In the US, 1 in 68 children lives with autism spectrum disorder (ASD), reports the Centers for Disease Control and Prevention (CDC), and the prevalence of ASD appears to have dramatically increased since 2000, when 1 in 150 children received the diagnosis. As a developmental disability, ASD causes “significant social, communication, and behavioral challenges.” While researchers continue to unlock the secrets of ASD, behavioral health programs must work to help parents and caregivers of children understand this disorder’s implications for daily activities and behaviors, including impact on the circadian rhythm, learning abilities, and treatment approaches.
Behavioral Impact of Autism
Children and teens with ASD may refrain from exhibiting the typical behaviors of children. According to the CDC, children with ASD may show the following signs and symptoms:
- Avoiding eye contact.
- Not appearing engaged when interacting with others.
- Experiencing difficulty in understanding the feelings of others.
- Preference to avoid contact, such as being held or cuddled.
- Repeating phrases or words in place of typical language.
- Having trouble speaking.
- Repeating actions multiple times.
- Having unusual responses to sensory perception of things.
- Exhibiting aggression, irritability, or inattention.
- Experiencing difficulty in adjusting to changes in routine, such as a change in sleeping habits may cause behavioral impact.
Adults are not strangers to how changes in environment can negatively impact sleeping patterns, the circadian rhythm. Sleep deprivation has been shown to decrease cognitive awareness and functioning, explains Len Kravitz, Ph.D. of the University of New Mexico. Yet, new research suggests the link between quality of sleep in children with autism may be more intrinsically linked to behavioral problems during the day.
Autism and Sleep
Children and teens with autism may be more likely to experience trouble falling asleep, staying asleep, or waking early. Psychologist Micah Mazurek and Dr. Kristin Sohl, pediatrician, found increased sleep difficulties in children with autism often coincided with increased behavioral problems during the day. For children and teens who experienced high levels of insomnia or difficulty when sleeping, the incidence of behavioral problems, especially aggression and hyperactivity, grew the most.
“It’s important that individuals with ASD are routinely screened for underlying medical conditions, including sleep disturbances,” asserts Autism Speaks™ Vice President for Clinic Programs and the Autism Treatment Network Donna Murray.
Since the risk for behavioral problems appears linked to sleep troubles, focusing on reducing behavioral-impact factors may be the best solution to reducing the disorder’s overall impact on daily life. Not surprisingly, behavioral health treatment of autism often focuses on helping children cope with the disorder’s impact by changing sleeping habits and encouraging positive behaviors.
Autism is incurable, and researchers have yet to find a definitive, biological test to diagnosis cases of ASD. The diagnosis is currently achieved by studying a child’s behaviors and health development. Although a diagnosis may be made as early as age 2, many children are not diagnosed until later during childhood, such as when reaching school-going age. A sooner diagnosis equates to the earlier use of treatment approaches to lessen the disorder’s developmental impact.
Autism and Applied Behavior Analysis
Treatment of autism may include behavior and communication therapies, dietary monitoring and regulation, medication treatment, and the use of complementary and alternative medicine.
The link between autism and applied behavior analysis (ABA) seems to hold the most promise. ABA teaches positive behaviors and discourages negative behaviors in a healthy environment. This is accomplished through the use of consequences and reinforcement.
For example, a child in ABA therapy may be given extra time to “play” if behaviors are exhibited appropriately throughout the day. The child’s progress is then tracked, and this information can be passed along to help parents and caregivers manage the child’s behaviors outside of the treatment setting.
ABA may also be broken down into four categories, according to the CDC, which include the following:
- Discrete trial training (DTT) breaks down complex behaviors into their simplest steps, and positive reinforcement is used to reward correct behaviors and answers. Negative reinforcement of ignoring behavior is used when the incorrect behaviors or answers are exhibited or given.
- Early intensive behavioral intervention (EIBI) refers to the use of ABA for children younger than 5-years-old.
- Pivotal response training (PRT) teaches children with ASD to monitor their own behaviors and start conversations with others. As a result, the impact of this type of ABA should extend to other behaviors. For example, a child in PRT may attempt to “go back to sleep” when awaking early without intervention from parents or caregivers.
- Verbal behavior intervention (VBI) teaches children with ASD verbal skills and further encourages the focuses of PRT and DTT.
Each state has a program in place to help the parents of children under age 3 attain early intervention services, including the aforementioned therapies, via the US Department of Education.
Certain medications may help manage hyperactivity or depression in children and teens with ASD; however, these medications are unable to treat the primary symptoms of the disorder.
Some health professionals may advocate for dietary changes in children and teens with ASD. For example, a diet with a reduced fluid intake after 6:00 p.m. may help to reduce waking while sleeping. Most dietary changes focus on improving overall health, which may help reduce the incidence of ASD symptoms and behaviors.
Complementary and Alternative Medicine
Complementary and alternative medicine, otherwise known as CAM therapy, explains the National Center for Complementary and Integrative Health, refers to the use of non-traditional methods of treating a given illness. These methods may include the use of herbal supplements, acupuncture, yoga, breathing exercises, and equine therapy. Up to 33 percent of parents and caregivers use CAM therapy to help with ASD. However, some of these therapies can be dangerous, such as a toxicity due to herbal supplementation of the diet and adverse interactions between supplements and medications. Behavioral health training should include a focus on the importance of discussing CAM therapies with a child’s pediatrician and psychologist prior to starting any therapy.
If every word in this article represented a child, the number of words in the bolded part of this sentence would be children with ASD. Autism represents a major challenge to modern mental health. Parents and caregivers must learn how autism impacts routine behaviors and understand the treatment approaches to managing the disorder, which may be the key to halting the incidence of severe developmental problems.