Autism and Occupational Therapy

Jul 21, 2020 in Medicine Essay

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1. Autism incorporates different groups of complex disorders in the development of the human brain. These disorders can vary. They are usually characterized by difficulties in verbal and non-verbal communication, social interaction and repetitive behaviors, such as childhood disintegrative disorder, Rett syndrome, autistic disorder, Asperger syndrome and pervasive developmental disorder - not otherwise specified (PDD-NOS) (What Is Autism?).

Autism develops in the earliest brain development. The signs of this disease can be observed in children aged 2-3 years old. The main symptoms are represented by a combination of impairments in communication and social interaction; repetitive behavior, and restricted interest.

According to the U.S. Centers for Disease Control and Prevention (CDC), about 1 in 88 of children in the USA are autistic. The rate of affected boys is 5 times higher than that of girls.

There is no general background of autism. In the last years, scientists identified several changed genes (mutations), which are associated with autism. However, there is an opinion that autism is caused by a combination of negative environmental factors that affected a child in the early years coupled with the risk genes. Among environmental stresses that make influence before and during birth are maternal illness during pregnancy and certain difficulties during birth, advanced parental age of conception, particularly those involving periods of oxygen deprivation to the baby’s brain.

The authentic person communicates with the other people in a special way. Sometimes such people can feel themselves psychologically clumsy in the society and become uninterested in communication with peers.

Often, authentic people make very little eye contact. Scientists state, this could be improved if autism was determined in the early age and special psychological programs were applied to the authentic people.

Authentic people hardly understand feelings of normal people because of their poor ability to make emphasis in the conversation. Often, conversation of a healthy person with an authentic individual appears like a one-way trip. Authentic people rarely exchange ideas, feelings and thoughts with others. However, they can take into account desires and feeling of the others.

Most of individuals who suffer from this disease talk to themselves.

Sudden loud noises, some smells and lights can be found shocking or unpleasant for a person with autism. This happens mostly because of surprise and because the individual has not been prepared for such conditions.

Speaking skills of the person depends greatly on the severity of the autism. A lot of children with autism do not speak. Some of them can repeat phrases or words which they hear from the other people (echolalia).

People with autism like predictability and routine without any emotions. This is because they are less adaptable to changes than people without autism.

Usually people who suffer from autism are learning very slowly, especially with the matters concerning social and language skills. 

People who suffer from autism have the same feelings as people who do not suffer from this disease. They feel happiness, love, sadness and pain. However, some of them cannot express their feelings in a common way.

Rather high proportion of authentic people has high IQ and a lot of unique talents in music, computer sciences, etc.

A lot of children with autism demonstrate outstanding abilities in music, visual and academic skills; about 40 % has average and above the average intellectual abilities. The effective and efficient treatment can decrease negative sides of the disease and improve physical health and communication. The earlier child is treated – the better recovery forecast will be (Prognosis).

Children with this mental disease usually understand everything in their own way. This differ them from others. However, they often have significant skills and interpret their vision of the world by music and paintings. Common people should try to understand autists and interact with them as with normal people. 

Occupational therapy is the application of various treatment measures for development, recovery and maintaining of everyday living and working skills of people, and they include conditions for improving of a mental, physic and development conditions. This therapy focuses on adaptation to the real life situations, learning skills and modifying tasks and educating family and close people of participation in a performance of daily activities (About occupational therapy).

Participation is of paramount importance because it helps not only to improve health and mental condition of the affected person, but it also helps the person with autism feel as a regular one.

Different health-providers recommend involvement of friends and parents into the treatment process and offer educational programs on how to perform such participation by themselves. This assistance includes nursing, rehabilitation, self-help, psychiatry and social work. 

Occupation therapy assists caregivers and ill persons to cater for normal development and growth through playing, feeding, education and acquisition of socials skills. The main forms of occupational therapy comprise of promotion of special wellness programs for eliminating obesity, individualized treatment, development of functional skills for living, teaching effective coping strategies, etc. 

Occupational therapy helps people with autism to live a normal life. Special hospital treatment includes acute rehabilitation, in-patient rehabilitation, and out-patient rehabilitation, skilled nursing facilities, home health, and rehabilitation programs.

2. The International Classification of Functioning, Disability and Health (the ICF) represents a classification of health-related and health domains. They are determined from individual, body and social perspectives by using 2 lists: a list of participation and activity and a list of body structure and functions. Additionally, the classification includes a list of environmental factors (International Classification of Functioning, Disability and Health (ICF)).

Health and disability at population and individual levels are measured by a special framework that was proposed by the World Health Organization in 2001. Child’s well-being and health are described in terms of such components: body structures, body functions, activities and participation.

Body structures are represented by anatomical parts of the body, including structures of sensory, nervous and musculoskeletal systems.

Body functions are represented by physiological functions of body systems, for example, respiration and digestion, attending, thinking, and remembering.

Activities are tasks performed by children, like communicating, studying, feeding, walking, bathing, reading, shopping, preparing mills, etc.

Participation is represented by community life, for example, going to school, relationships with peers and recreation activities (Gray, 2008).

Contextual factors of a patient’s life, including personal and environmental are described in the ISF model. Environmental factors are represented by a social and physical facilitations, policy, and barriers, attitudes of other individuals, discriminatory practices and legal protection. Among personal factors are gender, age, sense of self-efficacy and interests.

At the present moment, the 2 standardized criteria are used for diagnosing of autism. Core diagnostic features incorporate impairments of social interaction and communication with stereotyped and restrictive patterns of behavior, activities, and interests. They are determined in the preschool years and accompanied by delays in attention and nonverbal skills, delays in language understanding and use, symbolic play difficulties, as well as difficulties in social interactions with peers and parents. The medical differential diagnosis of this disease incorporates developmental language disorders (DLDs), global developmental delay, and severe sensor-neural hearing impairments.

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3. Psychologists help people to understand themselves and interact with other people and the environment. They use various types of therapies for their patients with autism. Most people with this disease have compromised abilities in spoken language. That is why, psychologists rarely use talk therapy while working with autists (Rudy, 2010). However, if the individuals have strong spoken language skills, psychologists can use spoken therapy. During work with autistic individual, psychologist should understand how the patient utilizes his or her social communication skills.

Autistic individuals have a different way of thinking, misinterpretation of signals and often have problems with making sense of what they are seeing. Therefore, usually patients are suffering from anxiety, and psychologists have a lot of work to do.

Psychologists perform different treatment programs and support process of evaluating  problems, such as social anxiety, perseverative behavior, and depression. They help autistic persons to manage social interactions, school and work relationships, and understand social cues.

Psychologists are usually involved from the beginning, providing services for diagnostics and treatment to autistic persons,

Applied Behavior Analysis (ABA) is a special service provided by psychologists against autism and its consequences. ABA incorporates different principles and techniques for bringing beneficial and positive perceptions in behavior. It focuses on the observable behavior within the environment, including hypothetical constructs. Usually, for autistic persons psychologists use different methods of validated intensive behavioral interventions.

One of the most popular interventions is the Lovaas model. It is a mode of early intensive behavioral intervention. It is the only therapy approved by the United States Surgeon General's office. The model includes discrete-trial learning, breaking skills down to their basic components, rewarding positive performance with praise, followed with generalizing skills in a naturalistic setting. The Lovaas model required to be intervened for about 30-40 hours a week for obtaining positive results, such as gaining language, basic living and academic skills for the children under 5 years of age.

This therapy is based on discrete trial training methods for decreasing stereotypical autistic behaviors by means of provision and extinction of acceptable alternatives to self-stimulatory behaviors in society. 

During the first year treatment, psychologist teaches imitation, decrease self-stimulating behavior, establishes playing with toys in their intended manner, and integration of the family into the treatment against autism. 

During the second year, the autistic child is learning abstract and early expressive linguistic skills, basic socializing and peer interaction skills, and strives for incorporating child's community in the treatment for optimization mainstreaming while decreasing any stigmatization sources. 

During the third year, the therapy is directed towards variation and emotional expression, in addition to observational studying, and pre-academic skills, such as arithmetic, reading and writing (Autism). 

Each lesson contains combinations of prompts (gestural, verbal, physical, etc.), like ‘put on’, ‘give me’ referred to color or object. The child should respond to the prompt correctly. Every correct response is supported by edible or verbal praise or something like this.

Another popular intervention is the pyramid educational model. It consists of 4 main elements: functional communication; functional activities; powerful reinforcements and strong behavioral intervention plan. Usually, different pictures are used in the visual reward systems, like ‘puzzle’ cards in which a child earns pieces of a picture of a desired object. 

Pictures are used for various forms of interactions during the day activities, such as visual supports for verbal instructions, for an example, showing a picture of an apple with the request, "Let’s take an apple". Children are also taught to use sequences of pictures as efficient schedules for activities.

4. Autistic persons face various challenges. Often, they cannot properly understand other people and interact with them; they have no ability to pay attention to one particular subject, perform everyday activities (like dressing and eating in a proper way) and receive education, just because they cannot write or read. 

Abovementioned interventions will help such children to identify subjects and use them in a proper manner, as well as understand other people and interact with them. 

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