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Why Autism Awareness is Important

Categories: Autism Psychological Disorders

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Published: Aug 24, 2023

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104 Autism Essay Topic Ideas & Examples

Inside This Article

Autism is a complex neurodevelopmental disorder that affects millions of people worldwide. Writing an essay on autism can be challenging, as there are numerous aspects to consider and various topics to explore. To help you get started, here are 104 autism essay topic ideas and examples that cover different aspects of this disorder:

Historical Perspectives on Autism: Explore the evolution of autism research and how our understanding of the disorder has changed over time.
Diagnostic Criteria for Autism: Discuss the diagnostic criteria used to identify individuals with autism and how they have evolved.
Early Signs of Autism: Explore the early signs and red flags that may indicate the presence of autism in young children.
Autism Spectrum Disorder: Explain the concept of the autism spectrum and how it encompasses a wide range of abilities and challenges.
Social Communication Challenges in Autism: Discuss the difficulties individuals with autism face in social interactions and communication.
Sensory Processing Issues in Autism: Explore how individuals with autism may experience sensory processing issues and how it affects their daily lives.
Autism and Language Development: Investigate the language development challenges faced by individuals with autism and the different communication methods used.
The Role of Genetics in Autism: Discuss the genetic factors that contribute to the development of autism and how they interact with environmental influences.
Autism and Brain Structure: Explore the differences in brain structure and connectivity observed in individuals with autism.
Autism and Executive Functioning: Discuss the executive functioning challenges faced by individuals with autism and how it affects their planning, organizing, and problem-solving skills.
Autism and Theory of Mind: Investigate the theory of mind deficit commonly observed in individuals with autism and its impact on their understanding of others' thoughts and emotions.
Autism and Mental Health: Explore the high prevalence of mental health issues, such as anxiety and depression, among individuals with autism.
Autism and Co-occurring Conditions: Discuss the common co-occurring conditions associated with autism, such as ADHD, epilepsy, and intellectual disabilities.
Autism and Gender Differences: Investigate the differences in autism prevalence, presentation, and diagnosis between males and females.
Autism in Adulthood: Explore the challenges faced by adults with autism, including employment, relationships, and independent living.
Autism and Education: Discuss the educational strategies and interventions that are effective in supporting individuals with autism in school settings.
Inclusive Education for Students with Autism: Investigate the benefits and challenges of including students with autism in mainstream classrooms.
Autism and Specialized Therapies: Explore the various therapies used to support individuals with autism, such as applied behavior analysis (ABA), speech therapy, and occupational therapy.
Autism and Assistive Technology: Discuss how assistive technology can enhance communication, socialization, and independence for individuals with autism.
Autism and Employment: Investigate the barriers and opportunities faced by individuals with autism in the workforce.
Autism and Bullying: Discuss the increased vulnerability of individuals with autism to bullying and strategies to prevent and address it.
Autism and Parenting: Explore the unique challenges and experiences of parents raising a child with autism.
Autism and Siblings: Discuss the impact of having a sibling with autism on neurotypical siblings and the importance of support and understanding.
Autism and Society: Investigate how society can become more inclusive and accepting of individuals with autism.
Autism and Advocacy: Discuss the importance of advocacy and self-advocacy for individuals with autism in promoting their rights and well-being.
Autism and Cultural Perspectives: Explore how autism is understood and treated in different cultures and the impact of cultural beliefs on individuals with autism.
Autism and Vaccines: Investigate the controversies surrounding the alleged link between vaccines and autism and the scientific evidence debunking this myth.
Autism and Complementary and Alternative Medicine (CAM): Discuss the use of CAM therapies in treating autism and the importance of evidence-based practices.
Autism and Technology: Explore how technology, such as mobile apps and virtual reality, can be used to support individuals with autism.
Autism and COVID-19: Discuss the impact of the COVID-19 pandemic on individuals with autism and the challenges they face during lockdowns and social distancing measures.
Autism and Animal-Assisted Therapy: Investigate the benefits of animal-assisted therapy for individuals with autism, including emotional support and social interaction.
Autism and Peer Relationships: Discuss the difficulties individuals with autism face in forming and maintaining friendships and strategies to promote positive peer interactions.
Autism and Sleep Disorders: Explore the high prevalence of sleep disturbances among individuals with autism and the impact on their overall well-being.
Autism and Aging: Discuss the unique challenges faced by individuals with autism as they transition into older adulthood.
Autism and Stigma: Investigate the stigma attached to autism and its impact on individuals' self-esteem and social inclusion.
Autism and Social Skills Training: Explore the effectiveness of social skills training programs in improving social interaction and communication for individuals with autism.
Autism and Sensory-Friendly Environments: Discuss the importance of creating sensory-friendly spaces to support individuals with autism in various settings, such as schools, workplaces, and public spaces.
Autism and Sleep Interventions: Investigate evidence-based interventions and strategies to improve sleep quality for individuals with autism.
Autism and Music Therapy: Explore the benefits of music therapy in supporting individuals with autism, including emotional expression and social engagement.
Autism and Art Therapy: Discuss the therapeutic benefits of art therapy for individuals with autism, including self-expression and sensory integration.
Autism and Sports: Investigate the role of sports and physical activities in promoting social skills, physical fitness, and overall well-being for individuals with autism.
Autism and Transition Planning: Discuss the importance of transition planning for individuals with autism as they move from school to adulthood, including vocational training, independent living, and community integration.
Autism and Applied Behavior Analysis (ABA): Explore the principles and techniques of ABA and its effectiveness in improving skills and reducing challenging behaviors in individuals with autism.
Autism and Medication: Discuss the use of medication in managing symptoms associated with autism, such as hyperactivity, anxiety, and aggression.
Autism and Assistive Communication Devices: Investigate the use of augmentative and alternative communication (AAC) devices in facilitating communication for nonverbal individuals with autism.
Autism and Eating Disorders: Explore the increased risk of eating disorders among individuals with autism and the importance of early detection and intervention.
Autism and Transition to College: Discuss the challenges and support services available for individuals with autism transitioning to higher education.
Autism and Employment Accommodations: Explore the reasonable accommodations that can be provided in the workplace to support individuals with autism.
Autism and Independent Living Skills: Discuss the importance of teaching and developing independent living skills for individuals with autism to enhance their autonomy and quality of life.
Autism and Emotion Regulation: Investigate the difficulties individuals with autism face in regulating emotions and strategies to support emotional well-being.
Autism and Visual Supports: Explore the use of visual supports, such as visual schedules and social stories, in promoting understanding and independence for individuals with autism.
Autism and Executive Functioning Interventions: Discuss evidence-based interventions to improve executive functioning skills in individuals with autism.
Autism and Transition to Adulthood: Investigate the challenges and opportunities associated with the transition to adulthood for individuals with autism, including housing, employment, and social relationships.
Autism and Specialized Schools: Explore the benefits and limitations of specialized schools for individuals with autism and inclusive education options.
Autism and Special Interests: Discuss the role of special interests in the lives of individuals with autism and its potential benefits in skill development and well-being.
Autism and Savant Skills: Investigate the phenomenon of savant skills observed in some individuals with autism and the theories explaining this exceptional ability.
Autism and Executive Dysfunction: Explore the impact of executive dysfunction on daily living skills and strategies to support individuals with autism in managing tasks and responsibilities.
Autism and Mental Health Interventions: Discuss evidence-based interventions and therapies used to address mental health issues in individuals with autism, such as cognitive-behavioral therapy (CBT) and mindfulness.
Autism and Employment Discrimination: Investigate the challenges and legal protections against employment discrimination for individuals with autism.
Autism and Early Intervention: Explore the benefits of early intervention programs in promoting positive outcomes for children with autism.
Autism and Parent Training: Discuss the importance of parent training programs in equipping parents with the necessary skills and knowledge to support their child with autism.
Autism and Transition to Independence: Investigate the challenges and resources available for individuals with autism transitioning to independent living.
Autism and Mental Health Stigma: Explore the stigma associated with mental health issues in individuals with autism and strategies to promote acceptance and understanding.
Autism and Special Education Laws: Discuss the legal protections and rights of individuals with autism in the education system, such as the Individuals with Disabilities Education Act (IDEA).
Autism and Sleep Hygiene: Investigate the importance of establishing good sleep hygiene habits for individuals with autism and strategies to promote healthy sleep patterns.
Autism and Peer-Mediated Interventions: Explore the effectiveness of peer-mediated interventions in promoting social skills and inclusion for individuals with autism.
Autism and Classroom Accommodations: Discuss the accommodations and modifications that can be implemented in the classroom to support students with autism.
Autism and Mental Health Screening: Investigate the importance of early mental health screening and intervention for individuals with autism.
Autism and Social Media: Explore the pros and cons of social media use for individuals with autism, including opportunities for connection and potential risks.
Autism and Trauma: Discuss the increased vulnerability of individuals with autism to experiencing trauma and strategies for trauma-informed care.
Autism and Parental Stress: Investigate the impact of raising a child with autism on parental stress levels and the importance of self-care and support.
Autism and Executive Functioning Apps: Explore the use of mobile applications and technology to support executive functioning skills in individuals with autism.
Autism and Employment Training Programs: Discuss vocational training and employment programs available for individuals with autism.
Autism and Gender Identity: Investigate the experiences of individuals with autism who identify as transgender or nonbinary and the unique challenges they face.
Autism and Mental Health Services: Explore the availability and accessibility of mental health services for individuals with autism.
Autism and Bullying Prevention Programs: Discuss the effectiveness of bullying prevention programs in schools and communities for individuals with autism.
Autism and Epilepsy: Investigate the relationship between autism and epilepsy, including prevalence rates and shared risk factors.
Autism and Access to Healthcare: Explore the barriers and challenges individuals with autism face in accessing healthcare services and the importance of healthcare providers being autism-informed.
Autism and Post-Secondary Education: Discuss the resources and support services available for individuals with autism pursuing post-secondary education.
Autism and Sleep Training Programs: Investigate evidence-based sleep training programs specifically designed for individuals with autism.
Autism and Mental Health Disparities: Explore the disparities in mental health services and outcomes for individuals with autism from diverse cultural and ethnic backgrounds.
Autism and Transition to Work: Discuss the importance of supported employment programs and job coaching for individuals with autism transitioning into the workforce.
Autism and Social Skills Groups: Explore the benefits of social skills groups in promoting social competence and peer relationships for individuals with autism.
Autism and Physical Therapy: Discuss the role of physical therapy in addressing motor coordination difficulties and promoting physical well-being for individuals with autism.
Autism and Mindfulness Interventions: Investigate the effectiveness of mindfulness-based interventions in reducing anxiety and improving emotional regulation in individuals with autism.
Autism and Sleep Hygiene Interventions: Explore evidence-based interventions to improve sleep hygiene and establish healthy sleep routines for individuals with autism.
Autism and Mental Health Policy: Discuss the impact of mental health policies on the availability and quality of services for individuals with autism.
Autism and Transition to Retirement: Investigate the unique challenges faced by individuals with autism

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The Argument Over a Long-Standing Autism Intervention

Illustration of three children encapsulated by three volumetric shapes.

When Tiffany Hammond was growing up in Texas, in the nineteen-nineties, other children teased her for how she spoke: she talked too softly, she talked in a monotone, she paused too long between words, she didn’t talk enough, she talked to herself. “Something’s wrong with her head,” kids would say. She was always fidgeting with pens or Troll dolls. She tried to connect with her peers by taking on their interests as her own—the Goosebumps series of scary novels, the N.B.A.—but the attempts backfired, as when she printed out an N.B.A. schedule, laminated and color-coded it, and brought it to school as a conversation piece. She kept a notebook on “how to be human,” which included tips such as remembering to staple your worksheets at the top-left corner and acquiring a pair of the correct Filas. Nothing worked. “I wondered why I didn’t have friends, or if I even deserved friends,” Hammond said. She dreaded school so much that, on a few mornings, when she was supposed to be walking there, she instead tried to make it to her great-grandparents’ house, some twenty-five miles away.

When Hammond was twelve, she took an overdose of Tylenol. She told me that she’s not sure if she intended to attempt suicide; she just wanted the noise and negativity in her head to stop. Her mother brought her to doctors who gave Hammond a prescription for Paxil and a diagnosis of Asperger’s syndrome, which, at the time, was recognized as an autism-related disorder that affects communication and social-emotional skills. She began going to a clinic for therapy twice a week, and continued for two years. “It was, ‘You have to sit right in the chair, you can’t cross your legs this way, you have to enunciate, no fidgeting,’ ” Hammond said. She might be asked to practice speaking clearly by reading the same paragraph from “Charlotte’s Web” out loud, over and over, and then do it again the next session. The work was tedious and difficult. “As a kid, you think, Why am I like this? Why can’t I get it?” Hammond said. “And then you have those times when you’re, like, Why can’t they just let me sit the way I want to sit?”

It was not until she was in her late twenties that Hammond, an autistic advocate who is the author of the best-selling picture book “ A Day with No Words ,” realized that her childhood therapist was practicing something called Applied Behavior Analysis. A.B.A. therapy aims to build skills and habits that many autistic people do not have by breaking tasks down into small steps and reinforcing desired behaviors through repetition and rewards, which, with little kids, could take the form of candy or extra time with a favorite toy. Hammond had aged out of such incentives by the time she was enrolled in A.B.A., but earning praise from her therapists was reinforcement enough. “I wanted to please these adults. I wanted people to feel good being around me,” she said.

A.B.A. is the only autism intervention that is approved by insurers and Medicaid in all fifty states. The practice is widely recommended for autistic kids who exhibit dangerous behaviors, such as self-injury or aggression toward others, or who need to acquire basic skills, such as dressing themselves or going to the bathroom. The mother of a boy with severe autism in New York City told me that her son’s current goals in A.B.A. include tolerating the shower for incrementally longer intervals, redirecting the urge to pull on other people’s hair, and using a speech tablet to say no. Another kid might be working on more complex language skills by drilling with flash cards or honing his ability to focus on academic work. Often, A.B.A. targets autistic traits that may be socially stigmatizing but are harmless unto themselves, such as fidgeting, avoiding eye contact, or stereotypic behaviors commonly known as stimming—rocking, hand-flapping, and so forth.

Hammond is now the mother of two autistic sons. Her older son, Aidan, who is sixteen, is nonverbal and needs round-the-clock care. When he was young, he attended a traditional school, but teachers, Hammond said, “were literally calling me every single day: ‘Can you please come here and sit with him? Can you please pick him up?’ ” Hammond tried physical, occupational, and speech-language therapy for Aidan, but he was “kicked out of every single one,” she said. Therapists “felt that his behaviors were interfering with his learning, and that he needed to be in A.B.A.” A.B.A. clinicians, she added, “were at least willing to look at my son.”

She drove him to A.B.A. appointments at a clinic about an hour from their home in southwest Texas, but stopped treatment after just a few sessions. This was partly due to the commute and the co-pay, but also to a discomfort with the approach, which required Aidan to spend long periods, over multiple sessions, solving a puzzle in which he matched shapes to the right-sized holes. “He’s having to do this over and over and over again,” Hammond recalled, “and, when he picked the right thing, it’s, like, Ooh, here’s a Skittle! Like he’s a puppy.”

In recent years, A.B.A. has come under increasingly vehement criticism from members of the neurodiversity movement, who believe that it cruelly pathologizes autistic behavior. They say that its rewards for compliance are dehumanizing; some compare A.B.A. to conversion therapy. Social-media posts condemning the practice often carry the hashtag #ABAIsAbuse. The message that A.B.A. sends is that “your instinctual way of being is incorrect,” Zoe Gross, the director of advocacy at the nonprofit Autistic Self Advocacy Network, told me. “The goals of A.B.A. therapy—from its inception, but still through today—tend to focus on teaching autistic people to behave like non-autistic people.” But others say this criticism obscures the good work that A.B.A. can do. Alicia Allgood, a board-certified behavior analyst who co-runs an A.B.A. agency in New York City, and who is herself autistic, told me, “The autistic community is up in arms. There is a very vocal part of the autistic population that is saying that A.B.A. is harmful or aversive or has potentially caused trauma.”

Until recently, the American Medical Association officially endorsed “evidence-based treatment of Autism Spectrum Disorder including, but not limited to, Applied Behavior Analysis Therapy.” Last summer, the medical students’ body of the association proposed that the organization withdraw its support for A.B.A., citing objections by autistic self-advocates. The association did not adopt the resolution as submitted, but its house of delegates eventually approved an amendment removing any explicit reference to A.B.A., and autistic activists spread the word that A.B.A. no longer appeared to have the outright endorsement of the nation’s largest medical society.

Alison Singer, who is the president and co-founder of the Autism Science Foundation, believes that criticism of A.B.A. has gone too far. She told me that her daughter, Jodie, now in her twenties, acquired essential language skills in A.B.A., such as naming the parts of her body. “If she had a toothache, she could say, ‘Tooth hurts,’ rather than screaming or tantruming, with me having no idea that she needed to go to the dentist,” Singer said. Jodie used to have hours-long meltdowns during transitions. “A lot of kids with autism are not able to wait their turn,” Singer told me. “In A.B.A., she learned, over time, that first we will do this, and then we will do this”—for example, first, we’ll practice some new words, and then we can have some free time on the iPad. The intervals between “first” and “then” might begin at just ten seconds, then build up to thirty seconds, then one minute, and so on.

A generation ago, Singer said, “everyone who was diagnosed with autism got A.B.A. That type of one-size-fits-all treatment never really made sense for a child who had intact language or a high I.Q.” Now those children have grown up. “They’re talking about A.B.A. and how negative it was for them. But that doesn’t mean that we should eliminate it for the people who need it.” Singer’s position is, in part, a pragmatic one, but the debate over A.B.A. goes beyond practicalities. It is not simply a matter of whether a particular treatment works but what it means to be autistic, and what all autistic people do, or do not, have in common.

The origins of A.B.A. are undeniably disturbing. The person most closely associated with A.B.A.’s genesis is O. Ivar Lovaas, a clinical psychologist at U.C.L.A. who worked with severely autistic children. Beginning in the nineteen-sixties, Lovaas sometimes used “aversives”—shouting, slaps, and even electric shocks—to punish tantrums, stimming, and inattention in his child subjects. (Today, the Judge Rotenberg Center, in central Massachusetts, is believed to be the last institution in the U.S. that still administers electric shocks as part of A.B.A. therapy.) Some of the children in Lovaas’s care were not served regular meals, only receiving spoonfuls of food, such as sherbet, as rewards for complying with commands. And Lovaas openly shared appalling views of the autistic children he treated, once telling an interviewer that “they are not people in the psychological sense.”

In 1987, Lovaas authored a seminal study of sixty autistic children. In it, nearly half of the kids who were treated with an A.B.A. technique known as discrete trial training became, in Lovaas’s words, “indistinguishable from their normal friends.” “We would argue that that’s not a good goal in the first place,” Zoe Gross noted, dryly, “but, even for what it purports to do, which is to reduce the quote-unquote symptoms of autism, A.B.A. has not been rigorously proven to be good at that.” There is ample research, collected over decades, supporting the efficacy of A.B.A., but much of it is based on small studies and what are known as single-subject designs, in which subjects effectively serve as their own control group. Weighing the data also becomes more complex owing to the proliferation of A.B.A. subgenres, which tend to be more play-based and less repetitive than old-school A.B.A.

An idiosyncrasy of A.B.A. is that, often, the highly credentialled analyst is not the person directly providing service to the client; rather, the analyst supervises groups of lower-skilled behavior technicians. “The logic was that anybody could do A.B.A., and it can be cheap, because these are basic principles of behavior that you can use with a rat,” Catherine Lord, a professor at U.C.L.A. who studied under Lovaas as an undergraduate, told me. (“It’s not true,” she added.)

In recent years, private equity has taken a voracious interest in A.B.A. services, partly because they are perceived as inexpensive. Private-equity firms have consolidated many small clinics into larger chains, where providers are often saddled with unrealistic billing quotas and cut-and-paste treatment plans. Last year, the Center for Economic and Policy Research published a startling report on the subject, which included an account of how Blackstone effectively bankrupted a successful A.B.A. provider and shut down more than a hundred of its treatment sites. Private-equity-owned A.B.A. chains have been accused of fraudulent billing and wage theft; message boards for A.B.A. providers overflow with horror stories about low pay, churn, and burnout. High rates of turnover are acutely damaging to a specialty that relies on familiarity between provider and client. “The idea that we could just franchise A.B.A. providers and anyone could do the work—that was misinformed,” Singer, of the Autism Science Foundation, said.

Some autistic people are trying to change the field from within. Armando Bernal, who is autistic and runs an independent A.B.A. clinic outside Houston, doesn’t work on helping clients make eye contact—in fact, he tends to avoid it himself. He also flaps his hands when he gets excited. (If a parent is concerned about their own child’s stimming, Bernal tries to put them at ease by telling them that his hand-flapping is how his fiancée knows that she’s got him the perfect Christmas or birthday gift.) He’ll work on stereotypic behaviors only if he’s convinced that they’re disruptive—for example, if a child is stimming in certain school settings. “I don’t agree that it forces people to be less autistic to focus on these behaviors,” he said. “It allows these children to be successful and independent while being able to manage themselves in a space with neurotypical individuals.”

Allgood, another autistic A.B.A. provider, spent the early months of the pandemic speaking with people who oppose A.B.A., then hired autistic self-advocates to tutor her staff. Her clinic does not use food rewards, partly owing to concerns that they can contribute to eating disorders. “Eye contact, I really don’t care,” she told me. “I have met so many doctors who don’t look at me.” Her agency has also moved away from a technique known as extinction, in which unwanted behaviors are simply ignored; the hypothesis is that if, for example, a child’s meltdowns are denied the oxygen of attention, they will cease to exist. But, Allgood said, “I’ve come to learn how damaging extinction can be,” because it doesn’t address challenges native to autism—such as sensory triggers or underlying executive-function issues—that may be causing the meltdowns in the first place. “It is the last moment that we should be turning our backs on you,” she said.

“Autistic people are not the sum of their behaviors,” Paige Layle, a neurodiversity activist in Ontario, told me. “If you change the behavior, the autistic person still has all those same feelings and all the same reactions.” Layle has nearly three million followers on TikTok and is the author of the forthcoming memoir “ But Everyone Feels This Way .” After she was diagnosed with autism, at the age of fifteen, Layle underwent A.B.A. therapy that focussed on socializing: how to read social cues, how to avoid making blunt or hurtful comments, and so forth. “I was like, I’m sorry that I offend people so much, and I would love people to like me, but that’s not my main problem—like, I want to like me,” Layle, who is now twenty-three, said. “I want to learn how I can emotionally regulate myself so I don’t get angry, so I’m not having panic attacks, so life isn’t so hard.” Sometimes her therapist, noticing that she was becoming frustrated, would suggest a short break, and walk away. The message, Layle said, was “that when I’m upset, people will go away, and I have to be happy for people to pay attention to me.”

Layle expressed support for autistic therapists who are working to reform A.B.A., but other self-advocates are more dubious. “The people who claim that they’re neurodiversity-affirming, I think you’re going to find that those people are not doing A.B.A., but labelling it that for insurance purposes,” Gross, of the Autistic Self Advocacy Network, said. This work-around, she went on, may at times seem “like a parent’s best option. Technically, it’s also insurance fraud. It’s not a policy solution.”

A.B.A.’s strongest detractors and supporters often seem to be describing two completely different phenomena. The autistic self-advocates describe a coercive practice that forces kids to smother who they are for the comfort of those around them. The parents of kids with high support needs describe a life-altering intervention that has taught their child how to put on her shoes, or how to communicate a need or desire in ways that don’t involve banging her head against a wall or hours of screaming.

This schism is a microcosm of a larger, equally contentious debate over how to define autism itself. In 2013, the DSM-V retired several autism-related diagnoses, including Asperger’s syndrome, and created a new, single category: autism-spectrum disorder. “When the DSM-V lumped everyone together, it did a disservice,” Singer said. She advocates for the DSM-VI , whenever it may arrive, to break off a new diagnosis from the spectrum, called profound autism, to describe a person who requires constant supervision and has limited cognitive and verbal ability. “The umbrella term ‘autism-spectrum disorder’ provides absolutely no information about a person’s functional level or their needs,” she said.

A new category is also necessary, Singer told me, because some neurodiversity advocates “intentionally advocate against recognizing the suffering and acute needs wrought by profound autism.” She went on, “The truth is that, for some people, autism may be a gift, while the simultaneous truth is that for other people autism symptoms are a tremendous burden, a lifelong disorder, for which society should seek understanding, prevention, and medical intervention.”

The Autistic Self Advocacy Network and other like-minded organizations largely reject the concept of profound autism. “It’s an attempt to make autism into these two monolithic categories, whereas autism is one heterogeneous spectrum,” Gross said. She is concerned that an official designation of profound autism might be used by health insurers and social-service agencies as a pretext to limit services to those who lack the diagnosis, and that it risks segregating certain autistic people from their communities. “We think that it’s important that everyone has access to community living and to integrated education, and to be supported to have a job in the community if that’s what they want,” Gross said.

This line of thinking seems to take for granted that all autistic people can successfully communicate what they want. Tiffany Hammond has come to question whether it genuinely accounts for the challenges that many autistic people face. “There are really loud voices in the community that almost make autism seem like it’s a personality quirk, and that society is the only thing that disables us,” she told me. “They’re not leaving space for my son’s experience.” Although Hammond ultimately pulled Aidan from A.B.A. therapy, she believes that some strains of the anti-A.B.A. movement have become divorced from reality. “Advocates say, ‘There’s better ways than A.B.A.,’ and I’m, like, ‘Where are the better ways?’ They don’t know the systems that we have to navigate. They just kind of talk .” Hammond now homeschools her sons; she knows many single and working parents who don’t have that option. “But they can enroll their child in an all-day A.B.A. center that is more than willing to accept their child, even if it’s not perfect,” she said. “I hate that that would be the only option. But, if they’re not in that, they’re in nothing.” She has heard from parents who have sustained multiple concussions owing to their autistic children’s behavior. “They don’t know where to turn for help.”

Hammond and her sons are Black, and she likened some of A.B.A.’s lessons to the masking and code-switching that Black people have to do all the time. “You learn to be different people, because you have to get a job and put a roof over your head, and all you have to do is be a muted version of yourself for x hours a day.” A.B.A. may emphasize conformity and compliance, but, then again, Hammond said, “we live in a compliance-based society.”

For Hammond’s family, the question of compliance might have terrifyingly high stakes. More than once, she said, when she is with Aidan in public, people have called the police or security. “My kid does not know how to mask, he doesn’t know how to rein it in, he’s loud, he’s animated, he’s all over the place, and he doesn’t speak. When the cops come, he might be running in circles, he might be reaching for his iPad, and they’re reaching for their firearms. Are you going to try to change the cops, or are you going to try to change my son?” She added, “A.B.A. is just a symptom. It’s a leaf of a tree with rotted roots.” ♦

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Autism Spectrum Disorder (ASD) Essay

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Introduction

Biological and genetic aspects of autism spectrum disorders, asd etiology, prevalence of asd, diagnosis of asd, treatment of asd.

Autism is a serious disorder that has the potential to disrupt the success of people living with it. This report shall set out to explore various aspects regarding this disorder. To this end, an overview of the symptoms, causes, diagnosis and treatment shall be offered. This shall aim at expanding our understanding regarding this disorder so as to enable us to be better prepared to handle it whenever the need arises.

Autism has been noted to be among the most prevalent childhood psychiatric disorder. Kuder (2003) denotes that in the USA, an estimated 2.1% of the population aged between 8 and 17 is affected by autism in its various forms.

Autism is manifested by varied behavior but it is chiefly characterized by inability to communicate, lingual deficits, lack of a sustained attention, low level of activity, temper tantrums, sleep disturbance, aggression inadequate motor control and other non-compliant behavior. These behaviors are detrimental to the social and educational endeavors of the people involved.

Autism spectrum is a medical term that is used to describe children and adults who experience difficulties in motor coordination, socializing, communicating (verbal and non-verbal) and language acquisition (Tager-Flusberg, Paul and Lord, 2005). The authors describe autism as a neurological disorder that stems from the brain’s inability to carryout some functions normally.

The causes of Autism as well as the reasons why it affects lingual and communication skills are not entirely known though there is a close linkage between Autism and genetics.

Studies indicate that Autism Spectrum Disorder (ASD) is inherited between family members. A study conducted by the American Psychiatric Association (2000) indicated that there is a 3-6% chance of getting autism amongst siblings.

However, Korvatska et al (2002) state that the difficulty experienced by scientists in pinpointing the genetic aspects of autism emanates from the lack of extended family histories. In most cases, autistic individual become more detached socially that they rarely marry or have children. As such, finding a family that has detailed genetic information regarding autism is difficult.

On a brighter note, twins have been used to explore the genetics behind autism (Beaudet, 2007). One study indicated an 82% likelihood of an autistic identical twin having the same disorder. This is in contrast to the 10% likelihood indicated by results from fraternal twins. More sophisticated studies have in the recent past concluded that 90% of autism related behavioral phenotypes are as a result of inherited genes (Happé & Ronald, 2008). This shows that there is a strong relationship between autism and genes.

Biologically, the root cause of autism has been difficult due to relative inability to access and study the brain systematically. However, technological innovations and advancements such as MRIs, CT scans and SPECT have made it possible to study the structure and functionality of the brain.

As a result, specialists have been able to deduce that majority of the brain’s structures play a pivotal role in the development of ASD. According to NIMH (2009, p. 1) they include but are not limited to “the cerebellum, cerebral cortex, limbic system, corpus callosum, basal ganglia, and brain stem”.

Similarly, other studies indicate that various neurotransmitters such as serotonin and epinephrine have a strong link to autism. The diagram below shows the biological basis of Autism Spectrum Disorder. It shows various structures of the brain and explains the functions that each play. Various symptoms of ASD are as a result of the structures’ inability to carry out their normal function.

A diagram showing brain structures linked to ASD

As mentioned earlier, the causes of ASD are not well known. However, researches conducted in this regard indicate that genetic, nutritional and environmental factors play a pivotal role in the development of the disorders. Results from numerous studies indicate that genetic factors predominate.

Others indicate that certain foods, infectious diseases, plastic and metallic extracts could cause autism. Similarly, smoking, alcohol, illicit drugs and some (mercury-based) childhood vaccines have also been attributed to causing autism. However, none of these causes are conclusive and more research needs to be conducted. This is to mean that the theory of causation regarding autism is not complete as yet.

The most recent survey conducted by center of disease control (CDC) indicated that autism rates have increased significantly over the past three decades. In most cases, studies indicate that autism is most prevalent among children. According to Rutter (2005), boys are four times more likely to be autistic than their female counterparts.

In addition, the author states that the symptoms of autism exhibit themselves from childbirth until three years of age. Parents are the most likely to discover these symptoms. As a result, they should ensure that they have their children checked at the onset of various abnormal behaviors.

Rutter (2005) asserts that the prevalence of autism disorder has been facilitated by ignorance and assumptions made by caretakers. In some cases, parents assume that their children are ‘slow and that they will develop as they grow up. However, this approach has proven to be costly since autism can best be handled as soon as it is detected.

Delaying makes it difficult to come up with remedies and coping mechanisms for both parents and the individuals having autism disorders. The main symptoms of this disorder include communication (verbal and non-verbal) difficulties, inability to develop and maintain relations with other people, abnormal lingual patterns and repetitive behaviors. Whenever any of these symptoms are discovered, it is highly recommended that medical or psychiatric assistance be sought.

An early diagnosis of ASD is important since it enables the people involved to come up with effective interventions before its too late. Recent studies show that intensive interventions administered in a control environment for a minimum of two years during preschool leads to behavioral and social improvements among children with ASD.

Clinicians base their diagnosis depending on the behavioral traits exhibited by a child. For a diagnosis to be made, NIMH (2009) asserts that at least one of the symptoms associated with ASD must be present. This means that a patient must have abnormal patterns of communication, socialization and restrictive behaviors.

In most cases, the diagnosis is made through a two-stage process. The first stage is “a developmental screening normally conducted during the routine childhood check-ups, while the second one involves a more comprehensive behavioral analysis by a team of experts (NIMH, 2009, p. 1).” Below are the stages that are followed to diagnose ASD.

The American Psychiatric Association (2000) recommends that every parent should ensure that a developmental screening test is carried out for his/her child during the “well child” check-up. The author contends that screening plays a pivotal role in the early identification of ASD symptoms.

Due to its importance, there are various screening instruments that have been developed to facilitate the diagnosis process. They include but are not limited to Checklist of Autism in Toddlers (CHAT) and its modified version; M-CHAT. Similarly, the Screening Tool for Autism in Two-Year-Olds (STAT) as well as the Social Communication Questionnaire (SCQ) have proven to be effective in diagnosing ASD in children aged between two years old and above four years old respectively.

According to Tadevosyan-Leyfer et al (2003), questionnaires given to parents provide important information during the diagnosis process. As such, some instruments rely on such responses while others depend on these responses as well as observations made by the caregiver. However, these screening instruments are not as effective as they should be when it comes to identifying mild ASD or Asperger syndrome. As a result, other screening instruments such as the Autism Spectrum Screening Questionnaire (ASSQ) and the Childhood Asperger Syndrome Test (CAST) among others have been developed so as to diagnose these forms of ASD (NIMH, 2009).

Comprehensive Diagnostic Evaluation

This is the second stage of diagnosis and it relies on the skills of a team of different experts such as psychologists, psychiatrists, neurologists, and therapists among others. This evaluation entails a comprehensive analysis of neural, genetic, cognitive and language testing in order to conclude whether a patient is suffering from autism or other behavioral disorders.

Some of the instruments used at this stage include: Autism Diagnosis Interview-Revised (ADI-R), which is a structured interview designed to test a child’s “communication, social interaction, restrictive behaviors and age-of-onset symptoms, and the Autism Diagnosis Observation Scheduling (ADOS-G), which is designed to identify abnormal, missing or delayed communication and social behaviors (NIMH, 2009, p. 1).”

The teams of experts that conduct this diagnosis determine the strengths and weaknesses of the child and recommend various treatment options that should be undertaken.

According to Freitag (2007) there is no one-shoe-fits-all approach to treating ASD. However, specialists in this area seem to agree on the fact that early interventions are of great importance. Arguably, the best treatment is one that considers the interests of the patient, allows the patient to learn in accordance to his/her ability and causes no harm to the overall well being of the patient. With this in mind, there are specialized programs and treatments that have proven to be effective against ASD symptoms.

For starters, Applied Behavioral Analysis (ABA) is among the most used intervention in treating ASD (SAMHSA, 2011). Similarly, there are dietary and medical interventions that help suppress unwanted behaviors among autistic children (NIMH, 2009). In regard to learning, there are specialized educational programs that seek to enhance the socio-communicative, cognitive and language skills of autistic students.

It can be articulated from this report that Autism is a problem that needs to be focused on. With proper understanding as to what the condition entails, parents and practitioners are better armed to assist patients overcome the weaknesses brought about by the condition and therefore achieve successful lives.

From this study, it can be authoritatively stated that early diagnosis and treatment of Autism spectrum is necessary to increase the chances of success in learning for the child suffering from this disease. Whereas Autism is not curable, it can be managed so as to ensure that it is not disruptive to the life of the individual during his/her future endeavors.

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders: DSM-IV-TR (fourth edition, text revision). Washington DC: American Psychiatric Association.

Beaudet, A. L. (2007). Autism: highly heritable but not inherited. Nat Med, 13(5): 534–6.

Freitag, C. M. (2007). The genetics of autistic disorders and its clinical relevance: a review of the literature. Mol Psychiatry. 12(1): 2–22.

Happé, F., & Ronald, A. (2008). The ‘fractionable autism triad’: a review of evidence from behavioral, genetic, cognitive and neural research. Neuropsychol Rev, 18(4): 287–304.

Korvatska, E et al. (2002). Genetic and immunologic considerations in autism. Neurobiology of Disease , 9: 107-125.

Kuder, S. (2003). Teaching Students with Language and Communication Disabilities. USA: Allyn and Bacon.

NIMH. (2009) Autism Spectrum Disorders (Pervasive Developmental Disorders) . Web.

Rutter, M. (2005). Incidence of autism spectrum disorders: changes over time and their meaning. Acta Paediatr. 94(1): 2–15.

SAMHSA. (2011). Autism Spectrum Disorders . Web.

Tadevosyan-Leyfer, O et al. (2003). A principal components analysis of the autism diagnostic interview-revised. Journal of the American Academy of Child and Adolescent Psychiatry, 42(7): 864-872.

Tager-Flusberg, H., & Lord, C. (2005). Language and Communication in Autism. Web.

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Autism - List of Essay Samples And Topic Ideas

Autism, or Autism Spectrum Disorder (ASD), refers to a broad range of conditions characterized by challenges with social skills, repetitive behaviors, speech, and nonverbal communication. Essays could explore the causes, symptoms, and treatment of autism, the experiences of individuals with autism, and societal understanding and acceptance of autism. We’ve gathered an extensive assortment of free essay samples on the topic of Autism you can find at Papersowl. You can use our samples for inspiration to write your own essay, research paper, or just to explore a new topic for yourself.

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I. Introduction An anonymous speaker once said, “some people with Autism may not be able to speak or answer to their name, but they can still hear your words and feel your kindness.” Approximately thirty percent of people diagnosed with Autism Spectrum Disorder never learn to speak more than a few words (Forman & Rudy, 2018). Fortunately in today’s society, new technologies have made it possible for these individuals to communicate and socialize with others. Purpose The primary focus of […]

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Over the last 20 years, there has been an alarming increase for children who have been diagnosed with Autism Spectrum Disorder (ASD) in the United States. According to the Centers for Disease Control, in the year 2000 1 in 159 children would be diagnosed with ASD. In the latest version of the study, the number has been reduced to 1 in 59 children will be diagnosed with ASD (Centers for Disease Control and Prevention, 2018). This is a subject that […]

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How To Write an Essay About Autism

Understanding autism.

Before writing an essay about autism, it's essential to understand what autism is and the spectrum of conditions it encompasses. Autism, or Autism Spectrum Disorder (ASD), is a complex developmental disorder that affects communication and behavior. It is characterized by challenges with social skills, repetitive behaviors, speech, and nonverbal communication. Start your essay by explaining the nature of autism, its symptoms, and the spectrum concept, which acknowledges a range of strengths and challenges experienced by individuals with autism. It's also important to discuss the causes and diagnosis of autism, as well as the common misconceptions and stereotypes surrounding it. This foundational knowledge will set the stage for a more in-depth exploration of the topic.

Developing a Focused Thesis Statement

A strong essay on autism should be centered around a clear, focused thesis statement. This statement should present a specific angle or argument about autism. For example, you might discuss the importance of early intervention and therapy, the representation of autism in media, or the challenges faced by individuals with autism in education and employment. Your thesis will guide the direction of your essay and ensure that your analysis is structured and coherent.

Gathering and Analyzing Data

To support your thesis, gather relevant data and research from credible sources. This might include scientific studies, statistics, reports from autism advocacy organizations, and personal narratives. Analyze this data critically, considering different perspectives and the quality of the evidence. Including a range of viewpoints will strengthen your argument and demonstrate a comprehensive understanding of the topic.

Discussing Implications and Interventions

A significant portion of your essay should be dedicated to discussing the broader implications of autism and potential interventions. This can include the impact of autism on individuals and families, educational strategies, therapeutic approaches, and social support systems. Evaluate the effectiveness of these interventions, drawing on case studies or research findings. Discussing both the successes and challenges in managing and understanding autism will provide a balanced view and demonstrate a comprehensive understanding of the topic.

Concluding the Essay

Conclude your essay by summarizing the key points of your discussion and restating your thesis in light of the evidence and examples provided. Your conclusion should tie together your analysis and emphasize the significance of understanding and supporting individuals with autism. You might also want to highlight areas where further research or development is needed or the potential for societal changes to improve the lives of those with autism.

Final Review and Editing

After completing your essay, it's important to review and edit your work. Ensure that your arguments are clearly articulated and supported by evidence. Check for grammatical accuracy and ensure that your essay flows logically from one point to the next. Consider seeking feedback from peers or experts in the field to refine your essay further. A well-crafted essay on autism will not only inform but also engage readers in considering the complexities of this condition and the collective efforts required to support those affected by it.

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Transl Pediatr
v.9(Suppl 1); 2020 Feb

Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation

Holly hodges.

1 Department of Pediatrics, Baylor College of Medicine and Meyer Center for Developmental Pediatrics, Texas Children’s Hospital, Houston, TX, USA;

Casey Fealko

2 Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI, USA;

Neelkamal Soares

3 Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI, USA

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social communication and the presence of restricted interests and repetitive behaviors. There have been recent concerns about increased prevalence, and this article seeks to elaborate on factors that may influence prevalence rates, including recent changes to the diagnostic criteria. The authors review evidence that ASD is a neurobiological disorder influenced by both genetic and environmental factors affecting the developing brain, and enumerate factors that correlate with ASD risk. Finally, the article describes how clinical evaluation begins with developmental screening, followed by referral for a definitive diagnosis, and provides guidance on screening for comorbid conditions.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social communication and the presence of restricted interests and repetitive behaviors ( 1 ). In 2013, the Diagnostic and Statistical Manual of Mental Disorders —5 th edition (DSM-5) was published, updating the diagnostic criteria for ASD from the previous 4 th edition (DSM-IV) ( Table 1 ) ( 1 , 2 ).

Changes	DSM-IV	DSM-5
Location in manual	Disorders usually first diagnosed in infancy, childhood, or adolescence	Neurodevelopmental disorder
Sub-criteria	3 sub-criteria	2 sub-criteria
	Qualitative impairment in social interaction	Persistent deficits in social communication and social interaction across multiple contexts
	Qualitative impairments in communication	Restricted, repetitive patterns of behavior, interests, or activities
	Restricted repetitive and stereotyped patterns of behavior, interests, and activities
Needed to diagnose	Triad: 3/3 diagnostic criteria must be met	Dyad: 2/2 diagnostic criteria must be met
Diagnostic criteria	Qualitative impairment in social interaction, manifested by at least 2 of the following:	Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following:
	Marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction	Deficits in social-emotional reciprocity, (including abnormal social approach and failure of reciprocal conversation, reduced sharing of interests, emotions, or affect, failure to initiate or respond to social interactions)
	Failure to develop peer relationships appropriate to developmental level	Deficits in nonverbal communicative behaviors used for social interaction (poorly integrated verbal and nonverbal communication, eye contact and gesture/body language abnormalities
	A lack of spontaneous seeking to share enjoyment, interests, or achievements with other people	Deficits in developing, maintaining, and understand relationships (including adjusting behavior in various social contexts, difficulties in sharing imaginative play or in making friends, or lack of interest in peers)
	Lack of social or emotional reciprocity	Restricted, repetitive patterns of behavior, interests, or activities, manifested by at least two of the following:
	Qualitative impairments in communication as manifested by at least one of the following:	Stereotyped or repetitive motor movements, use of objects, or speech
	Delay in or total lack of, the development of spoken language	Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior
	In individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others	Highly restricted, fixated interests that are abnormal in intensity or focus
	Stereotyped and repetitive use of language or idiosyncratic language	Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment
	Lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level
	Restricted repetitive and stereotyped patterns of behavior, interests, and activities, manifested by at least one of the following:
	Encompassing preoccupation with one or more stereotyped 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
	Persistent preoccupation with parts of object
Age of development	Onset prior to age 3 years	Symptoms must be present in early developmental period but may not manifest until social demands exceed limited capacities or may be masked by learned strategies
Not better explained by	Rett’s disorder or childhood disintegrative disorder	SPCD
Sensory symptoms	Not addressed	Sensory symptoms are a new criterion introduced in DSM-5 under the sub-criteria of restricted, repetitive patterns of behavior, interests, or actviities

ASD, autism spectrum disorder; SPCD, social (pragmatic) communication disorder.

In DSM-5, the concept of a “spectrum” ASD diagnosis was created, combining the DSM-IV’s separate pervasive developmental disorder (PDD) diagnoses: autistic disorder, Asperger’s disorder, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified (PDD-NOS), into one. Rett syndrome is no longer included under ASD in DSM-5 as it is considered a discrete neurological disorder. A separate social (pragmatic) communication disorder (SPCD) was established for those with disabilities in social communication, but lacking repetitive, restricted behaviors. Additionally, severity level descriptors were added to help categorize the level of support needed by an individual with ASD.

This new definition is intended to be more accurate and works toward diagnosing ASD at an earlier age ( 3 ). However, studies estimating the potential impact of moving from the DSM-IV to the DSM-5 have predicted a decrease in ASD prevalence ( 4 , 5 ) and there has been concern that children with a previous PDD-NOS diagnosis would not meet criteria for ASD diagnosis ( 5 - 7 ). There are varying reports estimating the extent of and effects of this change. One study found that with parental report of ASD symptoms alone, the DSM-5 criteria identified 91% of children with clinical DSM-IV PDD diagnoses ( 8 ). However, a systematic review suggests only 50% to 75% of individuals maintain diagnoses ( 9 ) and other studies have also suggested a decreased rate of diagnosis of individuals with ASD under the DSM-5 criteria ( 10 ). Often those who did not meet the requirements were previously classified as high functioning Asperger’s syndrome and PDD-NOS ( 11 , 12 ). Overall, most studies suggest that the DSM-5 provides increased specificity and decreased sensitivity compared to the DSM-IV ( 5 , 13 ); so while those diagnosed with ASD are more likely to have the condition, there is a higher number of children whose ASD diagnosis is missed, particularly older children, adolescents, adults, or those with a former diagnosis of Asperger’s disorder or PDD-NOS ( 14 ). Nevertheless, the number of people who would be diagnosed under the DSM-IV, but not under the new DSM-5 appears to be declining over time, likely due to increased awareness and better documentation of behaviors ( 4 ).

It has yet to be determined how the new diagnosis of SPCD will impact the prevalence of ASD. One study found the new SPCD diagnosis encompasses those individuals who possess subthreshold autistic traits and do not qualify for a diagnosis of ASD, but who still have substantial needs ( 15 ). Furthermore, children who previously met criteria for PDD-NOS under the DSM-IV might now be diagnosed with SPCD.

Epidemiology

The World Health Organization (WHO) estimates the international prevalence of ASD at 0.76%; however, this only accounts for approximately 16% of the global child population ( 16 ). The Centers for Disease Control and Prevention (CDC) estimates about 1.68% of United States (US) children aged 8 years (or 1 in 59 children) are diagnosed with ASD ( 6 , 17 ). In the US, parent-reported ASD diagnoses in 2016 averaged slightly higher at 2.5% ( 18 ). The prevalence of ASD in the US more than doubled between 2000–2002 and 2010–2012 according to Autism and Developmental Disabilities Monitoring Network (ADDM) estimates ( 6 ). Although it may be too early to comment on trends, in the US, the prevalence of ASD has appeared to stabilize with no statistically significant increase from 2014 to 2016 ( 19 ). Changing diagnostic criteria may impact prevalence and the full impact of the DSM-5 diagnostic criteria has yet to be seen ( 17 ).

Insurance mandates requiring commercial plans to cover services for ASD along with improved awareness have likely contributed to the increase in ASD prevalence estimates as well as the increased diagnosis of milder cases of ASD in the US ( 6 , 20 , 21 ). While there was only a modest increase in prevalence immediately after the mandates, there have been additional increases later as health care professionals better understood the regulatory and reimbursement process. The increase in prevalence may also be due to changes in reporting practices. One study in Denmark found the majority of increase in ASD prevalence from 1980–1991 was based on changes of diagnostic criteria and inclusion of outpatient data, rather than a true increase in ASD prevalence ( 21 ).

ASD occurs in all racial, ethnic, and socioeconomic groups, but its diagnosis is far from uniform across these groups. Caucasian children are consistently identified with ASD more often than black or Hispanic children ( 6 ). While the differences appear to be decreasing, the continued discrepancy may be due to stigma, lack of access to healthcare services, and a patient’s primary language being one other than English.

ASD is more common in males ( 22 , 23 ) but in a recent meta-analysis ( 24 ), true male-to-female ratio is closer to 3:1 than the previously reported 4:1, though this study was not done using the DSM-5 criteria. This study also suggested that girls who meet criteria for ASD are at higher risk of not receiving a clinical diagnosis. The female autism phenotype may play a role in girls being misdiagnosed, diagnosed later, or overlooked. Not only are females less likely to present with overt symptoms, they are more likely to mask their social deficits through a process called “camouflaging”, further hindering a timely diagnosis ( 25 ). Likewise, gender biases and stereotypes of ASD as a male disorder could also hamper diagnoses in girls ( 26 ).

Several genetic diagnoses have an increased rate of co-occurring ASD compared to the average population, including fragile X, tuberous sclerosis, Down syndrome, Rett syndrome, among others; however, these known genetic disorders account for a very small amount of overall ASD cases ( 27 - 30 ). Studies of children with sex chromosome aneuploidy describe a specific social functioning profile in males that suggests more vulnerability to autism ( 22 , 23 , 31 , 32 ). With the increased use of chromosomal microarray, several sites (chromosome X, 2, 3, 7, 15, 16, 17, and 22 in particular) have proven to be associated with increased ASD risk ( 28 ).

Other risk factors for ASD include increased parental age and prematurity ( 33 - 35 ). This could be due to the theory that older gametes have a higher probability of carrying mutations which could result in additional obstetrical complications, including prematurity ( 36 ).

ASD is a neurobiological disorder influenced by both genetic and environmental factors affecting the developing brain. Ongoing research continues to deepen our understanding of potential etiologic mechanisms in ASD, but currently no single unifying cause has been elucidated.

Neuropathologic studies are limited, but have revealed differences in cerebellar architecture and connectivity, limbic system abnormalities, and frontal and temporal lobe cortical alterations, along with other subtle malformations ( 28 , 37 , 38 ). A small explorative study of neocortical architecture from young children revealed focal disruption of cortical laminar architecture in the majority of subjects, suggesting problems with cortical layer formation and neuronal differentiation ( 39 ). Brain overgrowth both in terms of cortical size and additionally in terms of increased extra-axial fluid have been described in children with ASD and are areas of ongoing study both in terms of furthering our understanding of its etiology, but also as a potential biomarker ( 40 , 41 ).

Genetic factors play a role in ASD susceptibility, with siblings of patients with ASD carrying an increased risk of diagnosis when compared to population norms, and a much higher, although not absolute, concordance of autism diagnosis in monozygotic twins ( 42 - 44 ).

Genome wide association studies and whole exome sequencing methods have broadened our understanding of ASD susceptibility genes, and learning more regarding the function of these genes can shed light on potential biologic mechanisms ( 45 ). For example candidate genes in ASD include those that play a role in brain development or neurotransmitter function, or genes that affect neuronal excitability ( 46 , 47 ). Many of the genetic defects associated with ASD encode proteins that are relevant at the neuronal synapse or that are involved in activity-dependent changes in neurons, including regulatory proteins such as transcription factors ( 42 , 48 ). Potential “networks” of ASD genetic risk convergence include pathways involved in neurotransmission and neuroinflammation ( 49 ). Transcriptional and splicing dysregulation or alterations in epigenetic mechanisms such as DNA methylation or histone acetylation and modification may play a role ( 42 , 49 - 51 ). A recent study describes 16 newly identified genes associated with ASD that raise new potential mechanisms including cellular cytoskeletal structure and ion transport ( 52 ). Ultimately, ASD remains one of the most genetically heterogeneous neuropsychiatric disorders with rarer de novo and inherited variants in over 700 genes ( 53 ).

While genetics clearly play a role in ASD’s etiology, phenotypic expression of genetic susceptibility remains extremely variable within ASD ( 54 ). Genetic risk may be modulated by prenatal, perinatal, and postnatal environmental factors in some patients ( 35 ). Prenatal exposure to thalidomide and valproic acid have been reported to increase risk, while studies suggest that prenatal supplements of folic acid in patients exposed to antiepileptic drugs may reduce risk ( 55 - 57 ). Research has not confirmed if a small positive trial of folinic acid in autism can be used to recommend supplementation more broadly ( 58 ). Advanced maternal and paternal age have both been shown to have an increased risk of having a child with ASD ( 59 ). Maternal history of autoimmune disease, such as diabetes, thyroid disease, or psoriasis has been postulated, but study results remain mixed ( 60 , 61 ). Maternal infection or immune activation during pregnancy is another area of interest and may be a potential risk factor according to recent investigations ( 62 - 65 ). Both shorter and longer inter-pregnancy intervals have also been reported to increase ASD risk ( 66 ). Infants born prematurely have been demonstrated to carry a higher risk for ASD in addition to other neurodevelopmental disorders ( 34 ). In a prior epidemiologic review, obstetric factors including uterine bleeding, caesarian delivery, low birthweight, preterm delivery, and low Apgar scores were reported to be the few factors more consistently associated with autism ( 67 ). A recent meta-analysis reported several pre, peri and postnatal risk factors that resulted in an elevated relative risk of ASD in offspring ( 35 ), but also revealed significant heterogeneity, resulting in an inability to make true determination regarding the importance of these factors.

Despite the hysteria surrounding the now retracted Lancet article first published in 1998, there is no evidence that vaccines, thimerosal, or mercury is associated with ASD ( 68 - 70 ). In the largest single study to date, there was not an increased risk after measles/mumps/rubella (MMR) vaccination in a nationwide cohort study of Danish children ( 70 ).

Ultimately, research continues to reveal factors that correlate with ASD risk, but no causal determinations have been made. This leaves much room for discovery with investigators continuing to elucidate new variants conveying genetic risk, or new environmental correlates that require further study ( 52 ).

Evaluation in ASD begins with screening of the general pediatric population to identify children at-risk or demonstrating signs suggestive of ASD, following which a diagnostic evaluation is recommended. The American Academy of Pediatrics (AAP) guidelines recommend developmental surveillance at 9, 15 and 30 months well child visits and autism specific screening at 18 months and again at 24 or 30 months ( 28 , 71 ). Early red flags for ASD include poor eye contact, poor response to name, lack of showing and sharing, no gesturing by 12 months, and loss of language or social skills. Screening tools for ASD in this population include the Modified Checklist for Autism in Toddlers, Revised, with Follow-up (M-CHAT-R/F) and Survey of Wellbeing of Young Children (SWYC) ( 72 , 73 ). Red flags in preschoolers may include limited pretend play, odd or intensely focused interests, and rigidity. School age children may demonstrate concrete or literal thinking, have trouble understanding emotions, and may even show an interest in peers but lack conversational skills or appropriate social approach. If there is suspicion of ASD in these groups, screening tools available include the Social Communication Questionnaire (SCQ), Social Responsiveness Scale (SRS), and Autism Spectrum Screening Questionnaire (ASSQ) ( 74 - 76 ).

If concerns are raised at screening, primary care clinicians are recommended to refer the child to early intervention if less than 3 years of age or to the public school system for psychoeducational evaluation in order to establish an individual education program (IEP) if the child is three years of age or older. Clinicians should additionally refer the child to a specialist (pediatric neurologist, developmental-behavioral pediatrician, child psychiatrist, licensed child psychologist) for a definitive diagnosis and comprehensive assessment ( 71 ). A comprehensive assessment should include a complete physical exam, including assessment for dysmorphic features, a full neurologic examination with head circumference, and a Wood’s lamp examination of the skin. A parent interview, collection of any outside informant observations, and a direct clinician observation of the child’s current cognitive, language, and adaptive functioning by a clinician experienced with ASD should be components of this comprehensive assessment. ( 28 , 71 , 77 , 78 ).

Additionally, primary care clinicians need to be aware of (and evaluate for) potential co-occurring conditions in children with ASD. According to a surveillance study of over 2,000 children with ASD, 83% had an additional developmental diagnosis, 10% had at least one psychiatric diagnosis, and 16% at least one neurologic diagnosis ( 79 ). In the past, rates of co-morbid intellectual disability (ID) in patients with ASD were reported from 50% to 70%, with the most recent CDC estimate reported at 31.0% (26.7% to 39.4%) with ID defined as intelligence quotient (IQ) ≤70 ( 6 , 80 ). Other common co-occurring medical conditions include gastrointestinal (GI) disorders, including dietary restrictions and food selectivity, sleep disorders, obesity, and seizures ( 81 - 84 ). Studies using electronic health record (EHR) analysis revealed prevalence of epilepsy ~20% and GI disorders [without inflammatory bowel disease (IBD)] at 10–12% ( 82 ). Epilepsy has been shown to have higher prevalence rates in ASD with comorbid ID and medical disorders of increased risk such as tuberous sclerosis complex (TSC) ( 85 - 87 ). GI disorders or GI symptomatology, including diarrhea, constipation, restrictive eating, or reflux, have been shown to be prominent in ASD across multiple studies ( 81 , 82 , 88 , 89 ). Sleep problems have been reported to occur in anywhere from 50% to 73% of patients with ASD with variation in prevalence dependent on the definition of sleep symptoms or the measurement tool used ( 90 - 92 ). Rates of overweight and obesity in ASD are reported to be roughly 33% and 18% respectively, higher than rates in typically developing children ( 81 - 84 , 93 ).

Other behavioral or psychiatric co-occurring conditions in ASD include anxiety, attention deficit/hyperactivity disorder (ADHD), obsessive compulsive disorder, and mood disorders or other disruptive behavior disorders ( 81 ). Rates of co-occurring ADHD are reported anywhere from 25% to 81% ( 81 , 94 ). A recent meta-analysis of 30 studies measuring rates of anxiety and 29 studies measuring rates of depression reported a high degree of heterogeneity from the current literature, but stated pooled lifetime prevalence for adults with ASD to be 42% for any anxiety disorder and 37% for any depressive disorder, though the use of self-report measures and the presence of ID could influence estimates ( 95 ). In children with ASD seeking treatment, the rate of any anxiety disorder was found to be similar at 42% and in addition this study reported co-morbid oppositional defiant disorder at a rate of 46% and mood disorders at 8%, with 66% of the sample of over 600 patients having more than one co-occurring condition ( 94 ).

Currently no clear ASD biomarkers or diagnostic measures exist, and the diagnosis is made based on fulfillment of descriptive criteria. In light of a relatively high yield in patients with ASD, clinical genetic testing is recommended and can provide information regarding medical interventions or work up that might be necessary and help with family planning ( 96 ). The American College of Medical Genetics and Genomics (ACMGG) guidelines currently recommend chromosomal microarray for all children, fragile X testing in males, and additional gene sequencing, including PTEN and MECP2 , in certain patients as first tier genetic testing in the work up of ASD ( 97 ). High resolution G-banded karyotype, once recommended for all patients with ASD, is no longer routinely indicated based on recent consensus recommendations, but might still be performed in patients with a family or reproductive history suggestive of chromosomal rearrangements or specific syndromes such as sex chromosome anomalies or Trisomy 21 ( 96 - 98 ). Several professional societies recommend genetic testing for ASD, including the American Academy of Neurology, the AAP, ACMGG, and the American Academy of Child and Adolescent Psychiatry, and a child may require further referral to a geneticist and/or genetic counselor, depending on results of testing ( 25 , 28 , 97 , 99 ). As the field of genetics continues to advance rapidly, recent publications suggest whole exome sequencing may become the preferred method for clinical genetic testing in individuals with ASD ( 100 , 101 ).

Aside from genetic testing, no other laboratory work up is routinely recommended for every patient with a diagnosis of ASD. However, further evaluation may be appropriate for patients with particular findings or risk factors. Metabolic work-up should be considered in patients with any of the following concerning symptoms or signs: a history of clear developmental regression including loss or plateau of motor skills; hypotonia; recurrent episodes of vomiting, lethargy or hypoglycemia; microcephaly or poor growth; concern for other organ involvement; coarse features; or concern for seizures or ataxia. Based on the patient’s history and presentation, components of a metabolic laboratory evaluation could include complete blood count (CBC), liver and renal function tests, lactate, pyruvate, carnitine, amino acids, an acylcarnitine profile, urine organic acids and/or urine glycosaminoglycans ( 97 , 102 ). Children with a history of pica should have a lead level measured ( 28 , 103 ). In a child with significantly restricted food intake, one should consider a laboratory evaluation of nutritional status. Sleep symptoms may warrant a referral for a possible sleep study, and if restless sleep symptoms are present, an evaluation for iron deficiency is not unreasonable, particularly if dietary rigidity limits iron intake ( 104 ).

Neuroimaging is not routinely recommended for every patient with ASD ( 28 , 99 ), but may be appropriate in patients with a suspicion for TSC or other neurocutaneous disorders, microcephaly, or an abnormal neurologic exam (spasticity, severe hypotonia, unilateral findings). Patients with suspected seizures should have an electroencephalography (EEG) obtained ( 102 ). If accessible, it might be appropriate to immediately refer children with concern for further genetic, metabolic or neurologic conditions to a specialist who can then obtain and interpret the aforementioned testing. At this time there is inadequate evidence to recommend routine testing for celiac disease, immunologic or neurochemical markers, mitochondrial disorders, allergy testing, hair analysis, intestinal permeability studies, erythrocyte glutathione peroxidase studies, stool analysis, urinary peptides or vitamin and mineral deficiencies without a history of severe food selectivity.

ASD is a neurodevelopmental disorder characterized by deficits in social communication and the presence of restricted interests and repetitive behaviors. Recent changes to the diagnostic criteria occurred with the transition to the new diagnostic manual (DSM-5) and will likely impact prevalence, which currently stands at 1 in 59 children in the US. ASD is a neurobiological disorder influenced by both genetic and environmental factors affecting the developing brain. Research continues to reveal factors that correlate with ASD risk and these findings may guide further etiologic investigation, but no final causal pathway has been elucidated. Clinical evaluation begins with developmental screening of the general pediatric population to identify at-risk children, followed by referral to a specialist for a definitive diagnosis and comprehensive neuropsychological assessment. Children with ASD should also be screened for common co-morbid diagnoses. While no clear biomarkers or diagnostic measures exist, clinical genetic testing is recommended as part of the initial medical evaluation. Further medical work up or subspecialist referrals may be pursued based on specific patient characteristics.

Acknowledgments

Funding: None.

Ethical Statement : The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Conflicts of Interest : The authors have no conflicts of interest to declare.

My autism makes me who I am. There is nothing ‘wrong’ with me

First Person is a daily personal piece submitted by readers. Have a story to tell? See our guidelines at tgam.ca/essayguide .

Illustration by Drew Shannon

“There’s nothing wrong with you.”

It sounded more like an accusation than a reassurance. I had asked Dad to dig up some old report cards and notes Mom had made about my milestones as a toddler. They’re things a psychologist asks for when performing an autism assessment.

I never used the word “autism” with dad. I’m certain what little he knew about it was laced with stigma, so I said I was getting some tests done. I think he had some idea what was really happening, though. After all, he had a front-row seat to my strange childhood. But he probably dismissed the exercise as some psychological fishing expedition and felt the need to douse it with cold water.

The diagnosis came back as autism. I felt relief, but no surprise. I always knew there was something different about me, but never had a word for it. Finally, I knew the name for this part of me. I wasn’t deficient, broken or less than anyone else. I was just different.

That didn’t make the stigma disappear; I had plenty of reminders. Whenever someone blurted out a variation of “I’m not autistic” to signal their IQ or emotional fluency. Every time someone asked if I was a robot. Or all the times I was told I’m too intense, too blunt, too emotionally flat. Too different.

I buried the diagnosis for years. I didn’t want to be judged, labelled or diminished. I kept trying to act normal, trying to be like everyone else and cover up the gaps when I failed. You can get very good at playing a role, especially if you practice the part daily for 53 years. But every time I thought I was finally passing as normal, autism had other plans.

Like the time I couldn’t read my boss’s reactions and ended up unemployed. The years spent alone because I was clueless about social interactions. All the people I annoyed by being blunt because I didn’t know any better. No matter how much I tried to act normal, I could never quite pull off the act, but I kept trying.

You can run from yourself for a very long time. Some people run their whole lives. It took a trip to Pride Toronto to make me finally stop running.

I’d been before, but had really only paid attention to the street vendors. This time I found myself on Church Street before the vendors had opened, and for the first time I really started paying attention to the people around me and how happy they were. I saw so many happy faces, I didn’t know how I had never picked up on them before.

So many people just seemed glad to be themselves, walking around, holding hands, laughing and chatting with strangers, and I thought, “I wish I could be myself that way.”

Then I remembered I’m not eight years old being bullied at recess. No one’s trying to beat me up for being weird. No one’s calling me a freak. It’s okay to be different, because it’s 2024, not 1979. Today it’s supposed to be okay to love differently, to look different, to sound different, to be different.

It’s also okay to think differently.

I don’t wish I weren’t on the autism spectrum. It’s as much a part of me as my toes or sense of humour, not some unfortunate bug in the system. It’s part of a complete package: if you remove one part of the system, you change the whole thing. That system made me smart enough to get into Mensa, the high-IQ society. It made me a scholarship student, a playwright, an essayist, a husband and all the things I am. If you remove autism, you change the whole system and then I’m not the same person.

Maybe that would finally make me normal. But I don’t really yearn to be normal anymore. All I want is to stop running from myself and maybe get a little acceptance from the world. There will always be people who judge you because of your differences: how you look, how you sound, how you think … But at a certain point, you either stop caring so much, or you spend a lifetime trying to be something you’re not.

The other reason to speak my truth now is the hope that doing so chips away at the wall of indifference, ignorance and intolerance that still exists. Maybe this essay can make it a little bit safer for other people to be different.

Ultimately, I wish I could reach myself as a kid. I’d tell Mark he’s different, and it’s going to be a rocky road, but he’s okay. I’d tell him he’ll learn how people work and how to fit in when he wants to. But I’d want him to know he doesn’t need to fit in and he doesn’t need to change himself, because he’s not deficient, broken or less than anyone else.

Because there’s nothing wrong with me.

Mark Farmer lives in Toronto.

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Essay on Family

Children With Autism Argumentative Essay Example

Type of paper: Argumentative Essay

Topic: Family , Poverty , Skills , Challenges , Autism , Development , Children , Sociology

Words: 2250

Published: 12/17/2019

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Introduction

Autism refers to an intricate developmental disability (Bryna, 2008, pp 24). It is known to appear in children within their first three years of life. This developmental disability is normally caused by a neurological disarray which affects usual brain function. It thus affects the development of a child’s social and communication skills. Children who suffer from autism experience challenges with non-spoken communication, various social interactions as well as other activities which involve elements of play (Bryna, 2008, pp 27). Children are social creatures who require interaction with other people in order to flourish and grow. Socializing enables children to laugh, smile, cuddle and respond to games such as hide and seek. However, sometimes a child may not interact with other people as per the other people’s expectations. As a result, the child will appear to exist in a different world with the other people in the society. Such a child will show strange behaviors, communication difficulties and a complete lack of social consciousness or concern in other people. These characteristics indicate that such a child will be suffering from autism. Apart from the social challenges, children suffering from autism also experience intellectual difficulties. According to Bryna (2008), such children have poor brain development. The brain controls other functions of the body including communication and social interaction (Bryna, 2008, pp 30). In this connection, autism can be highly associated with poor brain development and consequently intellectual challenges because the brain has control over all the body functions. For example, children with autism experience intellectual challenges because they cannot use two word phrases at the age of twenty four months, they can’t wave other people at twelve months and they have no social skills. Although some people argue that children with autism have social problems, it can better be argued that children with autism experience intellectual challenges.

Children with autism experience both intellectual and social challenges. Intellectual challenges for children with autism include reading challenges, creativity, understanding and solving problems. Due to these intellection challenges, children with autism encounter social skills. Social skills depend on an individual’s intellectual development. As a result, children with poor intellectual development will find it hard to socialize with other people in the society. Such children do not understand the significance of what is happening around them in the society. As a result, they tend to remain withdrawn while other normal children interact with one another. Children with autism experience social challenges because of their impaired intellectual development. In this connection, it is true to say that children with autism experience poor intellectual growth which results to social challenges.

References:

Bryna, S. The World of the Autistic Child. 2008. Oxford. Oxford University Press Catherine, M at al. Behavioral Interaction for Young Children With Autism: A manual for

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Disorders : A Critical Analysis. p59-63. 2006 National Research Council. Educating Children with Autism. 2011. New York. National

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Guilford Press Wendy, L. & Lauren T. The Impact of Autism on Child Development. 2005. Encyclopedia of

Early Child Development. 2005. USA

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