Autism Spectrum Disorder (ASD)

Autism Spectrum Disorder (ASD)

Autism Spectrum Condition (ASD), a clinical diagnosis of autism, is a brain development disorder affecting how individuals see and socialize with others, resulting in social interaction and communication difficulties (Boucher & Anns, 2018). Restricted and consistent behavioral patterns characterize ASD. “Spectrum” in ASD defines the symptoms and severity’s significant range. According to the CDC (2020), ASD manifests itself during childhood, before 3 years of age, and later leads to functioning problems in society in terms of socialization. This disorder can eventually last throughout an individual’s life, even though improvement of symptoms may be noted over time.

CDC (2020) further notes that the etiology of ASD may be attributed to genetic conditions while others are idiopathic. The ability of ASD people varies significantly. For instance, some may possess advanced conversational skills, while others may remain nonverbal. Dai et al. (2019) claim that some ASD children gain novel skills and attain developmental milestones until the approximate age of 18 to 24 months, which is then accompanied by an alteration of acquiring a new skill or losing the skill they once possessed. As these children grow to the adolescence stage, they may present with challenges of making and maintaining new friends, peer and adults communication, or comprehending the expected behavior in school. Due to the conditions like anxiety, depression, and hyperactivity disorder that are present in ASD people, they may require the immediate attention of healthcare professionals. This paper analyzes the autobiography of Donna William, linking its evidence to Autism Spectrum Disorder and how this condition could have been managed in today’s time bearing in mind the available DSM-V that is currently used in diagnosing ASD.

Summary of the Autobiography

In the “Nobody Nowhere” article, Donna William presents an eloquently written presentation of self as a woman diagnosed with increased functioning autism and a look at the universe from her perspective. She describes the challenges she experienced in maintaining family and other relationships due to her difficulty with social nuances appreciation. The title is grounded on her mother’s evaluation to be “nobody” and had “nowhere” to go.

Donna’s parents viewed her behavior as eccentric. While her father was caring and hopeful that Donna could change, her mother, on the other hand, was cruel and abusive to the extent of calling her “crazy” and “mad”. Donna’s brother called her a moron, joining their mother’s side. Besides, Donna wanted to be in a relationship but never knew how to be in one. Her several boyfriends used her in many ways, taking advantage of her vulnerability. Throughout the presentation, Donna undergoes tribulation and wants to leave her created “world” and enter the alien “real world”. However, Donna creates coping strategies with life as she comprehends it. She could summon “Willie,” her imagination’s violent creature, to protect her when she felt in danger. Donna’s autobiography is a real presentation of what autistic children undergo.

DSM-V ASD Diagnostic Criteria

According to the American Psychiatric Association (APA) (2015), ASD can be diagnosed depending on the symptoms that the ASD patient presents. In addition, the child must have recurring socialization and engagement difficulties and a minimum of two limited and repetitive behavioral kinds. As a result, Donna’s autistic behavior is consistent with DSM-V Part A (consistent inability of social connection and engagement). Donna had a social-emotional reciprocity deficiency by having a modest response to social engagements, such as embracing on several occasions. She indicates, “I never hugged either of them; neither was I hugged.” “…all touching was pain, and I was frightened.” (Williams, 2009, p. 15). Secondly, Donna lacked nonverbal communicative behaviors utilized in social interaction. She poorly integrated nonverbal and verbal communication on many occasions throughout her childhood. Thirdly, Donna had difficulty making friends. Due to her strange behavior, her first-day friends found her rather strange that they never wanted to interact with her the second time, such as Carol, a friend that she met at the park (Williams, 2009, p. 23). This behavior confirms a deficit in maintaining and understanding relationships.

Donna presents some characteristics that can be classified in part B of DSM-V, which specifies the severity of ASD. This section is based on issues with socialization and restrictive repeating behavioral patterns. Donna manifested this aspect by having repetitive speech during her childhood years. She could repeat everything the other person talking to her would say (Williams, 2009, p.11). Secondly, she highly restricted herself to specific foods such as “custard, jelly, lettuce, baby food, honey and white pieces of bread” (Williams, 2009, p.12).

In addition, Donna’s symptoms were present in her early developmental period and became fully manifested when social demands exceeded limited capacities. Besides, her symptoms caused clinically elementary impairment in socialization and occupation. Therefore, in this context, Donna’s autistic presentation could be grouped as level 1, which requires support.

Specific Causes of Donna’s ASD experiences

Donna presented sensory impairments evidenced by malnutrition, a deficiency, or imbalances of energy and nutrients intake. According to research, children diagnosed with autism possess a significant feeding challenge and eat a limited range of foods. Donna restricted herself to foods that she only liked, such as lettuce leaves, honey, custard, jelly, and baby food, even at thirteen years (Williams, 2009, p.12). Besides, Donna could hang on the highest branch of a tree and “sometimes she would hum. As long as everything moved to the rhythm.” People with autism can sometimes not withstand the sounds of dishwashers or injure themselves to be fully aware of their bodies (Rudy, 2021). Sensory impairments in autism are caused by sensory overload occurrence. For instance, Donna’s obsessive behavior of eating selective foods leads to decreased nutrient levels.

Another Donna symptom included difficulty in maintaining friends. This can be caused by fear of vulnerabilities, social anxiety experience, and struggle with appropriate social skills in making new friends (Oswald, 2021). Donna wanted to have friends but never knew how to make one since all friends that came her way left on the second day leading to her making false imaginations. Also, the boyfriends she got took advantage of her to the extent that she feared being vulnerable. 

Treatment Plan

If Donna were a child today, I would propose sensory integration therapy as one of the effective modalities (Rudy, 2021). This could help Donna manage her sensitiveness and cravings. Particularly, according to the American Occupational Therapy Association, I would recommend that Donna should undergo a sensory diet program that involves a day-to-day menu plan that comprises personalized and supportive sensory approaches. Also, I would recommend education for involved individuals, such as her brother and mother, about the influence of sensory functions on her performance and the negative impact of minimization strategies on functionality. Finally, I would recommend complementary and alternative treatments such as art therapy and relaxation therapies (CDC, 2020).

Personal Reflection

ASD is a neurodevelopmental condition attributed to variation in communication and social interaction. People diagnosed with ASD demonstrate varied restricted and repetitive interests or behavioral patterns. ASD begins at birth and manifests into old age. It is fascinating how Donna William documented her autobiography despite her autism state despite the available evidence on the developmental phases of autistic individuals.

On further investigation, I learned that ASD might be caused by a genetic mutation, a fragile X syndrome that can be transmitted from the mother, being born to older parents, and metabolic imbalances. Besides, a child may have ASD if the mother has a history of viral infection or exposure of the fetus to medications thalidomide. Therefore, mothers need to take care during pregnancy to prevent the fetus from being exposed to thalidomide medications, viral infections, or heavy metal and environmental toxin exposure.

Conclusion

ASD is a developmental brain disorder that affects how people perceive and socially their behavior, resulting in difficulties with socialization and connection. In reference to Donna’s autobiography, ASD symptoms can be divided into two categories, recommended by the DSM-V: communication and interaction deficit and restricted or repetitive behavioral patterns or activities. These criteria help psychologists to classify ASD according to its severity. The causes of autism symptoms can vary depending on the patient’s manifestation. Therefore, its treatment should be primarily focused on the manifested symptoms. As such, the treatment modalities include behavioral therapies, sensory integration therapies, pharmacological therapies, even if their intervention is limited to specific symptoms, and educational interventions. Lastly, the key takeaway point includes acknowledging the primary causes of ASD and the available diagnostic ways of the disorder. It is recommended that research should be done that elementarily investigates how ASD can be prevented with an acknowledgment that ASD occurs during birth. Genetic therapies should be put in place to prevent children from being born with autism.

References

American Psychiatric Association. (2015). American psychiatric association diagnostic and statistical manual of mental disorders (DSM-IV). SpringerReference. https://doi.org/10.1007/springerreference_179660

Boucher, J., & Anns, S. (2018). Memory, learning and language in autism spectrum disorder. Autism & Developmental Language Impairments, 3, 239694151774207. https://doi.org/10.1177/2396941517742078

CDC. (2020, August 11). Basics about autism spectrum disorder (ASD) | NCBDDD | CDC. Centers for Disease Control and Prevention. Retrieved April 1, 2022, from https://www.cdc.gov/ncbddd/autism/facts.html

CDC. (2020, March 16). Treatment | Autism spectrum disorder (ASD) | NCBDDD | CDC. Centers for Disease Control and Prevention. Retrieved April 1, 2022, from https://www.cdc.gov/ncbddd/autism/treatment.html

Dai, Y. G., Miller, L. E., Ramsey, R. K., Robins, D. L., Fein, D. A., & Dumont-Mathieu, T. (2019). Incremental utility of 24-Month autism spectrum disorder screening after negative 18-Month screening. Journal of Autism and Developmental Disorders, 50(6), 2030-2040. https://doi.org/10.1007/s10803-019-03959-5

Oswald, T. (2021, 25 maart). Making Friends When You’re On The Autism Spectrum. Tasha Oswald. Geraadpleegd op 2 april 2022, van https://opendoorstherapy.com/making-friends-when-youre-on-the-autism-spectrum/#:%7E:text=Often%20individuals%20with%20autism%20struggle,necessary%20to%20make%20new%20friends.

Rudy, L. J. (2021). Is sensory integration therapy helpful for autism? Verywell Health. Retrieved April 1, 2022, from https://www.verywellhealth.com/sensory-integration-therapy-and-autism-260509

Williams, D. (2009). Nobody nowhere: The remarkable autobiography of an autistic girl. Jessica Kingsley Publishers.