Autism first identified by Kanner in 1943, knowledge and understanding of autism has grown and it is now recognized as a lifelong, neurodevelopment disorder that impairs a child’s ability to communicate, interact or related to others and the world around them (Batten,2005; Willis,2006). Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by significant social, communication, and behavioral deficits (Dr. Dilip Jeste 2013). The core characteristics found in a child with ASD include difficulties in social communication, language and related cognitive skills, and behavior, as well as emotional regulation (American Psychiatric Association, 2013) Autism isn’t something a person has or a ‘shell’ that a person is trapped inside. It is pervasive, it colors every experience, every sensation, perception, thought, emotion, and encounter, every aspect of existence.
It is possible to separate the autism from the person (The Public Health Institute for Scotland,2001). Description of autism makes it clear that not only is autism an intrinsic part of the individual, it also makes them the person that they are. Typically, a child’s impairments are noticeable from early infancy and will progress throughout the child’s development (American Psychiatric Association,2000). Autism Spectrum Disorder (ASD) is the ‘umbrella term’ given to a range of disorders. These disorders vary from mild (Asperger’s syndrome (AS)) to severe (Rett’s syndrome), where the child may develop very limited or no language and find it extremely difficult to communicate with others. In addition, as a ‘spectrum disorder’, although there is a range of impairments and behaviors which have been associated with autism, there is no conclusive list as it affects everyone differently (The Scottish Government, 2011).
There is no ‘typical’ case: each child is unique and will present a variety of behaviors to a lesser or greater degree, ranging from mild to severe (de Boer, 2009; Wall 2010).Today, genetic research is delving into the biological causes of autism-associated health conditions. The significant number of children facing difficulties is now a well- documented phenomenon worldwide, and Malaysia is no exception to this trend, where the number of children enrolled in special needs programs has increased from 2006 till 2013 (Joanna Menon Lim, July 2015). This is part of a new avenue of autism research aimed at identifying the many biological subtypes of autism and developing personalized treatments and supports. Meanwhile, specialists at leading autism care centers are working with patients and their families to improve the health and quality of life of all those with autism by developing and disseminating evaluation and treatment guidelines for healthcare providers. (Perrin 2012, Warfield 2016).
This effort also includes autism-specific medical education and teleconferencing programs to share expertise. (Vasa RA, Mazurek MO, Mahajan R 2016) Also for social communication deficits of a child with ASD which may create a limitation in social experience, contributing to impaired development and learning, and challenging behaviors. Thus, children with ASD require a clear and effective mode of communication. (Beukelman DR, Mirenda P. Augmentative 1998). First outlined by Wing and Gould in 1979, ‘the triad of impairments’ has made a significant contribution to a greater understanding of autism and has also proved influential as a diagnostic tool (Woodward& Hogenboom, 2000).
It identifies three core deficits as the defining features of all Autism Spectrum Disorder (ASD): social interaction, social communication, and social imagination. Crucially, elements of all three features must be present for a diagnosis to be made (Wall,2010). However, the triad of impairments fails to provide the full picture. As it focuses only on the deficits associated the condition, it does not acknowledge the particular strengths individuals with autism have such as honesty, reliability, eye for detail, analytical thinking skills and, because they perceive things differently, original thinking (Winter and Lawrence,2011). This can be particularly challenging, as children with autism may not only prefer to work individually on tasks but may also lack some of the skills necessary for working effectively in groups, such as the ability to negotiate and to perceive others’ points of views (Plimley & Bowen, 2006).
Problem behaviors (or maladaptive behaviors as they are referred to in this paper), characterized by disruptive, destructive, aggressive, or significantly repetitive behaviors, are prevalent in young children with ASD (Dominick KC, 2007). For example, Dominick found that 32.7% of children with ASD displayed aggressive behaviors including hitting, kicking, biting and pinching others. More than three-quarters of these children showed aggressive behaviors both at home and outside the home, and aggression was directed toward more than one person in 92% of cases. Self-injurious behavior, including head banging, hitting oneself, and biting oneself, was present in almost one-third of children with ASD. Furthermore, 70.9% of children with ASD had experienced a period of severe temper tantrums and, for 60% of these children, tantrums occurred on a daily basis and were a constant (rather than episodic) problem during the period in which they were present (Dominick KC, 2007).
Autism Spectrum Disorder (ASD) children may lack a desire to interact with others, the language to do this or may not understand the reciprocal nature of interactions and the ‘rules’ governing social situations (Pierangelo & Giuliani,2008). All of these deficits make social situations challenging and forming friendships difficult (The Scottish Government,2009). Most scientists agree that genes are one of the risk factors that can make a person more likely to develop ASD. (Huquet G, Ey E, Bourgeron T.
2013). The exact causes of autism are not yet known, but there are many theories and ideas around. In general, there seem to be genetic and biological factors involved (Victoria Honeybourne, 2016). Some ASD diagnosed children have exceptional abilities in math, arts, visual skills, and music. Children with autism can have a profound problem dealing with the social world.
They rarely interact with other people for they are suffering from aloneness (Davidson, Hopkins, Kring & Neale, 2010). They tend to ignore people around them and focus on one thing that attracts their attention. ASD patients experienced difficulty in sleeping and repeated awakening at night (Lamm, 2015). This phenomenon causes the children to sleep during the daytime that affects their relationship within the family. Because of ASD child impairments, parents also face a range of challenges in dealing with them. Their difficulties understanding and interpreting language and, in particular, metaphorical speech can lead to ‘higher order’ questions, where inference is required (Pittman,2007; Plimley & Bowen,2006).
ASD child often experiences organizational too, both when attending to their own needs, e.g. getting ready for school, interval or lunch, and when selecting the resources and materials they require for tasks. Most parents of autistic children first begin to be concerned about their child’s development because of early delays or regressions in the development of speech.
Effective interventions for ASD in early childhood are needed; to reduce impairment during the preschool period itself and for the family, which is a strategy that may alter the disorders longer-term. There’s a possible emotional and social impact for ASD child which they have difficulties following social rules and to make friends. Social communication deficits of a child with ASD may create a limitation in social experience. Frequent negative feedback for acting out and not paying attention can impact self-esteem and motivation.
Parents’ positive and negative feelings about their young children influence both parenting behavior and child problem behave or (E.Kurtz-Nelson, L.L.
Mclntyre, 2017) The number of individuals diagnosed with ASD as children continue to experience the disorder as adults (Cardwell,2013). Parenting programs include psychosocial interventions that teach techniques that parents can use to manage their child’s challenging behavior. Parent-focused education on managing symptoms for a child with ADHD has been shown to improve quality of life for both parents and child. Entry into an elementary school or high school is a critical transition for children and families. These transition periods reflect different stages of the family life cycle and are associated with different parenting tasks and challenges (Kumabe, Nishida, O’Hara, & Woodruff, 1977; Walsh, 2003). Autism spectrum disorder (ASD) is developmental coordination disorder (DCD) and primarily considered a motor disorder, multiple studies have reported psychological and social concerns in children with this condition. Because developmental coordination disorder (DCD) can have profound effects on a number of aspects of children’s lives, there is a good reason to suspect that the condition will also affect their parent’s quality of life (QOL).
A number of studies have established that parents of children with autism face higher levels of stress than parents of children with other chronic diseases or intellectual disorders. The stress is higher among mothersthan fathers, and mothers reported more anxiety or more depression. Recently the distress of the parents with PDDs including Asperger’s disorder and any PDD not otherwise specified (PDD-NOS) are receiving more attention. Many studies show these parents also have high distress (Yamada,2007).
