Introduction
Autism spectrum disorder (ASD) is a developmental disorder affecting an individual’s behavioral and communication aptitudes. It is possible to diagnose autism at any age; however, typically, the onset of this disorder takes place within the first two years of life. Autism is seen as a spectrum disorder since its severity and symptoms vary greatly among affected individuals – from mild and occasional to persistent and interfering with all aspects of life.
ASD permeates age, class, gender, and ethnicities, hence, one may argue that specific demographic cohorts are more prone to developing the said disorder. For instance, according to the statistical analysis by the Centers for Disease Control and Prevention (2018), ASD is four times more common among men than women. As of now, the average prevalence of the disorder in Europe, Asia, and North America does not exceed 1-2% or 16 affected individuals per 1,000 people (Centers for Disease Control and Prevention, 2018). This paper will discuss symptoms, types, causes, and life prognosis of ASD and outline psychological and sociological implications.
Symptoms
In general, individuals with autism spectrum disorder struggle with communication and social interactions, and their behavior and lifestyle are characterized by restricted, “special” interests and repetitive patterns. As of now, researchers have compiled lists of common symptoms useful for diagnosing a person with ASD; however, it should be noted that not every person with the said disability displays every sign listed.
At an early age, parents may notice that their child does not maintain eye contact with other people. Moreover, he or she does not tend to look at people or listen to them – in other words, react to them in some way (Woodman, Smith, Greenberg, & Mailick, 2015). Further, they do not possess a common characteristic of children their age – sharing excitement about someone or something by pointing at a person or an object.
As children with ASD grow, they may start to display such symptoms as having difficulties with two-way communication and not tuning their voice tone and intonation to what they say. However, when it comes to their areas of interest, children and teenagers with autism remember information in detail, may study diligently, and talk about the subject matter with unmatched enthusiasm (Woodman et al., 2015). As for their behavior, individuals on the ASD spectrum tend to repeat actions and be distressed by slight changes in their routines.
Causes
So far, researchers have proposed numerous hypotheses on the causal nature of autism; however, there has not been a general consensus yet. As of now, the most feasible version pertains to genetic factors. For instance, some studies on twins showed that the disorder heritability amounts to 90%; more recent studies, however, assess the heritability at 60-90% (Schaefer, 2016). All in all, explaining the genetics of autism spectrum disorder remains fairly challenging. It is not completely clear which genes are responsible for ASD development; in some cases, there is an association between exposure to teratogens – substances causing birth defects – and autism. A rather popular theory links early childhood immunizations such as vaccines to ASD, but there has not been found scientific evidence yet.
Common Types
Researchers single out three different types of autism spectrum disorder:
- Autistic disorder (“classic” autism). Individuals with autistic disorder display the majority of the symptoms listed above: language delays, communication struggles and social challenges, persistent, repetitive behaviors, and speech patterns.
- Asperger syndrome. Individuals with Asperger syndrome usually have milder symptoms and, thus, are overall high-functioning. Even though such characteristics as inhibited social adaptation and communication remain, they usually do not suffer from language delays or intellectual disabilities.
- Pervasive developmental disorder (not specified) means that an individual might display some of the classic symptoms, but it is not entirely possible to diagnose him or her with autistic disorder or Asperger syndrome.
Prognosis
Once the parents of a child or teenager with ASD discover the developmental differences, they become overwhelmingly concerned about the prognosis and perspectives. A longitudinal study by Woodman et al. (2015) has shown that throughout 8.5 years, the participants – adolescents and adults with ASD – displayed a tangible improvement in communication skills. The findings showed that the majority of them learned to handle the symptoms better and took control over maladaptive behaviors to a certain extent. The authors argue that this tendency is not biologically predisposed; on the contrary, societal factors might play a significant role in shaping the future of a young person with ASD.
Historically, people with ASD were confronted with numerous challenges, but nowadays, modern health care, support, and community-based interventions may improve these people’s chances to live a full life (Woodman et al., 2015). Among the most influential factors is the family environment: stable and loving mother-parent relationships were found especially beneficial (Woodman et al., 2015). Lastly, one should not dismiss the importance of early diagnosis: early treatment and evidence-based practice implementation enhance the entire family’s quality of life (Elder, Kreider, Brasher, & Ansell, 2017).
Psychological Implications
Individuals with autism spectrum disorders often experience mental health issues, which is a matter of concern for their families, counselors, and social workers. Often, ASD is aggravated by the presence of other disorders, for instance, depression and anxiety (Fuld, 2018). The psychological community has only recently recognized ASD comorbidities as a pressing issue that needs to be addressed. As of now, it is estimated that 70% of individuals with ASD have one more mental disorder, whereas 40% have two or more (Fuld, 2018). Hence, comorbidities among the ASD community are not an exception but a tragic norm.
Moreover, some studies suggest that the prevalence of suicide ideation (SI) is significantly higher among ASD youth as compared to the general, neurotypical population (Fuld, 2018). However, this claim can be undermined by the fact that the prevalence of SI among youth with ASD is comparable to that of youth with other underlying mental disorders. One may conclude that a negative outlook and suicidal thoughts might be rather associated with depression and anxiety than ASD itself.
One of the hypotheses concerning the psychological implications of autism is that the presence of other mental disorders might be correlated with the severity of ASD. For instance, Reinvall et al. (2016) have found that depression and anxiety were more common for high-functioning individuals. Researchers have referred this tendency to the heightened self-awareness of individuals with milder ASD symptoms, for example, those with Asperger syndrome. Since they do not suffer from any intellectual disabilities, they realize what reaction they derive from neurotypical people and how they might be perceived in society, which to them is upsetting.
There are two main approaches to addressing psychological issues in individuals with ASD. The first approach is a family-based behavioral intervention that aims at enhancing social and academic outcomes by teaching a person with ASD to handle the symptoms more efficiently (Gotham, Brunwasser, & Lord, 2015). Thus, the main goal of behavioral therapy is to reduce the likelihood of adverse outcomes. The other approach targets the emotional well-being of an individual with ASD and capitalizes on his or her unique history of life (Gotham et al., 2015). Within the second approach, a counselor needs to carefully assess an individual’s stressful and traumatic experiences to seek safe processing and healing.
Sociological Implications
Family Life
Since some types of autism interfere with a person’s functioning and day-to-day life, his or her family has to assist the said person with daily routines. Raising a child with ASD is usually quite challenging for parents as it can be both emotionally and physically draining, especially in the case of an unclear prognosis. A study by Valicenti-McDermott et al. (2015) showed that the level of parental stress does not correlate with parents’ age, ethnicity, and financial status.
Other factors, however, contributed to the stress level, and namely, children’s irritability and lethargy (Valicenti-McDermott et al., 2015). Weitlauf, Vehorn, Taylor, and Warren (2014) did not find a positive association between depression in mothers and the presence of ASD in their children. The researchers reasoned that parental depression is a complex issue that could not be attributed to a single factor – ASD.
Public Perception
In recent years, as researchers have been paying more attention to ASD, public perception of individuals on the spectrum has changed for the better. However, there are still some persistent myths about people with ASD, for instance, some people are convinced that autism is caused by poor parenting or vaccinations. When it comes to youth with ASD, there is a common misconception about their inability to study in the same environment as neurotypical students or that they cannot and do not want to socialize.
Popular culture is not always helpful with normalizing the condition and eliminating the stigma: in movies and TV series, characters with ASD are often portrayed as either antisocial and unempathetic or savants and geniuses (Nordahl-Hansen, Øien, & Fletcher-Watson, 2018). Nevertheless, popular culture and social media can do justice to individuals with autism by supporting them in their struggle and providing believable portrayals that would reflect the complexity of the disorder.
Work Environment and Legal Aspects
Autism impacts the ways a young person navigates his or her life. For instance, the severity of the disorder determines the likelihood of a person with ASD receiving a driver’s license. While ASD itself is not a barrier to enrolling in a driver’s school, the curriculum and practicals may be challenging for an individual with special needs. Moreover, many parents are reluctant even to entertain the option of giving their teenage child a chance to try and learn how to drive.
Individuals with autism may experience significant problems when it comes to employment. Due to misconceptions about the disorder, some employers might be biased against hiring a person with special needs to begin with. Overall, the chances of a person with ASD to be hired are tied to his or her education, skills, and VIQ (verbal intelligence coefficient). In recent years, a number of large corporations launched programs in support of diversity and started training people on the autism spectrum.
Vocational Rehabilitation Considerations
As it was mentioned before, more often than not, the chances of individuals with ASD are rather thin, and unemployment and underemployment are some of the most pressing issues in the ASD community. Individuals in their late teens are especially at risk: their transition from adolescence into adulthood may present numerous difficulties (Chen, Sung, & Pi, 2015). At the same time, there is a lack of awareness about available vocational rehabilitation (VR) services in the ASD community. Moreover, there is not enough evidence of positive outcomes of using vocational rehabilitation services by individuals with ASD (Chen et al., 2015).
It is suggested that VR workers assess not only the severity of the disorder in a person but also the specifics of their age. Even if a person with ASD is employed, he or she might be struggling to adapt to the work environment. In this case, it is only reasonable to make adjustments to accommodate this person: pay attention to their strengths such as precision and systematizing, introduce flexible working hours, and ensure a respectful attitude from coworkers. For those individuals with ASD who are non-verbal or have limited verbality, there are applications through which they can express themselves in a written form.
Conclusion
Autism is a lifelong disorder of genetic nature that might also be caused by exposure to teratogens causing congenital disabilities. Common symptoms include special interests, inability to monitor and read social and emotional clues, difficulties communicating with people, and verbalizing thoughts and ideas. Children with autism usually display symptoms early on – within the first two years of their life – and the specifics of the disorder impact their interaction with the world, daily routines, academic life, and employment.
The interference with a person’s life depends on its severity: many people with ASD are high-functioning and have intact intelligence, which allows them to enroll in secondary and tertiary education and secure a job. However, a significant share of the ASD community experience difficulties navigating life, partly due to misconceptions about the disorder. It has been found that even though there is no cure for autism, symptoms might become milder over time, and some of the predisposing factors for improvement are community- and family-based support and intervention.
References
Centers for Disease Control and Prevention. (2018). Data & statistics on autism spectrum disorder. Web.
Chen, J. L., Sung, C., & Pi, S. (2015). Vocational rehabilitation service patterns and outcomes for individuals with autism of different ages. Journal of Autism and Developmental Disorders, 45(9), 3015-3029.
Elder, J. H., Kreider, C. M., Brasher, S. N., & Ansell, M. (2017). Clinical impact of early diagnosis of autism on the prognosis and parent-child relationships. Psychology Research and Behavior Management, 10, 283.
Fuld, S. (2018). Autism Spectrum Disorder: The Impact of Stressful and Traumatic Life Events and Implications for Clinical Practice. Clinical social work journal, 46(3), 210-219.
Gotham, K., Brunwasser, S. M., & Lord, C. (2015). Depressive and anxiety symptom trajectories from school age through young adulthood in samples with autism spectrum disorder and developmental delay. Journal of the American Academy of Child & Adolescent Psychiatry, 54(5), 369-376.
Nordahl-Hansen, A., Øien, R. A., & Fletcher-Watson, S. (2018). Pros and cons of character portrayals of autism on TV and film. Journal of Autism and Developmental Disorders, 48(2), 635-636.
Schaefer, G. (2016). Clinical genetic aspects of autism spectrum disorders. International Journal of Molecular Sciences, 17(2), 180.
Valicenti-McDermott, M., Lawson, K., Hottinger, K., Seijo, R., Schechtman, M., Shulman, L., & Shinnar, S. (2015). Parental stress in families of children with autism and other developmental disabilities. Journal of Child Neurology, 30(13), 1728-1735.
Weitlauf, A. S., Vehorn, A. C., Taylor, J. L., & Warren, Z. E. (2014). Relationship satisfaction, parenting stress, and depression in mothers of children with autism. Autism, 18(2), 194-198.
Woodman, A. C., Smith, L. E., Greenberg, J. S., & Mailick, M. R. (2015). Change in autism symptoms and maladaptive behaviors in adolescence and adulthood: The role of positive family processes. Journal of Autism and Developmental Disorders, 45(1), 111-126.