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  • Mila Sonkin

A Closer Look at Autism: Current Research & Behavioral Interventions

Background Information

According to CDC, autism spectrum disorder (ASD) is a developmental disability that can cause significant social, communication, and behavioral challenges. In other words, it’s a developmental disorder that affects how individuals think, behave, and communicate with others. Furthermore, there are many stereotypes about people on the spectrum, some of which state that they are aggressive, really smart, unintelligent, can’t communicate, look different, don’t have emotions, and can’t have relationships (Autism Learning Partners).



To start, it is true that autistic people do experience occasional outbursts, but they are a result of a trigger, which includes sensory sensitivities, frustration from being misunderstood, social understanding, bullying, anxiety, and stress. Moreover, the stereotype that individuals with autism have a wide range of intelligence is a result of the media (Autism Learning Partners). According to Autism Learning Partners, “​​An autism diagnosis does not mean that you cannot learn and develop skills, nor does it affect an individual’s ability to do well academically.” Furthermore, people with autism certainly can have difficulties communicating with people, but this doesn’t mean that they can’t communicate or speak. Moreover, autism does not affect an individual’s physical appearance. However, an individual with autism may have another disability that causes noticeable differences in their appearance. Another stereotype that is invalid is that people on the spectrum do not experience emotions; in fact, they can experience all ranges of emotions just like anyone else. Lastly, although autistic people often struggle with communicating and reading social cues, that does not mean they can’t have meaningful relationships (Autism Learning Partners).


Additionally, since autism is a spectrum disorder, it has such a wide range of severity and each individual with autism is different, with their own strengths, habits, and weaknesses. Some common strengths of people who are autistic include having a high tolerance for repetitive tasks, recognizing patterns, honesty, loyalty, mathematical and technical abilities, creative and artistic talents, extremely impressive memory, visual perception, attention to detail, and having some sort of mapping technique in their brains (Smith).


Levels of Autism

Moreover, there are three classifications or levels of autism that are distinguished by the amount of support and help the person needs. Essentially, most autistic people have receptive language but lack expressive language. ASD level 1 is the mildest form of autism and requires the least amount of support. In fact, they are either at or above regular IQ levels. They have some executive dysfunction issues, meaning that they don’t have very many social skills. Individuals with ASD level 1 will possibly have difficulty understanding social cues and may have trouble maintaining relationships with others. In addition, they may understand and speak in complete sentences despite the fact that they will likely have difficulty engaging in constant conversation. According to The Place for Children with Autism, “Children with ASD level 1 experience some inflexibility of behavior, like difficulty switching between tasks, staying organized, and planning,” suggesting that oftentimes they struggle with keeping up with the world around them.


Next, ASD level 2 is characterized by requiring substantial support. These individuals substantially struggle with social communication, both verbal and nonverbal. They also have reduced or abnormal responses to social cues. Similarly, repetitive behaviors appear more frequently. Also, people diagnosed with this kind of autism have difficulty coping with changes in routine or habits, displaying their inflexible behavior (The Place for Children with Autism).


Lastly, ASD level 3 is categorized as requiring very substantial support. They have extreme difficulty in social communication and will be either completely nonverbal or speak only a few words. Their initiation of social interaction and response to others is very limited, which makes sense that they interact with others abnormally. Additionally, they have a hard time coping with changes to routine, proving that switching from one activity to another may be extremely challenging and may cause significant distress. Also at this level, repetitive behaviors often interfere with the ability of the individual to function (The Place for Children with Autism).


Contributing Factors to Autism

According to Drake, “Although recent research has advanced the understanding of autism, there is much more to learn about the factors that influence this neurotype.” According to the Centers for Disease Control and Prevention (CDC), one in thirty-six kids is autistic, while twenty years ago, one in one hundred fifty children was diagnosed with autism.


Furthermore, scientists have several different perspectives on the various factors associated with autism. Some scientists believe that variants in genes cause autism. Other scientists think that environmental factors, like exposure to toxins, cause the development of autism. In addition, some think that possible imbalances in the intestinal microbiome may contribute to this neurotype. In essence, the latest research on autism is investigating the several factors that associate with this neurotype, including genetic variants, gut biome imbalances, and neurological factors (Drake).


“The Study to Explore Early Development” is a huge multi-year study that is funded by the CDC, which is mainly focussing on learning more about the many things that cause autism. There are six study sites involved in “The Study to Explore Early Development” in the United States that are a part of the Autism and Developmental Disabilities Research and Epidemiology network. They focus on children who are between the ages of two and five, and the main objective is to discover what health conditions occur in children who are on the spectrum and children who are not. Another goal is to determine what factors result in the likelihood of developing ASD. Moreover, the Autism and Developmental Disabilities Research and Epidemiology network hopes to differentiate the physical and behavioral characteristics of children without any disorder, children with autism, and children with other developmental conditions. As a result of this research, several studies have already been published. One of their recent studies determined that a mother’s exposure to ozone pollution during the third trimester of pregnancy was associated with her child developing autism. In another one of their latest studies in the journal, Epidemiology, researchers found that air pollution, called particulate matter, being exposed to a newborn child increased the chances of the child being diagnosed with autism later in their life (Drake).


New Technology

Moreover, autism can be extremely hard to detect, especially when it comes to trying to discover it in young children. Current research has shown that early diagnosis and treatment interventions result in better long-term outcomes for autistic people, highlighting the importance of knowing early on if one has autism. Consequently, scientists are working toward finding new diagnostic methods that can detect this neurotype in individuals at a young age. In Florida, researchers from Harvard Medical School in Boston, MA, and the University of Miami looked at data from auditory brainstem response (ABR) hearing tests that were consistently given to newborns. They compared the data they discovered from the children when they were infants to the data from the Florida Department of Education of those same individuals who had been diagnosed with developmental conditions. The researchers discovered that those who developed autism had slower brain responses to sounds in their ABR tests when they were babies, which suggests that ABR tests could possibly be used to recognize autism in individuals at a young age (Drake).


Recently, there has been some research on biomarkers. Using data from the Children’s Autism Metabolome Project, researchers found metabotypes that are linked with autism in 357 children who are between the ages of eighteen and forty-eight months. By comparing these metabotypes with others that had been previously discovered, the researchers were able to detect autism in 53% of the individuals. Ultimately, this approach to discovering if individuals have autism shows the differences that appear in the metabolism of those on the spectrum, which can lead to more specific treatments (Drake).


Overall, researchers hope to find more evidence that confirms the main causes of autism. Currently, they are striving to develop tests that can accurately detect autism in individuals at a young age and find more specialized treatments for symptoms (Drake).


Treatments & Behavioral Interventions

The latest treatments for autism are reducing the symptoms that ultimately cause problems and affect their quality of life. Each person with autism has different needs and experiences different challenges. The treatments can improve their education, their health, their communication skills, and/or their daily activities. Essentially, they are broken down into the following categories: behavioral, developmental, educational, social-relational, pharmacological, psychological, and complementary (Centers for Disease Control and Prevention).


To start, behavioral treatments specialize in altering behaviors by comprehending what actually happens before or after the behavior. This type of treatment has the most evidence for treating symptoms. One behavioral treatment is called Applied Behavior Analysis (ABA), which promotes desired behaviors and attempts to get rid of unwanted behaviors. One ABA treatment, called Discrete Trial Training (DTT), teaches lessons to those on the spectrum and uses step-by-step instructions, giving rewards for the desired behaviors. Another ABA treatment called Pivotal Response Training (PRT) aims to improve pivotal skills, like interacting with others (Centers for Disease Control and Prevention).


Developmental treatments strive to improve developmental skills, including language and physical skills. The most common treatment is called Speech and Language Therapy, which improves the individual’s use of speech and understanding of it. Another treatment, called Occupational Therapy, helps individuals on the spectrum learn basic independent skills. Lastly, based on Applied Behavior Analysis, a developmental treatment called The Early Start Denver Model (ESDM) originated, which focussed on autistic children between the age of twelve months and forty-eight months (Drake).


Furthermore, there are several educational treatments, one of which is called Treatment and Education of Autistic and Related Communication-Handicapped Children (TEACCH). Ultimately, TEACCH uses the idea that people with autism need visuals as well as consistency in order to learn. This approach allows teachers to improve the structure of their classrooms by having straightforward visual instructions on display for the students (Centers for Disease Control and Prevention).


Additionally, social-relational treatments, oftentimes involving mentors, work to improve the social skills of autistic individuals allowing them to build relationships with people. One model called the Developmental, Individual Differences, Relationship-Based model focuses on the development of communication skills through the individual’s interests. RDI or Relationship Development Intervention encourages individuals on the spectrum to participate in social situations which gives them the opportunity to practice communicating (Centers for Disease Control and Prevention).


Considering the use of medication, there are technically no medications that treat symptoms of ASD. However, some medications help people on the spectrum function better by treating other symptoms that they may have, including depression, self-harming behavior, hand biting, head banging, high energy levels, lack of focus, anxiety, seizures, gastrointestinal problems, and others. In essence, these pharmacological approaches treat medical, psychological, and behavioral conditions but don’t treat autism directly. Ultimately, specific medications may help the individual even though they aren’t working towards eradicating autism (Centers for Disease Control and Prevention).


One well-known psychological treatment called Cognitive-Behavior Therapy (CBT) focuses on understanding and figuring out how an individual’s thoughts, feelings, and behaviors are connected. Essentially, CBT provides a therapist to a person with autism which gives them support and works with them to change the person’s perspective on several situations to ultimately change their behavior and reactions (Centers for Disease Control and Prevention).


Social Communication Skills

Social environments and communicating with others can be challenging for people who have autism. There are several common characteristics in autistic people when it comes to social interaction. To start, people with autism often avoid or do not make eye contact. Additionally, another thing that is extremely common in individuals with autism is that they do not respond to their names by the time they are nine months old. Similarly, by nine months old, they often do not show any emotions or even facial expressions. In other words, their faces do not change when they are angry, happy, sad, etc. Not to mention, when young children with autism are twelve months old, they do not play games like pat-a-cake, which are interactive yet relatively straightforward. Moreover, by the age of twelve months, they use little to no gestures. For instance, they don’t wave hi or goodbye or give high-fives to others until they are a lot older. In addition, by fifteen months of age, they are still not interested in the same things as others their age. Likewise, children with autism who are eighteen months old surprisingly do not point others to look at something that they like or are fascinated with. Shockingly, by the age of two, kids with autism still do not notice or understand when others are mad, annoyed, or hurt. Furthermore, by the age of thirty-six months, they do not notice other children. Even at the age of four, they do not play pretend games, where they act as a character, and by the age of sixty months, they still do not dance, sing, or perform in front of others for attention (Centers for Disease Control and Prevention).


Repetitive Behaviors

Additionally, people on the spectrum often have behaviors that are unusual and unique, which ultimately set them apart from individuals with other developmental conditions when it comes to difficulties with social interaction. One repetitive behavior that people with autism often have is the act of lining up objects or some kind of toy, and when the order is changed, they get extremely agitated. As a result, they often get aggravated easily by small changes. Something similar is that individuals who are on the spectrum likely play with toys the same exact way every time. Likewise, following specific routines is another behavior that individuals with autism often have. Another common characteristic is called echolalia, which is when individuals with autism repeat words or phrases over and over again. Moreover, autistic people often obsess over certain parts of objects and direct all their attention to that specific thing. Furthermore, obsessive, intense interests are extremely common in people with autism. They often develop from a very young age and they continue throughout their lifetime (Centers for Disease Control and Prevention). According to the National Autistic Society, some common interests include “art, music, gardening, animals, postcodes or numbers” and “for many younger children it's Thomas the Tank Engine, dinosaurs or particular cartoon characters.” Depending on how far the individual is on the spectrum, they may often flap their hands, spin in circles, or rock their body. Lastly, autistic people may have interesting reactions based on their senses: how things feel, sound, taste, look, or smell (Centers for Disease Control and Prevention).


Other Characteristics

Some other characteristics that individuals with autism may express are delayed learning skills, language skills, and movement skills. Additionally, autistic people may express inattentive behavior. In other words, they are extremely restless, and due to their low attention span, they might have impulsive behaviors that may be hyperactive at times. Moreover, people on the spectrum may experience epilepsy and have seizures often. In addition to having abnormal sleeping and eating behaviors, people with autism likely also have excessive stress and anxiety. Spontaneous mood reactions are also extremely common in individuals who have autism and are often caused by a trigger that causes a lot of emotions for them. Lastly, autistic people may experience a lack of fear or an uncontrollable amount of fear in certain situations (Centers for Disease Control and Prevention).


Optimal Ways to Communicate with Autistic People

Maintaining Their Attention

Firstly, in order to communicate more effectively with people on the spectrum, one main factor is holding their attention. One way to do this is to make sure to say their name directly to them whenever you are starting a conversation with them. Additionally, talking very clearly and having a lot of emotion will keep their attention. Furthermore, another useful tip that is very helpful when interacting with autistic individuals is talking about their hobbies, their interests, or whatever they are currently doing so that they stay engaged (National Autistic Society).


Allow Them To Process Information

Furthermore, people who have autism may get overwhelmed easily when they are presented with a lot of information. Therefore, it is extremely important to be simple whenever you are communicating with them as well as talking to them slowly. In addition, to get them to understand a certain topic or stay engrossed in the conversation, repeat specific keywords. Additionally, it is critical to pause between phrases or words so that you are giving them enough time to process what you have said. Pausing also gives them time to think of how to respond. Another thing that is important to consider is not asking too many questions because it can be stressful and mentally overwhelming to come up with responses to several questions that are asked consecutively. Similarly, although using visual supports may be beneficial when communicating with autistic people, limiting gestures and body language often makes an individual with autism feel more comfortable and less overwhelmed. Lastly, it is essential to be aware of the environment that you are in when you are talking to them. If it is very loud or crowded, acknowledge the fact that they might not be able to process a lot of what you are saying and make the conversation easier for them by talking slowly, pausing, and keeping it simple to make them feel comfortable (National Autistic Society).


Avoid Open-Ended Questions & Be Clear

To engage whoever you may be speaking to without overwhelming them, it is crucial that you ask only the most necessary questions and try to keep questions short. Similarly, a good question to ask them gives them options to choose from. For example, “What ice cream do you like better? Vanilla or chocolate?” In addition to the structure of your questions being extremely important, the specificity is also crucial. The more specific a question is, the easier it is going to be for them to answer it. Additionally, it is vital to recognize the fact that autistic people often take sarcasm, metaphors, similes, irony, exaggeration, hyperboles, and idioms very literally, so avoiding them, in general, would be ideal (National Autistic Society).


Conclusion

In conclusion, autism is a unique disorder, and those who are diagnosed with it often have problems with social communication and interacting with others. However, some individuals can be farther on the spectrum than others and have more difficulty communicating and learning. Additionally, autistic people often have obsessive interests, repetitive behaviors, and uncontrollable outbursts in response to a trigger. Currently, a lot of research is being done to determine the several main causes of autism, discover techniques for early detection of it, and find more treatments that are specialized to certain symptoms for people on the spectrum to get the help they need as soon as possible.


Bibliography

  • CDC. “Autism Spectrum Disorder (ASD) | CDC.”Centers for Disease Control and Prevention, 28 June 2023, https://www.cdc.gov/ncbddd/autism/index.htm.

  • CDC. “Data and Statistics on Autism Spectrum Disorder | CDC.”Centers for Disease Control and Prevention, 12 May 2023, https://www.cdc.gov/ncbddd/autism/data.html.

  • Communication Tips. National Autistic Society, https://www.autism.org.uk/advice-and-guidance/topics/communication/tips. Accessed 4 January 2023.

  • Debunking 8 Common Stereotypes of Individuals with Autism (Part One). , 16 Sept. 2021, Autism Learning Partners, https://www.autismlearningpartners.com/debunking-8-common-stereotypes-of-individuals-with-autism.

  • Drake, Kimberly. Autism Research: Recent Findings. 16 Apr. 2021, https://www.medicalnewstoday.com/articles/what-is-the-latest-research-on-autism.

  • Obsessions and Repetitive Behaviour - a Guide for All Audiences. National Autistic Society, https://www.autism.org.uk/advice-and-guidance/topics/behaviour/obsessions/all-audiences. Accessed 18 January 2023.

  • “Signs & Symptoms | Autism Spectrum Disorder (ASD) | NCBDDD | CDC.” Centers for Disease Control and Prevention, 11 Jan. 2023, https://www.cdc.gov/ncbddd/autism/signs.html.

  • Smith, Ed. “Focus on Strengths as Well as Challenges.” Autistica, 7 Oct. 2019, https://www.autistica.org.uk/news/focus-on-strengths-and-challenges.

  • “The 5 Best Types of Toys for Children with Autism Spectrum Disorder.” Big Sky Therapeutic Services, 11 Dec. 2018, https://bigskytherapy.com/resources/the-best-toys-for-children-and-adults-with-autism.

  • “The 3 Levels of Autism – Diagnosing Autism.” The Place for Children with Autism, https://theplaceforchildrenwithautism.com/diagnosing-autism/the-three-levels-of-autism. Accessed 2 January 2023.

  • “Treatment and Intervention Services for Autism Spectrum Disorder.” Centers for Disease Control and Prevention, 9 Mar. 2022, https://www.cdc.gov/ncbddd/autism/treatment.html.



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