Introduction
The main topic discussed in the given paper is autism spectrum disorder across the lifespan. The major purpose of the study is the investigation of various social and psychological implications of the disorder for both diagnosed and undiagnosed adults and children with autism, as well as their caregivers and family members. The specific areas researched in the paper are epidemiologic and clinical features of autism, the impacts of the disorder on the domains of social and family interactions, and the challenges the undiagnosed people with autism face in their everyday life.
Methodology
The literature review is employed as the main research method in the study. The data was collected from 8 scholarly peer-reviewed articles located via Academic Search Complete, ProQuest, and PubMed. All sources were randomly selected. To meet the quality criteria of the given study, high-quality materials which suit the theme and thematic orientation of the paper are chosen. The sample articles are published in such periodicals as American Journal of Psychiatry, Progress in Health Sciences, and others. All these academic journals are reliable sources of evidence in many scientific fields. Therefore, it is possible to say that the data selection method used in the study is well justified.
The evidence from the articles is synthesized in the following paragraphs. Such issues related to autism spectrum disorders (ASD) as impaired social communication and the overall influence of the disorder on life and well-being of individuals is analyzed. To understand ASD more profoundly, the first paragraph of the literature review is devoted to the research of epidemiology of the illness. It is meant to provide a sufficient background for the further investigation of the social implications of autism.
Epidemiology and Symptoms of Autism
The term “ASD” is used to define a set of life-long developmental impairments that are present in almost all communities around the globe. It is characterized by underdeveloped social interaction skills, restricted functionality, and interests. The disorder is referred to as a “spectrum” because it includes a great variety of features linked to several areas of functioning. According to Nicolaidis, Kripke, and Raymaker (2014), this spectrum is not linear and is rather dynamic connections because autistic individuals can demonstrate clinical features of both “low” and “high” functioning simultaneously. The challenges associated with autism are related to spoken and written communication, routine daily activities, sensory sensitivity, social-emotional regulation, etc. A person with autism usually never has all of the mentioned areas impaired, and he/she may even have an outstanding performance in one or a few of them. Moreover, skills and abilities largely depend on different environmental stimuli and can change under their influence (Nicolaidis et al., 2014). Thus, by removing particular stressors and providing sufficient support, it is possible to achieve significant improvement in autistic person’s condition.
Just a few decades ago, ASD regarded as a rare disorder, but the recent statistical data reveals that over 1 percent of adults demonstrate the symptoms of the disorder (Nicolaidis et al., 2014). It is also observed that, during the last decade, the rate of diagnosed children has drastically increased to 15 individuals per 10.000 of births (Ślifirczyk, Krajewska-Kułak, Brayer, & Maciorkowska, 2013). Additionally, the average rate of morbidity is about 21 per 10.000 clinical cases whereas the incidence is four times more frequent in males than in females (Ślifirczyk et al., 2013).
Shortly after the discovery of autism in the 1940’s, the researchers became interested in the investigation of its causes. As Schaefer (2016) observes, the early theorists suggested that ASD was an acquired disorder and its major cause was the unfavorable environment in which children lived (e.g., lack of close emotional bonds with mothers, etc.). However, the recent research findings make it clear that autism may be caused by multiple factors including the environmental, biologic, and genetic ones.
According to Chaste and Leboyer (2012), the heritability of ASD equals 55 percent. It is also found that siblings of a child with autism are at risk of the cognitive disorder development, and the propensity may increase from 2 to 20 percent depending on the severity of the autistic child development (Chaste& Leboyer, 2012). It is a high rate but other it cannot be considered as the sole cause. For example, prenatal and neonatal factors contribute to the recurrence of autism as well. These factors include various physiological abnormalities such as low birth weight, various birth complications (e.g., traumas), small gestation period, and so on (Chaste& Leboyer, 2012). It is possible to say that the factor of prenatal development is closely linked to other environmental factors such as socioeconomic status, and exposure to substances. The evidence for the negative impact of adverse environmental conditions on the physiological and psychological development of the fetus is provided in many studies. Maternal distress, poor nutrition, and medication or drug abuse increase the risk of ASD and other developmental disorders (Chaste& Leboyer, 2012).
The literature review demonstrates that ASD is a complex phenomenon in both clinical manifestations and mechanisms of its development. Each case of autism is unique and individual. Therefore, a stereotypical approach to its diagnosis and intervention is not acceptable. However, despite the differences in symptoms and etiology of individual cases, people with autism face somewhat similar challenges in their lives. The problems that an autistic person regularly encounters in his/her social and family life are discussed in the following paragraphs.
Effects on Social Life
Autism has a strong impact on the social development of individuals who have it. The disorder is primarily associated with low levels of social engagement. According to Kasari and Patterson (2012), autistic children do not know how to enter into or maintain relationships with others. It is also found that children with autism seem to lack the awareness of other people and are more focused on objects. The researchers observe that the diagnosed children usually interact with their peers only to request items they want to play with and, moreover, they can be too involved in the process of playing so the others will find it difficult to join in the game (Kasari & Patterson, 2012). As a result, a child with the disorder spends much of his/her time alone.
Another problem which individuals with autism have and which contributes to low social engagement is the inability to read emotions of other people. Due to this reason, they fail to interpret others’ feelings, thoughts, and perspectives. As a consequence, they may have an egocentric stance when interacting with people, and it prevents them from developing friendships and leads to a reduced number of social encounters (Kasari & Patterson, 2012). Normally, empathy and emotional connectedness are regarded as the major prerequisites for positive social experiences, and, moreover, a person usually expects his/her interlocutors to be emotionally and psychologically sensitive during conversations. These qualities are perceived as the signs of friendliness, while egocentrism and the lack of emotions, on the contrary, are viewed as negative from the common point of view. Thus, along with the lack of sufficient social interaction skills, the inability to recognize subtle social cues results in a frequent feeling of loneliness in children and adolescents with autism because they are often misunderstood by other people, especially those who do not know the physiological reasons for their behavior.
Social-emotional well-being largely affects the overall quality of life. Therefore, the lack of well-developed communication skills and inability to establish friendships may significantly lower the life quality. According to Lin (2014), social relationship domain is associated with most challenges for individuals with autism during adulthood as well and represents the major area of their concern. Due to low social engagement, adults with ASD feel unhappier and less satisfied with own life than the majority of people without the disorder. Enduring negative emotions connected to impaired social interactions in autism may also be linked to the development of comorbid psychiatric conditions throughout the lifespan. The disorders that can often be observed in patients with autism are depression, obsessive-compulsive disorder, and anxiety (Lin, 2014).
To prevent possible aggravation of psycho-emotional condition, researchers suggest various intervention strategies aimed to develop social perceptions and understanding in children with the disorder. The core elements of social communication addressed in such interventions include polite manners (e.g., greetings, shaking hands, etc.), eye-contact, initiating conversations (Kasari & Patterson, 2012). Social skills interventions for children with impaired cognitive abilities help them to obtain essential social experiences and generate a positive perception of social interactions. The absence of the history of social communication, on the contrary, usually leads to persisting inability to establish close and enduring relationships in adolescence and adulthood. Therefore, the early diagnosis and intervention can substantially support the sound development of people with autism throughout the lifespan.
Undiagnosed Population
Although the early diagnosis may significantly improve the overall patient outcome, many individuals with ASD remain undiagnosed. The findings of a cohort general population study conducted between 2005 and 2009 in South Korea reveal that over a half of autism cases in the total sample of 55.266 7-12-year-old children were previously undiagnosed, and attended mainstream classes (Young Shin et al., 2011). The striking results have many social and medical implications. The research makes it clear that the current diagnosis methods may be still not efficient enough. At the same time, the fact that many of the children diagnosed with ASD in the study had no history of psychological conditions points out to the absence of awareness of the disorder’s symptoms within the general population. As a result, it may be hard to diagnose autism promptly especially in case a child does not demonstrate severe autistic symptoms.
Autism is not just a childhood disorder, and a person cannot simply grow out of it. Jennings (2005) observes that the majority of adults with autism are not formally diagnosed mainly because the disorder was poorly investigated until 1994 when it was included in the Diagnostic and Statistical Manual, a standard defining various psychiatric conditions in the USA. Without being diagnosed, individuals may not have sufficient support and can struggle in their everyday life. The clinical features of ASD vary from person to person and can be manifested in different degree.
For example, lower functioning autistic people are usually quiet and inert but engaged in repetitive actions all day long, while severe symptoms of ASD also include tics, vocalizations, and even head banging, self-harming, and some extent of aggressiveness (Jennings, 2005). It may be difficult for lower-functioning autistic individuals to organize and perform the routine daily activities which a person without cognitive abnormalities can easily handle. The cognitive abnormalities and atypical responses to physical environments in which they live are often correlated with bad dietary habits, poorly developed toileting and hygiene skills (Jennings, 2005). Therefore, in the absence of sources of family, social, and professional support, an undiagnosed person can face significant problems throughout a day.
Despite the challenges which ASD provokes, autistic people obtain life experience and mature like all others and, over some time, they may develop coping skills and strategies that help to disguise their symptoms and adjust to the social environment (Nicolaidis et al., 2014). However, growing up undiagnosed may be difficult. Sensory sensitivities; inability to comprehend social contexts, interpret communicative nuances, etc. do not exclude outstanding intellectual capabilities of those who have ASD but create the feeling of psychological separation of self from others. The continual sense of loneliness and separation, the realization of personal difference from peers can cause the identity crisis and not every person can overcome psychological distress without a helping hand.
At the same time, one can develop a positive perception of own difference. Some people even tend to believe that autism as such is not a disorder in common understanding of the term, but rather a gift and ability to see the world in a different way (Jennings, 2005). It is considered that a lot of talented people and historical figures who contributed to the development of various professional fields from literature to physics could have ASD. Therefore, the attitude of an autistic person towards own differences, his/her personal qualities and the degree to which the disorder is manifested in him/her largely define the ability of that person to succeed in life. Nevertheless, the role of the context in which an individual lives cannot be underestimated. Understanding, acceptance, and inclusive climate in various social environments (e.g., school) in which people with autism function on a daily basis are important, and it is possible to say that the support provided to an autistic person by the family can support the development of a positive self-identity in him/her most.
Impact of ASD on Family
Parents are the major source of support for children, but parenting children with different disabilities and disorders is a challenging task. Often parents may be overwhelmed with fear and uncertainty because they do not know if they will be able to find energy, love, and compassion needed to help their child no matter how challenging and abnormal his/her behavior may be (Ĺšlifirczyk et al., 2013). Therefore, without substantial resources of support, parents of children with autism become exposed to excess stress which may result in conflicts between family members or even family splitting or domestic violence in especially hard cases. The accumulated tension leads to parental “burn out” that occurs due to contact with a child with special emotional, intellectual, and physical needs (Ĺšlifirczyk et al., 2013). Such a condition is associated with depression, anxiety, and overall dissatisfaction with life, and it can interfere with a person’s functioning in multiple spheres including parenthood. In this way, the illness affects all family members, and support is critical to the maintenance of the family and individual well-being.
For the adults who have autism, parenthood may be challenging as well. As it was already mentioned above, deficiency in empathy and reciprocity associated with the illness can significantly inhibit the development of emotional bonds between autistic parents and their children. It may be difficult for a parent with autism to recognize needs of his/her children and fulfill them efficiently. Some researchers suggest that in families with autistic parents, children may often play roles of caregivers and act like parents (Jennings, 2005). It means that sometimes autistic mothers and fathers prefer to rely on their children and follow their guidance in decision making. It is possible to say that it is not necessarily a bad thing because, in this way, families may develop trustful and open parent-child relationships. Moreover, in case a child inherits ASD, the personal experience of the parent can help him/her to arrange the environment at home in a way to make this child feel better.
Overall, it is possible to say that support to parents with ASD or to families with autistic children implies plenty types of assistance and advice. Family members and friends can be regarded as the primary informal source of emotional and psychological support, while the formal sources should include various professionals, consultants, educators, and therapists. Overall, a balance between the different types of support is needed to achieve the best possible results and minimize environmental risks that may unfavorably impact a child and aggravate his/her condition.
In the following paragraph, we will summarize the findings of the literature review, and conclude the observations. We will combine the different areas of the topic discussed in the paper, and provide a holistic view of ASD and its significance.
Conclusion
The findings reveal that the characteristics of ASD significantly impact the life of those who have it. It is observed that the domain of social interactions is usually the most affected by the disorder, and it largely disturbs the individuals with autism. At the same time, it is wrong to say that all people with autism are isolated from the society because some may have other functional areas impaired and some may also learn to communicate and develop the necessary skills in later years.
Autism implies a different view on things, and when growing up undiagnosed, a person may not necessarily regard it as a strength, may be anxious because of it, and even have an identity crisis. A supportive environment is essential for individuals with autism. Family, as a micro-social environment, plays a critical role in the development of autistic children and improvement of their conditions or skills. When speaking of a parent with autism, their ability to care for children largely depends on the severity of their symptoms. Nevertheless, it is reported that caregivers with ASD often have positive parenting experience, and their insider knowledge of the disorder can be particularly useful in case the family has other members with autism. At the same time, professional support should be engaged in the family care of such individuals on a regular basis. Family-wide well-being, professionals’ engagement in the intervention process, education about autism, and time for self-care are the primary needs of parents of autistic children, and the ability to meet these needs affect the overall quality of life in the family and individual treatment outcomes.
References
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