Early Stages of Pregnancy
Autism comes in many forms from being relatively mild to extremely debilitating. It was first identified in 1943 and scientists have found it very hard to diagnose how a child comes to have autism. Is it a genetic disorder or an early exposure to thalidomide, a drug used for morning sickness in the early stages of pregnancy (Rodier, 2000)? What scientists have found is autism does begin in the early weeks of pregnancy at the start of brain and nervous system development (Rodier, 2000). If we could identify the biological basis of autism this would allow the possibility to create treatments for the disorder (Rodier, 2000).
After examining whether it is inherited, which would be a genetic factor, it has been discovered that it does indeed run in families. There is a 3 to 8 percent chance that siblings of people with the disorder may also be diagnosed with the same disorder (Rodier, 2000). After further examination it has been discovered that a variety of several genes can be linked to autism. There is also the environmental factor of autism, the drug thalidomide, the drug used for morning sickness. Not only do studies show a link to autism they also show a series of malformations such as stunted arms and legs, misshapen or missing ears and thumbs, and some neurological dysfunctions to the facial and eye muscles (Rodier, 2000). It has also been discovered that whether it be genetically or environmentally induced they both have the same characteristics such as abnormalities either with eye movement or facial expression or in some cases both (Rodier, 2000).
Studies have shown that autism is initiated in the early gestational period of pregnancy. Common symptoms of autism are sleep disturbances, no facial expressions, language delays, sensitivity to touch and sounds and limited social and emotional skills (Rodier, 2000). It has been discovered that autism is not a change in the forebrain but the lack of neurons in the cerebellum which is the processing center of the hindbrain which controls muscle movements (Rodier, 2000). The effect of autism includes a significant change to the brain stem. The brain stem of someone born with autism is shorter than someone without. The main factor that scientists agree on is that whether it is genetic or environmental, the changes happen very early in gestation (Rodier, 2000). Scientists remain confused about autism because the symptoms revolving around it are so complex (Rodier, 2000).
Early Diagnosis Issues
With 1 in 68 children exhibiting behaviors that are common with autism spectrum disorder (ASD) it is of utmost importance to diagnose it as early as possible. This is becoming a challenge in child psychiatry since most children aren’t diagnosed in the United States until they are 4 years old or older (Shen & Piven, 2017). Many behaviors associated with ASD are not usually seen in the first 2 years of childhood. Although these behaviors aren’t typically seen until the age of 2 it has become important to try and identify markers in siblings that have already been diagnosed with ASD (Shen & Piven, 2017). This brings about the “infant sibling” study design which suggests that if an older sibling has ASD there is a 20% reoccurrence rate in younger siblings. It also shows that subsequent siblings have a 15-20-fold greater risk of developing ASD (Shen & Piven, 2017).
Need for Early Detection
Early detection is necessary if we are to help children suffering from ASD. Knowing what behavioral markers to look for will ensure the best possible outcome for children with ASD and their families. Of the infant sibling studies done, many indicate that the social behavior of a 6-month-old is normal and begins to emerge over the first 2 to 3 years of life (Shen & Piven, 2017). During the sibling infant studies, behavioral markers have not been significant enough to show sensitive or specific information before the age of 12 months (Shen & Piven, 2017). Unfortunately, child psychiatrists don’t initiate treatment for autism until a child has been fully diagnosed with the disorder. Studies have shown that the earlier detection for autism the more effective treatment will be. Therefore, there is a need for early detection of ASD in infancy (Shen & Piven, 2017).
There are many clinical and ethical implications that warrant consideration when trying to diagnose children under the age of 12 months with ASD. First there is no concrete evidence that neuroimaging in infancy will replace a physician’s diagnosis, it may only serve as a tool for higher risk infants (Shen & Piven, 2017). Second, most children do not fully show signs of ASD until later in childhood usually after 24 months of age. Lastly, the most important thing is to be mindful of the parental and social effects of an early diagnosis. There is much more work that lies ahead in the field of autism, “the development and validation of biomarkers for ASD will help move the field of psychiatry toward its aspiration of precision medicine, in order to determine the best treatment, at the optimal time” (Shen & Piven, 2017).
Inclusion in Classrooms With Typically Developing Peers
Young children with disabilities are now being included in regular classrooms with typically developing peers including those children with ASD (Hart & Whalon, 2012). The challenge that lies ahead for educators is determining if a child with ASD is misbehaving or hasn’t yet been diagnosed with ASD. Recognizing the behaviors that are associated with ASD are important. The way children with ASD communicate are associated with their behavior and oftentimes may be “inappropriate” (Hart & Whalon, 2012). Conducting ongoing assessments of children can key into why a child might be exhibiting certain behaviors and give insight to whether those behaviors could be associated with ASD (Hart & Whalon, 2012).
Social communication in an inclusive setting is important for children with ASD, according to the Individuals with Disabilities Education Act. Educators need to be well informed on current practices that can improve social communication with children who have been diagnosed with ASD (Hart & Whalon, 2012). Despite the importance of implementing developmentally appropriate practices for children with ASD, evidence has shown many early childhood educators report using them infrequently. Many reasons surrounding the limited use of these practices is because typical diverse early childhood classrooms are not targeted for research (Hart & Whalon, 2012).
Importance of Early Skill Development
Ongoing research has found that the early childhood years are critical for children, with or without ASD, in developing their social skills. Therefore, it is important to have plenty of opportunities for children with ASD and other disabilities to learn in a classroom with typically developing peers. Educators need to be proactive and able to create intentional learning opportunities for all students in their classrooms. Teachers can help students with ASD communicate by using peer-mediated instruction, scripts, and providing choices (Hart & Whalon, 2012). Research has also shown that both socially and academically students with ASD and any other disability have increased social competence, positive academic outcomes, and overall improved quality of life when taught in an inclusive classroom setting (Hart & Whalon, 2012).