International Journal of Social Science Research (IJSSR) eISSN: 2710-6276 [Vol. 2 No. 4 December 2020]
Journal website: http://myjms.mohe.gov.my/index.php/ijssr
THE KNOWLEDGE AND INFORMATION OF AUTISM SPECTRUM DISORDERS: DIAGNOSIS, TREATMENT AND
AWARENESS
Norshahidatul Hasana Ishak1*, Norasiken Bakar2, Siti Nurul Mahfuzah Mohamad3, Hazmilah Hasan4 and Aliza Alias5
1 2 3 4 Fakulti Teknologi Maklumat dan Komunikasi, Universiti Teknikal Malaysia Melaka, Melaka, MALAYSIA
5 Fakulti Pendidikan, Universiti Kebangsaan Malaysia, Bangi, MALAYSIA
*Corresponding author: hasana@uitm.edu.my
Article Information:
Article history:
Received date : 18 November 2020 Revised date : 25 November 2020 Accepted date : 10 December 2020 Published date : 25 December 2020
To cite this document:
Ishak, N., Bakar, N., Mohamad, S., Hasan, H., & Alias, A. (2020). THE KNOWLEDGE AND INFORMATION OF AUTISM SPECTRUM
DISORDERS: DIAGNOSIS,
TREATMENT AND AWARENESS.
International Journal Of Social Science Research, 2(4), 217-229.
Abstract: Autism which also known as Autism Spectrum Disorder (ASD) is categorized as a neurodevelopmental disorder. The cause of Autism is still a mystery until today.
None of the scientific research can prove the cause of Autism. Most of the community always heard about Autism, however, there is still a lack of knowledge about it and how to cope with it. Autism can appear in everyone self, either they are rich or poor, in any ethnic, in any country, in any religion. Previous research shows that the number of Autism was increasing every year. There are lots of diagnosis and screening tools that can be used to test the Autism and early intervention is very important as an expert can give treatment at an early stage. Education is also very important to Autism children, and this is the reason important of special education for special need people. Not only focusing on school, but special need centre also plays it an important role. Autism people need to undergo therapy to increase their neurodevelopmental.
These therapies cannot be done once, it will take time to see the effectiveness. For examples Music therapy, Sensory Integration therapy and the help of technology like Robot therapy.
Keywords: Autism Spectrum Disorder (ASD), Therapy
1. Introduction
The increasing of number for autism can be seen year by year. The cause of autism still cannot be identified until today. This paper will discuss general information about autism. The prevalence of Autism Spectrum disorder (ASD) is increasing in Asia and the world (Qiu et al., 2020b). This paper will cover the knowledge and information about autism, how to diagnosed children or adult, the importance of awareness of autism and treatment that could be used to help autism.
2. Literature Review 2.1 Autism
Autism can be found in any race, any people, any religion all around the world. ASD refers to a type of neurodevelopmental disorder that typically manifests before the age of three years and is characterized by persistent deficits in social communication and social interactions, as well as restricted, repetitive patterns of behaviour, activities, and interests (Elberson, 2010). According to World Health Organization, 2019 Autism spectrum disorder (ASD) refers to a range of conditions characterized by some degree of impaired social behaviour, communication, and language, and a narrow range of interests and activities that are both unique to the individual and carried out repetitively. Autistic disorder diagnostically involved a combination of qualitative impairments in reciprocal social interaction, communication, and repetitive, restricted, and stereotyped patterns of behaviour (Ilias et al., 2017). To identified autism in someone's self, some of the tests should be done. There are lots of tests that can be done to trace autism according to age. The symptoms of autism can be diagnosed as early from 4 months (Ramachandram, 2019). However, identification of an autism spectrum disorder is difficult before the age of about 12 months but a diagnosis is usually possible by the age of 2 years (WHO, 2017). These symptoms then will be diagnosed by the expert to clarify either the children is autism or not. Early detection from babies is very important as it can help to detect autism in children and we can take fast action to help this child.
It can optimal development and well-being of people with an ASD. Early identification of ASD could improve the quality of life for ASD children and their family, universal and standardized diagnostic processes for ASD should be adopted for the prevention and control programs of ASD in future (Qiu et al., 2020a).
Monitoring of child development as part of routine maternal and child health care is recommended.
Clinical studies that have shown that early intervention after early detection can enhance their potential and lead to an optimal outcome (Windiani et al., 2016). Some characteristics of autism are they might have problems with social interaction and communication, and by restricted and repetitive behaviours, extremely disruptive antisocial behaviour, tantrums, self-destructive acts, and other forms of inappropriate persons’ behaviour (Mohd Salleh et al., 2018). Previous research also has shown that autism occurs 4 times prevalence in the boy than the girl. According to the pool that has been done by (Qiu et al., 2020b), it shows that prevalence in male is higher than
According to (Goy & Tai, 2016), there is 1 in 150 children in Singapore has autism, which the number is a higher rate than the World Health Organisation’s (WHO) global figure of one in 160 children. Some of the factors that had been determined as a factor to this problem are because Singaporean had children at older age other than genetic issues. Meanwhile, in Malaysia, it was prevalence to be approximately 1.6 in 1000, and the number is increasing every year, this is the result gathered from only 1 screening tool used which is M-Chart and it is widely used at Klinik Kesihatan Malaysia as a checkup routine (Ramachandram, 2019). At the west specifically United State, it was reported there are 1 over 68 children were diagnosed with Autism, which means there are closely 9000 kids with Autism in Malaysia (What Is Autism, n.d.). It shows that the statistic for autism children in Asia is increasing yearly.
2.2 Diagnosing Autism
There are a lot of ways to do diagnosis people towards autism. Most of the diagnosis was done at an early age as early as 18 months. It is because early detection is very important as it can help to give therapy to them. However, there is also a diagnosis for adult. Research by (Thabtah & Peebles, 2019), analyses 37 different ASD screening tools to identify possible areas that need to be addressed through further development and innovation. Consequently, various screening methods have been developed by leading medical experts and psychiatrists across the world seeking to identify autistic traits in their primitive stage to readily provide the necessary medications.
Appendix A shows some of the diagnosis that had been used for detecting autism (Hashmi et al., 2018; Hossain et al., 2017; Lang et al., 2012; Mayes et al., 2009; Vaan et al., 2016).
2.3 Awareness of Autism
The word Autism is widely used and frequently hear, however not everyone knows the meaning of Autism. The study and awareness about Autism are very important, as the number of Autism increased yearly. Besides that, the awareness of Autism may help in reducing discrimination and stigmatization and creating a sense of responsibility among people towards autistic children and families (Chevalier et al., 2017). Second April has been nominated as World Autism Awareness Day. This is one of the ways to increase awareness and knowledge about Autism. WHO South- East Asia Regional Committee and World Health Assembly resolutions on ASD have outlined several actions to be taken by the Member States and WHO, implementation of which needs coordinated action at the regional and country levels. One example of this is the Center for Disease Control and Prevention in the United States, which offers extensive online training, downloadable curriculum, facilitator’s guides and videos dedicated to educating medical practitioners about autism (Lim, 2015).
Other than that, the media has to play its role to spread awareness. This highlights the importance of spreading awareness through media and incorporating specialized behavioural training classes for teachers about childhood disorders. However, misconceptions about autism may be due to the influence of public media which often portrays autistic children as having high IQ, excellent mathematical talent and skills (Ayub et al., 2017).
Another important thing to do with Autism children is to send them to a special school. There are some special treatment and different learning style that suitable for them can be done (Satibi, 2017). A special education provided by the government usually for all of the special children.
However, there is some centre that can focus on treating Autism. One of the centers in Malaysia is the National Autism Society of Malaysia (NASOM). NASOM is a non-profit, nationwide non- governmental welfare organisation which was formed in 1987 by a group of concerned parents and professionals. Currently, NASOM has established 20 centres around the whole country which provide a variety of programs.
Social interaction and communication skills significantly impact human development, learning, and well-being. The lack of these elements can hinder individuals from being successfully integrated into a complex society. Emotional awareness is very important especially in Autism self and also their parents or caregivers.
2.4 Therapy for Autism
Most of the disease and symptoms have their ways to prevent or to overcome the problem. There are a lot of ways to help autism people and it is known as therapy. These therapies will be applied to autism people according to their age, as there are different therapies for adult and children. Some therapy can be used to help the autism population. And each of the therapy is different according to the age level.
This therapy needs to undergo repeatedly and required frequent diagnosis. It is not one-time therapy. The younger the patient, the more sessions that they have to go. It is usually done by an expert. This approach, of course, requires proportional commitments of time and effort by trained experts (Alnajjar et al., 2020). Music therapy is one of the therapies that occur for autism. Research done by (Network, 2012), it shows that by using music therapy, it can help autistic children in reducing their restlessness and fidgety behaviour. It also shows that by using music and movement therapy is effective in helping younger children to reduce their temper tantrum behaviour during the sessions. According to (Geretsegger et al., 2014), music therapy may improve their skills in primary outcome areas that constitute the core of the condition including social interaction, verbal communication, initiating behaviour, and social.
ASD is a part of developmental disabilities which is it is related to sensory integration. Another therapy is Sensory Integration Therapy (SIT). This therapy was developed by A. Jean Ayres and it has been used since the 1970s as a treatment for children. It was used to restore effective neurological processing and increase the individual’s ability to integrate sensory information and by enhancing each of this system. This therapy is focusing on 9 elements which it covers (a) child safety, (b) opportunities to obtain tactile, vestibular, and/or proprioceptive sensory stimulation to support self-regulation, sensory awareness, or movement, (c) appropriate levels of participant alertness, (d)challenge to postural, ocular, oral, or bilateral motor control, (e) novel motor behaviours and efforts to organize movements in time and space, (f) preferences in the choice of activities and materials, (g) activities that are not too easy or too difficult, (h) activities in which the participant experiences success (i) support for intrinsic desire to play, and (j) a therapeutic reliance (Lang et al., 2012). Research done by (Iwanaga et al., 2014) proved that the sue of SIT effective as it shows improvement in coordination, non-verbal cognitive abilities, and combined abilities of sensory-motor and cognition in children for high-functioning autism spectrum disorder (HFASD).
Figure 1: Robot Nao (Alnajjar et al., 2020)
Widely used of robot nowadays play important role in human life. Example of using a robot to assist human is like robot vacuum, robot machine for engineering purpose, robot for entertainment and others. There is a robot for helping autism people, as it called Robot-assisted autism therapy.
The main role of social robots that examine is to engage children in interactive learning activities that supplement and augment those delivered by therapists. Recently, social robots have been used to this end because many children with ASD find them enjoyable and engaging, perhaps due to their human-like yet predictable and nonthreatening nature, this therapy also aims at the improvement of joint attention, imitation, verbal communication skills, and improvement of social interaction of ASD children (Ali et al., 2020; Rudovic et al., 2018). Another reason for using a robot as a therapy to improve the academic capabilities of ASD patients by increasing the length and the quality of their attention (Alnajjar et al., 2020). According to the test that has been done by (Ali et al., 2020), it has been applied triad model communication and it shows that improvement in terms of multi-human social interaction skills of ASD children along with the clinical expert’s support. There is a lot of robots that have been used to do this autism therapy, it can be humanoid or non-humanoid. One of the famous robots that widely used for therapy is NAO. According to (Zamin et al., 2018), they used RoboTherapist to teach autism children in learning basic shape.
Based on the study, it shows improvement in autism children, however, children with autism will get easily distracted, need to repeat several times in making them understand. It is very challenging in attracting and retaining the autistic children attention, especially in learning.
3. Methods and Materials
Collecting data was begun by developing an instrument to identify problems among autism children. The instruments were set up following (Mayes et al., 2009). The Checklist for Autism Spectrum Disorder (CASD) offers a quick, valid means of screening for, and diagnosing, children with Autism, regardless of age, IQ or Autism severity. It consists of a comprehensive list of 30 symptoms of Autism. However, this set of questions has been modified according to the culture in Malaysia. There are two versions of instruments have been developed, which in Malay and English and it also has been checked by 3 specialists which are Language Specialists and Children Specialist. Samples from Parents, teachers have been collected. There are eighteen parents and seven teachers involved in answering the questions. The survey consists of 30 questions and it is divided into seven sections: demographic, a problem with social interaction, preservation, somatosensory disturbance, atypical communication and development, mood disturbance and problems with attention and safety. This survey is open to all parents who have autistic children and teachers who teach autism children. The survey has been distributed via a google form, and because of pandemic COVID-9, there is a limitation on getting respondents. However, respondents from the whole of Malaysia has been collected.
4. Results
According to (Mayes et al., 2009), Symptoms 1–30 is considered present if any sub-item under the symptom is checked. Scores of 15 or higher are in the autism range. Based on the result gathered, there are 4 children get to score more than 15, only 1 get less than 15. This is because he is clever and has fewer symptoms. He also following typical class at school and did not join any special class. The mean Checklist score is 26, with a range of 15–30 and a standard deviation of 4. The importance of using this checklist, it can identify symptoms that occur in autism children.
There are six sections of the questions. For section A it is about A problem with social interaction.
There are five items in section A. For section B it discusses preservation. There are four items in section B. For section C it discusses Somatosensory disturbance. There are 0 items for this section.
For section D it discusses Atypical communication and development and there are 5 items in this section. For section E, it discusses Mood disturbance and there are four questions in this section.
Finally, is section F which discuss Problems with attention and safety and it contains items in the section. Further detail about the question can be referred to Appendix B. Figure 2 to Figure 6 shows the results for each of the sections. The symptoms of autism analyse are the most frequently occur in autism children.
Figure 2: Section A: Figure 3: Section B:
A problem with social interaction Preservation
Figure 5: Section D:
A typical communication and development
Figure 4: Section C:
Somatosensory Disturbance
Figure 6: Section E: Figure 7: Section F:
Mood disturbance Problems with attention and safety
5. Conclusion
This study is focusing on the knowledge and information of Autism in general. Not all of the Autism people easily handle, and not all of them has high IQ. Because of that, the awareness of Autism is very important as it can help in increasing knowledge and teach society to coop with Autism. Especially in dealing with parents with autism children. As an early screening process can help with surveillance of children at risk for ASD, it can also help in providing early intervention programs which can reduce the effects of the disorder along with overcoming factors related.
Education is very important and so special education for Autism children is also very important.
There are lots of ways to help them, they may choose the best for themselves.
6. Acknowledgement
The authors express gratitude to all the participants, their families, and teachers. This study was conducted by the Faculty of Information and Communication Technolgy, Universiti Teknikal Malaysia Melaka (UTeM) in close collaboration with the Faculty of Education, Universiti Kebangsaan Malaysia (UKM). This research was funded by MRUN-RAKAN RU-2019-003/1, 4IR Cross-Creative Learning Environment for Autism using Physical and Digital Learning Spaces.
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The Instrument to Diagnose Autism
Table 1 Instruments to diagnose Autism
Instruments Description
Diagnostic and Statistical Manual fourth edition (DSM-IV)
1. Underlying criteria for diagnosing autistic behaviours.
2. Asperger disorder, pervasive development disorder—not otherwise specified (PDD-NOS), Rett’s disorder, and childhood disintegrative disorder (CDD).
3. Scaling from Moderate to excellent.
DSM (DSM-5) 1. Consisting of DSM-IV, Asperger syndrome (AS), pervasive development disorder–not otherwise specified (PDD-NOS), Rett syndrome (RS), and childhood disintegrative disorder (CDD).
2. Scaling from Moderate to excellent.
Autism Diagnostic Interview-Revised (ADI-R)
1. Effective instruments in differentiating autism from other related developmental disorders, and having adequate validity and sensitivity.
2. Time-consuming, having long questionnaires and scoring methods.
3. Requiring licensed clinicians and observers to administer them.
Autism Diagnostic Observation Schedule (ADOS)
1. Effective instruments in differentiating autism from other related developmental disorders, and having adequate validity and sensitivity.
2. Time-consuming, having long questionnaires and scoring methods.
3. Requiring licensed clinicians and observers to administer them.
Childhood Autism Rating Scale (CARS)
1. Used for 6 to 13 years.
2. Distinguish their severity through direct observation of the child’s functioning in responses that include smell, touch, light, sound, body use, social behaviour, verbal and nonverbal communication, and consistency of intellectual response
Autism Spectrum Quotient (AQ) 1. Focus on the adult Childhood Asperger Syndrome Test
(CAST)
1. Used for children 8 to 12 years old.
Quantitative Checklist for Autism in Toddlers (Q-CHAT)
1. Questionnaires based on observations of the child’s behaviour.
Modified Checklist for Autism in Toddlers (M-CHAT)
1. An upgraded version from Q-Chat.
2. Consist of 10 questions from 12 questions.
3. Enhance the sensitivity of the original CHAT method.
4. Take only 5-10 min to complete the process.
5. Used as measurement at Kementerian Kesihatan Malaysia, Indonesia
Autism Behaviour Checklist (ABC)
1. Up to 14 years old.
2. Involve the teacher and parents.
3. 57 questions.
4. Consists of Sensory behaviour; communication and language skills; behaviour related to object use; body language; and social and adaptive behaviours.
5. The range is poor to excellent.
Screening Tool for Autism in Toddlers and Young Children (STAT)
1. 24 to 36 months using the toolkit.
2. Test on interactive social behaviours, such as imitation, play, reaction, and requesting.
3. 12 items, and took 20 minutes to complete
Pervasive developmental disorders (PDD)
1. Specific developmental disorders in which there are qualitative impairments in social interaction and communication combined with a restricted repertoire of interests, activities and behaviours, with onset in early childhood.
