Autism spectrum disorder: characteristics, diagnosis, and support

Autism

The neural development of someone with autism is not the same as the neural development of those who do not have the disorder (Caronna, Milunsky, & Tager-Flusberg, 2008; Piggot, et al., 2009; Shattuck, et al., 2009). Those who have autism struggle with communication, and they may also show significant (or relatively minor) social impairment. Behaviors are restricted and repetitive in many cases, as well, and people with autism have trouble controlling those behaviors (Shattuck, et al., 2009).

Generally, the symptoms of autism are seen in children that are younger than three, and newer diagnostic options are catching autism and related disorders more quickly than in the past (Caronna, Milunsky, & Tager-Flusberg, 2008). This is very good news for parents, and for their children who need the help and support that they can get once they have been diagnosed with autism and treatment can be sought. Without a clear understanding of the challenges their child faces, parents cannot make an informed decision as to what kind of treatment would be best and whether they should focus on a specific kind of treatment would be a better fit for their child and family.

In the general population autism is seen in approximately one in 2000 individuals (Caronna, Milunsky, & Tager-Flusberg, 2008; Piggot, et al., 2009). Those who are on the autism spectrum with other, related disorders such as Aspergers, though, raise that number to two in 2000 individuals (Shattuck, et al., 2009). Because of the "checklist for autism in toddlers," it is possible for children with autism to receive a very early diagnosis. Kids as young as 18 months can be tested for autism and related disorders, and diagnosing them early is one of the best ways to get them help quickly (Tanguay, 2000).

The early diagnosis is also very important because there may be a genetic link in autism which may include more than just one gene and can affect twins and other children in a family (Tanguay, 2000). Naturally, this is very significant for parents who may have more children or who are planning on having more children in the future - and may want to understand their genetic risk.

Most psychiatrists are interested in treating autism with medication after it has been detected (Tanguay, 2000). It is also vital that any kind of intervention is started early. Some of the behavior that is seen in autism is considered to be bizarre by those who do not have the disorder or who do not have children with the disorder, so there are many social and behavioral therapies that can be used in order to help these children (Caronna, Milunsky, & Tager-Flusberg, 2008; Piggot, et al., 2009).

Some of the behavioral problems are linked to communication skills, and others are linked to the social aspects of the disorder (Piggot, et al., 2009; Shattuck, et al., 2009). Those who can learn to have good social relationships will be much better off than those who cannot - but autism can be severe and children do not always have a "choice" as to whether they can overcome their difficulties. Not every treatment works for every patient, of course, and patients who have a very severe form of autism or do not respond to therapy will often have to be medicated in order to function as well as possible (Tanguay, 2000).

There is a great deal of literature on whether autistic students should be (and can be) included in classrooms that are for general education students (Caronna, Milunsky, & Tager-Flusberg, 2008; Piggot, et al., 2009; Shattuck, et al., 2009; Tanguay, 2000). This is one of the most significant issues for those who have autism, and it can also affect the other students in the classroom. Perceptions on autism and inclusion change frequently, and more recent literature is often the best gauge of how parents and educators feel about this very important issue (Shattuck, et al., 2009).

The focus currently should be on what parents are seeing in education and whether their children are being treated appropriately for the diagnoses they have received. There are various issues that parents and their autistic children face with inclusion into general education classrooms, and there are both pros and cons to inclusion. Because this is such a significant issue with autism, it is important that inclusion be discussed.

Throughout Europe, and most significantly in Spain, many teachers are focused on helping out students who are struggling with learning disabilities like autism (Casas & Castellar, 2004). This is especially true where students have to deal with math, because it can be highly difficult for them. The highest goal of the majority of these teachers is to make sure that students who are autistic are able to live normal lives as much as possible (Caronna, Milunsky, & Tager-Flusberg, 2008).

That generally means including them in general education classrooms so that the autistic students can have a stronger sense that they belong at that school (Casas & Castellar, 2004). By giving them a sense of belonging they can keep them from feeling a sense of isolation from the other children in the school. It also builds self-esteem and self-confidence (Caronna, Milunsky, & Tager-Flusberg, 2008).

Autistic children have trouble making eye contact and they generally prefer not to be touched - especially by strangers (Caronna, Milunsky, & Tager-Flusberg, 2008; Piggot, et al., 2009). The earlier they are diagnosed, the more likely it is that they can have stronger social skills. This can include more eye contact and more toleration of being touched by others (Caronna, Milunsky, & Tager-Flusberg, 2008).

This, in turn, provides them with more confidence on a social level, so they have a higher chance of being placed in classrooms where there are general education students (Shattuck, et al., 2009). While information about autism is not limited to whether autistic children should be included in classrooms that are for general education students, this is a significant part of the issue with autism because autistic children are often excluded. That can definitely cause them to be less comfortable with their peers and their surroundings, and that can lead to struggles that can be avoided.

When autistic children are placed into general education classrooms they not only learn more social skills but they have an opportunity to practice those skills. Additionally, they gain confidence in the social skills that they are able to master and use with others. That confidence has been seen as significant in many cases.

That makes it a suggestion for a large number of schools around the country to use a curriculum in general education classrooms that autistic children can also use (Caronna, Milunsky, & Tager-Flusberg, 2008). That allows these children to take part in various types of curricula and gives them an opportunity to gain both confidence and competence. When they do those things, they move forward in life and that can give them an opportunity to try even more things in the future (Piggot, et al., 2009).

Of course, not everyone feels as though inclusion is the right idea for autistic children (Caronna, Milunsky, & Tager-Flusberg, 2008). The concept has some controversy to it, and children and adults both have to be aware of the concerns that will be faced. In other words, many people still believe that inclusion should be avoided and that self-contained options are the best choices for autistic students.

The largest controversy and biggest concern about this issue comes from the idea that teachers who work in general education classrooms are only equipped for working with general education students. That does not in any way negate the work these teachers do, but only emphasizes that different teachers have different skills.

The lack of understanding of techniques to deal with autistic students and handle them properly can cause extra stress for teachers in general education classrooms if there are autistic students added to that classroom (Casas & Castellar, 2004; Shattuck, et al., 2009). General education students need a good quality education, and it can be more difficult for them to get that kind of education if there are autistic students in the classroom who are not cared for properly (Casas & Castellar, 2004).

The point is valid, but also a significant issue for many teachers and many parents of both general education and autistic students. Very few general education teachers working in the public school system today have worked with children with autism, meaning these teachers simply do not have a strong understanding of the needs of those children (Casas & Castellar, 2004).

Another important issue to consider is that children who are autistic and who are placed in a general education classroom have needs that are different from the majority of the other children in that classroom (Caronna, Milunsky, & Tager-Flusberg, 2008). There may also be a teacher who feels that handling autistic students is difficult and takes away from the other children in the classroom.

If there is one autistic student in the classroom this may not be that much of an issue, but if there are many students who are autistic in the classroom it could be that the teacher will not feel (or be) adequately prepared to handle all of the different needs of those students (Casas & Castellar, 2004). In some students, autism is more severe than it is in others, and teachers must learn to anticipate this if they are to be successful in the classroom.

The severity of the autism can make the difference between whether students with autism should be included or whether they should be taught separately (Shattuck, et al., 2009). Students cannot make that decision, of course, but the parents and teachers can work together to determine which is going to be the best option for the individual student. Where some subjects are concerned it is more difficult to make this choice, as well.

One of those subjects is math, because math can be complicated and can build on what was previously learned (Jimenez & Garcia, 2002). That can be a problem for autistic students, because they often do not learn as easily or retain the information they have learned for as long or as well as general education students. When students have concepts with which they struggle, like mathematics, they can have serious trouble keeping up with their peer group (Jimenez & Garcia, 2002).

Naturally, this is something significant in the lives of the teachers who are trying to help them and also in the lives of the students who may lose confidence when they have trouble keeping up and they see that they are failing at something the other students can do easily (Caronna, Milunsky, & Tager-Flusberg, 2008).

When autistic students are not included in general education classrooms they generally hold their own or even excel among their peers in a special education classroom, which can mean that they have much more confidence than they would have had if they would have been included with general education students (Shattuck, et al., 2009). One failure (or perceived failure) can breed additional failures and lower confidence levels, and those would not be seen if the student was not placed in with students in a general education setting.

The emotional health of autistic students is very important. While they may not register and react to emotions like others do, that does not mean that they do not feel emotions. The issue is one of expression, not one of feeling. Because that is the case, those who are autistic must be nurtured and treated with respect and care, just like others. When a person's emotional health is nurtured, that person often excels (Davidson & Begley, 2012).

Treating a person with care and focusing on the emotional health of that person is one of the best ways to ensure that an individual can reach his or her full potential (Davidson & Begley, 2012). While this is not effective for everyone and no treatment is guaranteed to work, making sure that an autistic student's emotional health needs are met is one of the best ways to help that student, whether he or she is in a general or special education classroom.

All too often, emotional health issues are overlooked (Davidson & Begley, 2012). That is not only true for autistic students, but it is a problem that can be seen in the general population. Little thought is given to the significance of the issue, but in reality it is highly important and also very problematic in nature. People who learn to control their emotional health and not have that health be dependent on anyone's else's perception of them often fare much better in life (Davidson & Begley, 2012).

When autistic students fail, that failure lowers confidence and makes future failures more likely. Additionally, when a student is classified as autistic and then put in a general education classroom, there is a stigma attached to the label (Caronna, Milunsky, & Tager-Flusberg, 2008). That can make the autistic child uncomfortable, but it can also make the other children uncomfortable. When they are unsure how to act around one another, they avoid making friendships that might otherwise have blossomed (Caronna, Milunsky, & Tager-Flusberg, 2008; Piggot, et al., 2009).

There are two ways this can be avoided. One of those ways is to put autistic students only in special education classrooms and not in the general education population. The other way is not to put labels on students, and to allow them to assimilate into the general education population without calling them autistic or anything else.

In the United States, the inclusion of special needs students - including those who are autistic - is something that is very significant to education (Cross, et al., 2004). Studies into the issue show that there are four specific areas that have to be addressed when autistic children are going to be included in general education classrooms (Cross, et al., 2004). These areas have to be addressed properly so that autistic students can feel comfortable with themselves and with each other (Cross, et al., 2004).

The areas are adaptations, attitudes, therapeutic interventions, and parent-provider relationships (Cross, et al., 2004). General education teachers and special needs teachers have to work successfully together if they are going to help autistic students succeed in the general education classroom and allow them to work with and understand one another (Odom, Schwanz, & ECRII Investigators, 2002).

Children have to be ready for the inclusion programs, but the programs themselves have to be able to accept and handle the students (Stake, 2003). There will be challenges that take place in these programs, and the students and teachers have to be prepared for those challenges (Stake, 2003). It is very important for the teachers to take a careful look at the practices and the procedures that have to be used in autistic classrooms, so those teachers are able to determine what the best way would be to include children who have significant autistic traits (Caronna, Milunsky, & Tager-Flusberg, 2008).

When those children can be included and it is possible that all the children involved are able to work together, everyone wins and the situation can be highly beneficial to all of the children (Piggot, et al., 2009; Shattuck, et al., 2009). Autistic children learn better communication and social skills, and general education students learn more about working with others who are different from them.

It can be stressful and sometimes difficult for an autistic child to be incorporated into a general education classroom, but there are ways in which that student can be made to feel more comfortable (Janesick, 2003). That will go a very long way toward helping children who are autistic and meeting the various needs that they have in their education (Horn, et al., 2002). Parents who have autistic children often feel that letting their children attend general education classes can help them socialize (Janesick, 2003).

These children also strengthen their developmental abilities because they are being taught at a higher level than what they would receive if they were in a special education classroom (Caronna, Milunsky, & Tager-Flusberg, 2008). Those are both important issues on which to focus, but despite that there are still teachers who are not comfortable welcoming autistic children into their classrooms when they generally teach general education students. The concern is that it will be too distracting for both the general students and those who are autistic (Shattuck, et al., 2009).

Undoubtedly, some of that concern comes from the idea that teachers may feel incapable of handing autistic children (Beckman, Hanson, & Horn, 2002). Some also comes from the idea that teachers are concerned about autistic children disrupting the rest of the children in the classroom (Caronna, Milunsky, & Tager-Flusberg, 2008). While this certainly makes sense, it seems unfair to continue to exclude children who want and need to learn. Learning is important, and it is not that autistic children cannot be successful at learning. It is simply that they learn differently and, therefore, sometimes have to be taught differently in order to help them succeed (Shattuck, et al., 2009).

The most important of all the factors that relate to an autistic child's performance in a general education classroom is the way that student is treated by the teacher (Beckman, Hanson, & Horn, 2002). The attitude that the teacher and the student have toward one another and the task at hand matters very much, and the better the attitude the more likely the student will be to see success. The way the other students feel about the autistic student also matters, of course, because it is important that the autistic student is properly included in classroom activities and interaction with other students.

The autistic student must find ways to adapt to the setting of a general education classroom, but the general education students must also look for appropriate ways to adapt to the special needs child (Caronna, Milunsky, & Tager-Flusberg, 2008). There will be differences in educational ability, but there will also be differences in learning style and personality (Piggot, et al., 2009; Shattuck, et al., 2009). When students are accepting of one another, good things can happen in a general education classroom. There is so much taught in general education that autistic students should have the opportunity to engage in that and learn as much as they can from other students (Shattuck, et al., 2009).

While learning from one's peers is a very important part of growing up, some autistic children are shunned by general education students, even if they share a classroom (Caronna, Milunsky, & Tager-Flusberg, 2008). That shunning can be very hard on their mental state and can cause them extra difficulties. For the most part, however, these issues are not significant and they are treated well by their general education peers. When autistic children are shunned, it often only comes from a lack of understanding on the part of the general education students (Shattuck, et al., 2009).

Students who are used to having only other general education students in class with them are uncertain how to treat students who are autistic (Caronna, Milunsky, & Tager-Flusberg, 2008). That comes from not understanding the disabilities that autistic children have and not realizing how to adapt communications and social skills for those students (Piggot, et al., 2009). Children who are in general education classrooms often try to work with autistic children, but they are unsure how to treat them and that can lead to discomfort until the children find some common ground.