The disorders place a burden not only on the individuals and families involved, but also on systems of support and on the community (for example, increased needs for service providers and funding for special education and professional training, and loss of work time for family members needing to attend to their child).
A little about ASDs
Autism Spectrum Disorders, also known as pervasive developmental disorders, involve deficits in an individual’s ability to communicate and socialize, and can also include many odd behaviors, strange reactions, and different ways of seeing and understanding the world. The vast majority of children with ASDs will require special intervention services well into their school years (and for many, beyond the school years), and their families will often need assistance in managing the challenges of ASDs.
The causes of ASDs are not yet clear. Genetic factors have been identified and other possibilities are being considered, such as exposure to environmental toxins and/or infections at various times in a child’s development. Many people fear that vaccines are the cause. Multiple studies using large population bases have not found any evidence to support the link between ASDs and childhood vaccines.
The good news is that many children with an ASD get better with intensive interventions and can reach significantly higher levels of functioning. This means that many children can improve their basic communication and attention skills and be able to attend general education classes, become more independent, and contribute more to community and family life.
Treatment is intensive and demanding
The treatments for ASDs are quite time consuming and comprehensive. They require the ongoing involvement of family members, various professions and care providers. Basic skills that most children learn automatically have to be taught, such as responding to people, communicating, and understanding basic social rules and nonverbal communication (for example, accurately reading facial expressions). Many normally developing children learn how to talk by watching and interacting with others. This is not the case for most children with an ASD.
In addition to learning communication and social skills, many individuals with an ASD also need to learn how to expand their idea of play, how to relate to siblings, and how to perform usual developmental tasks such as toileting, eating and dressing. As they grow, there are also transitions to school, community, church, jobs, college, independent living, marriage and parenthood that often require additional support and lessons. All of this learning is made more challenging for individuals with ASDs because of their difficulty coping with changes in routines and unfamiliar situations.
You can understand how parents may feel overwhelmed by so much to do at the same time that they are dealing with the emotions of having a special needs child.
How to help
Awareness is the first step, because it can help you understand why people don’t act the way you expect and because it can prepare you to take effective action. Applying your knowledge about individuals and families dealing with ASDs to your social situations, family gatherings, or your planning and policies is the next step. This could include considering the needs of individuals with ASDs in schools, colleges, workplaces and homes, as well as with emergency response, security checkpoints, medical provision, and health insurance.
For example, when you see a child who mistreats or avoids children, does not appear to listen to his parents or respect others, or has temper tantrums, he or she should not be immediately judged as spoiled or as having bad parents. Also, knowing that your niece with an ASD has only a few toys that interest her, and making sure you have some of those toys at your house when she visits, could provide her comfort and improve your visit. Teaching and support staff of public and private schools can be aware that a child with autism may not respond well to traditional education or traditional methods of discipline. Knowing what to do in these cases is critical for successful education and behavior management. For police, fire and other emergency responders, knowing that a child with an ASD may not follow the directions of an unfamiliar person could aid in preventing conditions that might cause trauma or create other negative reactions. Homeland Security and TSA could use this information to understand why a parent requests to have his child walked through an airplane to become familiar with it before traveling, and could develop procedures to make travel a more pleasant experience for everyone. In addition, health providers can consider that a mother may need to have a “pre-appointment” for her son so he can get familiar with a doctor/dentist’s office, before having a procedure. These accommodations are important not only for the family and child, but also for other customers, patients and community members around the child.
To find out more, you can contact the Autism Society of the CNMI ([email protected]), the Northern Mariana Protection and Advocacy Systems, Inc. (235-7273) or go to the Autism Society of America website (www.autism-society.org), Autism Speaks website (www.autismspeaks.org) or call the Children’s Developmental Assistance Center (664-4820), or Early Childhood Special Education (664-3953).
Some other facts
For those of you who are interested in the statistics, in 2009 the U.S. Centers for Disease Control estimated that, on average, 1 in every 110 children born in the United States has an ASD. The CNMI rate of ASDs in 2007 matched the CDC’s estimate. Of the 1,388 births in the CNMI in 2007, 12 were diagnosed with an ASD. CNMI rates before 2007 were 1 in every 226 (2005), and 1 in every 185 (2006). Data from more recent years (2008, 2009, and 2010) is not available because children with ASDs born in those years are only now being identified.
Regardless of the year of birth, the number of new CNMI ASD cases has more than doubled since 2005. According to our clinic records, 16 children were newly diagnosed with ASDs between 2005 and 2007. For the following three years, 2008-2010, 42 children were newly diagnosed. 2010 had the highest number of new ASD cases identified, with 20 children total. Since 2005, 58 more children in the CNMI have been diagnosed with an ASD.
ADRIAN C. BRENN, Ph.D.
President
Pacific Clinical and Consulting
