships often proves to be difficult for those with autism which may affect the quality of life severely.
About a third to a half of individuals with autism do not develop enough natural speech to meet their daily communication needs (Noens 2006). Research by Noens also found that differences in communication may be present from the first year of life, and may include delayed onset of babbling, unusual gestures, diminished responsiveness, and vocal patterns that are not synchronized with the caregiver. Landa & Caronna (2007) indicated that autistic children are less likely to make requests or share experiences, and are more likely to simply repeat others’ words. Autistic children may have difficulty with imaginative play and with developing symbols into language (Tager, 2007).
Lam & Aman (2007) pointed out that autistic individuals display many forms of repetitive or restricted behavior, with the “Repetitive Behavior Scale-Revised (RBS-R)” categorized as “Stereotypy, Compulsive behavior, Ritualistic behavior and Self-injury”. No single repetitive or self-injurious behavior seems to be specific to autism, but only autism appears to have a prominent pattern of occurrence and severity of these behaviors (Bodfish, 2000).
From clinical point of view, autism is a behavioral syndrome that is initially evident in early childhood and reflects underlying neurons’ developmental abnormalities. (Rapin & Katzman, 1998). Bauman & Kemper (1994) identified that core symptoms of autism include abnormal or unanswered interpersonal and emotional interactions, disordered language and communication, and recurring and stereotypic actions. Damasio & Maurer (1978) explored that autism is not associated with specific physical stigmata and is unpredictably associated with mental retardation and abductions.
Happe & Ronald (2006) pointed out that it has long been presumed that there is a common cause at the genetic, cognitive, and neural levels for autism’s symptoms. Autism has a strong genetic basis, although the genetics of autism are complex. Moreover it is unclear whether symptoms of autism are explained more by rare transformation with major effects, or by rare multi-gene interactions of common genetic variants. Haznedar et al., (2001) indicated that although the neurobiological mechanisms underlying autism remain largely unknown but certain brain regions, including the limbic system, particularly the hippocampus, amygdalae, and cerebellum, have been implicated in the clinical expression and path physiologic mechanism of the disorder.
It is found in a study by Courchesne et al. (2001) that increased cerebral volume or brain weight also has been associated with autism. Some evidences from a series of postmortem examinations, CT studies, and an MRI study that evaluated children by cross-section between ages 2 and 16, suggests that findings of increased brain weight or brain volume may be age related and reflect accelerated developmental processes in younger children with autism (Hoshino et al, 1984).
Paul & Cohen (2005) identified in a research that over the past 20 years, a variety of therapies have been proposed to improve the symptoms associated with ASD. Current treatments include pharmacological therapies and various complementary therapies including diet modifications, vitamin therapy, occupational therapy, speech and language therapy. There are some behavioral and developmental interventions that help treatment of ASD and control the symptoms of this disease. Schopler (1984) defined interventions as taking such step or making such arrangements that help coping with a particular problem and try to improve the condition.
Krebs et al found that interventions that fall within the range of behavioural and developmental interventions have become the major treatment approach for promoting social, adaptive and behavioural function in children with ASD. These interventions may be viewed in terms of their position on a continuum from highly structured behavioural approaches to social realistic approaches (Chalmers et al 1981). It is necessary to expand autism treatment services to effected children and help their parents to cure their child (Symon 2005).
Smith (2000) found that cognitive behavior therapy shows significant improvements in the child’s behavior management, social skills, and parent’s mental health. There is limited and uncertain evidence for various combinations of distinct trial training, incidental teaching, pivotal response training, and environmental teaching (Wang, 2005). Koegel et al (1996) evidenced in a research that critical response training may be beneficial for communication and social interaction.
One of the behavioral interventions is training of children to learn in natural surroundings and training is done by teachers or in some cases by parents themselves. It is important to include parents as direct service providers in their children’s intervention process as a means of increasing the quantity and availability of intervention (Iacono, 1993).
It is also pointed out in a research by Powers (1993) that involvement of parents in treatment of autism not only helps the children suffering from disorder but also supports the family as a whole. Parents have successfully learnt to design and implement behavioral, social, and communication programs for their children with special needs. Within these programs, the parent trainers typically demonstrate and model techniques for the parents and provide the family with information. The goal is for the parents to absorb the information and learn to use the techniques themselves (Hancock et al, 2002). By placing the supporting parents in the mentor role, these programs have benefited many families (Ainbinder et al., 1999).
Shores (1987) defined social interaction as a mutual process in which children effectively initiate and respond to social stimuli presented by their peers. Social participation of children suffering from autism in peer interaction is low in frequency and poor in quality. It is usually composed of more ritualistic behaviors and only maintaining close proximity, rather then performing (Sigman & Ruskin, 1999).
Social dysfunction is the single most important feature of autism and it is most handicapping as well (Kanner, 1943). From the beginning, better social functioning has been considered one of the most important intervention outcomes. A variety of social interventions have been designed, empirically examined, and published in the autism literature. One of the social interventions is to enhance Parent-Preschooler interactions. This intervention was used by Dawsan and Galpert (1990) in a research. They designed an intervention that involved teaching the parent to imitate the child in play with toys for 20 minutes each day for2 weeks. Follow-up after 2 weeks demonstrated significant increases over baseline in increased gaze to mother’s face, increased number of toys played with, and increased number of play schemas used, as well as generalization to novel toys.
Rogers (1986) used a similar pre-post design to assess changes in child behavior of 13 preschoolers following 6 or more months of intensive intervention in a daily preschool program that emphasized positive adult-child interactions, play, and communication. Several markers of significantly improved social functioning were found, including improvements in the social-communicative play levels with a familiar adult and increase in child positive affect and social initiations and decreased negative responses to mother’s initiations during mother-child play. There is also another intervention that enhances preschoolers’ interactions with other adults as Stahmer (1995) used “pivotal response training (PRT)” in which certain behaviors are seen as central to wide areas of functioning.
Krantz & McClannahan (1998) used a visual cuing system involving a script-fading procedure to increase social initiations to a teacher. Another intervention is to increase Preschoolers’ Peer interactions as these strategies are powerful in increasing the social interactions of young children with autism (Goldstein et al 1992). There are interventions that increase school-aged children’s social interactions with adults These have included self-management strategies, teaching socio dramatic role-play using pivotal teaching responses, and video-modeling techniques, as well as more straightforward adult instruction.
(Koegel & Frea 1993) reported improving conversational skills using a pivotal response training approach in which two high-functioning teenagers with autism were taught self-management strategies for behaviors such as maintaining eye contact and topic maintenance. (Charlop & Milstein 1989) reported the successful use of video modeling to teach conversational skills. A particularly well-publicized intervention involving adult instruction involves Gray’s (Gray & Garand, 1993) social story technique, in which written stories are created to teach social rules and the reasons for them in a supportive, non critical and understanding way.
Review of the literature on ASD, its causes, symptoms, treatment and implications illustrate that autism is not a disease but an unusual condition that is experienced by a child. Early diagnosis and proper treatment may help curing this disorder without affecting health and life of the child. More important is support of parents, peers and teachers in order to help the children come out of this situation and make them competent enough to survive in this world.
Discussion:
This research was conducted to answer the questions whether there are behavioral and developmental interventions that can help assessing needs of a child suffering from ASD and how there interventions may help the child come out of this situation. The research aimed at exploring the features of ASD, its causes, symptoms, impact on life of individual and possible treatment.
It is found that ASD is not a genetic disease but may present in any child due to some vaccine experienced by parents or due to some mental disturbances. But the core point is that to cure ASD, diagnosis must be made at early stage so that an infant gets treatment. The techniques identified in this research mainly focus on participation of parents, peers and teachers in overcoming the effects of this disease in child. It is also pointed out in this research that parents training in treating their ASD child help the child recover from this disorder as parents can handle their child well and the child also responses to the parents more effectively.
In this research it is also found that application of any of the above mentioned interventions has a positive impact on the children suffering from ASD. There was positive response from the children and their learning ability got improved. Interventions also helped them to communicate with their surroundings both verbally and non-verbally. So it can be said that interventions developed for curing children experiencing ASD play a vital role in improving mental condition of the affected children and allow them to live normally.
Conclusion:
From issues discussed in the research it is concluded that there is possibility of developing behavioral and developmental interventions that may support a child come out of the disabilities caused by autism disorder. It is also obvious from research material that it is not necessary that a children suffering from ASD would have got this disease in genes but there is possibility that genetic chemistry is one of the reasons. It may also infer from this research that presence of ASD is not dependent on gender of the child; any child may get it irrespective of gender.
It is also found in research that role of parents in curing the child is very crucial and is demanded by the therapists. Without moral and physical support form parents it is not possible to cure a child especially if a child is infant or under age of 10. Moreover siblings, peers, and teachers can also participate in treatment of the child suffering form autism disorder. It is important to notice that all interventional strategies stated to cure ASD demand involvement of people with whom a child is in interaction.
But it is important to diagnose the disease at early stages of life, which is possible through taking notice of actions and expressions of the infant and checking the child’s behaviors towards routine happenings. If a children is not reacting in the prototype manner it indicates that there may be possibility of presence of ASD.
ASD is not a life risking disease but its prevalence in one’s life makes it difficult to survive in this world as that individual lacks the ability to interact with environment, meet social needs and behave in socially acceptable manner.
Recommendations:
All of the above illustrated successful strategies for curing children suffering from ASD are complex in administration, data collection, and maintenance and generalization procedures. These interventions require trained staff and focused involvement that extends over weeks to months. So it is recommended to make some new interventions that are easy to be apply and can be done by an average person also.
As application of intervention is a costly process and requires huge funds for data collection and processing, it is recommended that such measures must be adopted in future that minimize the cost on applying such interventions so that it is in reach of every individual. It is also recommended to take into consideration the family background and history of child before applying any intervention as there is variability in ethical and socio-economic background of every child. It is also recommended that future works include participant families who represent a variety of ethnic backgrounds and family structures.
