Autism is a condition of a person's birth or when the toddler, which makes him unable to form social relationships or normal communication. As a result the child is isolated from other human beings and in the world of repetitive, obsessive behavior and interests. (Baron-Cohen, 1993). According to Power (1989) characteristics of children with autism is the presence of six disturbances in the areas of: social interaction, communication (language and speech), behavior, emotions, patterns of play, sensory and motor disturbances and delayed or abnormal development. These symptoms start to come from birth or when they were small, usually before the child was 3 years old.
Autism in the Diagnostic and Statistical Manual of Mental Disorder-IV R is one of the five types of disorders under the umbrella of EDU (Pervasive Development Disorder) out ADHD (Attention Deficit Hyperactivity Disorder) and ADD (Attention Deficit Disorder). Perpasiv development disorders (EDU) is the term used to describe a number of clusters under development disorders (umbrella term) EDU, namely:
Autistic Disorder (Autism) Appearing before the age of 3 years and demonstrated restriction in social interaction, communication and imaginative play ability and the presence of stereotype behavior in interest and activity.
Asperger's Syndrome barrier development of social interaction and the availability of limited interest and activity in general did not show language and speech delays, and has a level of intelligence in the average to above average.
Pervasive Developmental Disorder - Not Otherwise Specified (EDU-NOS) refers to the term atypical autism, EDU-NOS diagnosis occurs when a child does not show the whole criteria on specific diagnosis (Autism, Asperger's or Rett Syndrome).
Rett's Syndrome more common in girls and rarely occurring in young men. Had time to experience normal development then there is retrogression / lose the ability already possessed; losing functional ability to move the hand that replaced moving the hand over and over in the age range 1-4 years.
Childhood Disintegrative Disorder (CDD) show normal development during the first 2 years of age progression then suddenly lose the faculties which have been achieved previously.
Diagnosis Pervasive Disorder Not Otherwise Specified Develompmental (EDU - NOS) generally used or worn in the United States to clarify the availability of some of the characteristics of autism in a person (Howlin, 1998: 79). National Information Center for Children and Youth with Disabilities (NICHCY) in the United States stating that Autism and EDU - NOS is a developmental disorder that is likely to have similar characteristics and symptoms appear before the age of 3 years. Both are of a neurological disorder that affects the ability to communicate, language understanding, and ability to play in relation to others. Inability to adapt to change and availability of responses that do not fit the sensory experience is also often linked to symptoms of autism.
Diagnosis
Historically, the diagnosis of autism have a question; once experts and researchers in the field of autism are based on the applicability of the symptoms, the current experts and researchers seem to migrate toward various characteristics referred to as autism continuum. Aarons and Gittents (1992) recommends the availability of descriptive approach to diagnosis. This is a descriptive approach in diagnosing to include extensive observations on social these settings children. Settingya possible in schools, in parks or maybe playing at home as a child everyday environment where obstacles or difficult they may appear obvious in their peers 'normal'.
Other concerns that affect the accuracy of a diagnosis often also emerged from of the fact that the problematic behaviors is an attribute of the foster care system is not accurate. Behaviors may just be the result of a negative family dynamics and not as a symptom of corruption. The existence of a wrong interpretation of the causes of why children managements show behavioral questions could create some negative feelings for parents. Any further questions then is what can be done so that more accurate and consistent diagnosis of autism earnest until separated by the conditions that increasingly exacerbating? Need for a model that includes the diagnosis and to evaluate the overall survival rate of the obstacles and difficulties children as well as on the faculties and skills-skills of children. It could be any later recommended that professionals in the field of autism also consider the entire area, for example: early child development, child appearance, child mobility, control and attention of children, sensorisnya functions, the ability to play, the development of policy concepts, the ability of a Sequence, musical ability, and so the whole self into her own.
For parents and families themselves should also note that the symptoms of autism is individual; would differ from one another despite equally be regarded as a low functioning or regarded as high functioning. Requires patience to handle and consistency to the handling so that the phenomenon should be realized that this is a long journey. Do not stop at the inability of the child but also to dig the talents and potentials available to the children themselves. As mentioned some inspiration hopefully capable of defending autism develop existing talent and potential in them, for example: Temple Grandine capable of developing visual abilities and systematic patterns of thinking to become a doctor in the field of animal husbandry, Donna William who is able to develop the language skills and artistic talent to be able to become a writer and an artist, Bradley Olson a student who is able to develop his physical fitness and cognitive ability to be an active young and agile and probably still are many other names that can be a source of inspiration for us all. In the end, a label from a diagnosis can be considered useful when able to provide guidance to parents and educators about the state of the true nature of a child. Menimbukan label confusion and dissatisfaction parents and educators obviously will not bring any benefit.
Clinical symptoms
Children with autism may appear normal in the first year or second year of life. The older people are often unaware of a delay in language skills and specific ways that different when playing and interacting with others. These children may be very sensitive or even non-responsive to stimuli from the fifth rangasangan manifold senses (hearing, touch, smell, taste and sight). Repetitif behaviors (flapping-kepakan hands or fingers, shook his body and to repeat words) are also found. Behavior can become aggressive (good to yourself or others) or even very passive. In all likelihood, behaviors previously considered normal may be additional symptoms. Apart from playing a repetitive, restricted interests and barriers to socialize, some other things that was always attached to the incumbent autism are responses that do not fit the sensory information they receive, for example; voices, noise, light, surface or texture of a particular material and particular taste in food choices that become their favorite.
Some or all of the following mentioned characteristics can be observed in the spectrum with autism defending well with the current situation, even the lightest to the heaviest.
Barriers in communication, for example: speak and understand language.
Difficulty in relating to other people or objects around it and connect the events that occurred.
Playing with toys or other things improperly.
Hard to accept changes in routine and environment are known.
Move the body or the presence of repetitive patterns of behavior specific
The incumbent Autism spectrum with very diverse both in capacity owned, intelegensi floor, and even behavior. Some of them are not 'talk' while some others might have been his language so often found to repeat words or phrases (echolalia). Those who have high language skills generally using limited themes and difficulty understanding abstract concepts. Thus, there is always a unique individuality of individuals incumbents.
Autism is a pervasive developmental disorder in children characterized by disruption and delays in the cognitive, language, behavior, communication and social interaction. Bizarre interruption behavior in children should be observed is concerning the various developments.
Interference in verbal or nonverbal communication
EF delayed or totally unable to speak. Use of words without linking it with common sense used.
Communicate using body language and only able to communicate in a short time.
These words can not be understood other people ("the language of the planet")
Do not understand or do not use words in the right context.
Ekolalia (mimic or imitate), imitate words, sentences or songs without know what it means.
Discretion monotone like a robot
Discretion is not used for communication
Mimic flat
Disruption in social interaction
Push or pull to one side for a face-to-face
Do not look when called, so often alleged deaf
Felt uneasy or reject cuddle
When you want something, pulled the hand of the nearest and hope people do something for him
Not sharing enjoyment with others
When playing away when approached even
When you want something it pulls the hands of others and expect the hands to do something for him.
Interruption in play
Play very monotonous and strange example row soap into one long row, play the ball on the toy car and carefully observe for sometime.
There adhesiveness with certain things such as paper, photographs, card or rolling, continue to be held where have brought him off.
Happy when a toy does not want another toy.
Do not like puppets, but more like a less interesting things like bottles, rubber bracelets, batteries or any other object
No spontaneous / reflexes and can not imagine the play. Can not mimic his actions and can not be started games hypocracy.
Often observe their own fingers, a rotating fan or the wind that moves.
Ritualistic behaviors occurred frequently difficult to change the daily routine, such as when playing have to do a certain sequence, when traveling to go through the same route.
Behavior disorders
Often regarded as a happy child rigor should put certain things in place
Hyperactive children can be seen for example when in the house the first time they come, it will open all the doors, walk fro, running indeterminate direction.
Repeating a particular motion (moving his hand like a bird flying). It also often hurt yourself like hitting your head or ram head on the wall
Can be very hyperactive or very passive (quiet), sit still mark time with empty eyes staring. Angry for no reason that makes sense. Very very put attention on one thing, idea, activity or person. Can not show the sense sehatnya. Can be very aggressive to others or himself.
Sleep cognitive disorders, eating disorders and other behavior disorders.
Feelings and emotional disturbance
Laugh-laugh himself, crying or upset without apparent reason
Often uncontrollable rampage (temper tantrum), especially when they do not get something you want
Often uncontrollable rampage (temper tantrum) when desire is not being obtained, but can become aggressive and destructive.
Can not share feelings (empathy) with another
Disturbance in sensory perception
Sensitivity to light, hearing, touch, smell and taste (tongue) of from mild to heavy.
Biting, licking or kissing toy or thing whatsoever
When you hear loud noises, ear cover
Cried every time her hair washed
Meraskan uncomfortable when given certain clothing
Do not like feeling or a hug, When digendong often deteriorate or break away from the hug.
Regardless of the various characteristics of the above, there are instructions and guidelines for parents and practitioners to more waspasa and care about the visible symptoms. The National Institute of Child Health and Human Development (NICHD) in the United States mentions 5 types of behavior should look out for and the need for further evaluation:
Children not suppress up to 12 months
Children do not show the ability gestural (pointing, chest, grasping) up to 12 months
Child does not say a word until the age of 16 months
Children are not able to use two sentences spontaneously at the age of 24 months
Children lose language skills and social interaction at a certain age
The existence of the fifth 'red light' on does not mean that the child is held because the characteristics of autism but autism disorder a very diverse then a child should get a multidisciplinary evaluation, which can include; Neurolog, Psychologist, Pediatric, speech therapy, Paedagog and other professional who understands question of autism.
Clinical symptoms according to DSM IV clinical
A. Social interaction (at least 2):
Not able to establish non-verbal social interaction: eye contact, facial expressions, body posture, gestures less toward me
Difficulty playing with peers
No empathy, behavior sharing pleasure / interest
Less able to establish social relationships and emotional two directions
B. Social communication (at least 1):
No / late talking, not trying to communicate non-verbal
Can talk but not for communication / initiation, self-absorbed
Strange language & diulang-ulang/stereotip
Way less varied play / imaginative, less social imitation
C. Imagination, flexible thinking and imaginative play (at least 1):
Defending one or more interest in a very special and excessive, good intensity and focus
Glued on a ritualistic activity / routine that is not useful
Some strange movements and repetitive special. Very often dazzled on certain parts of an object
A child of autism patients, with an array of toys that they do
Autism symptoms can be very mild (mild), medium (moderate) to severe (severe), so that the community may not be aware throughout its existence. Serious or trivial disorder autism often then in-parallel both by functionality. It is said by the experts that children with autism with cognitive level and low intelegensi, did not speak (nonverbal) behavior has hurt himself, and shows very limited interests and routines done then they are classified as low functioning autism. While those who show cognitive function and high intelegensi, capable of using language effectively and discretion as well as demonstrate the ability to follow a general routine classified as high functioning autism. Two of the characteristic dichotomy indeed interference will affect the educational implications or treatment models given in the incumbent autism. Presumably through this media writers bring up to the members and paktisi in the field of autism to further develop strategies and teaching techniques appropriate for them. Especially considering the fact of previous research results that 80% of children with autism have low intelegensi and does not speak or nonverbal. But, again, any diagnosis or label given immediate priorities are given timely intervention and truly relevant to their needs.
Reference standard used universally in recognizing the types of developmental disorder in children is ICD (International Classification of Diseases) Revisions to-10 in 1993 and DSM (Diagnostic And Statistical Manual) Revision IV in 1994 which both common content. Specifically in the category of Perpasiv Developmental Disorder (Pervasive Developmental Disorder / EDU): Autism is shown when found six or more of 12 symptoms, which refers to three main areas of disturbance, namely: Social Interaction - Communication - Conduct.
Autism as a spectrum disorder symptoms can then be evidence of various combinations of a developmental disorder. When tes-tes in Behavioral or communication can not detect the presence of autism, then some of the current screening instruments have evolved can be used to diagnose autism:
Childhood Autism Rating Scale (CARS): the scale of childhood autism made by Eric Schopler in the early 1970s based on the observation of behavior. Tool using a scale to 15; children evaluated based relationship with, the use of body movement, adaptation to change, listening and verbal communication ability
The Checklis for Autism in Toddlers (CHAT): be a list at the time of the toddler's autism screening used to detect children, aged 18 months, was developed by Simon Baron Cohen in the early 1990's.
The Autism Screening Questionare: is a list of questions consisted of 40 scale items used in her children over the age of 4 years to evaluate their social and communication skills
The Screening Test for Autism in Two-Years Old: autism screening test for children 2 years of age developed by Wendy Stone at Vanderbilt, based on the capabilities of the three areas, namely: play, motor imitation and concentration.
The accurate diagnosis of autism or other related developmental disorder requires a thorough observation of: the child's behavior, communication skills and ability to other developments. Will be very difficult diagnose because of the wide range of disorders seen. Observations and interviews with older people is also very important in diagnosing. Evaluation team consisting of many disciplines allows for a standardization in diagnosing. The team may consist of neurolog, psychologist, pediatrician, paedagog, speech pathologist / linguistic, occupation therapists, social workers and other sebaginya.
Handling autism
Intensity of behavioral treatment in children with autism is very important, but fundamental questions found in Indonesia becomes very crucial to overcome first. Without ignoring other factors, some of the facts that are deemed relevant to the question of handling the problem of autism in Indonesia including:
The shortage of trained therapists in Indonesia. The old man always been a pioneer in the intervention process until earlier intervention centers for children with autism build on the importance of the family to ensure the continuity of their own children's education.
The lack of a formal treatment indication in Indonesia. Not enough to simply implement guidance from outside the applicability teatment not always fit with the culture of Indonesian children's lives.
Still a lot of cases that are not in the detection of autism in childhood so that when child gets bigger, the more complex the question faced by the elderly interventions. The members are able to diagnose autism, information about the disorder and the characteristics of autism as well as informal institutions that provide educational services for children with autism has not been spread evenly across regions in Indonesia.
Not to terpadunya maintenance education for children with autism in schools. In Article 4 of Law no. 20/2003 on National Education System has mandated democratic education and non-discriminatory to uphold human rights, and supporting this great opportunity for the incumbent to get autism in public schools (inclusion) because nearly 500 state schools have been directed by government to maintain inclusion.
The final problem is no less important is the poor knowledge of good clinical practice as well as supported by empirical data validity (Empirically validated Treatments / EVT) from handling-handling autism in Indonesia. Studies and other autism research requires large funds also to be supported by empirical data validity, but certainly no ethically parents who want their children to be test of a particular methodology. Certainty and security for the child's education is a major consideration for parents in choosing one type of treatment for their children so that when these doubts can be answered through scientific authority-authority, the more open to the wider community information about good knowledge-knowledge of a clinical or practical in the process of handling the problem of autism in Indonesia.
Therapy for Individuals with Autism
If you have questions about what is effective therapy? So the answer to this question is very complex, even the parents of children with autism also feel confused when faced with the many treatment and education offered to their children. Some more traditional types of therapy and have been tested from time to time while other therapies may just appear. Unlike other developmental disorder, not a lot of indicators that have been published much less treatment of the standard procedures in dealing with autism. However, even the experts agree that therapy should begin early and should be directed at obstacles or delays that are commonly owned by all children with autism, for example; communication and problem-persolan behavior. Comprehensive Treatment generally includes; speech therapy (Speech Therapy), occupation Therapy (Occupational Therapy) and Applied Behavior Analysis (ABA) to change and modify behavior.
Here is a simple description of a variety of existing literature and a non-exhaustive summary explanation of some of the current recognized treatment. Become imperative for parents to find out and identify the chosen treatment directly to those that professional specialty. Some of these techniques is a comprehensive program, while others are designed to target specific an obstacle or difficulty of the incumbent.
Educational Treatment, including but not limited to: Applied Behavior Analysis (ABA) that the principles used in the study Lovaas so often equated with Discrete Trial Training or Intensive Behavioral Intervention.
Associated developmental approach to education known as Floortime.
TEACCH (Treatment and Education of Autistic and Related Communication - Handicapped Children).
Biological Treatment, including but not limited to: diet, vitamins and grant giving drugs to reduce certain behaviors (aggressiveness, hyperactivity, hurt themselves, etc..).
Speech - Language Therapy (speech therapy), including but not limited to joint association disturbance and interference handling process auditory / hearing.
Communication, increase communication skills, such as PECS (Picture Exchange Communication System), sign language, visual strategies to use images in communication and other communication exponents.
Intensive Autism service, including team work from different disciplines who provide intervention both at home, school and other social lngkungan.
Sensory nature of therapy, including but not limited to Occupational Therapy (OT), Sensory Integration Therapy (SI) and Auditory Integration Training (AIT).
With the availability of various types of therapy can be selected by parents, it's important for them to choose one type of therapy that can improve functionality and reduce the effects of child and autism barriers. Unfortunately still minimal scientific data capable of supporting a wide range of therapies that can be selected elders in Indonesia. Mention the fact that it is very difficult to make a study about autism. Very many variables owned subsidiary, from the severity of the interference to the surrounding environment and ethics are not in it to make an earnest study of the holdback. Very unlikely to control all the variables that have to the data generated from the study, previous studies may be statistically inaccurate.
None of these types of therapies that work for all children. Therapy should be tailored to the needs of children, based on the potential, limitations, and of course the interests of their own children. Therapy should be done in a multidisciplinary science, such use; occupation therapy, speech therapy and behavior therapy as his base. Experts who deal with children should be able to direct you options for different types of therapy available today. There is no guarantee whether therapy selected by parents and family members will surely run effectively. However, select one type of therapy and perform consistently, when you do not see a real change or progress for 3 months can make a difference therapy. Guidance and direction given by the elderly should be implemented consistently. When seen significant progress for 3 months then you can add other forms of intervention. Remains to be objective and ask the experts when something other behavior changes.
Partly there are 400,000 individuals with autism in the United States. Since the 80 -'s, babies born in California - U.S., have blood drawn and stored in Autism research center. Research done by Terry Phillips, a medical expert from George Washington University nerves. Out of the 250 blood samples taken, the result turned out to astonish; fourth of the children showed symptoms of autism. National Information Center for Children and Youth with Disabilities (NICHCY) estimate that autism and EDU in 2000 approached 50 to 100 per 10,000 births. Frombonne study (Study Frombonne: 2003) produces along with the prevalence of autism spectrum (Autism Spectrum Disorder / ASD) is: 60/10.000 - current best estimate and there are 425,000 disabled ASD is under 18 years old in the United States. In English, the latest data is: 62.6/10.000 ASD. Autism in general has been known to occur four times more often in boys than that occurring in young women. Until now, the exact cause is not known. Current members continue to expand their research to find out why until they too can find a 'cure' the right to counteract this phenomenon. The areas that the major focus of research experts, covering; crash neurological and imbalance in the brain that is biochemistry.
Since 1980 in Canada and Japan increased the number of children affected by autism disorder to 40 percent. In California in 2002 concluded there were 9 cases of autism per-day. In the United States mentioned autism occurs in 60,000 to 15,000 children under 15 years of age. Other literature cites autism prevalence rate of 10-20 cases in 10,000 people, some say even one among 1000 children. In English in early 2002 even reported an incidence of autism increased very rapidly, suspected one among the 10 children suffering from autism.
Even Dr. Widodo in 2006, declared that the estimated number of children with autism in Indonesia can reach 150 -200 thousand. Comparison between males and females is 2.6 to 4: 1, but the affected daughter will show symptoms more severe. If it is true that he had actually started indonesai government should give serious attention to the phenomenon of generation in order to safeguard the quality of the race.
Several factors cause autism, namely:
Genetic susceptibility - may be genes Runway Runway Showroom in families
Chromosome 7 - speech / language chromosome
Variety of problems in pregnancy at Birth or even afterwards Birth
Although the experts and practitioners in the field of autism is not always possible to accept or even agree with the reasons for the above. The most important thing that should be noted by previous research findings, is that autism is not caused by the interference factors are psychological, such as older people do not want their pregnancy.
Each year, the incidence of autism is increasing rapidly. The latest data from the Center for Disease Control and Prevention United States says, now one of the 110 children there suffer from autism. This figure is up 57 percent from the 2002 data to estimate the figure 1 compared to 150 children.
According to official data released U.S. government, the mentioned one percent of children there now showing some symptoms of autism, such as communication disorder, language, and cognitive abilities, ranging from mild to heavy.
These data corroborate the findings of various studies that mention autism symptoms are more commonly seen in boys than girls. According to CDC data, in boys prevelansinya up 60 percent compared with the data of 2002. While the daughter is only 48 percent.
Various studies indicate rise of the number of children with autism can be explained later widely worn karateristik to diagnose austis children and increase access to information on the condition of autism. Despite this, there is still a big question mark about the cause of this behavior is the increasing trend of harassment.
Because many of the symptoms of autism diagnosed before the child was two years old, most experts believe that factors pencetusnya happened in the pregnancy or in the early months of a baby's life.
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