CHILDHOOD AUTISM AND BENEFITS OF DIFFERENT THERAPY TYPES by Amy L. Hanson A SENIOR THESIS m GENERAL STUDIES Submitted to the General Studies Council in the College of Arts and Sciences at Texas Tech University in Partial fulfillment of the Requirements for the Degree of BACHELOR OF GENERAL STUDIES Approved 'JSROf:ESSOR JOYCE ARTERBURN Department of Exercise and Sports Sciences Chairperson of Thesis Corum ittee PROfESSOR LAURA BORCHARDT Department of Exercise and Sports Sciences PROFESSOR VINCE LEMBO Department of Psychology Tarrant County College Accepted PROFESSoR MitHAEL SCHOENECKE Director of General Studies AUGUST 2001 -"fl ~oot ACKNO~EDGEMENTS tlO·IJ C , ;;._.. I would like to thank my thesis committee, Professors Joyce Arterburn, Laura Borschardt, and Vincent Lambo, and Director of General Studies. Michael Schoenecke. for all their support, enthusiasm, and kindness. Without their understanding and belief in me, I could not have completed my thesis. In addition to my committee and director. I also want to acknowledge my family and friends who continually supported me with their understanding and fellowship during the period in which this thesis was written . .. 11 TABLE OF CONTENTS .. ACKNOWLEDGEMENTS ·························································································· 11 CHAPTER I. INTRODUCTION TO AUTISM I Disordered Language . .. 3 Social Impairment . .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 4 Social Awkwardness . .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 Repertoire of Unusual Behaviors .......... ................................................. 5 Abnormal Cerebellum .. .. .. .. .. .. 6 Autistic Savant . .. 7 II. MEDICAL AND NONMEDICAL APPROACHES TO AUTISM ................................................................................................ 8 Theory of Mind . 8 Lateral Pressure Equipment . .. 9 The TEACCH Method ........................................................................... 11 Applied Behavior Analysis .. .. .. .. .. .. .. .. ... .. .. .. .. .. .. .. .. .. .. .. .. .. .. 14 Medication . 16 Vitamin B6 and Magnesium .................................................................. 17 Secretin . 19 Melatonin . .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .... .. .. 20 III. SENSORY INTEGRATION DYSFUNCTION .......................................... 22 The Tactile System ................................................................................ 23 The Vestibular System .......... ............................................ .... ............ ..... 23 The Proprioceptive System .................................................................... 24 Ill Sensory Adventure Camp ............................. ......................................... 25 Sensory Integration Training . 26 Auditory Integration Training ................................................................ 27 IV. CONCLUSION ............................................................................................ ~9 Early Intervention .................................................................................. 29 Treatments .............................................................................................. 31 REFERENCES .............................................................................................................. 33 IV CHAPTER I INTRODUCTION TO AUTISM Autism is a neurobiological disorder that affects over 400,000 Americans. Autistic people have many deficits, typically in the areas of physical, social. and language skills. Leo Kanner coined the term "autism" in 1943 from the Latin word "aut." meaning self, because these people, specifically children, seemed to be excessively preoccupied and withdrawn. To this day, the cause of autism is unknown, but researchers are gaining knowledge that helps them better understand the consequences of this debilitating condition and how they can help those who are affected by it. Two years ago, there were four to five documented cases of autism out of every 10,000 live births. Now, the newest information published in 2000 states that there are as many as 45 to 60 cases out of 10,000 live births (Autism, 2001 ). The difference in these numbers is staggering. Several theories attempt to explain the dramatic increase in numbers. The increased awareness of childhood disorders is one theory. Another theory that causes much concern is that autism may be a result of the increased number of vaccines-many of which contain mercury as a preservative-administered to children. Although this has not been proven, the FDA has moved to eliminate the use of mercury in vaccines (Autism, 2001 ). With no cure and no prenatal test for autism, there is no immediate hope of eliminating this condition. Continued research concerning the best way to teach autistic children, and continued scientific research concerning possible treatments for autism, are the greatest hope for dealing with the effects of this profound developmental problem. I Of those labeled autistic, 80% are also classified as mentally retarded. Many characteristics differentiate an autistic person from a person who is only diagnosed with mental retardation. There is a greater likelihood that the autistic person shows awkward mannerisms, postures, and habits. Behaviors such as hand-flapping, rocking. strange food preferences, lack of eye contact, and insensitivity to pain may be evident in the autistic child, and some children frequently display self-injurious behaviors. Autistic children may also take great interest in inanimate objects, especially mechanical devices and appliances. In addition, they also display abnormal play behaviors, which will be discussed in detail later. Autism affects three times as many boys as girls. Frequently. this disorder is present at birth and in early infancy, but in all cases it becomes evident within the first 30 months of life. The first sign of autism in infants is a tendency to be indifferent towards affection and physical contact. Some infants will even arch their backs when held or cry until they are put down. Parents may also suspect something is wrong by the age of 2 when speech patterns generally develop. At this time, parents may notice that speech is abnormal, slow, or nonexistent. Psychologists may label an autistic child with the term "Pervasive Developmental Disorder" (PDD), which covers a spectrum of disorders that have some of the same characteristics such as delayed learning and communication. The extent or type of syndrome may not be evident until the child is 2 or 3. Other types of Pervasive Developmental Disorders are Rhett's Syndrome, Asperger's Syndrome. and Fragil X Syndrome. 2 Disordered Language One of the defining characteristics of autism is disordered language. There may be a replacement of speech by strange mechanical sounds. Another language charac­ teristic of autism is a term called "echolalia." This is when a person repeatedly uses a word or a phrase said by others. According to Cohen and Volkmar (1997), '"echolalia may be used when a child realizes he/she is expected to say something, but does not know what or how to formulate it" (p. 165). When an autistic child does not know how to formulate what he wants to say, the child tends to become irritated, and, as a result. a negative behavior arises. "Young children with autism or PDD develop very idiosyn­ cratic ways of expressing basic meanings. As a result, their behavior is incomprehensible to most people. Parents often become critical mediators between their children and the rest of the world" (Cohen & Volkmar, 1997, p. 167). For example, a 4-year-old autistic boy chanted "rabbit, rabbit" when he wanted to watch his favorite movie Alice and Wonderland. His mother understood what this meant since he became very excited when the rabbit appeared in the movie. Now, when the young boy wants to watch a movie, he continues to chant "rabbit" for "movie." This example clearly describes how closely experience and language are tied together with children who are affected by autism. If an autistic person does learn language, a better understanding is achieved when symbols are introduced to explain a specific act. According to Grad in ( 1999), they will use this model to interpret other similar situations and process them according to the symbols they have previously acquired. 3 Social Impairment Another one of the key characteristics of autism is an impairment in the ability to interact socially with others. In other words, individuals with autism usually avoid all forms of social interaction. Many autistic individuals display inappropriate behaviors such as tantrumming or running away in an attempt to isolate. At one point, researchers believed that autistic-like people feared others, but recent studies have helped discount this idea. Instead. it is thought that people with autism are hypersensitive to certain sensory stimuli. For example, children with autism may cringe at the sound or pitch of a particular person's voice, or they may get terribly offended by the smell of someone· s perfume. Subtle things such as these may agitate an autistic person to the point that a behavior becomes a serious problem. (More detailed information about sensory overload will be discussed in the sensory integration section.) Autistic people also seem to be socially indifferent at times. For instance, they do not mind being around others. but at the same time they do not mind being by themselves. According to Edelson