Understanding Autism Spectrum Disorder

Autism Specific Disorder is referred to the neurological developmental disorder which initiates in the childhood and impact to last throughout the extended life of the person (Duda et al., 2018). The people with ASD are mostly seen to have learning difficulty as the key issues apart from others. Asperger Syndrome is often considered as superior form of ASD but in DSM-5 it is not included within the ASD. Asperger syndrome is mainly neurodevelopmental disorder that is characterised by difficulties with social interaction as well as presence of non-verbal communication (Faridi & Khosrowabadi, 2017). In this study, initially the clinical diagnosis of Autism with learning disability and Asperger Syndrome is to be discussed. Further, the learning needs and barriers toward learning caused by autism spectrum disorder (ASD) is to be explained. The key concepts and models related to explain ASD people are to be mentioned. Moreover, the critical analysis of the effect of ASD on the independence, communication, autonomy and knowledge of the people affected by the spectrum is to be made. Finally, the policies and legislations available for ASD people and the impact of advocacy on them are to be discussed.

The Autism Spectrum Disorder (ASD) is related to brain development which impacts an individual to develop disoriented perception and socialisation with others creating problem for them to form meaningful social interaction and communication (Pearson et al., 2018). Autism Spectrum Disorder (ASD) is mainly diagnosed with the help of DSM-5 (Diagnostic and Statistical Manual of Mental Disorder) which is the standard psychological classification for determining mental disorder based on the assessment and presence of signs and symptoms of the disorder (Mazurek et al., 2019). According to DSM-V, persistent deficit in social communication and interaction is diagnostic criteria for detecting ASD individuals. This indicates that presence hindered social and emotional reciprocity, hindered non-verbal communicative behaviour and deficit in managing, developing and understanding relationships are diagnostic criteria for ASD (Morales-Hidalgo et al., 2017). The DSM-V mentions that repetitive or stereotype motor movement, highly fixated and restricted interest, hypo – or hyper-activity of sensory input and insistence of sameness are diagnostic features of individuals affected by ASD (autism.org.uk, 2020).

In comparison, the Asperger’s syndrome, whilst no longer recognised as a separate diagnosis in the DSM-5, remains in the ICD-10 (1992) until the new ICD-11 is published in January 2022 (Melis et al., 2020; WHO, 1992). According to DSM-IV criteria, the severe to sustained impairment in social interaction, development of restricted behavioural pattern, activities or interest, significant social and occupational impairment and others are diagnostic features of people affected by Asperger’s syndrome and it is developed as a result of impact of the disorder on the individual (McKernan et al., 2017). Apart from DSM criteria, the ICD-10 (1992) are also used in clinical diagnosis of ASD with learning difficulty and Asperger’s syndrome (WHO, 1992). The DSM criteria is mainly managed by the American Psychiatrist Association (APA) whereas ICD criteria are made and suggested by the World Health Organisation (WHO).

The Autism Spectrum Disorder (ASD) is diagnosed with ICD-10 (International Classification of Disease) (1992) which is developed by the National Centre for Health Statistic (NCHS) and Centres for Medicare and Medicaid Services (CMS). In regard to intelligent quotient (IQ) scores, the ASD individuals are seen to show average intelligence whereas individuals affected by Asperger’s syndrome express high functioning intelligence (Hosseini & Molla, 2020). In contrast, ASD individuals are seen to suffer from speech impairment but the individuals affected by Asperger’s syndrome show effective speech formation ability. Moreover, ASD is individuals are seen to be usually detected in individuals before their reach the school-age due to severity in the symptoms (Beardon, 2017). However, the individuals with Asperger’s syndrome are often seen to remain undetected until they show social hindrance in communication and interaction at school (de Giambattista et al., 2019). Thus, it indicates presence of lack of effective speech formation and lower intelligence quotient are diagnostic features for differentiating people affected by autism and Asperger’s syndrome.

The ICD-10 and 11 and DSM-V and IV mention that one of the common diagnostic features seen in people with ASD and Asperger syndrome us that both show similar nature of difficulty with social communication (WHO, 2016a; WHO, 2016; Melis et al., 2020). This is because both are seen to how difficulty in understanding facial expression, gestures and voice tone of the people. Moreover, both feel difficulty in initiating conversation, identifying topic for talking, understanding complex phrases and words (Wang et al., 2020). However, the diagnostic difference in ASD individual from Asperger’ syndrome people is that ASD people show higher ability of failure during communication by using no words, making no to minimum eye gaze and limited expression (Rodriguez, Hartley & Bolt, 2019). In contrast, people with Asperger’s syndrome show ability to use minimum amount of words rather than no word as seen in ASD people, have literal ability to mention their emotions and feelings to some extent (Pisula and Porębowicz-Dörsmann, 2017). The other difference of impact of ASD and Asperger’s syndrome is that people with ASD have feeling of less to lack of empathy due to their underdeveloped skills caused by hindered brain development. However, people with Asperger’s syndrome is seen to have enhanced understanding of empathy but they along with ASD individual instead of their differential understanding of empathy neither of them are showcase empathetic feeling (Sheffer, 2018).

One of the restrictive behaviours seen specifically present in ASD children is the stereotyped motor movement which includes making them show echolalia, develop idiosyncratic phrases, unnecessary flipping and lining of toys and others (Bal, Farmer & Thurm, 2017). This is one of the key diagnostic features to be considered for detect and differentiating people affected by Autism from Asperger’s syndrome. The ASD in individuals not only affects their social communication ability and behaviour but also creates learning disability in them which is not seen in Asperger’s syndrome (Foley-Nicpon et al., 2017). In learning, focus and organisation are one of the few key elements as they create gateway for the learners to develop perception, reasoning and decision-making ability to understand and memorise the facts learned (autism.org.uk, 2020). However, lack of focus and organisation is seen in ASD individuals which makes them unable to effectively think and process learning content to memorise them to be later used in life, in turn, making them show learning disability (autism.org.uk, 2020). In contrast, people with Asperger’s syndrome show enhanced focussed and no learning difficulty but their learning is negatively affected to some extent due to their challenge of anxiety and inability to holistically understand and express emotions (Camodeca Todd & Croyle, 2020).

The individuals affected with Autism and learning disability express the learning need of having extra time compared to typical individuals in completing their studies. This is because the autistic children due to their hindered cognitive function experience trouble in quickly processing language and understanding direction (Dijkhuis et al., 2020). Thus, the increased time is required for them to have opportunity in processing the instruction in education and act accordingly. In contrast, the study by Jones, Hanley & Riby (2020) mentions that individuals affected by autism and having learning disability expresses learning need of accessing education in a place with less noise and distractions. This is because of the hyperactivity of the brain that makes the children with ASD become impulsive and experience hardship in making effective focus. As mentioned by Ghazali, Sakip & Samsuddin (2019), autistic children experience increased bullying from typical individuals in the inclusive learning environment. This is because often the cognitive and social impairment among the autistic individuals makes them unable to react in normal manner in the social environment due to which they are mocked and bullied by the normal individuals for their disabled actions. As argued by Eroglu and Kilic (2020), bullying in the learning environment faced by autistic individuals makes them feel unsafe and disrespected which lead them to show cooperation in learning and quit education. This is because the autistic individual when bullied feel being vulnerable to harm and experience lack of value to participate in education for learning purpose. Therefore, another key learning needs of autistic individuals in presence of bully-free learning environment where they have access to safe education.

The barrier to learning created by presence of Autism Spectrum Disorder (ASD) in individuals is their inability to follow the pattern of information to understand and remember it. This is because ASD individuals are found to have narrowed focus due to which they have disoriented thinking which makes it difficult for them to pull back and watch the greater picture of the information develop through detailed structural pattern of the information (Rajaratnam et al., 2020). For example, an individual with ASD due to hindered focus would unable to follow the patterns with which a story progress. This leads them unable to understand or deduce the moral of the story and use the idea (Rajaratnam et al., 2020). In comparison, the study by Mash et al. (2017) mentioned that narrowed focus leads the ASD individuals not only face hindrance in processing information pattern but also makes them struggle with summarising their own idea. It leads the ASD individuals form meaningful interaction with the teacher to clarify doubts regarding any piece of information in the education environment in turn creating barrier for them develop effective understanding of any topic.

One of the systematic barriers in learning faced by the ASD individuals is lack of supportive resources in the classroom to meet their learning needs (Paskins, 2018). The lack of resources mainly occurs due to hindered funding due to which the special resources to create an inclusive learning environment for the individual with ASD is unable to be developed making them face hindrance to learn. In contrast, the study by Wilson & Landa (2019) informed that lack of knowledge and training of the educators regarding the way to manage and educate ASD individuals creates learning barrier for the children. This is because the educators are the key knowledge providers for ASD individuals and their lack of training make them incapable to create effective and supportive learning environment for the individuals with ASD. It leads the individuals unable to overcome their social issues with learning and experience challenges to be educated. The other environmental barrier faced by ASD individuals regarding learning is lack of specialised support staff for them who would provide time and act along with the educator to be able to learn by overcoming social and behavioural issues caused by the disorder (Paskins, 2018).

One of the concepts related with Autism Spectrum Disorder (ASD) is that it is regarded as health issue which creates additional support needs. According to functional development and clinical diagnosis, additional support needs is mentioned as the term for individuals who needs assistance for disabilities which may be psychological or medical (Van Herwegen, Ashworth & Palikara, 2018). It is seen that many people with low cognitive skill are regarded to be people with additional support needs. However, a person with ASD may have uneven cognitive skill due to which they may have exceptional numerical or comprehension ability, but their writing or oral communication skills could be poor making them unable to express themselves (Van Herwegen, Ashworth & Palikara, 2018). As argued by Mazurek et al. (2019), symptoms and representation of the autism in the individual makes them to develop inability to learn effectively. Thus, the representation of autism on the behaviour of individuals makes them to be regarded as special needs children. In the UK, the special needs are mainly related to education and since individuals with ASD experience hindrance with learning they does require special needs education (Duda et al., 2018).

The other concept related with ASD is principle of inclusive education that is engagement of individuals without discrimination to provide all individuals equal opportunity and capability to grow and learn (Padmadewi & Artini, 2017). As mentioned by Samadi & McConkey (2018), inclusive education of the ASD individuals leads them to have enhanced social acceptance along with creates opportunity for them to improve social communication. This is because inclusive education creates opportunity for the individual with ASD to interact at par with the normal individuals which leads them gradually perceive the modes of social communication. As argued by Van Kessel et al., (2019), inclusive educational concept is related with ASD as it leads to control stigma regarding the spectrum and create favourable social environment for ASD individuals to live. This is because during inclusive education the typical peers interact with the ASD individuals to understand how they are different from others and resolve false thoughts created through lack of practical knowledge regarding the spectrum. It intends to make the normal peers understand how they are to react with the ASD children, in turn, creating a favourable and acceptable social environment for the children.

The social model of disability mentions that people are considered disabled by the barriers in the society and not due to their difference or impairment of any nature (Chown et al., 2017). It is evident as individuals with ASD or families with presence of individual who has ASD is seen to be isolated or rejected by peers or communities. This is because the peers and community individuals think that presence of ASD in the individuals makes them have disruptive anti-social behaviour which would negatively affect them if they get involve with the individual or the families (Woods, 2017). It creates barrier for the individuals with ASD or families having such individuals to make them exposed in the society. This in turn creates disability for the family to arrange effective intervention at the right time for the individual with ASD to improve their health condition as they avoid being exposed which would bring shame and hatred for them as well as make them isolated in the society (Woods, 2017).

The presence of a supportive social environment with presence of effective social support services for individual with Autism Spectrum Disorder (ASD) help to promote their independence and participation in the school, community and at home. It is evident from the study of Egilson et al., (2017) where it is mentioned that enhanced socially supportive environment created 50-60% variation in the frequency of social participation and in-depth independent involvement of individuals with ASD. This is because social support helps the ASD people to feel included in the society and have perception of safety as well as assistance to be received for them to move freely (Kapp, 2018). For example, allowing recruitment of ASD people at jobs without discrimination would create economic independence of the individual to live in the society. Moreover, effective social support from colleagues and peers at work would lead individuals with ASD to feel independence in working with others. However, a non-supportive social environment makes the ASD individuals feel fear of being attacked or abused. The safety issues lead them to develop doubt and lack of confidence to live independently (Drew, 2017).

In case of ASD individual, an environment where the teachers and individuals in the community show willingness to provide meaningful rationale for the actions performed by them help ASD individuals to form flexible relationship rather than relationship of control and power. It creates support toward autonomy development of ASD individuals as they trust and feel free to provide own decision regarding their actions with the hope they would be understood, and the actions are to be accordingly followed (Shea, Millea & Diehl, 2013). However, a controlled environment in case of ASD individual makes them feel not to be listened by others, in turn, making them upset and lose self-control to make their decision to be forcefully fulfilled. This is because not listening to ASD individual’s ideas and opinion makes them feel ignored which results in their frustration and distress (Krieger et al., 2018). Thus, an authoritative environment hinders development of autonomy and self-control for the ASD individuals as they fail to the scope and audience to listen and act on their decision.

The Additional Support for Learning (Scotland) Act 2004 is seen to promote inclusion in education where they support inclusive curriculum to be set from 3-18 to provide enhanced learning support to people (gov.scot, 2004). Thus, according to the legislation, all the ASD children has equal right at par with the typical children to get admitted to normal school and access education.

The advocacy mainly seeks to ensure that all individuals in the society are effectively heard for their issues which are important to them (McCoy et al., 2020). The impact of allowing advocacy for individuals with ASD is that it impacts them to have the right of independence and sense of identity which makes them feel empowered in taking own decisions. Moreover, it supports their right of being valued and respected as advocacy allowed them to make own decision without being discriminated for their disabled condition (Rosenblatt, 2018). Thus, promoting advocacy for ASD individuals would impact them to make their views and needs regarding social life, education, physical health, etc to be heard by care providers and others rather than caring for them by deducing their views on own based on exiting evidence. The advocacy is to be promoted among the ASD children under the UNCRC (Incorporation)(Scotland) Bill 2021 as it states the way right to advocacy is to be maintained (togetherscotland.org.uk, 2020). The other impact of advocacy is that it ensures to create opportunity for the service users or patients to be partners in their care and improve their autonomy. In ASD people, the advocacy leads them with the help of their parents to be partners with care providers and educators in mentioning the way their care and education is to be arranged. This is because ASD children has hindrance with social communication establishment and therefore, their parents by understanding their opinions express them on their behalf to be followed to arrange support for them (Woods, 2017).

The above discussion mentions that Autism Spectrum Disorder (ASD) diagnosis of the condition is made by referring to DM-V and ICD-10 and the diagnostic features are social functioning, speech issues, inability to express emotions and others. The Asperger syndrome is different from ASD in the sense in the former condition no hindered or delayed speech formation is faced whereas in the later hindered speech development is the key issue faced by most individuals. The learning needs of ASD individuals include presence of visual and written cues, clam environment, audio-visual resources and others. The barriers to learning faced by ASD individuals are lack of trained staffs, specialised educators, resources and others. The social model of disability mentions that ASD is mainly considered as disability because there is wide stigma and lack of acceptance of spectrum present among the people in the society. The Additional Support for Learning (Scotland) 2004 is one of the key legislative context that supports rights of ASD individuals. The presence of advocacy promotes autonomy among the ASD individuals.

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