Autism spectrum disorder (ASD) is a type of intellectual development disorder (IDD) characterized by three main signs, i.e. impaired communication and social interaction, repetitive stereotypical behavior, and a restricted interest in early childhood acts. Genetics has a key role in the etiology of autism. Environmental factors are also interacting with the genetic profile to cause abnormal changes in neuronal development, brain growth, and functional connectivity. To date, no cure has been identified for ASD, but interventions (for example, multidisciplinary and behavioral) are available for exploitation in managing the condition in young children. Technologies are also in place to support ASD people in overcoming the adverse effects of autism. This review evaluates the current status of ASD in children, treatment approaches, and technological innovations for aiding patients in conquering the symptomatic challenges of autism.
Autism spectrum disorders (ASDs) describe a group of neurodevelopmental conditions characterized by weakened verbal and sometimes nonverbal communication. Autistic individuals face difficulties in social engagement and may end up not developing suitable peer relationships appropriate for their developmental level. Despite the various challenges, applied behavior analysis (ABA) therapy has been recommended for children with this condition, because it prepares them for a successful independent living later in their lives (Fennell & Dillenburger, 2018). Computer technology and the Internet are other areas which are slowly changing the lives of ASD people. Various innovations have been designed to help in compensating for verbal and communication problems, and ease the exchanges between ASD individuals and those around them. Behavioral impairments are known to limit autistic children opportunities to partake in recreation and physical activities (Memari et al., 2015). This paper discusses trends, recent research and scientific findings, ABA for ASD, and current innovations on ASDs.
Trends, Recent Researches, And Scientific Findings
The number of persons estimated to have the condition has been increasing over the years. According to a study by Özerk (2016), in the last decade, autism has been identified to be the fastest growing developmental disorder. In the study, Özerk (2016) notes that 10 out of 1000 children between the ages of 3 to 17 years were autistic in 2012. Likewise, 1 out of 88 children were diagnosed with ASD in the same year (Özerk, 2016). Moreover, the number of ASD children receiving special education services in different schools all over the world is rising, and the need to have quality instructors with evidence-based practices designed to counter this population is also increasing.
There are several environmental, genetic, and biological risk factors which have been linked to ASDs. The highest risk associated with autism entails the use of thalidomide and valproic acid during pregnancy. Other incidences which have been linked to this condition include prematurity and perinatal stress (Almandil et al., 2019). Advanced maternal age, lack of happiness during pregnancy, proximity to industrial zones, and preceding childhood infections are risk factors t ASD condition. However, a major factor is if one has an older sibling diagnosed with the disorder (Almandil et al., 2019). Essentially, ASD is mostly a genetic condition inherited from parents by children.
ABA Treatment for ASD
To date, there is no proven treatment for curing ASD, but several interventions are in place for consideration in managing the condition in young children. The mediations may either reduce the symptoms or increase the cognitive ability, life skills, and maximize the child’s ability to fully participate in society. Multidisciplinary interventions are those embraced by parents, and the main target is the individual needs of a child. Behavioral interventions, on the other hand, focus on developing social communication skills (mainly at early ages when a child starts to gain these skills naturally) and reducing restricted interests, as well as repetitive behavior (DeFilippis & Wagner, 2016). The above approaches are helpful in suppressing the adverse effects of autism in children.
Applied behavior analysis (ABA) is a special treatment therapy that makes use of constructive behavioral strategies in helping individuals with developmental disabilities. The various tactics employed in this kind of therapy stem from a set of behavioral theories, initially premeditated to show the consequences as well as, rewards of explicit behaviors which occur in real life situations. So far, this therapy has proved to be successful in inspiring positive behaviors in autistic people, and has been accepted by health professionals. It assists in improving skills by encouraging positive behaviors and discouraging negative ones (Fennell & Dillenburger, 2018). The progress of an individual is then tracked and measured to determine whether there is a notable improvement.
ABA therapy helps autistic individuals to have a clearer understanding of various behavioral mechanics, and this can be attained by using the antecedent, behavior and consequence (ABC) model. Antecedent entails the actions which lead to the behavior even before it happens. The precursor in this case can be physical, verbal, or closely related to forces in the external environment. Behavior encompasses a person’s positive or negative reaction to the antecedent. Consequence comprises the action that follows after the behavior is completed (Fennell & Dillenburger, 2018). It can be a reward-driven response, which may be a positive reinforcement for a noble behavior. Any inappropriate or incorrect reactions are usually met with little and sometimes no reaction at all.
The three components (antecedent, behavior and consequence) are normally designed such that they cover variant factors affecting the behavior and how the teaching is done. Mutually, they give a therapist an easy time of identifying the root of a behavior and the consequences that might alter behavioral outcomes. The therapist then designs different strategies of correcting the unsuitable behavioral issues (DeFilippis & Wagner, 2016). After resolving all these challenges, strategies such as communication competency, which can boost positive behaviors are developed. At the same time, these strategies may help in decreasing negative behaviors such as self-inflicting behavior.
Approaches employed in this treatment greatly differ depending on how the disorder is treated. Most behavior analysts put emphasis on the fact that the science of behavior must be put into consideration as a natural science and not a social science. Their main focus is on observable connections between the environment and behavior, different from speculation (DeFilippis & Wagner, 2016). ABA Therapists use various methods in teaching the autistic people better ways of coping with life. The method used largely depends on the current needs of the individual. An example is that a therapist can decide to employ a VBI approach if the goal is to train on verbal skills. On the other hand, if the therapist intends to encourage independent living, then an approach which is likely to promote self-management will be used. For instance, pivotal response training, verbal behavior intervention (VBI), and discrete trial training are some of the main approaches used.
Discrete Trial Training (DTT) is one type of ABA, which is a method of teaching that makes use of a series of trial for each step of a desired response (DeFilippis & Wagner, 2016). Teachings are apportioned into simple parts, and correct answers are rewarded through positive reinforcement while ignoring the incorrect ones. Early Intensive Behavioral Intervention (EIBI) is the second type of ABA, which is very beneficial to children under the age of 5. A teaching approach that is highly structured is utilized in building positive behaviors (for example, social communication) and reducing negative responses, such as self-injury, tantrums, and aggression (DeFilippis & Wagner, 2016). It is a one-on-one training under strict supervision by a health professional.
Early Start Denver Model (ESDM) is an ABA approach, which is applied to children between the ages of 12 and 48 months. Play and joint activities are used by parents and therapists to aid the ASD child advance their cognitive, social, and language skills (DeFilippis & Wagner, 2016). Pivotal Response Training (PRT) aims at increasing the motivation of learning, monitoring behavior, and initiating communication with those around. Verbal Behavior Intervention (VBI) is the final ABA approach, and it basically lays emphasis on improving the verbal skills. The aforementioned approaches are selected based on the nature of mental impairment associated with autism. All autistic children do not respond to ABA therapy in a similar way; thus, it is important to involve an experienced health professional to monitor their progress. However, with this kind of therapy, children are in a better position of cultivating a wide range of essential behaviors and skills, including improved social functioning, language development, and other independent care skills.
Efforts Towards New Innovations
Various devices, such as electronic tablets and communication boards, have been designed to aid the ASD persons communicate and interact with the people around them. For example, synchrony is a drum-like toy designed to assist autistic children in communication through music. It can either be formal or informal and has proven to be of great advantage to kids by broadening their emotional and social skills (Ben Sassi et al., 2018). The device supports the kids by letting them harmonize with playmates, thereby bridging the social gaps. Synchrony also responds to touch and is the basis of calm sound without dissonance, which is said to overwhelm ASD children.
Proloquo4Text, a text-based app, is designed in such a way that it changes typed words into speech at an instant. It is possible to be customized so that it displays words and phrases which are often used by an individual. Word and sentence prediction applied by learners in their communication patterns are featured for faster responses. Users are allowed to choose their voice on Proloquo4Text, and this gives them an autonomy on what they say and how they say it (Benssassi et al., 2018). Another innovation is Leka, an interactive toy which acts as a buddy for autistic people, and it is used to encourage children develop autonomy by playing independently. This device plays music and sounds, vibrates, lights up, and speaks to help these kids engage in multi-sensory activities (Benssassi et al., 2018). It is a customizable gadget, meaning that it can be tailored so that it fits the needs and comfort of kids.
A child-like robot referred to as Kaspar has also been designed to help autistic people understand how to communicate effectively. Kaspar can sing, talk, eat, and comb his hair, and his face is designed in such way that his facial expressions are easy to read (Wood et al., 2019). The robot’s response to touch lets a child know if their play is too rough. The wearable social coach is a smartwatch that helps interpret nonverbal communication, like gestures and facial expressions. It aids children diagnosed with Asperger’s in navigating social interactions. The innovation makes use of sensors, custom algorithms, and artificial intelligence systems of deep-learning to analyze one’s tone in real time (Benssassi et al., 2018). It is a device which facilitates the ASD people to decode the emotions of others during a particular conversation.
Other innovations that aid ASD patients are Skoog and Picture Exchange Communication System (PECS). Skoog is a musical cube intended to be used to enhance social interactions via music and play. The device is connected to an iPad, allowing kids to create music without prior lessons or knowledge (Benssassi et al., 2018). The gadget facilitates music therapy and helps in bridging communication gaps between ASDs and non-autistic persons. This gives ASD patients an experience which is sensory-friendly, thereby calming their nerves and, at the same time, encouraging interaction. Lastly, PECS teaches skills of communication by using picture symbols in a way that is appealing to the ASD patients (Benssassi et al., 2018). Thus, it motivates and supports an individual to learn how to apply picture symbols in answering and asking different questions during a conversation. The application of Skoog and PECS is therefore crucial in closing communication gap between ASD and non-autistic children.
Autism is a lifelong childhood condition, which is devastating, and, with its increased prevalence over the years, associated social concerns have emerged. While there is no treatment to cure ASDs, ABA therapy has been employed to help autistic people better their lives. Equally, there are strategies to help increase the cognitive ability, life skills, and maximize the child’s ability to fully participate in the society. In addition, assistive technologies have been designed to help the ASD persons communicate and interact with the people around them.
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