AN
OVERVIEW OF AUTISM WITH RECOMMENDATIONS
FOR PHYSICAL ACTIVITIES AND EXERCISE
By Rachael
Heilman; Undergraduate Student,
University of Florida
Autism
is classified as a Pervasive
Developmental Disorder and is the
result of a neurological
disorder that affects the normal functioning
of the brain. (1)
People who have autism have difficulty
in the social arena, with verbal and
nonverbal interactions, and display
repetitive behaviors and narrow interests.
(2) Out of the five total Pervasive
Developmental Disorders, autism is the
most common, affecting one out of every
150 births. This would translate to
about 1.5 million people in the United
States having autism. This number is
projected to increase ten to 17 percent
per year, according to different governmental
agencies. (1)
In order to understand autism in further
depth, the symptoms, causes, varying
lifestyles, and treatments of those
with autism will be explored.
Most people
are diagnosed with autism between the
ages of three and four years old, although
it can be diagnosed even sooner. There
are certain developmental milestones
that mark each age, and if those milestones
are not reached, then it is recommended
that the child be evaluated for autism.
For example, most children babble and
coo, gesture and wave by age one. At
16 months, most children have spoken
a single word and by age two, it is
developmentally appropriate for a child
to use two word phrases. If a child
has not reached these milestones at
the average age then it is suggested
that the child is seen by a physician
to be assessed for autism. (2)
The three
main developmental areas that children
with autism have trouble in are social
interaction, language, and behavior.
For example, it is common for children
with autism to avoid making eye contact
with others, to choose playing on their
own rather than with other children,
to have abnormal or a lack of social
play, to not respond when someone calls
their name, and to have a difficult
time being able to understand other
people’s feelings or point of
view. (3)
A child with autism may not gain any
insight into the difference between
hearing a tone of voice that is angry
versus one that is happy. Expressions
such as frowns and smiles are not always
interpreted or picked up on by a child
with autism. (4)
In general, it is difficult for children
with autism to interpret the world around
them and to respond appropriately to
outside cues. All of these characteristics
make it hard for a child with autism
to form connections and meaningful relationships
with others.
Communication
is another major difficulty for a child
with autism.
They may be delayed in talking or do
not talk at all. For some children it
may be difficult to express needs and
wants that they have in both a verbal
and non verbal way. Some children may
speak with a tone or rhythm that is
abnormal, such as speaking like a robot
or with a singsong voice. It is possible
that a child may learn certain words
or sentences, but at a later time, be
unable to access them. They also may
have difficulty understanding how to
use words to communicate ideas, and
may instead repeat certain words or
phrases over and over again. Being able
to start a conversation or to keep one
going is a difficulty.
(3) These difficulties with language
are probably not only frustrating for
the child with autism when he or she
tries to communicate with others but
are yet another social barrier.
Additionally,
children with autism may exhibit abnormal
behaviors such as movements that are
repetitive, like rocking or spinning.
Some children with autism express great
distress if a routine is altered, as
routines and rituals are markedly a
characteristic of autism. Other unusual
behaviors that many children with autism
share is a need to move constantly,
focusing on parts of a toy, such as
just the propellers of a model airplane,
rather than the whole, having restricted
and narrow interests and being unusually
sensitive to light, sound, and touch.
(3) An example of how sound,
a sensory experience, can be amplified
by someone with autism, can be illustrated
by Temple
Grandin, who has autism, and is
a savant, meaning she has an area of
specialized genius.
Temple stated,
"One of my sensory problems was
hearing sensitivity, where certain loud
noises, such as a school bell, hurt
my ears. It sounded like a dentist drill
going through my ears." (5)
Due to these altered sensory experiences,
children may react in a way that we
perceive as extreme, and may even, for
example, avoid certain people who have
voices that are high in pitch.
While autism
results from a neurological abnormality,
it is unknown as to what causes these
problems with the nervous system. Researchers
have, however, discovered that genetics
are greatly involved. Evidence suggests
that it is not just one gene, but a
combination of many, that increase one's
risk for autism. For example, in a family
that has one child with autism, the
risk of having another child with autism
is three to eight percent. There is
a thirty percent chance that if one
monozygotic
twin has autism that the other one
will as well. Exposure to certain things
in the environment may interact with
genetics and is another factor that
increases the likelihood of autism.
(2)
Additionally,
underlying medical conditions do not
cause but are linked to autism. Some
of these medical conditions include
metabolic disorders, congenital infections,
genetic disorders, developmental brain
abnormalities, and neurological disorders
occurring after birth. (2)
In a normal, developing brain, serotonin
levels decline. Some children with autism
do not have this decrease in serotonin,
leading researchers to wonder if chemicals
in the brain may be linked to autism.
(6) Race,
ethnicity, and socioeconomic levels
are not linked to causing autism; however,
gender is a factor. Boys are three to
four times more likely than girls to
have autism. (2)
The number
and severity of the symptoms for a person
with autism vary greatly, although in
order to be diagnosed with autism one
must show significant challenges and
delays in his or her social interactions,
communication (both verbal and nonverbal),
and show repetitive as well as restrictive
behavioral patterns. Most children who
have autism need more time to learn
something and to acquire new skills
due to their developmental disabilities.
(3)
Depending
on how severely each area is affected,
as well as the combination of deficits
that each person has, largely influences
their lifestyle and capabilities. Some
people who are higher functioning manage
to live independent lives, meaning they
have a job and live on their own. Other
people with autism who are lower functioning
will always depend on others for care.
Seventy-five
percent of people with autism have IQs
below average, while the other twenty-five
percent have an average or above average
IQ. A very small number of people with
autism are also savants,
and excel in one given area such as
math, art, or music. Some people with
autism become aware that they are different
than others and become anxious or depressed.
The most common time for this to occur
is during the teenage years. (2)
Although autism is a lifelong challenge,
there are many opportunities for growth
and learning new skills and appropriate
behaviors.
People with
autism each need a treatment plan that
fits their specific needs and is directly
tailored to help them with their weaknesses.
There is not a "one shoe fits all"
treatment plan but research has shown
that the earlier a person with autism
gets the treatment they need, the better
the outcome is for them in the long
run. Ideally, children should begin
treatment during or before preschool
age. (2)
According to the American Academy of
Pediatrics, children should be involved
in behavioral training and management,
special therapies, and may need to take
medication. (7)
The purpose
of behavioral training and management
is to improve communication and behavior.
Some methods of doing this are through
positive reinforcement, self help, and
teaching social skills. (7)
Research that has been done over the
past 30 years has shown that this method
has positive results, which include
an improvement in communication, learning,
adaptive behavior, and a decrease in
socially unacceptable behaviors. (2)
One of the goals in behavior therapy,
for example, may be to teach the child
how to respond appropriately in a given
social situation, or to help them communicate
ideas or feelings that they have. Another
goal may be to try to eliminate certain
behaviors that are inappropriate, or
to reward behaviors that are socially
acceptable.
Speech, occupational
and physical therapy are helpful for
people who have autism. The aim of speech
therapy would be to teach the person
how to use language and how to apply
it to social situations, so they could
be more effective communicators. Occupational
and physical therapy would both serve
to improve motor skills and coordination.
Occupational therapy may additionally
help a person with autism to better
deal with their skewed sensory perceptions.
(7)
Another component
to a treatment plan may be the use of
medications. Medications should be considered
if the person suffers from anxiety,
depression, hyperactivity, and obsessive
compulsive type behaviors, in order
to help manage those symptoms. (7)
Educational
therapies are yet another way that children
with autism can thrive and grow to their
fullest potential. Special education
programs that cater to the child’s
needs are not only a necessary component
to the child’s progress and development,
but are required by law through the
Individuals with Disabilities Education
Act (IDEA). (2)
Children with autism do well when in
education programs that are highly structured,
have routine built into the day, engage
their attention, break down tasks into
simpler steps, and reinforce behavior.
The success of such programs often hinges
on a team of specialists that can initiate
activities geared to improve social
skills, communication and behavior.
It is important that parents are involved
in their children’s learning,
and that they incorporate behaviors
and communication skills that their
children learned with daily home life.
(2)
Finally,
physical activity is beneficial for
any child, but is especially helpful
for people with autism. The upward trend
in weight gain among children with autism
has lead to more than half of children
with autism being either overweight
or at risk of being overweight. The
primary factor that has been suggested
to account for this trend is a decrease
in the amount of physical activity that
children with autism partake in. Children
with autism need to have an exercise
program included in their regular routine
in order to help manage their weight
and to try to avoid health problems
such as diabetes, cardiovascular disease,
bone and joint problems, and even depression.
(8)
While physical
activity may initially be a challenge
for a person with autism, over time,
if the program is properly implemented,
it can help the person to overcome difficulties
such as limited motor functioning, low
motivation, difficulty in planning and
self monitoring, a limited attention
span, and enhanced auditory, visual
and tactile stimuli. Research has shown
how aerobic exercise can significantly
help to control repetitive behaviors
such as body rocking, head-nodding,
spinning, hand flapping, and object
tapping, thus making it easier for a
child with autism to learn and display
positive social behavior. Exercise also
has been shown to decrease aggressive
and self-injurious behavior. It is thought
that a highly structured and repetitive
exercise routine is helpful due to it
distracting from or being similar to
the self-stimulating, repetitive behaviors
that are associated with autism. (8)
Exercise
is additionally beneficial in that it
can help release some of the energy
in people who are hyperactive and release
frustrations, as well as boosting moods
in people who are depressed. Physical
activity can be used in conjunction
with physical therapy to help develop
coordination and body awareness. Playing
simple games challenge children with
autism in a number of ways. When playing
a game, one must first know the rules.
This requires the child with autism
to understand each of the steps and
then apply them in the game. This requires
that they use their memory and have
mental organization.
Playing a
game additionally requires cooperation
and communication. For example, in order
for a child to receive a ball from someone
who is rolling it, it is necessary that
they pay attention to when the other
person is about to roll it, to signal
with a gesture or communicate with words
when they are ready to receive the ball,
or to communicate if they are not ready.
Since children with autism have trouble
picking up on body language and general
communication skills, this task would
challenge them and help them with every
day social interactions. Gaining ability
in a sport may give a child better self
esteem, a sense of belonging, and they
may even have some fun along the way.
Even if the child does not take to playing
a sport with other children, it is still
beneficial for them to do physical activities
such as running or swimming. (8)
The incidences
of autism are relatively high and are
expected to grow. This is only an additional
incentive as to why awareness about
the basic facts and needs of people
with autism should become basic knowledge.
People who have autism each have their
own talents and level of potential,
and it is our responsibility to continue
to educate others and make sure that
people with autism are given the opportunities
that they need to thrive.
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