Autism Spectrum Disorder is becoming a tragedy as more children are diagnosed with ASD in America and other developed countries. According to CDC reports as quoted by Boyd, Odom, Humphreys & Sam (2010) for the past 25 years the rate of autism among American children has increased to 1 in every 91 children being diagnosed with ASD. The figures have continued to increase as depicted in Torjesen (2016) which estimated that 1 in 68 children have ASD. The unprecedented prevalence in the growth of the autism syndrome can be depicted by the 1960s rates of 0.7 per 10,000 to 2 per 10,000 in 1960s and 1980s respectively. These rates to 1 in 91-150 and 1 in 68 children in 2004 and 2014 respectively (Torjesen (2016) demonstrate that the ailment is becoming a national catastrophe. According to Wallace & Rogers (2010), boys are 3 to 4 times more likely than girls to suffer from ASD but in the rare occasion whereby a girl suffers the ailment, and they are severely affected than boys are affected. The effects may be severe for girls because of the social aspects of females compared to the male counterparts, but no studies have tried to expound on the issue of gender. ASD unlike other ailments that tend to be prevalent among different races is equal in all groups of people as shown in studies between 2000 and 2009 (Reichow, 2011). Therefore, demonstrating that the problem affects all the people but due to the different economic status and access to quality healthcare, whites’ children with ASD are less affected by the disease compared to the minorities’ children. However, the move by the government to ensure that children can seek intervention through the Individuals with Disabilities Education Act (IDEA) have contributed to the early diagnosis of ASD and interventions. Autism syndrome is one of the most complex diseases that limit the development of children from infancy with signs that can be confusing to most parents with no information on the illness. The disorders impair social interactions, language and communication impairment and the occurrence of restricted and repetitive behaviors among these children. These issues have led to parents with such children to hide their children from human exposure in the bid of protecting their children from ridicule and harsh environments or societies that have limited information on the disease. Taking care of children with ASD is a challenge that can be too much to bear with parents having to do almost everything for the children even in their teens (Torjesen, 2016). If left untreated, it affects even the adulthood of these children, therefore, making it a social problem that must be understood to ensure communities are not judgmental to these children but help in creating a conducive environment for the children.
Importance
The study will enhance the understanding of ASD and demonstrate that early community-based behavioral interventions are effective in proving the society. The findings will also allow the social workers and policymakers to change the strategies towards increasing the civic education strategies and enhance mandatory screening of children below three years and interventions. The move will enhance the conducive environment for the parents and children with ASD and also indirectly influence positive economic growth as parents will be able to work rather than using all time caring for the children with ASD. Lastly, policies influenced by this study will also benefit children with ASD to improve their lives and futures.
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Review and Synthesis of the Literature
Scholars have over the years tried to understand the causes and treatment of ASD for the past six decades, but since the turn of the 21st century, improvement and studies on treatments have skyrocketed. The field of study is, but it is evident that in all these studies, ASD has no permanent cure or no cure. However, there are behavioral treatments that include parents and children that help improve the development of these children and enable them to at least improve their lives and limit the burden of caring for such parents. In the early 2000s, most of these studies demonstrated that behavioral techniques were improving the lives of the children, but the efficiency was not the same in all group of ASD children (Reichow, 2011). Since then scholars have understood that early intervention on children with ASD is more effective than when used with older children. In the bid to understand the different effects of interventions mainly behavioral programs, the study used the internet to access psychological, social, pediatric, among other journals and empirical articles to understand ASD and treatment or interventions. The topic is widely researched, but with most data restricting access to the journals, it was difficult to review a large number of studies. However, even with these shortcomings, the study was able to acquire informative and quality material for its literature review. The literature is limited to the efficiency of early interventions.
Early Intervention on Children with ASD
According to Camarata (2014), the ability to reduce the impacts of autism is through the development of diagnostic techniques. The evolution from infantile autism to autism spectrum disorder (ASD) was a significant challenge among parents and clinicians. However, the study demonstrates that the understanding of the ASD to refer to the early stages or relative subtypes would make it easier for clinicians to treat a specific subtype or spectrum thus yielding positive results. Autism, as was earlier know, was too complicated and hence the use of the AD to define the more severe disorder. In this study, Camarata (2014), demonstrate that the lack of justifiable data due to the absence of extensive data and randomly assigned control groups in the heterogeneous ASD population have resulted in contradictions on whether early interventions are as effective as some studies argue. The failure of the British National Health Service (NHS) to adopt the universal screening as proposed by the American Academy of Pediatrics for children below two years has been proof of the challenges in the studies undertaken on this subject. The study offers a literature review of studies on these factors and critically analyze them to determine whether screening of children under the age of 2 years would help improve their lives compared to identification of in the future. The study concluded that the use of speech delays among toddlers does not guarantee ASD and with most studies before 2014 using speech and language issues as the primary focus in determining ASD diagnosis, the field is lacking as it does not constitute substantial data evidence. The surveys were undertaken, and the unexplainable head diameters depict that even with the advancement in knowledge in the field, the studies do not constitute of substantial evidence for mandatory screening of children. Camarata’s allegations are disputed by (Rollins, Campbell, Hoffman & Self, (2015), through undertaking a study that examined Pathways Early Autism Intervention which employs a parent-mediated, community-based, intensive behavioral and developmental intervention program. Rollins and her colleagues used the program to understand the success and failures of the program when used as a model for state-funded early intervention programs. It used four boys, 2 Hispanics, one black and one white, for the study together with their mothers. The examination to involved educating mothers on the ways to intervene and help their boys which included identifying the reinforcers, using behavioral analysis (ABA) in daily interactions, and eye contact (Rollins, Campbell, Hoffman & Self, 2015). The mothers were encouraged to engage their children with toys, eye contact, use animations, expressions and object control and engage reciprocal imitation as a daily routine. The home visits by the interviewers would use 10 minutes of videos. The findings demonstrated that Pathways was useful for early social communication measures but did not improve the nonverbal turn taking. Three of the four children improved their eye contact and social engagement, but only two boys improved the nonverbal turn taking. The positive findings except for child 3 in the social communication and eye contact provide a 75% success rate, but it still had a lower success rate in nonverbal turn-taking which was 50% (Rollins, Campbell, Hoffman & Self, 2015). The study used four boys which is a meager number when undertaking such a study and proving Camarata’s allegations of inadequate synthetic data. The failure to include at least one girl in the study also failed to determine the effects of Pathways interventions in females. Therefore, it may seem to be correct that scholars in the field tend to focus on results rather than using sample sizes that would reflect the ASD population. Boyd, Odom, Humphreys & Sam (2010), addressed the issue of ASD demonstrating that the understanding of the ailment and early diagnosis and interventions are the keys to improving the lives of the children with ASD and their families. The study summarized different scientific and policy information on the topic thus supporting that based on their reviews the early interventions are appropriate and more effective in mitigating the effects of ASD. The authors proposed the use of behavioral and developmentally-based treatments to enhance the growth and development of the children (Boyd, Odom, Humphreys & Sam, 2010). However, most of the analysis lacks supporting evidence to the conclusion. Hume, Bellini & Pratt (2005), demonstrate that the extensive use of these strategies have been found lacking with the intensity of engagement lower than most scholars suggest. However, parents’ training was identified as a key contributor to the effectiveness of any technique used. The study examined the different interventional programs and approached with almost similar results apart from the music therapies that had 16% of people disagreeing on its relevance(Hume, Bellini & Pratt, 2005). Hume and her colleagues analyzed 195 questionnaires from parents of children with ASD to understand the best method they used to enhance their children’s development (Hume, Bellini & Pratt, 2005). The findings demonstrated that early interventions worked in more than 70% of the children with people either strongly agreeing or agreeing to the questionnaires questions (Boyd, Odom, Humphreys & Sam, 2010). The different early interventions boosted the social communication, emotions and cognitive development. In this study, it is evident that about 30% of the parents disagreed or strongly disagreed thus making it clear that the programs are imperfect. Sullivan, Stone & Dawson (2014) concur with the imperfect and over exaggerated results in the efficacy of early interventions. Sullivan and colleagues explored studies on the topic taking a neutral standpoint to understand the effectiveness and deficits in early intervention programs. By reviewing different researchers, it was evident that evidence-based characteristics of interventions for toddlers were lacking. It was evident that most of the studies on this topic relied on short-term strategies these programs use and inability to demonstrate the plasticity of the young brains responses to the interventions. The studies also fail to understand the family composition a view shared by Copeland, (2013) and Dunst & Trivette, (2009). The inability of these studies to focus on family composition, stress, anxiety and economic status result in policies that do not benefit the ASD population. Sullivan, Stone & Dawson (2014) demonstrated the gaps in the ASD intervention strategies. Unlike all other articles reviewed, this article employs all issues and scopes of the topic such as brain development science, sociology, psychology and other biological functions to explain ASD and child development. It concludes that as most studies on the efficacy of early intervention exaggerate the success rates, therefore, using a multidisciplinary aspect would improve the programs (Sullivan, Stone & Dawson, 2014). The authors agree that early intervention is essential to the success of mitigating ASD impacts but differs with the data and strong evidence depicted in most researchers.
Critical Analysis and Implications
The debate on the efficacy of early interventions is one of the hottest subjects among clinicians and ASD scholars. According to Camarata (2014), the studies and researchers lack evidence-based and statistical analysis that can be used to determine the efficacy of these programs. Sullivan, Stone & Dawson (2014), on the other hand, concurs and differs with Camarata and proponents of early interventions concurrently. Sullivan and colleagues agree that early interventions are successful, but most of the success stories are exaggerated due to lack of evidence-based studies and small samples or participants in the experiments conducted. Therefore, it is clear that studies such as that undertaken by Boyd, Odom, Humphreys & Sam (2010) only used four boys in a community that more children are diagnosed with ASD which fails to achieve the benefits of the study to the community at large. The reviews of different studies by Hume et al. does not change these limitations with the study’s limitation claiming that existence of bias and vague assumptions. Therefore, it is correct to claim that early intervention for children with ASD is successful but needs changes to provide reliable, evidence-based studies that can be used to facilitate change in policies and community understanding of ASD.
References
Boyd, B., Odom, S., Humphreys, B., & Sam, A. (2010). Infants and Toddlers With Autism Spectrum Disorder: Early Identification and Early Intervention. Journal Of Early Intervention, 32(2), 75-98. Camarata, S. (2014). Early identification and early intervention in autism spectrum disorders: Accurate and effective?. International Journal Of Speech-Language Pathology, 16(1), 1-10. Copeland, L. (2013). Early Intervention Issues in Autism Spectrum Disorders. Autism-Open Access,03(01). Dunst, C., & Trivette, C. (2009). Capacity-Building Family-Systems Intervention Practices. Journal Of Family Social Work, 12(2), 119-143. Hume, K., Bellini, S., & Pratt, C. (2005). The Usage and Perceived Outcomes of Early Intervention and Early Childhood Programs for Young Children With Autism Spectrum Disorder. Topics In Early Childhood Special Education, 25(4), 195-207. Reichow, B. (2011). Overview of Meta-Analyses on Early Intensive Behavioral Intervention for Young Children with Autism Spectrum Disorders. Journal Of Autism And Developmental Disorders, 42(4), 512-520. Rollins, P., Campbell, M., Hoffman, R., & Self, K. (2015). A community-based early intervention program for toddlers with autism spectrum disorders. Autism, 20(2), 219-232. Sullivan, K., Stone, W., & Dawson, G. (2014). Potential neural mechanisms underlying the effectiveness of early intervention for children with autism spectrum disorder. Research In Developmental Disabilities, 35(11), 2921-2932. Torjesen, I. (2016). Early intervention may limit severity of autism symptoms. BMJ, i5776. Wallace, K., & Rogers, S. (2010). Intervening in infancy: implications for autism spectrum disorders.Journal Of Child Psychology And Psychiatry, 51(12), 1300-1320.
