Autism Spectrum Disorder in Children Research Example

Abstract

Parents of children with autism face many challenges while raising such a child due to behavioral, social, and sensory related characteristics. Qualitative focus group methodology was used to examine the effects of providing Pivotal Response Treatment (PRT) intervention in the natural environmental activity of horseback riding on improving social communication, and sensory processing of children with Autism Spectrum Disorder (ASD). The purpose of this qualitative study was to describe parents' perceptions of how this intervention affects the lives of their children at home and across various natural settings. Key influences included (a) eye contact and joint attention, (b) peers and adults' interaction, (c) verbal and non-verbal communication, (d) behavior management, (e) eating and sleeping organized patterns, and (f) self-stimulatory behaviors. These elements were discussed across all parents who participated in the study. However, specific experiences and outcomes varied across the critical influences mentioned above.

Is your time best spent reading someone else’s essay? Get a 100% original essay FROM A CERTIFIED WRITER!

Save 25%

Introduction

Autism Spectrum Disorder (ASD) is a complex developmental disability that negatively affects the verbal and non-verbal communication, sensory regulation, and social interaction capability of an individual. The unique characteristics of children who are diagnosed with ASD pose unique challenges for caregivers who deal with them on a daily basis (Howlin, 2006). Deficits in social communication, language acquisition, and deficiency in generalizing specific complex social behaviors are core features of Autism Spectrum Disorder (ASD). Social interaction is broadly defined as an individual's ability to respond to social bids and initiate and maintain interactional discourse (Adamson, McArthur, & Markov et al., 2001; Bruinsma, Koegel, & Koegel, 2004; Jones & Schwartz, 2009). Social communication impairments are typically manifested by the difficulty in responding to verbal initiation exhibited by other factors such as inappropriate facial expressions, lack of eye contact during social interactions, and lack of joint attention skills. Equally important, additional symptoms may include echolalia or absence of verbalization (Koegel et al., 1993; Pierce & Schreibman, 1995). In addition, many children with Autism Spectrum Disorder (ASD) have difficulties processing everyday sensory information, which is indicated in the autism diagnosis criteria (DSM-5, 2013). Sensory processing difficulties fall under "restricted, repetitive patterns of behaviours" descriptors behaviour. Often, children with autism exhibit hypo or hypersensitivity behaviours in activities such as body movements, visual, tasting auditory, smelling and tactile. Other difficulties among children with ASD include sensory behaviours manifested through seeking or getting rid of any sensory stimulation in a particular environment (Ashburner, Ziviani, & Rodger, 2008).All in all, the characteristics affect the development and inclusion of children with autism across the lifespan (Dawson, 2008) and (Mundy, Sigman, & Kasaire, 1990).

A large body of research literature has accentuated the importance of improving social behavior at an early age to provide these individuals with the prerequisite communication skills needed for distinctive child development. In addition, Sensory difficulties are also one of the common features of autism that tends to influence the social communication of children with autism (Baker et al., 2008; Hilton et al. 2010). Ausderau et al. (2014) reported data from the Sensory Experience Questionnaire conducted on 1200 child with autism aged 2-12 years. Their study revealed that the most common sensory problems were hypo-hyper reactivity, atypical sensory interests, and repetitions. One of the most common sensory dysfunctions in children with autism is sensory adaptive. Sensory adaptive might range from sensitive to extreme problems in taste, smell, touch, and sound. In addition to sensory seeking and auditory filtering difficulties, children with autism exhibited the inability to discriminate and generalize sensory stimuli (Schaaf, & Lane, 2015; 2014). Researchers found that there is a relationship between poor auditory filtering and excessive sensory seeking and adaptive social problem primarily with school-age children with autism (Ashburner et al., 2008). Similarly, Hochhauser, & Engel-Yeger, (2010) found that children with autism who exhibited a pronounced level of sensory sensitivity had low social engagement during participation in school activities. The dysfunctional sensory system either over or under-responsive to various sensory input that most of the children with autism experience may be the underlying reasons for many social communication and behavior problems. Some of the maladaptive behaviors that might be a result of sensory issues include rocking, spinning, and hand flapping. Besides, over or under responsive sensory dysfunction might affect these children's attention, their ability to attend to tasks, and their potential for social engagement (Ausderau et al., 2014).

Despite the number of studies that examined the relationship between sensory processioning and social communication, further sensory assessment is highly recommended to provide more insight regarding the sensory features associated with social difficulties in children with autism (Schaaf et al., 2015; 2014).

One of the widespread intervention that has been applied to enhance children's attention, awareness, and overall arousal associated with sensory problems is the sensory integration technique. The sensory integration technique includes exposing the child to different types of stimuli in their environment. The inter-relationship of the senses through pressure, touch, smell, or sounds supports the child's ability to interpret and respond to different stimuli around them and also facilitate their social engagement in various educational and community settings (Ashburner et al., 2008). However, solely sensory integration techniques continue to lack adequate scientific basis; Thus, it is critical to integrate the sensory integration approach with other strong validated interventions to maximize the social and positive functioning of children with autism (Baranek, 2002; Dawson & Watling, 2000)

Fortunato, Sigafoos, and Morsillo-Searls (2007) provided an overview of the literature about how the treatment of autism with the use of interventions based on Applied Behavior Analysis (ABA), affects the communication skills of individuals with autism. Pivotal Response Treatment is a type of ABA intervention strategies that have been supported by empirical research to increase the communication skills of children with autism. This intervention has been identified to have a positive impact on other areas that have not been primarily targeted by the technique such as sensory and behavior. Pivotal Response Treatment is required to deliver the intervention in a natural environment, using natural reinforcements, and emphasizing the importance of direct and immediate reinforcements (Lovass, 1987; Yoder & Stone, 2006; Koegel and Koegel, 2006, and Prizant et al., 2008). The long-term outcomes of such intervention include enhancing functional communication skills through utilizing each child's natural motivations so the child could generalize the use of the competencies across different settings and with different people on the natural environment (Coolican, Smith, & Bryson, 2010).

Underlying PRT is motivational strategies that are used to teach language skills, reduce disruptive or self-stimulatory behaviors, increase social communication skills, and increase academic skills (Koegel et al., 2006). These researchers identified several central behavioral areas that when treated, produce substantial gains in desired outcomes due to the intervention. The behavioral regions include motivation in which the child is willing to engage interactively in social communication activities, social initiation in which child initiates participation in enjoyable activities, and self-regulation in which the child can manage and monitor personal behaviors.

Motivation and self-initiation are the primary pivotal areas of PRT intervention. Initiating social motivation for children with autism is an essential value related to the importance of being engaged in meaningful social interaction. Specific PRT motivational techniques include following the child's preferred items, varying task difficulties, rewarding and reinforcing immediately and continually, and delivering natural reinforcement that is related to the child's response (Koegel, Camarate, & Valdez-Menchaca, 1998). Other pivotal areas include self-management and the ability to respond to multiple cues or prompts. By targeting the pivotal essential areas, individuals with autism will exhibit progress in other areas that are not targeted in the intervention (Koegel et al., 2006).

The most significant aspect of PRT approach is the child-directed approach. In this methodology, the child determines the direction of the therapy by making choices. The toddler determines the activities and objects that will be utilized during the intervention (Koegel et al., 2006). Children with autism often demonstrate a lack of verbal initiation required to prompt language acquisition. Therefore, enhancing their motivation with specific PRT techniques will assist students to initiate meaningful verbal communication and ensure the generalization of oral initiation across different settings, stimuli, or people (Koegel et al., 1998).

Moreover, Generalization and maintenance have been at the heart of the intervention core for children with autism. Therefore, implementing the intervention in a natural environment has given significant attention concerning responses provided by controlling the stimuli in the natural environment (National Research Council, 2001). In addition, motivational components in the PRT intervention package can be better promoted in the natural environment where children have their preferred activities and reinforcements (Koegel et al., 2006). Researchers observed that the natural environment paradigm leads to collateral intervention gains in targeted and non-targeted areas such as academic, behavior, and social developments in addition to the generalized effect across individuals and settings (Baker, Koegel, & Koegel, 1998; Baker, 2000; Koegel, Koegel & Surratt, 1992; Koegel, O'Dell & Dunlap, 1988).

Equally important, Family involvement was an integral part of PRT. The notion of active parent involvement as interventionists could support the efficacy of targeted pivotal areas such as motivation. The active parent involvement provided families with a "goodness of fit intervention" in which the intervention strategies natura...