Autism is one of the disorders that are a part of the Autism Spectrum Disorders (ASD). The neuro developmental disorders manifest in symptoms such as exhibition of repetitive behavior, impaired social interactions and restrictions in communication and expression. Autism is thought to originate in childhood, when malfunctions occur during the development of the brain. However, it affects individuals throughout the life time. A large percentage of the research stories done in the past focused on autism in children. This is despite the fact that children with autism grow into adults with autism. A smaller number of individuals are also diagnosed with autism in their adult years.
Adult psychiatrists have initiated research projects that seek to understand how this behavioral disorder affects adults. This paper will focus on autism in adults from both a scientific and an analytical point of view. The paper will address research questions touching on the physiology, epidemiology and anatomy of the condition. It will also feature the implications of the disease as it relates to cost. Statistical analysis will also be applied in regards to the issues raised. The main research question to be addressed is how autism in adults affects the body and mind, and how these changes do affects the quality of life.
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Scientific Perspective of Inquiry
Anatomy of Autism
Autism affects the neuroanatomy of the human body. Individuals living with autism are observed to have neuroanatomical differences that distinguish them from exhibiting neuro typical controls. The anatomical differences are not observed in the same presentation for each behavioral diagnosis. However, a majority of the diagnosed patients exhibit a range of the following differences. The cerebellum shows the main changes in the brain of an adult with autism. The neuroanatomical change is hypoplasia observed in the 6th and 7th central cerebellar vermis lobules . The change shows that the cerebellum has an incomplete number of cells. The change is often due to under development and a deficient or less than the normally observed number of cells. Some of the adult patients with autism were also observed to have some reductions in the inferior cerebellar vermis volume. However, some of the diagnosed adults have cerebellar hyperplasia instead of hypoplasia. The cells in these regions are overgrown and they are more than the number of normal cells (Sharon et al., 2016).
The amygdala is the second most studied part of the brain when it comes to the neuropathy of autism. According to Donovan (2017), the amygdala is a group of nuclei located in the anterior medial temporal lobe. This part of the brain plays a major role in the processing of emotions. It is responsible for regulating responses to stimulus this elicit emotions such as pleasure, anger, fear and aggression. A malfunction in the amygdala and some of its supporting structures may be responsible for some of the malfunctions observed in the autistic adult. For example facial and emotional recognition is limited in such patients. Additionally, emotional memory and impulses related to prediction of reward is limited. The brains of most autistic adults are known to have a decrease in the size of neurona cells. Additionally, an increase in the cell densities is also observed. These abnormalities have also been associated with the seizures that some of these patients experience. An overgrowth of the frontal cortex is also thought to contribute to some of the symptoms (Donovan & Basson, 2017).
Physiological Issues
Conditions such as immune imbalance and gastrointestinal abnormalities have been associated with the pathophysiology of autism. Several factors aggravate the pathogenesis of the problem. They include gastroesophageal reflux, abdominal pain, reflux, vomiting, chronic diarrhoea and intestinal infections. These issues are additional symptoms that may be observed in autistic adults. They affect each adult in varying intensity. An additional study associated the condition with leaky gut due to hampered permeability of the intestinal mucosa. This study though inconclusive, showed a relationship between the gastrointestinal malfunctions and the suppressed immune system. The increased permeability causes more problems in the body.
Pathological Issues
Adults with autism experience pathological demand avoidance. It is inevitable if the characteristics that are used to diagnose the condition. These individuals avoid the everyday challenges and demands on their attention. It is not uncommon for such a person to avoid physical contact and even conversations as long as they feel uncomfortable. Such a person will be more comfortable giving excuses that allow them to distance themselves from interactive situations. The person will also be more inclined towards role playing because they maintain a semblance of control through the persona. The autistic adult will relax if they feel safe and in control. However, they will withdraw and become aggressive if they find themselves in a situation where their control is threatened (Samsam et al., 2014).
Epidemiological Issues
One out of 3 adults with autism experiences some mental problems. The problem is thought to be accelerated by the lack of continuous monitoring and therapeutic engagement in adulthood. The worsening of the situation could also be due to the repeated exposure to the environmental substances thought to contribute to the condition. The factors include air pollution and some disturbances in the endocrine balance (Lyall et al., 2017).
Body systems Affected
The body systems affected is the nervous system and the brain. Adults have challenges of verbal and non verbal communication as well as some motor skills. Halladay (2016) state that adults suffering from autism have difficulty communicating well with other people. They are often withdrawn and this hampers their ability to socialize. They do not respond easily to social cues like jokes or funny remarks. They rarely smile and do not respond to or initiate unnecessary physical contact. They are often preoccupied with order and routine. They are insistent on maintaining a particular routine despite any changes in the environment. This characteristic often makes it difficult to correctly diagnose autism as it is similar to obsessive compulsive disorder. Autistic adults are often focused on the object that captures their attention. They will concentrate on achieving these tasks, to the extent where they abandon other tasks.
Their attention span is much shorter than average and this makes it difficult to maintain a conversation. The combination of these symptoms makes autistic adults unresponsive at worst and socially awkward at best. Their social networking is limited and it is difficult for them to form and keep functional relationships. According to Cell Press (2016), the peripheral nerves of the nervous system are also affected. This causes the autistic adult to perceive touch differently from other people. The diagnosed patients exhibited a heightened sensitivity to any sensation and to certain sounds. The touch processing and sound sensitivity makes it uncomfortable for autistic adults to socialize on the same level as other people.
Processes at the Cellular and Genetic level
Current research shows that cellular dysfunction contributes to autism at a rate of 25%. The phenotypic manifestation occurs in the same percentage. Mitochondrial dysfunction is suspected to be responsible for some cases. This happens when the mitochondrial energy metabolism is impaired. At the genetic level, the autistic adult shows various changes. There is less phenotypic heterogeneity in genetically homogenous patients. According to Samsam et al. (2014), the genetic composition shows a mutation in the de novo copy numbers mutations. The condition may also be caused by variant mutations which are often rare.
They create abnormal alleles in the persons affected as well in their close relatives who share similar genes. These genes are responsible for the behavioral and neuroanatomical changes that are observed in autistic adults. Other studies show a change and malfunction in the genes responsible for synapse function. The scaffolding proteins responsible that participate in synaptogenesis as well as some transmembrane proteins may present abnormal structure and distorted assembly or arrangement. The synapse formation may also be affected by dysfunction of its signal transduction mechanism (Sharon et al., 2016).
Chemical or Biological Issues
Autism in adults is suspected to be worsened by exposure to pollution and other environmental agents. They include factors such as consumption of food substances, alcohol or drugs which interfere with the normal body systems. An epigenetic study supported by Autism Speaks, sought to demonstrate the effects of chemical pollution in food and water. Chemical and biological agents are suspected to be the factors that alter somebody components and result in mutation in the DNA (Halladay, 2016).
Mathematical / Analytical Perspective of Inquiry
Economic Issues Involved
Recent statistics show that autism is currently affecting more people than ever before. This makes it an economic issue because the maintenance of those affected by autism is high. The adults may experience low functioning or high functioning autism. Each of these bears an economic cost because the adult requires some level of support from those around them. Adults with high functioning autism require a minimal amount of support. Majority are able to live in private residences and even pursue an income generating activity. The adults in this classification rarely require hospitalization. A small percentage benefits from accommodation in supporting care or residential care facilities. These arrangements have a direct economic impact on the close relatives and spouses as they must facilitate this extra expense (Leigh & Du, 2015).
Adults living with low functioning autism needed additional support. About half of the people living with this form of autism relied on family members heavily. Majority of them live at home with either parents, siblings or close family members. About a tenth of these patients live with spouses. A smaller percentage of only 3% live alone while about 19% live in residential care. A tiny 1% lives in hospital so that they can get immediate and around the clock medical care. According to Durose and Richardson (2015), these circumstances raise the cost of living for all those involved. A budgetary allocation had to be made to ensure that the autistic adult receives the support they need. This includes family members and spouses sacrificing working hours in order to care for the autistic adult. Adults in residential care require the highest amount of financial investment. This is closely followed by supporting people who live with the afforded individuals (Durose & Richardson, 2015).
The Autism Society estimates that the cost of adult autism care in the US currently stands at 176 to 195 billion per year. These costs are three times higher than the health costs that children with autism incur. Leigh and Du (2015) elucidate that the cost of care of an adult with an intellectual disability can go up to 2.4 million over the span of his or her life time. This cost is crippling when you consider that this person is unable to generate an income to meet this cost by themselves. A person without an intellectual disability can incur up to 1.6 million dollars. Additionally, the extra help that an autistic student needs in the classroom costs a whopping 8600 dollars annually. Autism is an expensive and financially draining condition (Leigh & Du, 2015).
Economic Theories Applicable to Autism
The theory of production is the most applicable theory that can be used in the study of adult autism. This theory states that the price of a commodity is majorly determined by the process and cost of production. Factors that are considered include price of raw materials, labor, fuel and the volumes used. Durose and Richardson (2015) point out that this combination guides the baseline price as well as the projected profit margins. Similarly, autism is a mental health condition that affects the productivity a person as well as their quality of life. It is therefore important to apply the theory of production into the research that could generate a cure or prevent the genetic malfunctions that are suspected to cause it. For example, childhood vaccines have been thoroughly examined to disprove their role in triggering gene mutation that causes autism. This is a move in the right direction as it eliminates one of the suspected causes of the disease (Durose & Richardson, 2015).
It is also important to place emphasis on the research and fund it more because autism is currently on the rise. According to Tromans et al. (2018), each year, an additional number of individuals are diagnosed with autism. The startling part is that the health care practitioners estimate that the number of undiagnosed patients could be higher than those diagnosed. Adults suffering from autism are a burden to the economy as they are unable to sustain themselves. It is costly to care for them and to seek lifelong management therapy for them. The best solution would be to prevent or avoid the condition in the first place. In this case, the cost of production is prioritized as more money is put into prevention in order to guarantee a better economy for the future generations.
Statistical Facts on Adult Autism
The number of people diagnosed with autism in adulthood is largely unknown. However, The CDC estimates that about 50,000 teenagers join adulthood while suffering from autism diagnosed during the childhood days. More than two thirds of these numbers are male. The body projects that the figure could be higher because the girls and women are often under diagnosed. This group does not receive the kind of support they need to transition out of the school based support they are accustomed to. Most adults, who grow up seeing a pediatrician for autism, do not pursue further treatment. More than 50% of these adults do not continue their education. This limits their chances of getting into the job market. As a result, majority of these people spend the rest of their lives under the economic support of loved ones. The ability of persons with low functioning autism to be financially independent is therefore lowered by the circumstances (Tromans et al., 2018).
The government offers state funded vocational rehabilitation programs to the young adults living with autism. This program is supposed to help the young adults to develop skills that will introduce them to society and to the job market. However, only about 18, 000 of the youth take up this offer. This shows that the program is grossly underutilized. Additionally, the success rate of the program is very low. Of the enrolled participants who successfully complete the program, only 60% are able to secure employment. While this may seem like good news, it is saddening to note that only 20% of this group holds jobs that are above minimum wage. The other 80% take up part time jobs that pay an average of 160 dollars per week (Jacob et al., 2015). The program was built with the aim of capitalizing on the fact that autistic adults who engage in income generating activities promote independence. As a result, the symptoms of autism are slowly replaced by skills that help the individual to be self sufficient and less dependent on support. The independence gives the autistic adult greater autonomy and this subsequently results in a greater quality of life. However, the failure of the program dooms the autistic adult to oblivion and stagnation.
Conclusion
Autism in adults is a sad and crippling condition. It reduces some of its victims into children trapped in adult bodies. The families of these 'children' are forced to take on the responsibility of their upkeep and care. This is in addition to the gastrointestinal malfunctions and mental challenges that may arise as a result of the compromised immunity. Autism enslaved both the suffering patient and those around him. Additionally, the cost of care for an autistic adult is staggering and it affects the productivity of the entire family. It is clear from the findings above that everyone involved experiences a significantly lowered quality of life.
Eliminating the possible causes of autism from society should be the priority of every government. Awareness should also be a big part of the change that we all want to see. The government should push and back its rehabilitation programs so that it is taken up by more young adults. The program should also be drafted afresh so that the success observed by the 20% of successful graduands is replicated. This will ease the financial burden on the primary care givers who are responsible for the autistic adults. The program will also restore the adulthood to the students and help them to become productive members of society. Overall, such programs will help the entire breathe of stakeholders to enjoy a greater and fuller quality of life. The management of autism is vital to the growth of the economy and to the independence of thousands.
References
Donovan, A. P., & Basson, M. A. (2017). The neuroanatomy of autism–a developmental perspective. Journal of anatomy, 230(1), 4-15.
Durose, C., & Richardson, L. (2015). Designing public policy for co-production: Theory, practice and change. Policy Press.
Cell Press. (2016). Autism is not just a disorder of the brain, mouse study suggests. ScienceDaily. Retrieved November 18, 2018 from www.sciencedaily.com/releases/2016/06/160609134247.htm
Halladay, A. (2016) what is epigenetics, and what does it have to do with autism? Autism Speaks retrieved from https://www.autismspeaks.org/news/what-epigenetics-and-what-does-it-have-do-autism
Jacob, A., Scott, M., Falkmer, M., & Falkmer, T. (2015). The costs and benefits of employing an adult with autism spectrum disorder: A systematic review. PloS one, 10(10), e0139896.
Leigh, J. P., & Du, J. (2015). Brief report: Forecasting the economic burden of autism in 2015 and 2025 in the United States. Journal of Autism and Developmental Disorders , 45 (12), 4135-4139.
Lyall, K., Croen, L., Daniels, J., Fallin, M. D., Ladd-Acosta, C., Lee, B. K., & Windham, G. C. (2017). The changing epidemiology of autism spectrum disorders. Annual review of public health, 38, 81-102.
Samsam, M., Ahangari, R., & Naser, S. A. (2014). Pathophysiology of autism spectrum disorders: revisiting gastrointestinal involvement and immune imbalance. World Journal of Gastroenterology: WJG, 20(29), 9942.
Sharon, G., Sampson, T. R., Geschwind, D. H., & Mazmanian, S. K. (2016). The central nervous system and the gut microbiome. Cell, 167(4), 915-932.
Tromans, S., Chester, V., Kiani, R., Alexander, R., & Brugha, T. (2018). The Prevalence of Autism Spectrum Disorders in Adult Psychiatric Inpatients: A Systematic Review. Clinical practice and epidemiology in mental health: CP " EMH, 14, 177.
