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Winnifred Kern Mr.

Conrad Health 1 Block 1 Autism Spectrum Disorder 29 December 2012

Autism, also known as On the spectrum, Mindblindnss, and Retard, was first discovered in the 1940s by Leo Kanner, a child psychiatrist at John Hopkins Medical School in Baltimore, Maryland, while studying a group of kids he noticed that they all had similar characteristics- extreme social isolation, communication difficulties, and ritualistic behaviors. The word Autism came from a term that is used for describing people with Schizophrenia. The confusion between the two mental illnesses resulted in children that were once diagnosed with Autism later being re-diagnosed with Schizophrenia. Kanner hypothesized that Autism was due to abnormalities in the brain, others thought it was due to poor parenting. Supposedly it was thought that children who found their world scary and hostile tended to have unusual behaviors. Mothers were the ones who were mostly blamed, they were accused of being cold and unfeeling. So the children were removed from their homes and put into institutions. But Kanner recognized that is was most likely physiological reasons for the unusual development. In the 1960s, Bernard Rimland promoted the idea that Autism was due to brain abnormalities. He hypothesized that Autism is a neurologically based syndrome. O. Ivar Lovaas developed behavioral treatments that showed children with ASDs could learn given a highly structured environment where rewards and punishments were given in a constant manner: speech improved and aggression tendencies diminished. The separation of child and parent was no longer a choice in the 1970s, specialized school were built with staff trained for behavioral treatment. When a child did something that was deemed improper the punishments could become harsh, but when they did something that was considered right the rewards were positive.

No one knows the true cause if ASD. Studies shows that there is a familial pattern or genetic input, meaning that Autism tends to run in families. If a mother births identical twins and one is affected by Autism it is most likely that both are affected. Siblings of children with ASD have a 2-3% chance that they too have an ASD. Sometimes siblings do not show full symptoms of behavioral differences. Most professionals believe that children with ASD have abnormalities in the central nervous system. The brain has approximately a hundred billion special cells called neurons that enable its various parts to communicate. When flaws occur many symptoms may form, such as difficulty controlling body movements, and problems processing and apprehending information. The nervous system differences in children with Autism may directly affect their ability to communicate socially, the differences contribute to the rituals and repetitive behaviors. Scientists have hypothesized that there may be extra or too little of neurotransmitters in some children with Autism. These children may have high levels of certain neurotransmitters called serotonin. Serotonin can be controlled by a medication called Selective Serotonin Reuptake Inhibitors or SSRI. By controlling the amount of serotonin in the brain, the neurotransmitters may be able to function more on the MRIs of the brains belonging to children with an ASD. MRI studies have shown that there are often structural differences in the brain of people with Autism. Dr. Eric Courchesne reported that children with Autism have a smaller head circumference at birth, but then show rapid head growth in the first year of life. He presumed that rapid head growth in the first year makes learning difficult since the growth may cause an abnormally large amount amount of neural connections. Other studies show that small percentages have an uncharacteristic electroencephalogram (EEG) results. But most children with an ASD do not have an abnormal EEG reading. Autopsies of people with ASDs have shown

that their brains are heavier than usual, entailing that there may be an excess amount of nerves in the central nervous system. Most recent hypothesis involves immunization shots that are normally given to toddlers. The vaccinations usually contain a mercury based preservative called Thimerosal. Some people are concerned that the vaccinations that contain Thimerosal may be giving young people mercury poisoning. As a safety measure in 1999 the U.S Public Health Service, the American Academy of Pediatrics, and vaccine manufacturers agreed to cease the usage of Thimerosal in vaccines for children. No medical conditions has been shown between people with an ASDs but there is a higher probability that they had a history of encephalitis, phenylketonuria, tuberous sclerosis, maternal usage of cocaine during pregnancy, or anoxia, the loss of oxygen during birth. It may be one of theses factors that lead to the development in a fetus that has already been predisposed to Autism in some form. The diagnosing rate has risen over the decades. In the 1960s, 5-15 in 10,000 births were diagnosed. Recent studies have shown that as many as 1 in 88 have Autism. Diagnostic criteria in the Diagnostic Statistical Manual have increased the number of children that fall into the spectrum range. There are thoughts that immunization has caused this increase, others believe it is due to more pediatricians, psychologists and other evaluators that are now trained in recognizing symptoms of ASD. It is thought that Autism is four times more likely to develop in males. With an exception of childhood disintegrative disorder, behaviors affiliated with ASD must be present before the age of three. Diagnosis can be made when a child is older but records of early development must be present to ensure that there were early signs. Children with Autism usually test in the mental retardation range on traditional intelligence tests. Diagnosis of mental

retardation if necessary is an individual demonstrates difficulty with daily living skills (i.e. dressing, bathing, participation in the community) and scores less than a 70 on an IQ test. There are many difficulties for there is lots room for interpretation when diagnosing ASDs. Since there are no medical tests that can rule things in or out doctors must rely on observations, experience, and a childs medical history. The diagnosis relies solely on the assessment of whether the person displays symptoms of a certain ASD. Until the Diagnostic Statistical Manual IV there were only two Autism Spectrum Disorders- Infantile Autism and Atypical Autism. The other three spectrums, Asperger's disorder, Retts disorder, and CDD or Childhood Disintegrative disorder. were rarely acknowledged during evaluation before 1994. These three disorders have complicated the diagnostic process since children with ASDs exhibit a wide range of characteristics and abilities. In order to be diagnosed a child must show all three of the triad symptoms with at least six symptoms in these categories: two or more in qualitative impairment in social skills, at least one in qualitative impairment of communication, and at least one in the area of restrictive and repetitive behaviors. Qualitative impairment in socialization is shown by marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures. Other impairments would be failure o develop peer relationships appropriate to age, lack of spontaneous seeking to share enjoyment, interests, and achievements with other people, and lack of social or emotional reciprocity towards others. Qualitative impairments in communication include delay or total lack of the development of speaking. In individuals with adequate language is the impairment to sustain a conversation with others. Some children use stereotyped and repetitive use of language or idiosyncratic language. Communication may involve a series of

gibberish used on the child's part with hand motions and lack of eye contact. The child may stare at one thing, the floor, or continuously move his or her eyes and or head around while continuing to speak. Repetitive and stereotyped patterns of behavior and interests encompass the occupation with one or more stereotyped and restricted patterns of interest that i abnormal either in intensity or focus. A child might also show apparent inflexibility to routine or schedule changes and stereotyped and repetitive motor mannerisms. Symptoms of qualitative impairments in social skills, communication, and the presence of ritualistic behaviors a child will show uncommon behavior during socialization, uncharacteristic communication, and express odd behavior that is repeated continuously. Others will have a complete lack of varied make-believe play or socially intimate play. Symptoms must occur before the age of three. Signs may be disinterest in showing affection or absence of making eye contact or looking at another face, responding to ones name, and pointing. Some may develop a small vocabulary then lose it for no seen reason. There is no single treatment for ASD, but there are many ways to help minimize the symptoms and maximize a persons abilities. Common treatments for Autism involve behavioral and physical therapy, , education, and medication. Parents, as well as health providers, can provide effective treatments. Research shows that starting treatment for Autism as young as possible greatly improves long-term outcomes. A treatment called Applied Behavior Analysis uses one on one teaching approach that reinforces various skills. Since it is usually done at home this form of treatment is very expensive, often requiring parents to seek financial help. TEARCHC ( Treatment and Education of Autistic and Related Communication Handicapped Children) uses picture schedules and other visual cues that help the child work independently and organize their environments, helping to improve adaptation skills and accept problems better.

Medications are used to treat aggression, anxiety attention problems, compulsions, hyperactivity, mood swings, sleep difficulty, and tantrums. Some medications used to treat these problems are SSRI, Divalproex Sodium, mood stabilizers, and Methylphenidate. Other treatments involve occupational, physical, and speech-language therapy to improve socialization skills. The cost of annual financial aid in the United States is approximately $137 billion a year. For someones life span it will cost approximately $1.4 to $2.3 million depending on the severity of the childs Autism. The yearly cost can add up to $76 thousand for those with severe disabilities and approximately $67 for a less severe case. These costs include doctor visits, medication, occupational, speech, physical therapy special education camps, child care, and education. A total of thirty-seven states and the District of Columbia have laws related to Autism and its insurance coverage, at least thirty-one states require insurers o cover treatments. These states include, Arkansas, Arizona, California, Colorado, Connecticut, Florida, Illinois Iowa, Kansas, Kentucky, Louisiana, Maine, Massachusetts, Michigan, Missouri, island, South Carolina, Texas, Vermont, Virginia, West Virginia, and Wyoming. During the 2007-2008 legislative session, nine states passed legislation laws related to Autism and insurance coverage. Arizona, Florida, Illinois, Louisiana, Pennsylvania, South Carolina, and Texas made a bill requiring coverage for Autism. In 2009, Colorado, Connecticut, Montana, Nevada, New Jersey, New Mexico, and Wisconsin passed a law requiring insurance coverage for Autism. Illinois enacted a bill requiring insurance coverage for rehabilitative services for children with Autism. In 2010, Iowa, Kansas, Kentucky, Maine, Massachusetts, Missouri,New Hampshire and Vermont required insurance coverage for Autism. In 2011, Arkansas California, New York, Rhode Island, Virginia, and West Virginia passed a law requiring insurances to cover Autism Spectrum Disorders. In 2012, Alaska and Michigan

created a bill requiring coverage and in the same year Alabama required insurance plans to offer coverage for ASDs.

Works Cited

Ainsworth, Patricia and Pamela C. Baker. Mental Retardation. Mississippi: American University Press. 2004. Print. Autism Society. BBB Accredited Charity, 2012. Web. 28 December 2012. Autism Spectrum Disorders. NICHD. 30 November 2012. Web. 29 December 2012. Autism- World. Autism World, 2006. Web. 26, December 2012. Bruey Thornaworth, Carolyn. Demystifying Autism Spectrum Disorders. Maryland: Woodbine House. 2004. Print.

NCSL. National Conference of State Legislatures, 2013. Web. 30 December 2012 Neisworht T., John and Pamela S. Wolfe. The Autism Encyclopedia. Maryland: Paul H. Brooks. 2005. Print. Walencia Konrad. Dealing With the Financial Burden of Autism. The New York Times. 22 January 2010. Web. 29 December 2012.

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